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When it comes to urinary problems in our pets, we often think about urinary tract infections, bladder stones, or inflammation. But sometimes, the symptoms can be caused by something much more serious: Transitional Cell Carcinoma (TCC), also known as urothelial carcinoma.
TCC is the most common type of bladder cancer in dogs. Although considerably less common in cats, cats can develop this cancer as well.
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TCC is a malignant tumor that develops from the cells lining the urinary bladder and other parts of the urinary tract. It most commonly occurs in the bladder, particularly in an area called the trigone, where the ureters enter and the urethra exits.
Unfortunately, this location can make the tumor particularly challenging because it may interfere with the normal flow of urine.
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The signs of TCC can look remarkably similar to a routine urinary tract infection.
Watch for:
* Frequent urination or repeatedly asking to go outside.
* Straining or difficulty passing urine.
* Blood in the urine.
* Urinating small amounts frequently.
* Accidents in the house.
* Pain or discomfort when urinating.
* Recurrent urinary tract infections that donβt resolve as expected.
IMPORTANT: If your pet repeatedly strains but produces little or no urine, this is an emergency. A tumor can obstruct the urinary tract, particularly in male dogs and cats.
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TCC is most frequently diagnosed in middle-aged to older dogs.
Certain breeds have a higher reported risk, including:
* Scottish Terriers (particularly predisposed).
* West Highland White Terriers.
* Shetland Sheepdogs.
* Beagles.
* Wire Fox Terriers.
Environmental factors, including exposure to certain lawn chemicals and older-generation insecticides, have also been associated with increased risk.
Cats can develop TCC, although it is much less common and there are fewer established breed-specific risk factors.
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Because TCC can mimic a urinary tract infection, persistent or recurring urinary symptoms deserve further investigation.
Diagnostic testing may include:
* Urinalysis and urine culture: To evaluate inflammation, blood, and possible bacterial infection.
* Abdominal ultrasound: An important tool for identifying bladder masses, evaluating their location, and examining the kidneys and surrounding structures.
* Radiographs: May help identify certain urinary abnormalities or evidence of spread.
* Urine testing for BRAF mutation: In dogs, a specialized urine test can detect a mutation associated with many canine bladder TCCs. It can be a helpful noninvasive diagnostic tool.
* Biopsy or tissue sampling: May be necessary for definitive diagnosis, although sampling must be approached carefully because of the risk of tumor cell seeding.
We may also recommend chest imaging and additional staging tests to evaluate for metastatic disease.
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A diagnosis of TCC does not automatically mean there is nothing we can do!
Treatment depends on the tumorβs location, size, extent of disease, and the overall health of the patient.
Options may include:
* Medical management: Certain anti-inflammatory medications, particularly piroxicam in dogs, have demonstrated antitumor activity in some patients. Other medications and chemotherapy protocols may also be considered.
* Surgery: Surgical removal may be possible in select cases, but tumors involving the bladder trigone can be particularly difficult to remove completely.
* Chemotherapy: May help slow tumor progression and improve quality of life.
* Urinary stenting: In patients experiencing obstruction, a stent may help restore urine flow.
* Palliative care: Pain management, urinary comfort, and maintaining quality of life are essential parts of treatment.
Cats require individualized treatment plans, as treatment evidence and experience are more limited than in dogs.
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One of the most important takeaways is this:
Not every urinary tract infection is just a urinary tract infection!
If your dog or cat has recurrent urinary problems, blood in the urine, or symptoms that donβt improve with appropriate treatment, donβt simply assume another round of antibiotics is the answer.
An abdominal ultrasound and additional diagnostic testing may uncover something much more significant.
Early detection can make a difference in treatment options, management, and quality of life.
As always, our goal is not just to treat the symptoms, but to find the underlying cause and give our patients the best possible care.
β Dr. Cassie Sheehan, DVM, CVA, CVMMP Floral City, Fl
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