Through a variety of techniques and intersecting disciplines, University of Florida veterinarians are expanding their treatment capabilities for animals that suffer from urinary obstructions ranging from cancer to kidney stones.
UF veterinarians have been treating cancer of the urethra in dogs for several years now through a combination of high-dose targeted radiation and chemotherapy. Last year, however, veterinary oncologists began to devise treatments for cancers in the bladder neck, an area of thick muscle where the bladder joins the urethra.
“Most veterinarians aren’t aware that we can treat tumors in the bladder neck by surgically removing the area containing the cancer and then moving the ureters into a healthy part of the bladder,” said UF’s Nick Bacon, a clinical assistant professor of surgical oncology at the UF Small Animal Hospital. “Frequently, veterinarians will tell their clients that with cancer of the bladder neck that there is nothing that can be done, so we feel it’s important to get the word out that at UF we have the ability to help them.”
An early case in which UF veterinarians performed the procedure involved a mixed-breed dog named Tucker, owned by Stephen Roberts of Orlando. Tucker initially was diagnosed by his veterinarian as having a tumor in the bladder neck. Through subsequent contact between Tucker’s veterinarian and UF veterinary specialists, Tucker came to UF for the surgical procedure, which was followed by chemotherapy treatments.
“He was doing well, until around six months after surgery, when we began to see small tumor growth inside the bladder,” Bacon said, adding that by one year after surgery, the growth had begun to block the ureters — tubes that transport urine — and then the kidneys, causing Tucker’s kidneys to fail.
“With the new situation, I could not move those ureters, as the whole bladder was now lined with cancer.”
At that point, the UF oncology group looked to their colleagues in radiology and internal medicine for help. With radiologist David Reese providing real-time imaging, UF’s Kirsten Cooke and Alex Gallagher, both clinical assistant professors of small animal medicine, were able to successfully insert thin, flexible tubes, known as stents, within each ureter running from each kidney to the bladder. The procedure has removed the obstruction from Tucker’s kidneys.
“The Image-Guided Interventional Service includes specialists from medicine, oncology, surgery, cardiology and radiology,” Gallagher said. “Tucker’s ureteral stenting is just one example of the procedures in which our specialists can collaborate with the result of positive outcomes of our patients in a minimally invasive way.”
Although UF veterinarians have been placing stents in different parts of the body to address a variety of conditions, predominantly cardiovascular, Tucker’s procedure was the first time stents had been placed between the kidney and the bladder.
“The important thing is that more urinary tract obstructions are now potentially treatable,” Bacon said. “The majority of dogs with urinary cancer die from urinary obstruction and we can now treat them, or at least get better at treating them.”
With the capability to provide radiation therapy, perform surgery to remove cancers once thought inoperable and place stents to open up previously blocked areas of the body, UF offers services not available to pet owners anywhere else in the state of Florida.
Roberts, Tucker’s owner, said he had been impressed by UF’s team approach to treating his dog.
“I’m ecstatic about the way things are working out,” Roberts said. “I honestly never expected Tucker to last a year. Right now he’s 9-and-a-half years old, and the more time we can get with him, the better.”
When Tucker last visited UF for a check -up in June, veterinarians found that his kidney values had returned to normal.
“Tucker still has cancer, but he is doing great and is now one year out from when his owner was told initially that nothing could be done,” Bacon said.