Evaluation of chromocystoscopy in the diagnosis of cystitis in female donkeys.
Authors: Abd El Kader Naglaa A, Farghali Haithem A, Abu-Seida Ashraf M, Salem Noha Y, Khattab Marwa S
Journal: PloS one
Summary
# Editorial Summary: Chromocystoscopy for Diagnosing Cystitis in Female Donkeys Whilst conventional white light cystoscopy provides a baseline assessment of bladder mucosa, its diagnostic sensitivity for cystitis in donkeys remains suboptimal. Abd El Kader and colleagues evaluated whether methylene blue-based chromoendoscopy could enhance detection of bladder inflammation by comparing five clinically normal females with five presenting with cystitis, supported by urine analysis, histopathology and bacterial culture. The diseased cohort exhibited significantly elevated red and white blood cell counts in alkaline urine (P = 0.02), whilst white light examination showed only mild hyperaemia and vesicle formation; chromocystoscopy, however, revealed characteristic dark bluish oedematous mucosa with irregular, marbled appearance and deeply stained submucosal vessels, with small bluish dots marking absorbed dye in inflamed zones. Histological correlation confirmed hyperplastic urothelium with squamous metaplasia, leukocytic infiltration and gram-positive bacterial populations. For equine practitioners, chromocystoscopy offers a substantially more sensitive diagnostic approach that permits precise targeted biopsies, potentially accelerating treatment initiation and improving therapeutic outcomes in female donkeys with suspected cystitis.
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Practical Takeaways
- •Chromocystoscopy with methylene blue provides superior visualization of bladder inflammation compared to white light endoscopy alone and allows directed tissue sampling for diagnosis
- •The technique is feasible in female donkeys and can improve early cystitis detection, helping optimize treatment decisions and prognosis
- •Consider this diagnostic approach for donkeys presenting with turbid, alkaline urine and suspected lower urinary tract disease when conventional endoscopy findings are equivocal
Key Findings
- •Chromocystoscopy with methylene blue dye revealed dark bluish oedematous irregular mucosa in diseased donkeys versus faint bluish discoloration in healthy controls
- •Diseased animals showed turbid alkaline urine with significantly elevated RBCs and WBCs (P = 0.02) compared to controls
- •Chromocystoscopy findings correlated with histopathological changes including urothelial hyperplasia, squamous metaplasia, and leukocytic infiltration
- •Methylene blue chromocystoscopy enabled targeted biopsies and identified bacterial aggregations (gram-positive bacilli and coccobacilli) in inflamed areas