Oncology - Bladder and AGASACA Flashcards Preview

Small Animal Medicine > Oncology - Bladder and AGASACA > Flashcards

Flashcards in Oncology - Bladder and AGASACA Deck (46)
Loading flashcards...
1

Typically what type of neoplasia are bladder neoplasias?

Invasive transitional cell carcinomas

2

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

Dog - trigone
Cats - apical and mid-body

3

Where do TCCs like to spread?

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

4

What breeds are the poster children for TCC?

Scotties - 18x

5

What are some risk factors for TCC?

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

6

What presenting clinical signs are associated with bladder tumors?

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

7

What differentials should you consider with TCC?

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

8

How is clinical staging done for TCC?

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

9

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

30%

10

What diagnostic methods can be done for TCC?

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

11

What does CADET BRAF look for a mutation in?

BRAF gene

12

Does a negative CADET BRAF test rule out TCC?

No

13

How is traumatic catheter done?

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

14

What can mask a TCC when doing traumatic catheter?

a concurrent UTI

15

Can FNA be done for TCC?

Yes, but only if necessary
Seeding is possible

16

What are the options for treatment of TCC?

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

17

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

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

18

What palliative options are there for surgery of TCC?

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

19

Why is uterocolonic anastomosis not recommended?

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

20

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

25% have major incontinence

21

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

metastatic disease

22

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

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

23

What are the goals of palliative radiation therapy for TCC?

Improve the clinical status with low risk for severe toxicity

24

What is the approach of palliative radiation therapy for TCC?

Once weekly for 5 weeks or once daily for 10 days

25

What is the outcome for palliative radiation therapy for TCC?

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

26

When is palliative radiation therapy for TCC reserved?

For cases where medical therapies fail to improve QOL

27

What complications are associated with definitive radiation therapy for TCC?

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

28

What medical therapy do we use for TCC?

COX-inhibitors and chemotherapy

29

What COX inhibitors can be used for TCC therapy?

Piroxicam, Deracoxib, and Firoxocib

30

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

Mitoxantrone and piroxicam

Decks in Small Animal Medicine Class (100):