Exam 4: Neoplasia & Non-Renal Lesions of RF

Question 1

What is the most common primary urinary tract neoplasm of small domestic animals (dogs and cats)?

Answer 1

Transitional cell carcinoma -aka urothelial carcinoma

Question 2

What is the most common location of TCC (aka urothelial) carcinoma in the urinary tract?

Answer 2

Bladder Trigone
Can also arise from renal pelvis, ureter, bladder, urethra

Question 3

What breed of dog is highly predisposed to TCC?

Answer 3

Scottish Terriers

Question 4

What gene is implicated in ~85% of canine patients with TCC?

Answer 4

BRAF gene

Question 5

What lab testing can be done to detect TCCs?

Answer 5

BRAF Testing
BRAF Plus Testing
Both test together = 90% sensitivity - need 30mL of urine

Question 6

What toxic plant can predispose to bladder tumors in bovids? What is the toxin?

Answer 6

Bracken Fern
Ptaquiloside toxin

Question 7

What is the most common primary kidney neoplasm of pigs, chicken, fish?

Answer 7

Nephroblastoma

Question 8

What gene is implicated in nephroblastoma?

Answer 8

WT1 (wilms tumor 1) gene

Question 9

Nephroblastoma can sometimes be found in an extrarenal location; What is this specific location?

Answer 9

T10-L3 spinal canal

Question 10

What paraneoplastic syndrome can occur with nephroblastoma?

Answer 10

Polycythemia - due to extra EPO production

Question 11

Pathogenesis: Glossitis

Answer 11

Patients in RF are azotemic with excess BUN
BUN causes endothelial damage –> causes small bilateral and symmetric ulcers on tongue
May notice lingual ulcers and smell of ammonia on PE

Question 12

Pathogenesis: Metastatic mineralization

Answer 12

With renal failure, PO4 increases
Mineral may precipitate in tissue
Classic sites = stomach, lung, pleura, kidney

Question 13

Pathogenesis: Bilateral parathyroid hyperplasia/renal secondary hyperparathyroidism

Answer 13

Kidney is responsible for steps of Vit D synthesis
Small animal renal failure –> hypovitaminosis D –> hypocalcemia –> PTH is excreted to increase serum Ca
Bilateral parathyroid hyperplasia due to chronic stimulation of the glands

Question 14

Pathogenesis: Rubber jaw in young dogs

Answer 14

The goal of PTH release is to fix hypocalcemia
One mechanism is to remove calcium from bone via osteolysis
In young dogs, bones of the jaw are highly targeted for calcium removal - severe cases = bone becomes flexible because so much calcium has been removed

Question 15

Pathogenesis: Hypertension / retinal detachment

Answer 15

CRF results in dilute urine and pu/pd (CRF animals are constantly dehydrated) –> activation of RAAS –> hypertension –> fragile retinal vessels may rupture (can lead to acute blindness)

Question 16

Pattern: one or multiple masses

Answer 16

One = primary renal neoplasia
Multiple = metastatic cancer or granulomatous disease

Question 17

Answer 17

Uremic glossitis

Question 18

Answer 18

Uremic glossitis

Question 19

Answer 19

Uremic glossitis

Question 20

Answer 20

Uremic glossitis

Question 21

Answer 21

Metastatic mineralization - stomach

Question 22

Answer 22

Metastatic mineralization - stomach

Question 23

Answer 23

Metastatic mineralization - stomach

Question 24

Answer 24

Metastatic mineralization - pleura

Question 25

Answer 25

Metastatic mineralization - pleura

Question 26

Answer 26

Metastatic mineralization - pleura

Question 27

Answer 27

Secondary renal hyperparathyroidism

Question 28

Answer 28

Secondary renal hyperparathyroidism

Question 29

Answer 29

Secondary renal hyperparathyroidism

Question 30

Answer 30

Hypertension

Question 31

Answer 31

Hypertension