Noninvasive Urine Test Detects Serious Bladder Disease

Analysis by Dr. Karen Shaw Becker

cadet braf test for dogs

Story at-a-glance -

  • Bladder cancer in dogs can be difficult to diagnose and is often misdiagnosed as a urinary tract infection; a new urine test may offer early detection
  • Researchers have found a mutation (V595E) in the canine BRAF gene in a large percentage of dogs with bladder cancer
  • The urine test, known as the CADET (CAncer DETection) BRAF Mutation Detection Assay, can detect the mutation at very low levels, as few as 10 cancer cells in the urine, making it useful for early detection, months before clinical signs appear
  • Because the test is noninvasive, it can be used not only as a diagnostic tool if symptoms are present but also as a screening tool for high-risk breeds

Bladder cancer in dogs, most of which are transitional cell carcinomas (TCC), typically causes symptoms such as blood in the urine, straining during urination and increased frequency of urination. These symptoms mimic the signs of a urinary tract infection, and many dogs with bladder cancer may have urinary tract infections (UTI) as well.1

As such, bladder cancer in dogs can be difficult to diagnose and is often misdiagnosed as a UTI. Treatment with antibiotics and non-steroidal anti-inflammatory drugs (NSAIDs) may temporarily improve symptoms, delaying diagnosis further. Unfortunately, most bladder cancer cases in dogs are not diagnosed until the disease has spread and treatment options are limited.2

Fortunately, there’s a new urine test that offers a noninvasive way to detect bladder cancer in dogs early, even before symptoms develop.

Noninvasive Urine Test Detects Bladder Cancer

Certain breeds are at an increased risk of developing bladder cancer, including TCC and urothelial carcinoma (UC). This includes the following, which account for one-third of bladder cancer cases in purebred dogs:3

Australian cattle dog

American Eskimo dog

Australian shepherd

Beagle

Bichon fries

Border collie

Lhasa Apso

Parson Russell terrier

Rat terrier

Russell terrier

Scottish terrier

Shetland sheepdog

West Highland white terrier

Wire fox terrier

There may be a genetic component and researchers have found a mutation (V595E) in the canine BRAF gene in a large percentage of dogs with TCC and prostatic carcinoma (PC).

According to veterinary oncologist Dr. Sue Ettinger, “In assessing various cancers, including epithelial, mesenchymal and hematopoietic, the V595E mutation was identified in canine UC cases with the highest penetrance rates of up to 87%.”4 Bladder cancer sheds tumor cells in urine, and the test is able to pick up the presence of the V595E mutation with excellent results.

According to one study published in 2015, the test “identified the mutation in free catch urine samples from 83% of canine UC and PC patients, demonstrating its utility as a noninvasive means of diagnosis.”5

Early Detection of Bladder Cancer May Save Lives

The urine test, known as the CADET (CAncer DETection) BRAF Mutation Detection Assay, can detect the mutation at very low levels, as few as 10 TCC or UC cells in the urine, making it useful for early detection, months before clinical signs appear.6 The CADET test became commercially available in July 2018. There’s also a Cadet BRAF-Plus test, which detects another biomarker, bringing the sensitivity to more than 95%. Ettinger explained:7

“A positive BRAF test result can substitute for tissue diagnosis (histology, cytology). If the BRAF mutation isn’t detected, the urine specimen is then assessed by the lab using a proprietary algorithm to determine whether it meets the criteria for analysis with Cadet BRAF-Plus. If eligible, the BRAF-Plus will be run, and no additional urine is required.”

Because the test is noninvasive, it can be used not only as a diagnostic tool if symptoms are present but also as a screening tool for high-risk breeds. It can also be used to monitor treatment outcomes in dogs undergoing treatment for bladder cancer. As Ettinger noted, the test is groundbreaking because earlier detection can result in lives saved:8

“Clinical signs for UC are often subtle, nonspecific and confused for other lower urinary tract diseases. The Cadet BRAF test provides a noninvasive urine test for earliest detection of emerging UC — even before overt signs of the cancer become evident.

Timely detection of UC allows owners to direct their resources toward effective treatment of the cancer itself, rather than the nonspecific clinical signs.”

What Causes Bladder Cancer in Dogs?

Some dogs may be genetically predisposed to bladder cancer, but the disease has also been linked to environmental exposures, including herbicides such as 2,4-dichlorophenoxyacetic acid (2,4-D) and 4-chloro-2-methylphenoxypropionic acid (MCPP), dicamba.9

Dogs may be exposed following lawn treatments (including via drift from a neighbor’s lawn treatment), and they may inhale, ingest or absorb the chemicals through the skin. In addition to avoiding lawn treatments like these, you can help protect your pet by bathing him if he’s been exposed to lawn care chemicals.

Even a basic footbath can make a dramatic difference in reducing your pet's overall chemical burden. If you live in a townhouse or community that applies chemicals to common areas, I recommend watering the chemicals down into the soil to reduce skin contact after application. Keep your pet on a leash (and on the sidewalk) until you've walked to your pesticide-free destination.

A regular detox protocol may also be helpful, and if your dog is a high-risk breed for bladder cancer, you may want to ask your integrative or holistic vet about whether using the urine test to screen for bladder cancer makes sense for your dog, as well as including fresh food in the diet, which has been shown to reduce the incidence of bladder cancer among Scottish terriers.10

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