Cancer of the urinary tract can affect the kidneys, ureters, bladder, urethra and prostate. The majority of urinary cancer cases present with lower urinary tract signs such as increased frequency of urination, unproductive straining and bloody urine. Tumours of the lower urinary tract are often poorly responsive to intravenous chemotherapy so other options have been developed.
Intra-arterial chemotherapy involves delivering the chemotherapy drug directly to the blood supply of the tumour. This results in an increased concentration of the chemotherapy directly within the cancer, which may result in an increased effectiveness of the drugs.
This video is a dog with a bladder tumour and highlights us mapping the blood supply to the bladder, prostate and local lymph nodes in order to deliver the chemotherapy directly the tumour rather than through the intravenous route. Early work has shown this allows significantly higher doses of the chemotherapy to reach the cancer.
Read more about intra-arterial chemotherapy.
The most common cancer of the lower urinary tract is a transitional cell carcinoma, which typically occurs around the bladder neck (trigone). This can commonly result in urinary tract signs including straining and blood tinged urine. As the tumour progresses it can lead to a complete obstruction whereby the patient is unable to pass urine – this is a life-threatening emergency. Using fluoroscopy we are able to place a small stent across the tumour and relieve the obstruction.
A stent is a small tube which can be passed from the kidney to the bladder around an obstruction such as a stone or cancer. Stents can be placed via cystoscopy (camera passed into the bladder) in female dogs and male dogs more than 8kg in weight. Stents are the preferred option for ureteral obstruction in dogs.
Subcutaneous Ureteral Bypass (SUB)
A SUB device can be used to divert urine around cancers which are blocking the urinary tract. These are placed under fluoroscopy (video X-ray) and are very well tolerated with a low complication rate.