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Small Animal Medicine > Oncology - Bladder and AGASACA > Flashcards

Oncology - Bladder and AGASACA Flashcards

1
Q

Typically what type of neoplasia are bladder neoplasias?

A

Invasive transitional cell carcinomas

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2
Q

Where do TCCs like to locate in the dog? Cat?

A

Dog - trigone

Cats - apical and mid-body

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3
Q

Where do TCCs like to spread?

A

Urethra, prostate, nodal metastasis, and distant metastasis (they like to move cranially)

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4
Q

What breeds are the poster children for TCC?

A

Scotties - 18x

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5
Q

What are some risk factors for TCC?

A

Female, neutered, obesity, exposure to older generation flea products and lawn chemicals, and cytoxan exposure

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6
Q

What presenting clinical signs are associated with bladder tumors?

A

Hematuria, dysuria, pollakiuria, tenesmus, and potential lameness due to bony metastasis or hypertrophic osteopathy

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7
Q

What differentials should you consider with TCC?

A

Chronic cystitis, fibroepithelial polyps, granulomatous cystitis/urethritis, gossypioboma, calculi, other tumor types, and Botryoid rhabdomyosarcoma in young dogs

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8
Q

How is clinical staging done for TCC?

A 
Good PE including rectal
Minimum database - azotemia
UA and culture
Chest rads
Abdominal ultrasound
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9
Q

____% of dogs will have neoplastic cells due to TCC in the urine.

A

30%

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10
Q

What diagnostic methods can be done for TCC?

A

UA
CADET BRAF and BRAF Plus
Histopathology - biopsy (last course), cystoscopy, traumatic catheter, or prostatic wash

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11
Q

What does CADET BRAF look for a mutation in?

A

BRAF gene

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12
Q

Does a negative CADET BRAF test rule out TCC?

A

No

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13
Q

How is traumatic catheter done?

A 
Catheterize and empty bladder
Attach a 12 cc syringe to the catheter
Apply suction while moving the catheter
Remove catheter and centrifuge sample
You will need to sedate females
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14
Q

What can mask a TCC when doing traumatic catheter?

A

a concurrent UTI

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15
Q

Can FNA be done for TCC?

A

Yes, but only if necessary

Seeding is possible

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16
Q

What are the options for treatment of TCC?

A

Surgery, radiation therapy, medical therapy/chemotherapy, interventional therapy

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17
Q

What surgical considerations do you need to keep in mind for TCC?

A

Complete excision is not usually possible
Is it appropriate to try?
You need to have superb surgical techniques
TCC is highly exfoliative = seeding
Refer in complicated cases

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18
Q

What palliative options are there for surgery of TCC?

A

Prepubic cystostomy catheters, ureter/urethral stents, balloon dilation, and laser ablation

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19
Q

Why is uterocolonic anastomosis not recommended?

A

The colon will reabsorb the urine resulting in an uptake of ammonia and eventually death

20
Q

What is one of the biggest problems associated with urethral stents?

A

25% have major incontinence

21
Q

In the case of using urethral stents for TCC, what is death usually due to?

A

metastatic disease

22
Q

What complications are associated with laser ablation as palliative care for TCC?

A

Stranguria, hematuria, stenosis, spread, urethral perforation, bacterial cystitis

23
Q

What are the goals of palliative radiation therapy for TCC?

A

Improve the clinical status with low risk for severe toxicity

24
Q

What is the approach of palliative radiation therapy for TCC?

A

Once weekly for 5 weeks or once daily for 10 days

25
Q

What is the outcome for palliative radiation therapy for TCC?

A

Can improve comfort and micturition but does not improve survival time beyond chemotherapy and NSAIDs

26
Q

When is palliative radiation therapy for TCC reserved?

A

For cases where medical therapies fail to improve QOL

27
Q

What complications are associated with definitive radiation therapy for TCC?

A

Low grade GI, genitourinary and skin
in-field recurrenct
geographic mass
30% late-onset difficulty urinating/defecating

28
Q

What medical therapy do we use for TCC?

A

COX-inhibitors and chemotherapy

29
Q

What COX inhibitors can be used for TCC therapy?

A

Piroxicam, Deracoxib, and Firoxocib

30
Q

What is the standard of care for TCC in dogs and cats?

A

Mitoxantrone and piroxicam

31
Q

What food can decrease the risk of developing bladder cancer?

A

Cruciferous veggies fed 3x/week

32
Q

What is the prognosis for TCC?

A

Signs can be controlled with a good QOL for several months or longer
Ultimately it is local disease that leads to death

33
Q

How is prostatic carcinoma treated?

A

Similarly to TCC, but radiation seems to have more effect

34
Q

What are the 3 perianal tumors that dogs can get?

A

Perianal adenoma. perianal adenocarcinoma, and apocrine gland anal sac adenocarcinoma

35
Q

What is the most common perianal tumor that you will see in private practice?

A

perianal adenoma

36
Q

What group of dogs is more commonly affected by perianal adenomas? Why?

A

Male, intact dogs because it is sex hormone dependent and increases with testosterone

NOTE: Females can still get them

37
Q

How are canine perianal adenomas treated?

A

Castration and mass removal - 90% cured

38
Q

True or False: Canine perianal adenocarcinomas are hormone dependent.

A

False

39
Q

What is the behavior of perianal adenocarcinomas?

A

They grow faster, larger, and are more adherent than adenomas - 15% can be metastatic

40
Q

How can AGASACA patients present?

A

Have no clinical signs OR tenesmus, straining to urinate, ribbon stools, scooting, licking perineal area, and mass effect

41
Q

How are AGASACAs diagnosed?

A

Good PE with rectal
Minimum database
Staging - there are high rates of metastasis
FNA

42
Q

What is the most aggressive treatment for AGASACA?

A

Surgical removal of the mass and abdominal lymph nodes

43
Q

How can you increase survival time after surgical removal of mass and LN of AGASACA?

A

Add radiation therapy and chemotherapy

44
Q

What chemotherapy drug can control AGASACA for about 5 months?

A

Palladia

45
Q

What is the prognosis for AGASACA?

A

Okay - 1.5 years MST

46
Q

What are negative prognostic factors for AGASACA?

A

Size: >5 cm in diameter
Hypercalcemia
No surgery
Pulmonary metastatic disease

Small Animal Medicine (100 decks)

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