References: Canine Transitional Cell Carcinoma of the Urinary Bladder
Caveat: most of these references are from scientific journals. Their proper interpretation depends upon training. If you are a pet owner, please print these and use them for a starting point for discussions with your veterinarian.
General
Eslinger, L. L., Byers, M. A., and Kantrowitz, B. M. What
is your diagnosis? Irregular surface of the bladder and urethra,
and circumferential filling defect at the neck of the bladder
and proximal portion of the urethra. Journal of the American Veterinary
Medical Association. 206(1):31-2, 1995 Jan 1.
Glickman, L. T., Schofer, F. S., McKee, L. J., Reif, J. S.,
and Goldschmidt, M. H. Epidemiologic study of insecticide
exposures, obesity, and risk of bladder cancer in household dogs.
Journal of Toxicology & Environmental Health. 28(4):407-14,
1989. .A case-control study of household dogs was conducted to
determine if exposure to sidestream cigarette smoke and chemicals
in the home, use of topical insecticides, and obesity are associated
with the occurrence of bladder cancer. Information was obtained
by interview from owners of 59 dogs with transitional-cell carcinoma
of the bladder and 71 age- and breed size-matched control dogs
with other chronic diseases or neoplasms. Bladder cancer risk
was unrelated to sidestream cigarette smoke and household chemical
exposures. Risk was significantly increased by topical insecticide
use (OR = 1.6 for 1-2 applications per year and OR = 3.5 for greater
than 2 applications per year; chi 2 trend; p = .008). This risk
was enhanced in overweight or obese dogs. Further studies of this
canine model may facilitate identification of specific carcinogens
present in insecticides commonly used on pet animals and in the
environment.
Nikula, K. J., Benjamin, S. A., Angleton, G. M., and Lee, A.
C. Transitional cell carcinomas of the urinary tract in
a colony of beagle dogs. Veterinary Pathology. 26(6):455-61, 1989
Nov. .Gross and light microscopic features of transitional cell
carcinomas (TCC) of the urinary tract were examined in Beagle
dogs used for the study of the long-term effects of low-dose,
whole-body, 60Co gamma radiation. Thirty-eight cases of TCC occurred
among 990 dogs that were from 0 to 14 years of age. There was
no conclusive evidence of a radiation effect. The 38 TCC were
equally divided between male and female dogs, but there was a
significant difference in the sex distribution of urethra-origin
TCC. Eleven males had a primary urethral TCC compared to only
two females. There was no significant difference between the urethra-origin
and bladder-origin TCCs in the number of tumors that caused clinical
signs, metastasized, or that contributed to the death of the dog.
All cases of urethral TCC in male dogs occurred in the prostatic
urethra. The majority of these cases were not recognized to be
neoplasms at gross necropsy, but microscopic examination revealed
the TCC. Our findings differ from previous reports stating that
TCC occurs more frequently in female than male dogs, and they
especially differ from reports claiming that urethra-origin TCC
is predominantly a disease of female dogs.
Petranto, M. R., and Stekler, S. A. What is your diagnosis?
Multiple, irregular, diffuse intraluminal masses in the urinary
bladder. Journal of the American Veterinary Medical Association.
202(12):1999-2000, 1993 Jun 15.
Valli, V. E., Norris, A., Jacobs, R. M., Laing, E., Withrow,
S., Macy, D., Tomlinson, J., McCaw, D., Ogilvie, G. K., Pidgeon,
G., and et al. Pathology of canine bladder and urethral cancer
and correlation with tumour progression and survival. Journal
of Comparative Pathology. 113(2):113-30, 1995 Aug. .Biopsy and
necropsy specimens, comprising 107 primary carcinomas and three
mesenchymal tumours, were reviewed from 110 dogs with cancer of
the bladder, urethra, or both. Histological classifications developed
for the assessment of human bladder cancer were found to be readily
applicable to the dog. These classifications are based on histological
features, including the pattern of growth, the cell type, the
grade of transitional tumour and the depth of invasion of the
bladder wall. Features associated with localized disease in canine
transitional cell carcinoma included papillary architecture, "in-situ"
tumour, low tumour grade and a strong peritumoral lymphoid cell
reaction. Features of tumours with metastasis included infiltrating
and non-papillary architecture, increasing tumour grade, depth
of invasion, vascular invasion and presence of peritumoral fibrosing
reaction. Wide variability was found within single tissue samples,
indicating that multiple sample sites are necessary for the adequate
characterization of a given lesion. Statistically significant
correlations were found between: tumour grade and depth of invasion
(P < 0.0001); tumour grade and presence of metastases (P <
0.029); and peritumoral desmoplasia and metastases (P < 0.029).
It was concluded that canine bladder cancer could be classified
for the purpose of clinical management with a modified World Health
Organization system as developed for human tumours.
Walter, P. A., Haynes, J. S., Feeney, D. A., and Johnston,
G. R. Radiographic appearance of pulmonary metastases from
transitional cell carcinoma of the bladder and urethra of the
dog. Journal of the American Veterinary Medical Association. 185(4):411-8,
1984 Aug 15. .Eleven cases of histologically proven transitional
cell carcinoma of the bladder or urethra of the dog were selected
for evaluation and characterization of the varied radiographic
appearances of the lungs. In the 8 dogs with metastases, those
appearances included radiographically normal pulmonary parenchyma,
a semidense, diffuse, lacelike haze referred to as interstitial
opacity, nodular interstitial opacity, and consolidations. One
affected dog had hilar lymphadenopathy. In the 3 dogs without
pulmonary metastases, the radiographic appearance was either normal
pulmonary parenchyma or increased unstructured interstitial opacity.
Of all dogs in the study, 6 had a radiographic appearance of increased
unstructured interstitial opacity. Four of those 6 had histologically
proven metastases in the peribronchiolar lymphatics or alveolar
capillaries. Dyspnea was not identified in any of the affected
dogs. The radiographic appearance for 3 of the 8 dogs with pulmonary
metastases was misinterpreted as opacity compatible with age.
The radiographic appearance for 1 of the 3 dogs without pulmonary
metastases was misinterpreted as highly suspect for metastases.
Piroxicam Therapy
Knapp, D. W., Richardson, R. C., Chan, T. C., Bottoms, G. D.,
Widmer, W. R., DeNicola, D. B., Teclaw, R., Bonney, P. L., and
Kuczek, T. Piroxicam therapy in 34 dogs with transitional
cell carcinoma of the urinary bladder [see comments]. Comment
in: J Vet Intern Med 1995 Mar-Apr;9(2):113-4 Journal of Veterinary
Internal Medicine. 8(4):273-8, 1994 Jul-Aug. .Thirty-four dogs
with histopathologically confirmed, measurable, nonresectable
transitional cell carcinoma of the urinary bladder were treated
with piroxicam (0.3 mg/kg PO sid) and were evaluated for tumor
response and drug toxicity. Dogs were evaluated at the Purdue
University Veterinary Teaching Hospital by means of physical examination,
thoracic and abdominal radiography, cystography, complete blood
count, serum biochemistry profile, and urinalysis. In selected
cases, prostaglandin E2 (PGE2) concentrations in plasma and in
supernatants of stimulated monocytes, and natural killer cell
activity were quantified. Dogs were evaluated before therapy and
at 28 and 56 days after initiation of therapy. Dogs with stable
disease or remission at 56 days remained on the study and were
evaluated at 1 to 2 months intervals. Tumor responses were 2 complete
remissions, 4 partial remissions, 18 stable diseases, and 10 progressive
diseases. The median survival of all dogs was 181 days (range,
28 to 720+ days), with 2 dogs still alive. Piroxicam toxicity
consisted of gastrointestinal irritation in 6 dogs and renal papillary
necrosis (detected at necropsy) in 2 dogs. Monocyte production
of PGE2 appeared to decrease with therapy in dogs whose tumors
were decreasing in size, and increased in dogs with tumor progression.
A consistent pattern in natural killer cell activity was not observed.
In vitro cytotoxicity assays against 4 canine tumor cell lines
revealed no direct antitumor effects of piroxicam. In summary,
antitumor activity, which was not likely the result of a direct
cytotoxic effect, was observed in dogs with transitional cell
carcinoma of the bladder treated with piroxicam.
Cisplatin Therapy
Chun, R., Knapp, D. W., Widmer, W. R., Glickman, N. W., DeNicola,
D. B., and Bonney, P. L. Cisplatin treatment of transitional
cell carcinoma of the urinary bladder in dogs: 18 cases (1983-1993).
Journal of the American Veterinary Medical Association. 209(9):1588-91,
1996 Nov 1. .OBJECTIVE: To determine whether cisplatin administered
at a dosage of 60 mg/m2 of body surface area, IV, every 21 days,
would induce remission of transitional cell carcinoma of the urinary
bladder in dogs. DESIGN: Retrospective analysis of medical records.
ANIMALS: 18 dogs with histologically confirmed transitional cell
carcinoma of the urinary bladder. PROCEDURE: Clinical staging
was performed by means of physical examination, contrast cystography
or ultrasonography, and thoracic radiography prior to and 42 days
after the initiation of cisplatin treatment. Dogs with clinical
signs of tumor progression were reevaluated earlier than 42 days
in some instances. Complete remission (CR) was defined as complete
resolution of measurable tumor. Partial remission (PR) was defined
as a > or = 50% reduction in tumor volume without development
of new tumors. Stable disease was defined as < 50% change in
tumor volume at 42 days without development of new lesions. Progressive
disease (PD) was defined as > or = 50% increase in tumor volume
or development of new tumors at any time. Dogs were reevaluated
at 42-day intervals until they had a CR, developed PD, or developed
unacceptable adverse effects. RESULTS: Three dogs had a PR, 4
had stable disease, and 9 had PD. Tumor response could not be
assessed in 2 dogs: 1 dog developed grand mal seizures 3 hours
after the first dose of cisplatin was given and was euthanatized;
the other dog continued to have clinical signs of urinary tract
obstruction and was euthanatized 8 days after the first dose of
cisplatin. Four dogs developed renal azotemia that was suspected
to be secondary to cisplatin nephrotoxicity. CLINICAL IMPLICATIONS:
The cisplatin dosage was higher than that reported in studies
of dogs with transitional cell carcinoma of the bladder. Even
with this higher dosage, none of the dogs had a CR, and only 3
of 18 had a PR. A more effective, less toxic treatment for transitional
cell carcinoma in dogs is needed.
Moore, A. S., Cardona, A., Shapiro, W., and Madewell, B. R.
Cisplatin (cisdiamminedichloroplatinum) for treatment of transitional
cell carcinoma of the urinary bladder or urethra. A retrospective
study of 15 dogs. Journal of Veterinary Internal Medicine. 4(3):148-52,
1990 May-Jun. .The records of 15 sequential cases of transitional
cell carcinoma of the urinary bladder or urethra in dogs were
examined to determine the results of treatment with cisplatin
(cisdiamminedichloroplatinum) and to record and assess toxicities.
All dogs had measurable disease and were considered eligible for
evaluation of toxicity following one cisplatin treatment. Three
dogs were eliminated from evaluation of efficacy because of acute
toxicities. Of the 12 remaining dogs that received two or more
cisplatin treatments, evaluations at the end of the second month
of treatment revealed no complete responses; however, three dogs
showed partial responses and six dogs maintained stable disease.
Three dogs had tumor progression. The median survival time for
these 12 dogs was 180 days (mean, 220 days; range, 36 to 589 days).
Three dogs were azotemic before treatment. Two of these dogs showed
improvement in renal function following therapy. Six of the other
twelve dogs developed increases in serum creatinine during therapy.
The objective and subjective improvements of some dogs to cisplatin
chemotherapy suggest that this agent is active in selected dogs
with transitional cell carcinomas of the urinary tract.
Radiation Therapy
Withrow, S. J., Gillette, E. L., Hoopes, P. J., and McChesney,
S. L. Intraoperative irradiation of 16 spontaneously occurring
canine neoplasms. Veterinary Surgery. 18(1):7-11, 1989 Jan-Feb.
.Sixteen dogs with malignant neoplasms were treated with intraoperative
radiation therapy after surgical debulking. Fractionated external
beam radiation therapy was given postoperatively to 11 dogs. Healing
of surgical incisions was uncomplicated in 14 dogs. When the ureters
or urinary bladder were included in the irradiation field, they
became stenotic and fibrotic. Urinary incontinence and secondary
renal injury were common. Local tumor control was poor regardless
of site or tumor type.
Surgery
Anderson, W. I., Dunham, B. M., King, J. M., and Scott, D.
W. Presumptive subcutaneous surgical transplantation of a
urinary bladder transitional cell carcinoma in a dog. Cornell
Veterinarian. 79(3):263-6, 1989 Jul. .A urinary bladder mass in
a 12-year-old spayed female West Highland White Terrier was diagnosed
after exploratory surgery and biopsy as a transitional cell carcinoma.
Four months later the dog presented with an ulcerated plaque-like
cutaneous lesion at the previous surgical incision site; concurrent
inguinal lymphadenopathy and recurrence of the urinary bladder
mass were identified. Transitional cell carcinoma was diagnosed
at all 3 sites. Although a definitive relationship cannot be established
between the initial surgery for urinary bladder mass and the resultant
subcutaneous lesion, surgical implantation should be considered
as a source for the neoplastic cells.
Montgomery, R. D., and Hankes, G. H. Ureterocolonic anastomosis
in a dog with transitional cell carcinoma of the urinary bladder.
Journal of the American Veterinary Medical Association. 190(11):1427-9,
1987 Jun 1. .Ureterocolonic anastomosis and cystectomy were performed
in a dog for treatment of transitional cell carcinoma of the urinary
bladder. The dog remained an acceptable house pet for 10 months
after surgery. However, the tumor recurred 10 months after surgery,
and the dog was euthanatized. Our results indicated that the combination
of ureterocolonic anastomosis and cystectomy can be an acceptable
form of palliative treatment for transitional cell carcinoma of
the urinary bladder in the dog.
Smith, J. D., Stone, E. A., and Gilson, S. D. Placement
of a permanent cystostomy catheter to relieve urine outflow obstruction
in dogs with transitional cell carcinoma. Journal of the American
Veterinary Medical Association. 206(4):496-9, 1995 Feb 15. .Permanent
cystostomy catheters were placed in 7 dogs to relieve urine outflow
obstruction from presumed transitional cell carcinoma of the bladder
trigone and urethra. The catheters were easily managed at home
by the owners. Complications were minimal. The most frequent complication
was urinary tract infection. Two owners complained of difficulty
in draining the bladder 1 week before euthanasia of their dogs.
The primary reason for euthanasia of all dogs was progression
of the tumor. Survival times of these dogs were similar to those
previously reported for dogs with transitional cell carcinoma
involving the bladder and urethra, irrespective of treatment.
Placement of a permanent cystostomy catheter should be considered
in dogs with transitional cell carcinoma associated with urine
outflow obstruction when, owing to the dog's condition or the
owner's preference, radical surgery or other treatment is not
an option.
Stone, E. A., George, T. F., Gilson, S. D., and Page, R. L.
Partial cystectomy for urinary bladder neoplasia: surgical technique
and outcome in 11 dogs. Journal of Small Animal Practice. 37(10):480-5,
1996 Oct. .Partial cystectomy was performed in 11 dogs with bladder
neoplasia (10 with transitional cell carcinoma and one with rhabdomyosarcoma).
Between 40 and 70 per cent of the bladder was excised during the
partial cystectomies. In eight dogs, all the grossly visible tumour
was excised but on histopathological examination of the excised
tissue, neoplastic tissue was found to extend to the surgical
margins in four of these dogs. A ureteral stoma was excised with
the tumour in four dogs necessitating ureteral reimplantation;
one dog had both ureteral stomas excised and bilateral ureteral
reimplantation. The bladder incision dehisced in two dogs, necessitating
a second surgery. Six dogs were pollakiuric after surgery. Pollakiuria
resolved within two months in four dogs and persisted in two dogs.
None was incontinent. Local tumour recurrence was suspected in
nine dogs based on imaging studies and confirmed in five dogs
during post mortem examination. Five dogs were euthanased two
to seven months after surgery. Six dogs survived at least one
year, two of these dogs remain alive at 17 and 27 months after
surgery. It is concluded that partial cystectomy may provide local
control of bladder neoplasia.
Stone, E. A., Withrow, S. J., Page, R. L., Schwarz, P. D.,
Wheeler, S. L., and Seim, H. B. d. Ureterocolonic anastomosis
in ten dogs with transitional cell carcinoma. Veterinary Surgery.
17(3):147-53, 1988 May-Jun. .Ureterocolonic anastomosis (UCA)
was performed in 10 dogs with transitional cell carcinoma of the
urinary bladder trigone or the urethra, or both. All grossly visible
tumor was excised. All of the dogs recovered from anesthesia and
surgery and had anal continence with no urine leakage. One dog
died of undetermined causes 7 days after surgery. Nine dogs survived
1 to 5 months. The owners of eight of the dogs considered their
dog's quality of life to be acceptable. Four dogs were euthanatized
because of neurologic disease, three of which also had nausea
and vomiting. The neurologic and gastrointestinal signs may have
been caused by hyperammonemia, metabolic acidosis, and uremia.
Blood ammonia levels were elevated in two dogs with neurologic
signs. Hyperchloremic metabolic acidosis that was reversible with
bicarbonate therapy was diagnosed in five dogs. All of the dogs
were azotemic because of intestinal recycling of urea. Serum creatinine
concentrations increased in four dogs after surgery. Drug-induced
renal disease may have developed in two dogs. Pyelonephritis developed
in five kidneys, two of which had outflow obstruction and two
had bilateral hydroureteronephrosis before the UCA. In this small
number of dogs, surgical excision of transitional cell carcinoma
was not curative with six dogs having confirmed metastatic lesions
at the time of death.
Photodynamic Therapy
Pyrimidine in Dogs
Alternative Treatments