When should euthanasia be considered in pets with bladder cancer?

Dog being petted

Has your pet been diagnosed with bladder cancer? If so, you might have a few questions, with one of the biggest being ‘how will I know the time is right to say goodbye?’

We’re going to look at bladder cancer in detail, which should help you when making difficult decisions for your cat or dog. Read on to find out more about this condition. 

 

What is bladder cancer in pets? 

Bladder cancer occurs when there is abnormal cell growth in the urinary bladder. Bladder tumours are uncommon in pets, accounting for about 1% of all the tumours that vets diagnose in dogs. In cats, it is even rarer, with bladder tumours making up only around 0.38–0.56% of all feline cancers. It often affects older pets. 

One of the main issues with bladder cancer is that it is often diagnosed late on in the disease process. The cancer is usually symptomless initially, growing unseen inside the bladder. 

As the disease progresses, emerging signs are very similar to those seen in common urinary tract infections, and some urine samples may even culture positive for bacterial infection. These symptoms often initially respond to symptomatic medications like antibiotics and anti-inflammatories, but they flare up again when each treatment course finishes. 

The most common type of bladder tumour in pets, transitional cell carcinoma, grows rapidly and is very aggressive. This means that often by the time a diagnosis is made, the cancer is already quite advanced, and treatment options are limited. 

 

What types of bladder cancer affect pets? 

There are a few different types of bladder tumour, which include: 

Transitional cell carcinomas  

In both cats and dogs, transitional cell carcinoma (TCC) is the most common type of bladder cancer. Certain breeds are more prone to it than others, including Scottish Terriers and Beagles. 

This malignant tumour arises from the epithelial cells lining the inside of the bladder. It is very invasive, grows quickly and can metastasise (spread) elsewhere in the body. Sadly, by the time patients are diagnosed, this tumour may have already spread to other areas of the body like the lymph nodes and bones. The long-term prognosis with this type of tumour is poor. 

Leiomyosarcomas  

This type of malignant tumour affects the smooth muscles of the bladder. They are often small when diagnosed and don’t tend to spread elsewhere in the body, but they can be locally invasive. 

Fibrosarcomas  

A fibrosarcoma is another malignant tumour which originates from the soft tissue structures of the bladder. 

It’s worth noting that general bladder thickening or benign growths like polyps can present in a similar way to these bladder tumours. So, diagnostic tests will be needed to definitively determine if your pet has a cancerous tumour and which type it might be. 

 

What are the symptoms of bladder cancer in pets? 

The symptoms of bladder cancer are often similar to those seen in many kinds of urinary bladder diseases. These include: 

  • Blood in the urine 
  • Straining to urinate 
  • Pain on urination 
  • Only passing small amounts of urine at a time 
  • Inappropriate toileting in the house 

As the cancer progresses, you may notice more generalised symptoms such as: 

  • Lethargy 
  • Weight loss 
  • Changes in appetite and thirst 

 

How is bladder cancer diagnosed? 

To reach a bladder cancer diagnosis, the following tests are often required: 

Physical examination – a full exam which includes checking your pet’s weight, feeling their abdomen and checking their external lymph nodes. 

Urinalysis – a urine sample can be a useful screen for urine tract infections or urinary crystals, but it is also a non-invasive way to look for certain cancerous cells in dogs. Cells containing something called the BRAF mutation are found in many dogs with TCC. There are some limitations, though, as there is currently no equivalent test for cats and this test also doesn’t detect the other types of bladder cancer. 

Blood tests – General blood screens are performed to look at your pet’s overall health, checking things like kidney function. 

Ultrasound scan – An ultrasound machine is used to look at the bladder in real-time, using soundwaves. If a suspected tumour is found, it can give an estimate as to the size, shape and approximate location. Bladder tumours are often found in the neck of the bladder, where the bladder starts to narrow as it exits to the urethra. 

Radiographs (X-rays) – X-rays can be used in bladder investigations, but are also used to identify tumour spread elsewhere in the body, such as the lungs. 

Biopsy – Sampling suspicious tissue in the bladder can give information about whether it is a cancerous process and what type of tumour it is. 

 

What treatment options are there for bladder cancer in cats and dogs? 

The main treatment options for bladder cancer are: 

Surgery  

Surgery can be tricky in these patients as tumours are often located in the neck of the bladder, near to where the ureters (tubes that deliver urine from the kidneys) and urethra (tube that urine passes through when your pet urinates). This means there is a risk of damaging these structures. In most cases the mass can’t be removed entirely, but debulking surgery may sometimes be feasible. This involves reducing the size of the tumour, which can relieve some symptoms temporarily, however the tumour will usually grow back. 

Chemotherapy  

Unfortunately, long-term chemotherapy success is limited for bladder tumours in pets. Medications given can extend average survival times to 10 -11 months, however. Some drugs like piroxicam and meloxicam (non-steroidal anti-inflammatories) have some good effects against these tumours when combined with chemotherapy agents, but may also be used on their own too. The survival time for dogs treated at home with piroxicam alone is around 6 months. 

Radiation therapy  

This can help manage tumour growth, but it is not without potential side effects. The bladder is located near many sensitive structures, plus its size varies depending on how much urine it is holding at the time, making targeted treatment tricky. If used alongside chemotherapy, survival times average around 20 months. 

Your vet will talk through all the options that are available for your pet and the costs involved. In many cases, treatment is palliative care, which means keeping your pet as comfortable as possible without curing the underlying disease. 

 

How do I know if it’s time to say goodbye to a pet with bladder cancer? 

Unfortunately, many pets with bladder tumours will continue to deteriorate. While treatment can help slow the progression of the disease, in many cases it is not curative. The exact time frame will depend on the treatments chosen and how far advanced the disease is at diagnosis. 

It’s important to check in regularly with your vet after your cat or dog has been diagnosed with a bladder tumour. This will help you to keep an eye on their weight and comfort levels. 

Your pet’s quality of life should be at the front of your mind during this time. If your pet is starting to have ‘more bad days than good’, this can be an indication that they are reaching the end. 

Signs that your pet is struggling with their bladder tumour may include: 

  • Pain when urinating 
  • Inability to pass urine (outflow obstruction) – an emergency, life-threatening issue 
  • Passing blood frequently 
  • Abdominal pain 
  • Reduced appetite 
  • Weight loss 
  • Lethargy 
  • Disinterest in playing or exercising 

We know that making the decision to say goodbye is an incredibly tough one. While your vet is there to support you with this, we are too. Our ‘Is it time?’ checklist can help owners assess their pet’s quality of life further. 

Please get in touch with our team if you need more support or if you wish to book an appointment for gentle at-home euthanasia. 

 

Summary 

Bladder tumours are an uncommon but often serious cancer in cats and dogs. If your pet has been diagnosed with a bladder tumour, then we understand that you might be anxious during this time. However, it’s important to keep working closely alongside your vet to ensure your pet remains comfortable for as long as possible. 

If your pet deteriorates, then any decisions should be made with their best interests in mind, including the right time to say goodbye. 

Cloud 9’s veterinary team offers compassionate euthanasia in the comfort of your own home, so please don’t hesitate to get in touch if you wish to discuss things further.