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31 Cards in this Set
- Front
- Back
Renal tumor
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rare primary tumor, usually maglinant
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Renal tumor in cats
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most often lymphoma
6y usually bilateral most often systemic dz, develop CNS lymphoma FeLV can directly cause lymphoma, FIV is indirect causeRen |
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For cancer affect kidney as primary organ in cats
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carcinoma
11y unilaterial azotemia prognositic factor |
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Renal tumor in dogs
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Lymphoma affect kidneys (often bilateral) but usually as part of multicentric dz
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Cancer affecting kidney as primary organ in dogs
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older, 8y
95% unilateral 2/3 carcinoma 1/3 sarcoma, |
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PE and history of feline renal tumor
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nonspecific signs: weight loss, lethargy, anorexia
palpable mass/ renomegaly lymphoma: bilateral renomegaly (non- painful) +/- CNS sign or rear limb paresis |
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PE and history of canine renal tumor
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nonspecific sign: wt loss, inappetance, lethargy, occasional vomit, pain (if sarcoma)
20-40% palpable mass 1/4 hematuria |
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Diagnostic for renal tumor:
1. min database/ FIV/ FeLV |
1. anemia in 1/4 dogs, 1/2 cats (affect erythropoietin, uncommonly bleeding into ab, anemia of chronic dz )
2. azotemia: 20% dog, 40% cats, HIGH BUN AND MILD ELEVATION OF CRE cause of GI bleeding (ulcer), high BUN and high CRE cause of azotemia 3. Urine abnormality common: proteinuria (low specific gravity), isosthenuria, pyuria and microscopic hematuria) |
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Diagnostic of renal tumor (cont.):
2. thoracic rads 3. ab imaginig |
thoracic rads: dogs high mets later in dz
cats mets early on in dz ab imaging: mass identified in rads/ ultrasound. highly locally invasive (may invade vena cava), regional mets (LN, liver and other ab organ, very mets in dog) |
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Definitive ddx of renal tumor
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FNA/ cytology: blind or ultraouns guide
most sensitive for lymphoma Biopsy: for unilateral tumor (not LSA) surgical excisional or exploratory ideal, laproscopy also used |
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Therapy and prognosis of renal tumor in cats
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Lymphoma: chemo, not nephrectomy (bilateral dz), MST 6M, renal failure not prognositic factor
Carcinoma: nephretomy, rare cats with low grade have prolonged survival |
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therapy and prognosis of renal tumor in dogs
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lymphoma: chemo
Other tumors: nephrectomy, dog do not usually get lymphoma in kidney, take biopsy 90% maglinant in dog (carcinoma, sarcoma), 90% unilateral, GFR and staging before necphrotomy, w/o surgery, dog do not do well, w/ surgery. 12-16 m |
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Differential for renal tumor
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For bilateral kidney enlarged: vertebral dz, CP decifict
w/ rads, ultrasound to confirm hyperchoic kidney and guide FNA (for lymphoma and infectious dz), otherise transabdominal lymphoma For unilateral kidney enlarged, one large, one lumpy bumpy, rule out hydronephritis, renal insufficiency |
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Tumor of urinary bladder
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rare, more often than renal tumor
most common transitional cell carcinoma (TCC) middle aged to older cats older female cats esp. scottie increased risk of TCC with cyclosphoshamide chemo, topircal insctisides, herbicies and decreased risk with leafy green/ orange vege |
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History and PE of urinary bladder tumor in cats
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history: similar to other lower urinary tract dz (urolith, bacterial cystitis etc.). Healthy cat seldom get recurrent UTI
PE: bladder mass often palpable (easier in cats than dogs) |
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History and PE of urinary bladder tumor in dogs
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clnical signs similar to other lower UT dz
further diagnostic needed for recurrent UTI (UA, urine culture, ab rads to look for stones, ab ultrasound before cysto) stranguria, pollakiruia, hematauria, dysuria, urinary incontience ) possibly palpable bladder ass |
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Diagnositcs for urinary tumor
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CBC (wnl), chem (azotemic), urinalysis (may see anaplastic epi cell on sediment, caution with concurrent infection, might just be responding to that)
urine culture: may see concurrent UTI cause bladder mucosa is compremised |
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Differential for renal tumor
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For bilateral kidney enlarged: vertebral dz, CP decifict
w/ rads, ultrasound to confirm hyperchoic kidney and guide FNA (for lymphoma and infectious dz), otherise transabdominal lymphoma For unilateral kidney enlarged, one large, one lumpy bumpy, rule out hydronephritis, renal insufficiency |
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Tumor of urinary bladder
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rare, more often than renal tumor
most common transitional cell carcinoma (TCC) middle aged to older cats older female cats esp. scottie increased risk of TCC with cyclosphoshamide chemo, topircal insctisides, herbicies and decreased risk with leafy green/ orange vege |
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History and PE of urinary bladder tumor in cats
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history: similar to other lower urinary tract dz (urolith, bacterial cystitis etc.). Healthy cat seldom get recurrent UTI
PE: bladder mass often palpable (easier in cats than dogs) |
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History and PE of urinary bladder tumor in dogs
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clnical signs similar to other lower UT dz
further diagnostic needed for recurrent UTI (UA, urine culture, ab rads to look for stones, ab ultrasound before cysto) stranguria, pollakiruia, hematauria, dysuria, urinary incontience ) possibly palpable bladder ass |
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Diagnositcs for urinary tumor
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CBC (wnl), chem (azotemic), urinalysis (may see anaplastic epi cell on sediment, caution with concurrent infection, might just be responding to that)
urine culture: may see concurrent UTI cause bladder mucosa is compremised |
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diagnostics for urinary bladder tumor (cont.)
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three view thoracic rads: lung mets <40% @ ddx, multiple interstital nodules
Ad rads: rule out urolith, rarely see mass unless mineralized. may identify sublumbar lymphadenomegaly or bone invasion ad ultrasound: most commonly used to ddx, highly sensitive to define extent of dz, most commonly trigone area |
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definitive ddx for urinary bladder tumor
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urine cytology:
-fine needle aspiration NOT recommanded ( rare reports of seeding) Biopsy (GOLD STANDARD): traumatic catheter biopsy commonly used, female required sedation cystoscopic also useful ultrasound guided biopsy (e.g. tru cut NOT recommended) cause of seeding cystotomy may also get seedling |
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might not need definitive ddx
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ddx with biopsy but 90% TCC so might not need to get definitive ddx if see in trigone area and ????
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Bio behavior of urinary bladder tumor
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Cats: 50% trigone, 50% apical, mets in 20% of pt @ ddx
dogs: usually trigone, usually obstruct ureter and uretra, urethral sphincter moderately mets (more than 40%) EXTREMELY EXFOLIATIVE TUMOR, easily seed with tru cut biopsy tract |
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Antigen test
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don't use as definitive ddx, should be use as screening e.g. for scottie. False +ve for other urinary tract dz
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Treatment and prognosis for urinary bladder tumors in cats
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localized tumor should be surgically resected (20% mets)
diffuse tumor should be treated medically MST 8-9M most cats die of local dz |
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Treatment for urinary bladder tumors in dogs: surgical
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surgery: in trigone area so surgically not possible, 40% mets in dogs
If apical, localized dz, rare cases curable with surgery. Need excellent surgical techniques to prevent seeding |
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Treatment for urinary bladder tumors in dogs: medical therapy
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TX OF CHOICE for most dogs (usually trigonal and non- resectable)
MONITOR RENAL FUNCTION cause chemo and NSAID are nephrotoxic COMBINATION of chemotherapy and NSAID with 35% response rate, 75% clinical improvement, MST 10-12m NSAID (piroxicam) alon 20% response rate and MST 6m |
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Palliative option for dog with urinary bladder cancer
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-tube cystotomy: may allow pt to survive for months beyond when they would have euthanized for urethral obstruction
-RT w/ chemo and NSAID, improve clinical signs but not increase in MST |