Bladder Cancer in Cats: Signs, Diagnosis, & Treatment

Bladder cancer is quite rare in cats. The most common type of bladder cancer, transitional cell carcinoma, has an estimated prevalence of 0.18% in cats, which means fewer than 2 in 1000 cats are affected.

Although bladder cancer is relatively uncommon in cats, pet parents need to be familiar with the signs. Bladder cancer is often life-limiting in cats, but with a proper diagnosis, pet parents can take steps to improve their cat’s comfort and prognosis.

Symptoms & Warning Signs

The following are signs of bladder cancer in cats:

Pet parents should note that these are also signs of feline lower urinary tract disease (FLUTD), bladder stones, and urinary tract infections (UTIs), all of which are much more common than bladder cancer in cats. If your cat’s urinary symptoms do not improve with treatment, bladder cancer should be ruled out. Bladder cancer should also be considered in a senior cat showing new urinary symptoms.

How Bladder Cancer is Diagnosed in Cats

Cats with any abnormal urinary signs should be evaluated by a veterinarian. The following are steps the veterinarian may take to diagnose bladder cancer:

• Physical exam, including palpation of the bladder which may reveal a mass. It is also possible for cats to develop benign bladder tumors, which can share the same signs with cancerous tumors. A veterinarian could only definitely tell you the type of tumor your cat has by collecting cells from the tumor.
• Urinalysis, which may detect blood cells, protein, or abnormal cells in the urine
• Urine culture to rule out urinary infection
• Bloodwork to evaluate kidney health
• X-rays (radiographs) to look for bladder stones and kidney abnormalities
• Abdominal ultrasound, which is more likely than X-ray to reveal a mass
• Collection of cells via a urinary catheter or surgical biopsy

Fine needle aspiration (i.e. using a needle to sample cells from a tumor) is a common means of sampling masses. However, FNA is not recommended for bladder cancers. Transitional cell carcinoma (TCC), which is the most common type of bladder cancer in both cats and dogs, can easily spread to other parts of the body by the insertion of a needle into the tumor.

While TCC is the most common type of bladder cancer in cats, cats can develop other types of bladder tumors, such as sarcoma or lymphoma.

Treatment Options for Cat Bladder Cancer

When your cat gets diagnosed with bladder cancer, you’ll get the option of either pursuing aggressive treatment intended to extend life (while maintaining comfort) or palliative treatment intended to keep your cat comfortable for their remaining time. Either option is appropriate—how your cat feels during treatment is the most important factor to consider.

Aggressive Treatment Options

• Surgical removal: Depending on the size and location of the tumor within the bladder, surgical removal can be attempted. Occasionally, surgical removal is curative. However, pet parents should note that even with surgical removal of a bladder tumor, recurrence and spread are likely.
• Chemotherapy is also an option for cats with bladder cancer. It’s sometimes used in addition to surgical removal to try to address spread of the cancer. Chemotherapy in cats is designed to maintain quality of life. Unlike in humans, negative side effects are not tolerated. Chemotherapy can include both oral and intravenous medications, and your cat’s bloodwork will be monitored throughout the protocol to ensure they are tolerating the medications well.
• Radiation therapy is also an option for bladder cancer in cats. Radiation therapy can be performed to maintain comfort or in addition to surgery or chemotherapy. It’s also an option for tumors that are in locations that are unfavorable for surgery, such as next to a ureter. Radiation is rarely curative or bladder cancer in cats but can improve quality of life. To receive radiation therapy, a cat must be anesthetized. Radiation therapy can be costly, and it is not available in all oncology practices. You may need to travel to a university if you are interested in pursuing radiation therapy for your cat’s bladder cancer.

Palliative Treatment Options

Palliative care is focused on maintaining comfort rather than extending length of life. As mentioned, palliative radiation is an option. However, it is much more common for pet parents to focus on pharmaceutical options, which are generally more affordable. Medications that can be used for palliative management of bladder cancer in cats include:

• Piroxicam: This non-steroidal anti-inflammatory drug (NSAID) can reduce inflammation and has some anti-tumor effects.
• Buprenorphine: This opioid can help with moderate to severe pain in cats.
• Gabapentin: This medication may reduce nerve pain, as well as relieve anxiety.

It’s important to maintain your pet’s hydration, as well. If blockage occurs, the veterinarian may place a urinary catheter to temporarily relieve obstruction. Removal of the catheter will likely result in recurrence, so the placement of a catheter is intended to keep your pet comfortable while you make plans to ease their passing or decide to pursue more aggressive treatments.

Cost of Bladder Cancer Treatment in Cats

Advanced treatments (i.e. surgery, chemotherapy, radiation) for bladder cancer are costly.

Surgery to remove a bladder tumor is going to be more expensive than a routine cystotomy to remove stones. According to Embrace Pet Insurance, surgical removal of a tumor starts as low as $300 to $500, but Lemonade Pet Insurance lists the cost of a cystotomy (i.e. bladder surgery) as $1,000 to $3,000. We would expect removal of a bladder tumor to be on the higher end of the cystotomy range, with at least a few hundred dollars added for the mass removal itself.

According to CareCredit, chemotherapy for cats cost $150 to $600 per dose, with the total cost of chemotherapy treatment ranging from $3,000 to over $10,000 depending on the protocol chosen and your cat’s response to chemotherapy.

Radiation can cost $1,000 to $1,800 if a palliative protocol is used. If an aggressive protocol is chosen, the cost can be closer to or more than $6,000.

Treatment is often cost-prohibitive for pet parents. Options that may help with funding of bladder cancer treatment include:

• Pet insurance (purchased prior to cancer diagnosis and waiting period)
• CareCredit
• Grants from non-profit organizations
• Fundraising

Prognosis & Monitoring

Without treatment, the prognosis for a cat with bladder cancer is only around 1-2 months. Surgery and/or other advanced treatments can extend life to around six months to a year. Regardless of the treatment selected, it is uncommon for cats with bladder cancer to live more than a year.

Cats whose urinary signs cannot be controlled with medication or other treatments are likely in pain. This is a quality-of-life concern that should be discussed with the veterinarian.

Obstruction of a ureter or the urethra is a major potential risk of bladder cancer, and it can quickly become fatal. If the cat is attempting to urinate but is producing either nothing or very little urine, this should be treated as an emergency.

Final Thoughts on Bladder Cancer in Cats

While bladder cancer is rare in cats, it can seriously affect the cat’s quality of life and is usually life-limiting. There are treatments available that can improve comfort and extend lifespan, and your veterinarian can help you decide what’s appropriate for your cat and your family.

If your cat has any abnormal urinary signs, speak with your veterinarian as soon as possible to rule out bladder cancer and other causes of urinary tract issues in cats.