Lecture 14: Urogenital Tumors Flashcards
List the most common tumors affecting the urinary tract in dogs:
- Urothelial Carcinoma (most common urinary tract tumor)
Urinary Bladder - Urothelial Carcinoma
- Rhabdomyosarcoma
- Young Dogs - Lymphoma
Urethra - Urothelia Carcinoma
Prostate - Urothelial carcinoma
- Adenocarcinoma
List the most common tumors affecting the urinary tract in cats:
UC in cats is rare!
* Tends to be diagnosed in older cats (median = 15 years)
* Trigone location still most common
* Similar workup, diagnostics (no BRAF test), and treatment options
* Prognosis (Griffin et al. 2020)
* Untreated - MST = 46 days
* Medical Therapy – MST = 176 days
* Partial Cystectomy (w/ or w/o other treatments) – MST = 294 days
What are the risk factors for developing urothelial carcinoma (UC)?
Breeds
- above 2, breed at risk
- Scottish Terrier (22% more likely)
- Fun fact: veggies 3x/week decreased risks
- Westies
- Beagle
- Shelties
- Eskimo dog
- Dalmatians
Slightly more common in females than males
- Sex predilection less pronounced in the high-risk breeds
Exposure to herbicide
- 2,4-dichlorophenoxyacetic acid (2,4-D)
Older topical parasite control
List the pros and cons of the different options available to diagnose bladder tumors:
- Surgery + Histopath
- Cystoscopy + Histopath
- Diagnostic catheterization + Histopath/cytology
- Cytology of urine sediment
- Can be significantly affected by the presence of infection/inflammation
- Not all carcinomas exfoliate (especially with each voided sample) - Aspirate mass + cytology
- Easily available, cheap, relatively non-invasive, turn around time is quick
- Controversial, due to the possibility of seeding tumors along the needle track - BRAF test (urine)
- A member of the RAF family, which are serine/threonine protein kinases that activate the MAPK/ERK signaling pathway
- About 85% of urothelial carcinomas in dogs will display a mutation in the BRAF gene
Histopathology is the Gold Standard
Urinary Tract Tumors:
How do you create a plan to stage these patients?
Do:
- CBC/Chemistry/Urinalysis
- Urine culture often required
- Chest x-rays
- Abdominal Imaging (usually ultrasound is adequate)
- UC: Trigone location most common
- Location is important
- UC can go anywhere in the body
What are the treatment options available for patients diagnosed with UC and the associated prognosis?
- Surgery
- If mass is NOT in the trigone
- 40-70% of the bladder can be removed
- Common to follow up with chemotherapy - Radiation Therapy
- limit the progression
- reduce obstruction disease
- pain relief in bony metastasis - Chemotherapy
- NSAID Therapy
- Slow tumor growth
- Mitoxantrone, Vinblastine, Carboplatin - Non-steroidal anti-inflammatory medications
- Often combined, but can be effective even by itself
- Piroxicam: historically utilized most often in studies, but does have higher rates of GI upset, so really any NSAID is fair to start- Carprofen, Deracoxib, Firocoxib, Metacam
The location and extent of the disease often dictate what treatment options are available for any one patient
Prognosis:
- Extent and location of disease
- Dogs who are obstructed, or have disease involving the urethra are likely to have decreased MST compared to dogs who do not
- Dogs where a tumor is found incidentally and no clinical signs are seen, are likely to survive longer
- Heritable tumor in GSDs
- Mutation in FLCN, a tumor suppressor gene coding for the protein folliculin
- Genetic tests available!
- Treatment: Nephrectomy (primary, unilateral renal tumors) &/or chemotherapy
- Prognosis: dependent on histopathology findings -> 6 -16 months (nephroblastoma, sarcoma, carcinoma)
Renal Cystadenocarcinoma
- Uncommon (Renal Tumors)
- Metastasis > Primary in Kidneys
(T/F) Primary renal tumors are seen more frequently than metastatic tumors of the kidneys. The most common primary tumors affecting the kidneys are carcinomas, lymphoma, and sarcomas
False
List the dog breeds that are at increased risk for developing urothelial carcinoma:
- Samoyed
- West Highland white terrier
- Scottish Terrier
- Beagle
