Bladder inversion and secondary hematuria in a 6-month-old domestic shorthair cat

A 6-month-old female domestic shorthair cat was admitted for evaluation of intermittent clinical signs of hematuria and inappropriate urination for the past 2 months.

Transabdominal ultrasonography revealed a multilayered mass in the urinary bladder apex consistent with full-thickness invagination of the bladder wall.

Exploratory surgery was performed, and partial inversion of the urinary bladder was confirmed. The invaginated bladder apex was manually reduced, and partial cystectomy was performed to remove the invaginated section of bladder wall. Histologic findings were consistent with vascular congestion and edema secondary to partial invagination. Bacterial culture of a section of the bladder mucosa demonstrated concurrent bacterial urinary tract infection. Clinical signs resolved following surgical resection of the bladder apex and antimicrobial treatment for the concurrent urinary tract infection.

Partial invagination of the urinary bladder should be considered in the differential diagnosis for cats with clinical signs of hematuria, stranguria, and inappropriate urination. A diagnosis may be made on the basis of detection of invaginated tissue in the bladder apex during abdominal ultrasonography.