Elimination & Detox 2: Urinary Tumors Flashcards by Nellie O'Leary

what is the MOST COMMON CANINE URINARY BLADDER CANCER?

MOST are ____ to ____ GRADE

INVASIVE UROTHELIAL CARCINOMA (IUC)

MOST are INTERMEDIATE to HIGH GRADE

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INVASIVE UROTHELIAL CARCINOMAS…

often located in the ____ region of the bladder, which is nearest & can ___ SPREAD to the ____ & ____ (in males)

3 OTHER regions it can spread to? which out of these is MOST COMMON?

often located in the TRIGONE region of the bladder, which is nearest & can LOCALLY SPREAD to the URETHRA & PROSTATE (in males)

3 OTHER regions?
1. LUNGS = MOST COMMON
2. LNs
3. BONE

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ID TOP, MIDDLE & BOTTOM BOX

TOP = APEX

MIDDLE = TRIGONE

BOTTOM = URETHRA

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FIVE RISK FACTORS for INVASIVE UROTHELIAL CARCINOMA…

BREED
FEMALE SEX > MALE
OLDER GENERATION OF FLEA CONTROL PDTS
LAWN CHEMICALS
DIETS

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6 most common BREEDS at risk for IUC?

which one seems to be the MOST AT-RISK?

SCOTTISH TERRIERS –> MOST AT-RISK
ESKIMO DOGS
SHETLAND SHEEPDOGS
WESTIES
SAMOYED
BEAGLES

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SEX PREDILECTION vs. BREED PREDILECTION for IUC?

DOGS are MORE AT RISK being one of the 6 PREDISPOSED BREEDS than BEING ANY KIND OF FEMALE DOG

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if a MALE dog gets IUC, he tends to be….

NEUTERED

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what type of FLEA-TICK PDTS should we use in patients with IUC?

NEWER PDTS that contain FIPRONIL

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how can LAWN HERBICIDES increase the RISK OF IUC?

CHEMICAL CARCINOGENS excreted in URINE (from being picked up in LAWN HERBICIDES) can EXPOSE THE BLADDER TO HARMFUL CHEMICALS

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vegetables & IUC? (2)

patients that CONSUMED VEGGIES were LESS LIKELY TO GET IUC
CARROTS that were given as treats MORE OFTEN FED

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3 PREVENTATIVE steps you can ADVISE OWNERS TO TAKE when DOG IS AT-RISK FOR IUC?

WARN owners who own HIGH-RISK IUC BREEDS & tell them CLINICAL SIGNS TO LOOK OUT FOR
LIMIT exposure to LAWN CHEMICALS & OLDER TYPES of FLEA CONTROL PDTS
FEED VEGGIES at least 3X PER WEEK

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3 COMMON clinical signs for IUC?

1 UNCOMMON clinical sign for IUC?

3 COMMON?
1. HEMATURIA
2. STRANGURIA
3. POLLAKIURIA

1 UNCOMMON?
1. LAMENESS

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what should we ALWAYS DO when ASSESSING A URINARY PROBLEM? what might we find?

perform a RECTAL EXAM because MIGHT BE ABLE TO FEEL THICKENED URETHRA

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what is the MOST COMMON METHOD for IUC DIAGNOSIS?

how does it work?

accuracy?

MOST COMMON METHOD FOR IUC = BRAF TEST for MUTATION

how does it work? = MUTATION in BRAF GENE leads to UNCONTROLLED CELL GROWTH –> CANCER

accuracy = PRETTY ACCURATE but NOT 100% because NOT EVERY DOG WITH IUC HAS BRAF MUTATION

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diagnostic OPTIONS for DIAGNOSIS OF BLADDER TUMOR? (3)

which is the MOST COMMON?

which his the MOST DEFINITIVE?

which is CONTRAINDICATED?

BRAF TEST = MOST COMMON
HISTOPATHOLOGY via CYSTOSCOPY or OPEN BIOPSY
URINE CYTOLOGY
–> DO NOT collect via CYSTOCENTESIS because CAN POSSIBLY SEED TUMOR

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what 4 DIAGNOSTICS should we perform to ASSESS HEALTH of RENAL TUMOR PATIENTS?

what are we looking for in each?

CBC = changes in HCT, PLATELETS, NEUTROPHILS?
CHEM = BUN & CREATININE for RENAL FUNCTION
URINALYSIS = USG for RENAL FUNCTION
URINE CULTURE = rule out UTI

what 3 diagnostic tests do we use to ASSESS RENAL CANCER SPREAD?

which is MOST SENSITIVE?

which is DONE MOST COMMONLY?

which is used for SERIAL STAGING?

CT SCAN = MOST SENSITIVE
ABDOMINAL US = done most COMMONLY & used for SERIAL STAGING
SURVEY CHEST RADS

NSAIDs & IUCs

IUC has INCREASED EXPRESSION of COX2, so NSAIDs can not only provide ANALGESIA & INHIBIT INFLAMMATION but also have ANTI-CANCER EFFECTS

using NSAIDs ALONE for IUCs can potentially achieve… (2)

REMISSION & STABILIZATION OF MASS

when do we perform SURGERY on URINARY TUMORS? (2)

has both ___ & ___ effects, such as… (2)

MST for patient with IUC treated with NSAIDs & SURGERY?

used for BLADDER MASSES that are…
1. NOT NEAR IMPORTANT STRUCTURES
2. can be COMPLETELY EXCISED

has both DIAGNOSTIC & THERAPEUTIC effects, such as…
1. SUBMITTING TISSUE FOR HISTOPATH
2. REMOVING URINARY TRACT OBSTRUCTION

MST for NSAIDs + SURGERY = ~1 YEAR

RADIATION THERAPY for urinary tumors…

this is the MOST ____ form of _____-____ treatment

used to treat ____-____ tumors

MST?

chance of remission?

this is the most AGGRESSIVE form of NON-SURGICAL treatment

used to treat NON-RESECTABLE tumors

MST? = ~6 months

chance of remission? ~60%

CHEMOTHERAPY for urinary tumors…

how is treatment OFTEN done for URINARY TUMOR patients?

treatment usually involves SEQUENTIAL, MULTIPLE DIFFERENT TX PROTOCOLS over the COURSE OF DZ

URETHRAL & URETERAL STENT PLACEMENT for URINARY TUMORS…

used when?

MST?

potential RISKS? (2)

most of the time…

used when urinary tumor GROWS to develop into a URINARY BLOCKAGE & we need EMERGENCY RELIEF

MST = ~1-2 months

potential RISKS?
1. can cause URINARY INCONTINENCE
2. if patient on CHEMOTHERAPY, URINARY INCONTINENCE can be DANGEROUS FOR OWNERS

most of the time owners elect for EUTHANASIA bc NOT GOOD MST & URINARY INCONTINENCE

regardless of the final treatment option for IUC chosen by owner, WHAT MEDICATION SHOULD WE ALWAYS PUT THE ANIMAL ON?

NSAIDs! PALLIATIVE, ANALGESIA & ANTI-CANCER

if a URINARY TUMOR is in the TRIGONAL REGION, then what 2 treatment options do we have?

1. RADIATION THERAPY 2. CHEMOTHERAPY

deciding between RADIATION THERAPY & CHEMOTHERAPY for urinary tumors?

RADIATION THERAPY is EXPENSIVE but MORE AGGRESSIVE, while CHEMO may be CHEAPER but can require LONGER/MORE VARIED TREATMENT

how do IUCs cause URETHRAL OBSTRUCTION? what TREATMENT would this indicate? what do owners often do though?

IUCs tend to occur in the TRIGONE, and then can be LOCALLY INVASIVE TO THE URETHRA this would indicate URETHRAL/URETERAL STENT, but owners often elect for EUTHANASIA

RISK of UTIs in dogs with IUCs tends to be ____ & can ____ clinical signs that's why we should ALWAYS submit a ___ & ____ if IUC suspected

RISK of UTIs in dogs with IUCs tends to be HIGH & can WORSEN clinical signs that's why we should ALWAYS submit a UA & CULTURE if IUC suspected

OVERALL PROGNOSIS of IUC? if ADVANCED dz, prognosis is ____, & could include these 3 findings...

OVERALL = considered VERY TREATABLE because 75% CHANCE OF CANCER CONTROL or REMISSION WITH Tx if ADVANCED dz, prognosis is POOR, & could include these 3 findings... 1. LOCALLY-INVADING TUMORS in URETHRA or PROSTATE 2. METS at LOCAL LNs 3. METS at LUNGS

FELINE URINARY BLADDER TUMORS... commonality? usually located at the ____ why is MST usually LOW?

RARELY reported in cats usually located at the TRIGONE MST usually low because CATS WILL HIDE CLINICAL SIGNS UNTIL THEY'RE AT SEVERE DZ

BOVINE URINARY BLADDER TUMORS... often presents as ___ tumors what is the MOST COMMON UROTHELIAL TUMOR in CATTLE? 2 things that can play a role in CARCINOGENESIS?

often presents as MULTIPLE tumors MOST COMMON UROTHELIAL TUMOR in CATTLE = LOW-GRADE CARCINOMA 2 things that are CARCINOGENIC... 1. BOVINE PAPILLOMA VIRUS INFECTION 2. ENZOOTIC HEMATURIA from BRACKEN FERN INGESTION or SECONDARY TO BOVINE PAPILLOMA VIRUS

CANINE RENAL TUMORS... commonality? bilateral/unilateral? 3 types? which is the LEAST common? 3 specific clinical signs? 4 lab findings?

NOT COMMON in dogs! usually UNILATERAL presentation 3 types? 1. RENAL CELL CARCINOMA 2. ADENOCARCINOMA 3. SARCOMAS --> LEAST COMMON clinical signs? 1. HEMATURIA 2. PAIN AROUND KIDNEYS 3. PALPABLE ABDOMINAL MASS 4 lab findings? 1. ANEMIA 2. NEUTROPHILIA 3. AZOTEMIA 4. HYPERCALCEMIA

4 DIAGNOSTICS for CANINE RENAL TUMORS? which ones can see SPREAD? which one allows for SURGICAL PLANNING? which one allows for DEFINITIVE DIAGNOSIS? what OTHER INFO does it provide?

1. THORACIC RADS --> spread 2. ABDOMINAL US --> spread 3. CT SCAN --> spread --> SURGICAL PLANNING 4. BIOPSY or REMOVAL OF MASS --> DEFINITIVE DIAGNOSIS --> DETERMINES PROGNOSTIC INFORMATION

MEDIAN SURVIVAL TIMES in 3 types of RENAL TUMORS in DOGS?

1. RENAL CARCINOMA = 16 MONTHS 2. RENAL SARCOMA = 9 months 3. NEPHROBLASTOMA = 6 MONTHS

NEPHROBLASTOMA.. = definition? often seen in WHAT AGE dogs?

= kidney mass that ARISES FROM EMBRYONIC REMNANTS often seen in dogs ~5 YEARS or YOUNGER

FELINE RENAL LYMPHOMA commonality when compared to another similar dz? 3 clinical signs? on PE, kidneys are... (2) MST range? and this range is only accurate if the patient is on ___

SECOND MOST COMMON form of EXTRANODAL LYMPHOMA (after BASAL) clinical signs? 1. HYPOREXIA 2. WEIGHT LOSS 3. PU/PD on PE, kidneys are... 1. BILATERALLY ENLARGED 2. LUMPY/IRREGULAR MST = 4-7 MONTHS WITH CHEMOTHERAPY

EQUINE RENAL TUMORS/RENAL CARCINOMA... commonality? best way to diagnose? what are we looking for renal carcinoma tends to be ____ ____ & ____, so we should perform THESE 2 DIAGNOSTICS... treatment of choice? this treatment should only be chosen IF... MST? what is the prognosis/why?

RENAL CARCINOMA is RARE in horses best way to diagnose = RENAL PALPATION of UNILATERALLY LARGE KIDNEY/MASS renal carcinoma tends to be LOCALLY INVASIVE & METASTATIC, so we should perform THESE 2 DIAGNOSTICS... 1. CHEST RADS 2. ABDOMINAL US tx of choice = NEPHRECTOMY if ONLY ONE KIDNEY AFFECTED MST = 11 days, ONLY A SHORT TIME bc HORSES USUALLY COME IN WHEN ALREADY SICK

what is the MOST COMMONLY DIAGNOSED RENAL CANCER in HORSES with UNILATERAL KIDNEY ENLARGEMENT?

RENAL CARCINOMA