4193. A dog has bladder cancer

 Over 13 years old male castrated shihtzu has small clusters of bladder stones for over 3 years. The stones are too small and owner worried to do surgical removal. So, diet change and oral tab(urocrash) for that. 
Over the times, the stones weren’t increased in size and amount. No signs of urinary problems. The dog was completely healthy. 
But the dog pee with blood spot in last 3weeks. But that was happened just only one time. 
For that, we checked Xray and ultrasound. And vascularization area likely tumor mass inside the bladder was noted in ultrasound. 
So, I decided to do laparotomy and surgical removal of mass and stones.
During surgery, we found the mass about 2cm in size and removed it. Then, sent for biopsy and result is TCC might be caused by various risk factors like the dog is slightly obese, old age and chronic irritation by uroliths.

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Thank you, here are test results.
I will ask crown lab for X-ray soft copies coz I have only flim right now.
Ask Crown to email X rays as what you gave me before are of small size

Yes 

Please draw the bladder, position of tumor in bladder, surgery and stitches

Video of dog?
Coz the tumor is malignant and high grade, I consider to use Chemotherapy after surgery. 
I've done a treatment plan for that. And here's my opinion. 

- Piroxicam 0.3mg/kg for it's antitumor effect in Transitional cell tumors. 
- Add pantoprazole 1mg/kg as GI protectant.
- Turkeytail mushroom as immunotherapy.
- Liver supplement

As Chemo, considering to use Chlorambucil 4mg/m2 once daily 

Or 

Carboplastin 240mg/m2 3weeks interval.

But Chlorambucil has immunocompromised effect and may has lower efficacy for tumor.
Carboplastin as IV infusion has higher efficacy but more side effects like myelosupplemention. 

I would like to know your opinion which chemo should I use in this case.  

The dog is totally fine right now, no more blood spot when urination. Can urinate well and the rest physical examinations are normal.

Yes 

What is the total cost of chemo? No point doing chemotherapy if owner cannot afford the treatment!
Do you have special chemotherapy area as drugs are toxic to you and staff?
Are you competent in chemo
If you don’t have safety precautions to handle the toxicity of chemotherapy, don’t practise chemotherapy as you may yourself suffer from blood cancers etc due to your work!
Around 1.5 lakhs per time. Owner can afford it.

Yes, We used to chemotherapy in practice. 
We can handle it with safety precautions.
Thank you for drawings.

Regarding chemotherapy, I have no experience on the drugs.  How do they work—-you did not say. Oral medication will be my choice
Thank you for photo. Any video of dog?

Good morning 
1. What proof eg X ray you said the dog had stone for over 3 years?
 

IMAGE. This 13-year-old Shih tzu has bladder cancer.  iPhone 16 image is excellent. However, the photographer vet must take pride in his photography by making a great photo (NO HUMAN HAND)!
Photo needed my time to remove the hand with Adobe, wasting time.