A 4-year-old female spayed German shepherd dog presented to Cornell University's Emergency Service for a 6 day history ofhematuria, stranguria, and pollakiuria progressing to urinary obstruction. She had initially presented to her primary care veterinarian for bloodwork and abdominal radiographs, which had no significant clinical abnormalities. She was discharged on meloxicam and amoxicillin/clavulanic acid. Her clinical signs improved until the course of meloxicarn was completed, at which point her previous clinical signs returned. She returned to her primary care veterinarian who found a large bladder on ultrasound and then referred her to Cornell. On presentation, the patient was very anxious, alert, and responsive. Physical examination revealed a large, turgid bladder, and crouched position in the hind limbs. Point of care bloodwork revealed a mild metabolic alkalosis, hypocapnia, and hyperkalemia. She was transferred to the Internal Medicine Service for further work up. Urinalysis was consistent with urinary inflammation or infection. Radiographs (thoracic and abdominal) and abdominal ultrasound were negative for calculi and mass lesions. The neurologic consult showed that there were no neurological deficits. The patient was observed to urinate normally and was continued on amoxicillin/clavulanic acid for a presumptive resolving urinary tract infection. The patient presented to Cornell's Emergency Service the next day for urinary obstruction. She was transferred to the Internal Medicine Service and was placed under general anesthesia for a cystoscopy, which revealed large amounts of proliferative, frond-like tissue in the lower urinary tract. Biopsies, culture, and laser debulking were performed. The patient was diagnosed with polypoid cystitis/urethritis on histopathology. This disease process is poorly understood. This case study will outline the clinical signs, diagnosis, and current management of the disease.