Treatment of cyclophosphamide-induced hemorrhagic cystitis in five dogs

Sterile hemorrhagic cystitis developed in 5 dogs after treatment with cyclophosphamide. Four dogs were being treated with various antineoplastic protocols, and the fifth dog had recurrent immune-mediated thrombocytopenia. In all instances, clinical signs of hematuria and stranguria persisted after cyclophosphamide administration was discontinued. Three dogs required cystotomy to remove necrotic mucosa and calculi. The other 2 dogs were treated with intravesicularly administered dimethyl sulfoxide to decrease inflammation and to inhibit fibroplasia of the bladder wall. In 4 dogs, clinical signs resolved after treatment. The fifth dog, treated surgically, continued to have intermittent urinary incontinence attributable to residual bladder wall fibrosis.