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Transitional Cell
Carcinoma in a Dog
Sarra Borne Lord
VETE 3313: Radiology and Clinical Imaging
Harriet – History and Signalment

10 year old

Spayed female

Scottish terrier

History of hematuria, without
bacteruria

Repeated treatment with
antibiotics to no avail

Generally good health otherwise,
good appetite

Current on vaccinations
Physical Exam

Weight: 16 pounds

BCS: 3/5

Rectal temp 101.2 F

Heart Rate: 120 bpm

Respiratory rate: 24 bpm

Normal thoracic auscultation

No discomfort on abdominal
palpation

Normal rectal palpation
Diagnostics – Laboratory Findings
CBC
Biochemistry Panel
RBC (red blood cells
6.59
5.50-8.50 M/uL
HCT (hematocrit)
42.5
37-55 %
HGB (hemoglobin)
15.3
12-18 g/dL
WBC (white blood cell)
8.23
5.7-16.3 K/uL
Neutrophils
5.76
3-11K/uL
PLT (platelet)
441
175-500 K/ul
Urinalysis
GLU (glucose)
97
60-125 mg/dL
BUN (blood urea nitrogen)
16
7-27 mg/dL
CREA (creatinine)
0.9
0.4-1.8 mg/dL
PHOS (phosphorus)
4.3
2.1-6.3 mg/dL
ALKP (alkaline phosphatase)
191
10-150 U/L
ALT(alanine
42
5-107 U/L
aminotransferase)
SpG: 1.017, pH: 8.5
K (potassium)
5.1
4.0-5.6 mmol/L
Negative for protein, glucose, ketones and bilirubin
Na (sodium)
147
141-156 mmol/L
Blood: 3+, WBC/hpf: 0-2, RBC/hpf: >100
Cl (chloride)
109
105-115 mmol/L
No casts, bacteria, crystals or mucus on sediment
CHOL (cholesterol)
217
112-328 mg/dL
Diagnostic Imaging – Retrograde
Cystography
NEGATIVE CONTRAST CYSTOGRAPHY
Photo courtesy Veterinary Imaging Associates, 2015

Bladder was catheterized, the urine
drained, and 60 ml carbon dioxide is
instilled into the bladder until
slightly turgid.

Negative contrast cystography
showed a potential mass effect in the
trigone area.

Carbon dioxide is removed from
bladder in preparation for a positive
contrast cystogram.

This procedure generally safe but can
cause air embolization. Carbon
dioxide or nitrous oxide can be used
if available and they negate this risk.
Diagnostic Imaging – Retrograde
Cystography
POSITIVE CONTRAST CYSTOGRAPHY
Photo courtesy Veterinary Imaging Associates, 2015

Diluted positive contrast media
(Renografin-60 60 ml total diluted
50:50 with sterile water) isinstilled
into the bladder.

Mass effect still visible but not
clearly defined.

Positive contrast allows
visualization of filling defects and
can be used to examine the
urethra for defects.
Diagnostic Imaging – Retrograde
Cystography
DOUBLE CONTRAST CYSTOGRAPHY
Photo courtesy Veterinary Imaging Associates, 2015

Contrast media removed from the
bladder and air re-instilled.

These radiographs are a double
contrast study

Any remaining positive contrast
media that adheres to bladder wall
is usually because of a lesion.

This helps to define the margins of
a mass effect.
Diagnostic Imaging - Ultrasound
)
BLADDER ULTRASONOGRAPHY
Photo courtesy Veterinary Imaging Associates, 2015

Increases visibility of the margins
of the mass.

Useful for scanning remainder of
abdominal organs for any
additional suspicious areas or
metatheses.

Harriet’s liver, spleen, kidneys, and
intestines were normal.

Some of her mesenteric lymph
nodes were mildly enlarged.
Diagnostic Imaging - Cystoscopy

Diagnosis of transitional cell
carcinoma requires obtaining a
sample of the mass.

An aspirate of the tumor should be
avoided due to the potential of
tumor seeding at the site of the
puncture.

Surgical biopsy can be done but is
very invasive.

Cytologic evaluation can be done by
rubbing the tip of a urinary catheter
against the mass to extract cells.

Cystoscopy is a better option but
requires referral.
Transitional cell carcinoma with white fimbriation (Finnish, n.d.)
Photo courtesy the Finnish Veterinary Association, n.d.
Transitional Cell Carcinoma

Cancer of the urinary tract can
affect any of the structures
(bladder, kidneys, ureters, urethra)

The most common cancer of the
dog urinary bladder is transitional
cell carcinoma (TCC)

It is a malignant cancer that arises
from the transitional epithelial
cells that line the bladder.

Scottish terriers have an 18-20%
higher risk of TCC than other
breeds (Knapp, 2013)
Cytology smear transitional cell carcinoma (Scurrell, 2012)
Therapeutic Recommendations

Surgical excision


Radiation therapy.



Can lead to harmful complications
Medical management


Not possible if the cancer is situated in
the neck or trigone area
Piroxicam
Chemotherapy

Mitoxantrone

Vinblastine

Metronomic chemotherapy
Chemotherapy with medical management
References
Caswell, M. (2011, June). Transitional cell carcinoma of the urinary bladder in a 14-year-old dog. The
Canadian Veterinary Journal, 52, 673-675. Retrieved from
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3095172/
Contrast studies of small animals. (2015). Retrieved from http://www.online-vets.com/contrast_4.html
Glickman, L. T., Raghavan, M., Knapp, D. W., Bonney, P. L., & Dawson, M. H. (2004). Herbicide exposure
and the risk of transitional cell carcinoma of the urinary bladder in Scottish Terriers. Journal of the
American Veterinary Medical Association, 224, 1290-1297.
Knapp, D. W. (2013). Canine bladder cancer. Retrieved from
https://www.vet.purdue.edu/pcop/files/docs/CanineUrinaryBladderCancer.pdf
Scurell, E. (2012). Transitional cell carcinoma (TCC) in a dog. Retrieved from
http://www.cytopath.co.uk/caseofmonthMarch2012.html
The Finnish Veterinary Association. (n.d.). Kuvat figures. Retrieved from http://www.sell.fi/index.php?id=513
Thrall, D. E. (2013). Textbook of veterinary diagnostic radiology (6th ed.). : Saunders.