Page 1980 - Cote clinical veterinary advisor dogs and cats 4th

Transitional Cell Carcinoma 991

• Major cross-matches detect antibodies against • Never use outdated or hemolyzed products. • Monitor patients closely during the
donor RBCs. Nonimmune reactions or reac- • Consider the recipient’s underlying disorders transfusion using a checklist to ensure early
recognition of potential reactions.
VetBooks.ir platelets, or proteins are not detected. • Follow strict guidelines for storage, handling, • All staff should be familiar with signs of Diseases and Disorders
tions from antibodies targeting leukocytes,
when choosing blood product and admin-
istration rate.
transfusion reactions.
Prevention
and administration (p. 1169).
• All donors should be blood typed and • Monitor (mentation, temperature, vital SUGGESTED READING
screened regularly for infectious diseases, use parameters) transfusions carefully. Tocci LJ: Transfusion medicine in small animal
flea and tick prevention, and have blood practice. Vet Clin North Am Small Anim Pract
collected using a sterile technique. Technician Tips 40:485-494, 2010.
• Recipients should be blood typed (all cats) • Inspect all units before infusion and discard AUTHOR: John M. Thomason, DVM, MS, DACVIM
and cross-matched if possible, especially if if discolored, hemolyzed, or expired. EDITOR: Jonathan E. Fogle, DVM, PhD, DACVIM
they have received previous transfusions.

Transitional Cell Carcinoma Client Education
Sheet

BASIC INFORMATION HISTORY, CHIEF COMPLAINT • Other bladder tumor such as botryoid
• Pollakiuria (common) rhabdomyosarcoma (in young, large-breed
Definition • Hematuria (common) dogs) or leiomyosarcoma
Neoplasms of epithelial origin that arise in the • Stranguria (common) Abdominal distention/tenderness or abdominal
bladder parenchyma are relatively common in • Tenesmus (occasional) mass:
dogs but rare in cats. • Abdominal pain (occasional) • Mass in spleen, mesenteric lymph node, or
• Abdominal distention (occasional) retroperitoneal space
Epidemiology • Lameness and joint thickening (rare; associ- • Ruptured splenic or hepatic mass with
SPECIES, AGE, SEX ated with hypertrophic osteopathy) hemoperitoneum
• Dogs: typically, older adults (median age, • Abdominal trauma or coagulopathy with
11 years). Females are at higher risk than PHYSICAL EXAM FINDINGS peritoneal or retroperitoneal bleeding
males. • Abdominal tenderness +/− • Rectal mass
• Cats: affects older adults rarely; males at • Caudal abdominal mass +/− • Prostatic abscess, cyst, or neoplasia
increased risk • Urethral mass on rectal exam +/− • Pyelonephritis
• Distended urinary bladder +/− • Hydronephrosis or hydroureter
GENETICS, BREED PREDISPOSITION • Abdominal distention with fluid wave if Radiographic:
Scottish terriers (up to 20-fold increased risk), bladder ruptured (rare) • Other bladder neoplasm or radiolucent
Shetland sheepdogs, West Highland white ter- urolithiasis
riers, wirehaired fox terriers, Airedales, beagles, Etiology and Pathophysiology • Ruptured splenic, renal, or hepatic mass with
and collies have higher incidences. • Bladder mass most commonly in trigone hemoperitoneum
region (dogs). • Traumatic bladder rupture
RISK FACTORS • Urethral or prostate involvement is common, Ultrasonographic:
• Dogs: female predominance. Exposure to often leading to obstruction. • Papillary cystitis
herbicides and insecticides is associated • Lymph node metastasis present in ≈15% of • Leiomyosarcoma
with an increased risk that is worsened cases at the time of diagnosis • Botryoid rhabdomyosarcoma
in the presence of obesity, possibly due to • Distant metastasis common (49% at death) • Lymphoma (rare)
accumulation of inert ingredients. Spot-on • Metastatic sites include lymph node, lung, • Other rare carcinomas or sarcomas
flea products do not appear to increase liver, kidney, spleen, uterus, gastrointestinal Urinalysis:
risk. Cyclophosphamide administration (GI) tract, bone, muscle, cystocentesis needle • UTI
and chronic urinary tract infection (UTI) tracts. • Urolithiasis
appear to increase risk. • Secondary bacterial cystitis is common. • Other bladder tumor
• Cats: possibly associated with chronic UTI; • Idiopathic renal hematuria
older cats at greatest risk DIAGNOSIS
Initial Database
ASSOCIATED DISORDERS Diagnostic Overview • CBC, serum biochemistry profile: no specific
• Bacterial cystitis Middle-aged to older animals with signs of findings. Azotemia and hyperkalemia if
• Hypertrophic osteopathy recurrent UTI should be screened for bladder obstruction present
• Urethral obstruction masses, and dogs of at-risk breeds (particularly • Urinalysis: proteinuria and hematuria are
• Bladder atonia/hypotonia Scottish terriers) should be screened early. Early common and may be complicated by sec-
diagnosis allows the best outcome. ondary bacterial UTI with pyuria, bacteruria.
Clinical Presentation Cystocentesis has been associated with
DISEASE FORMS/SUBTYPES Differential Diagnosis needle-tract neoplastic cell implantation and
• Most common form is invasive cancer into Pollakiuria, stranguria, hematuria: should be avoided if transitional cell carcinoma
muscularis, most often in trigone region. • UTI (TCC) is suspected or confirmed; recommend
• Early form of superficial cancer may be • Urolithiasis catheterization or free-catch method.
identified that may be more responsive to • Feline lower urinary tract disease/interstitial • Veterinary bladder tumor antigen test
therapy. cystitis (VBTA): ≈85% sensitive for TCC but only

www.ExpertConsult.com