Case Of the Month

UGELAB (Laser Ablation) treatment for trigonal transitional cell carninoma of the bladder in a 10 year old FS American Eskimo dog. Our Case Study Of The Month July 2014

A 10-year-old FS American Eskimo dog was presented for stranguria, hematuria, pollajuria and just not herself. She was non responsive to therapy for UTI. Severe azotemia and moderate anemia developed. Urinalysis revealed proteinuria, elevated WBC, blood and transitional cells, and isosthenuria.

DX

Non-resectable trigonal bladder transitional cell carcinoma with ureteral obstruction.

Outcome

After undergoing the initial UGELAB procedure the patient survived 227 days and then was humanely euthanized.

Comments

Special thanks to Dr. Dean Cerf and staff at Ridgewood Veterinary Hospital, Ridgewood, New Jersey where the ultrasound-guided laser ablation procedure was founded. More information on this procedure may be found in JAVMA Jan1 2012, Cerf D, Lindquist E. (http://avmajournals.avma.org/doi/abs/10.2460/javma.240.1.51?journalCode=javma) or contact Ridgewood Veterinary Hospital directly at 201-447-6000. Texas A&M University, Department of Radiology also performs this procedure

Clinical Differential Diagnosis

ARF, CRF, bladder neoplasia, obstructive urolithiasis, resistent UTI, infectious.

Sampling

Endoscopic bx- transitional cell carcinoma

Sonographic Differential Diagnosis

Bladder mass with obstructive pattern to both ureters. Non-resectable without ureteral transposition. Strongly mineralizing aspects of the bladder mass suggest transitional cell carcinoma.

Image Interpretation

A 3.5 centimeter mineralizing bladder mass is occupying the trigone and obstructing the ureters at the region of the ureteral papillae. The ureters did not appear invaded by the mass. Mild bladder rotation has occurred owing to mass expansion. Moderate to severe hydronephrosis is present in both kidneys owing to ureteral obstruction. Ultrasound-guided laser ablation was performed for palliative removal of the mass and decompression of the ureters. A minimal amount of ureteral dilation was noted at the end of the procedure with slight residual hydronephrosis on followup. Ureteral function appeared adequate noted by contractility.