Smith Fauna L, Magdesian K Gary, Michel Adam O, Vaughan Betsy, Reilly Christopher M
William R. Pritchard Veterinary Medical Teaching Hospital, University of California Davis, Davis, California.
Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California.
J Vet Intern Med. 2018 May;32(3):1202-1209. doi: 10.1111/jvim.15121. Epub 2018 Mar 31.
A new syndrome of hematuria in horses has been documented.
HYPOTHESIS/OBJECTIVES: Hemorrhagic cystitis is a novel cause of stranguria and hematuria in horses. This syndrome may be difficult to differentiate from bladder neoplasia because they share several clinical features.
Eleven horses with idiopathic hemorrhagic cystitis and 7 horses with bladder neoplasia.
Retrospective cohort study.
Hemorrhagic cystitis was detected on cystoscopy of affected horses, with hemorrhagic and thickened apical bladder mucosa. Clinical signs and endoscopic appearance of the bladder resolved within 3-8 weeks. Histopathology of bladder mucosal biopsy specimens featured neutrophilic and hemorrhagic cystitis. Histopathology was suggestive of dysplasia or neoplasia in 3 horses with hemorrhagic cystitis, yet the horses experienced complete resolution, suggesting that small biopsy specimens obtained by endoscopy can be difficult to interpret. Horses with bladder neoplasia had lower hematocrits, were older, more likely to be female, and more likely to have a mass detected on ultrasonographic examination of the bladder than horses with hemorrhagic cystitis syndrome.
Hemorrhagic cystitis represents a novel differential diagnosis for horses with hematuria, and is associated with a favorable prognosis. Although histopathology may suggest a neoplastic process, affected horses should be monitored cystoscopically, because complete resolution of hemorrhagic cystitis occurs. The cause of this disease is unknown, and warrants investigation.
已记录到马的一种新的血尿综合征。
假设/目的：出血性膀胱炎是马出现排尿困难和血尿的一种新病因。该综合征可能难以与膀胱肿瘤相鉴别，因为它们有一些共同的临床特征。
11匹患有特发性出血性膀胱炎的马和7匹患有膀胱肿瘤的马。
回顾性队列研究。
对患病马进行膀胱镜检查时发现出血性膀胱炎，膀胱顶部黏膜出血且增厚。膀胱的临床症状和内镜表现于3 - 8周内消退。膀胱黏膜活检标本的组织病理学特征为嗜中性粒细胞性和出血性膀胱炎。组织病理学提示3匹患有出血性膀胱炎的马有发育异常或肿瘤形成，但这些马病情完全缓解，这表明通过内镜获取的小活检标本可能难以解读。与患有出血性膀胱炎综合征的马相比，患有膀胱肿瘤的马血细胞比容较低，年龄较大，更可能为雌性，且在膀胱超声检查时更可能发现肿物。
出血性膀胱炎是马血尿的一种新的鉴别诊断疾病，且预后良好。尽管组织病理学可能提示肿瘤性病变，但仍应对患病马进行膀胱镜监测，因为出血性膀胱炎可完全消退。该病病因不明，值得研究。
