Transitional cell carcinoma (also called urothelial carcinoma) is the most common cancer of the urinary tract in dogs, that can affect the bladder and prostate. Diagnosis is usually confirmed with a biopsy (tissue sample) and sometimes cytology (fine-needle aspirate sample). However, biopsies and cytology may lead to seeding of cancer cells, where the cancer cells track along where the biopsy or needle tracts have entered in the body. The Cadet BRAF test is a non-invasive, highly sensitive and specific test that can detect urothelial carcinoma in dogs at an early stage, to help facilitate early intervention and treatment.

What is the Cadet BRAF test?

BRAF is a genetic mutation that is identified in around 80% of dogs with transitional cell carcinoma in the bladder and prostate. The Cadet BRAF test is PCR based genetic test that allows detection of this mutation in the urothelial cells that have been shed in the urine. 

How accurate is this test?

This test can detect mutated BRAF gene in as few as ten mutant-cancer bearing cells in a urine sample, so it can help detect early cases of urothelial carcinoma in dogs many months before clinical signs associated with the cancer becomes evident. 

The sensitivity in detecting urothelial cancer in a dog with clinical signs is around 80%. The specificity of this test is >99.5%. All cases that have the presence of this mutation have had histopathologic confirmation of urothelial carcinoma. Normal dogs, dogs with benign polyps or inflammation of the urinary tract will not harbour the BRAF mutation. This means if the dog has a positive result, the dog has >99.5% chance that it most likely has urothelial carcinoma somewhere in the urinary tract. However, if the dog has a negative result, the dog can still have urothelial carcinoma, because around 20% of urothelial carcinomas do not possess BRAF mutation. 

This test is not affected by the presence of blood, bacteria or protein in the urine. 

When is the BRAF test recommended?

• Any dog with an unexplained abnormal bladder wall (e.g. bladder mass) or abnormal prostate gland on ultrasound examination.

• Dogs with diagnostic imaging evidence of a bladder mass and clinical signs of lower urinary tract disease (e.g. haematuria, stranguria, dysuria and pollakiuria).

• A screening test in high-risk breeds of dogs more than six years of age. High-risk breeds include Scottish terrier, Beagle, West Highland White terrier, Shetland Sheepdog, Jack/Parson Russell terrier, Fox terrier and American Eskimo Dog.

• During chemotherapy to monitor treatment success by decreased levels of BRAF mutation detection, or to monitor cancer relapse by re-occurrence of BRAF mutation tumour bearing cells.

• Early diagnosis in clinical cases with recurrent, complicated or antibiotic-resistant urinary tract infections presenting with haematuria without ultrasonographic evidence of a bladder mass.

What sample is required?

40 mL of free catch urine (not cystocentesis or catheterised urine) needs to be collected and placed immediately in a special preservative containing BRAF container explicitly supplied by the laboratory. There are special instructions on how owners can collect this, but it is relatively straightforward. The urine sample can be collected over 2-3 days, and once the urine is the preservative solution, the sample is stable at room temperature for several days provided the sample is stored out of direct sunlight.

Is this test available in my country?

This test is readily available in the USA. However, it is also offered through other countries such as Australia, New Zealand, Hong Kong and Singapore. However, the sample will need to be shipped via FedEx to the USA, where this test is performed.  

How long do the results take to return?

Once the sample arrives at the laboratory, the turnaround time is 3-6 business days. Shipping internationally to the USA via FedEx typically takes a few business days.

Vets, if you would like to know more about this Cadet BRAF test, please do not hesitate to get in touch by clicking here.