Lecture 25 4/25/25 Flashcards
What are the charactersitics of urothelial carcinoma in dogs?
-aka transitional cell carcinoma
-locally invasive
-potential to metastasize to LN, lungs, and bone
-death typically due to local dz
What are the risk factors for TCC?
-predisposed breeds; esp. scottish terrier
-female
-exposure to old flea/tick prevention or cyclophosphamide
-neutered animals
-obesity
What is the presentation of a dog with TCC?
-lower urinary tract infection signs +/- response to antibiotics
-tenesmus
-urinary obstruction
-lameness (rare, due to bone mets)
What are the steps to a good physical exam in a suspected TCC case?
-watch animal urinate
-perform a rectal
-assess prostate; interpret results in conjunction with age of neuter
-assess urethra; should be flat like a fettuccine noodle
Which tests and findings are used to stage TCC?
*CBC/chem
-possible azotemia
*UA
-sediment like a UTI
-possible abnormal cells
*urine culture
-may have a UTI; more likely to have multiple organisms
*imaging
-chest rads
-abdominal ultrasound
What are the characteristics of cytology for TCC diagnosis?
-can be done on urine sediment, FNA, or diagnostic catheterization
-tricky diagnosis if inflammation is present
What are the characteristics of histopath. for TCC diagnosis?
-requires cystoscopic biopsy; must be done as a referral
-surgical biopsy is NOT recommended due to seeding risks
What are the characteristics of urinalysis collection in TCC dogs?
-TCC is associated with tumor seeding
-abdominal wall/cutaneous metastasis is rare and more commonly associated with surgery
-aspirates should be avoided in animals with minimal dz/better prognosis
-must communicate risk/benefit to clients
What are the characteristics of the BRAF mutation test?
-detects DNA mutation linked to TCC
-expensive
-85% sensitivity for mutation test alone
-add-on tests in patients without the mutation increase the sensitivity to 95%
-can still get false pos. and false neg. results
What are the requirements for the BRAF mutation test?
-20 to 40 mLs of VOIDED urine (must get transitional cells)
-specialized test kit from Antech
What are the characteristics of surgery as a treatment for TCC?
-high morbidity if tumor is in trigonal location
-“field effect” makes it difficult to get clean margins
-partial thickness cystectomy + piroxicam is the recommended treatment for apical lesions
What are the characteristics of radiation treatment for TCC?
*palliative:
-relieves urethral obstruction
-helps clinical signs
*definitive:
-may be helpful if done early
What are the characteristics of NSAIDs as a TCC treatment?
-TCC over-expresses COX-2
-piroxicam and other non-selective or COX-2 selective inhibitors are beneficial
-CANNOT use galliprant
What are the goals of chemotherapy as a TCC treatment?
-stabilize local dz
-delay tumor metastasis
What is the best chemo/NSAID combination for TC?
vinblastine + piroxicam
What are the characteristics of treatment monitoring in TCC patients?
-perform abdominal US every 6 to 8 weeks
-want disease to be stable or better to continue with same treatment
-should stop treatment and reconsider options if dz progresses
-worsening clinical signs could be related to dz progression or concurrent UTI
What is the prognosis for TCC?
-death typically due to urethral obstruction
-NSAID alone has MST of 6 months
-NSAID + chemo has MST of 10 to 12 months
How does feline urothelial carcinoma compare to the canine disease?
*similarities:
-clinical signs
-UTIs
-metastatic rate
*differences:
-males predisposed
-non-trigonal location
-decreased COX-2 expression
-role of chemo may be bigger
What are the charactersitics of prostate carcinoma?
-greater than 80% of prostatic tumors are actually urothelial carcinoma
-true prostate carcinoma arises from actual prostatic tissue
-similar clinical signs to TCC
-highly metastatic
-metastasizes to LNs, lungs, liver, spleen, and bone
Why are prostate carcinoma and urothelial carcinoma treated similarly?
no current methods can readily differentiate the two tumor types
What is involved in the staging of prostate carcinoma?
-CBC/chem/UA
-urine culture
-chest rads
-abdominal rads
-abdominal ultrasound
What are the characteristics of prostatic mineralization?
-mineralization only occurs with inflammation
-can be a normal finding in intact animals; red flag in neutered animals
What are the characteristics of prostate carcinoma diagnosis?
*BRAF mutation test not helpful
*cytology
-FNA
-diagnostic cath
-prostatic wash
-can be difficult to determine dysplasia via neoplasia
*histopath.
*difficult to diagnose in intact dogs
What is the prognosis for prostatic carcinoma?
-less than 30 day survival without treatment
-MST of 6 months with NSAIDs
-RT can be helpful for palliation or if caught early
