Interventions and experience after complicated total cystectomy in a dog with transitional cell carcinoma

A Systematic Review of Canine Cystectomy: Indications, Techniques, and Outcomes

This review provides a summary of the literature encompassing partial and total cystectomy procedures in dogs and subsequent conclusions that can be drawn. Surgical excision as a component of treatment for lower urinary tract neoplasia in dogs may enhance survival time and result in acceptable quality of life, though risk for surgical complications is substantial, particularly following total cystectomy procedures. However, for dogs with urothelial carcinoma, cystectomy is generally not considered curative and disease progression is common. Appropriate case selection and thorough preoperative discussion with owners regarding potential risks and benefits of cystectomy are imperative for successful outcomes.

Modified Toyoda technique for total cystectomy and cutaneous ureterostomy in a cat

OBJECTIVES

To report the technique and outcome of a cat treated with a total cystectomy and bilateral cutaneous ureterostomy.

ANIMALS

A 16-year-old male castrated domestic shorthair cat.

STUDY DESIGN

Case report.

CASE PRESENTATION

A cat was referred after a 2-week history of pollakiuria and hematuria. Transitional cell carcinoma (TCC) was suspected based on ultrasonographic, cytologic, and contrast computed tomographic (CT) findings. A total cystectomy was combined with a modified cutaneous ureterostomy: the ureter, incised like a fish-mouth aperture, was anastomosed to the skin after the creation of a rectangular-shaped defect. Complete excision of a TCC was confirmed histologically.

RESULTS

Ureteral stents were removed 7 days (left) and 28 days (right) postoperatively. The cat's incontinence was managed with an absorbent diaper surrounding the ureteral stomata. The right ureter became obstructed 14 months after surgery, and the cat died at home approximately 16 months after surgery. In spite of the urinary incontinence, the owner was satisfied with the surgery and evaluated the cat's quality of life as satisfactory.

CONCLUSIONS

The total cystectomy and cutaneous ureterostomy described here allowed urinary excretion and resulted in long-term survival of a cat with bladder TCC.

A combined protocol with piroxicam, chemotherapy, and whole pelvic irradiation with simultaneous boost volumetric modulated arc radiotherapy for muscle-invasive canine urinary transitional cell carcinoma: First clinical experience

The aims of this pilot study were to evaluate the feasibility and efficacy of high-dose hypofractionated volumetric modulated arc radiotherapy (VMAT) applied to whole pelvic region radiotherapy (WPRT) with multilevel simultaneous integrated boost (MLSIB) combined with piroxicam and chemotherapy for the treatment of canine transitional cell carcinoma (TCC) of the lower urinary tract with muscle invasion TCC. Twelve dogs were enrolled, according to stage, in two groups: group 1, TCC confined to the urinary tract; group 2, TCC with metastasis. The planning target volume dose was tailored from 36 to 42 Gy in 6 fractions. All dogs were prescribed piroxicam and radiosensitizing carboplatin, and six received chemotherapy after radiotherapy. Serial follow-ups with computed tomography and magnetic resonance imaging were performed. Disease control and toxicity effects were evaluated according to the Response Evaluation Criteria in Solid Tumors and Veterinary Radiation Therapy Oncology Group criteria. The treatment was well tolerated, and no high-grade side effects were reported. The median overall survival times for groups 1 and 2 were 1,230 and 150 days, respectively. A considerable percentage of patients in group1 (50%) were still alive at the time of writing this paper, and a longer follow-up could enable a more accurate survival analysis. This preliminary analysis shows that VMAT applied to the WPRT with MLSIB is an effective and safe option for dogs with lower urinary TCC, although the presence of metastases worsens the prognosis.