Cadet BRAF Urine Test

Why Veterinarians Use the Cadet BRAF Urine Test

The Cadet BRAF urine test is 95% accurate in detecting transitional cell carcinoma (TCC) that contains cells with the BRAF genetic mutation¹. TCC, also known as urothelial carcinoma (UC), is the most common type of canine bladder cancer^2,3. Bladder cancer in dogs is overall rare, only comprising 2% of all canine cancers². A negative Cadet BRAF urine test can mean either that it is not TCC or that it is a form of TCC that does not carry the mutation that is being tested for (BRAF), in which case further testing may be recommended¹.

This is a simple test that involves free catching of urine from your dog. You will use a special vessel with a preservative from the lab to catch urine as your dog pees. You can collect urine over several days, and the sample can be stored at room temperature out of direct sunlight.

Once you have collected enough urine, the sample will be returned to the lab for testing.

When Vets Recommend the Cadet BRAF Urine Test for Dogs

This test can be performed either as a screening test for bladder cancer in high-risk breeds (listed below) over the age of six years or as a diagnostic test in response to symptoms⁶. Symptoms of bladder cancers commonly overlap with urinary tract infections (UTI), and UTIs often also accompanies cancers of the urinary tract. Treatment for the UTI will appear effective at first, but symptoms will recur after treatment, mimicking a recurrent UTI.

Since the mutation in the BRAF gene occurs in about 85% of TCC cases, this relatively simple and highly sensitive test can quickly rule out a UTI^3,5. Radiography and ultrasounds can also be used to detect masses, however biopsies, which can be expensive and invasive, were previously the only option for a definitive diagnosis⁷. If diagnostic imaging provides evidence of a possible bladder mass, the BRAF test is recommended⁵.

By utilizing a quick, non-invasive test such as the BRAF test, TCC can be diagnosed earlier, which offers better chances for effective treatment⁷. At presentation, 20% of these cancers have already metastasized⁶, and because surgery is often not an option, a new method for early detection is a welcome addition to TCC care. This test can also be used to follow up on detection of a mass in the urinary tract or in monitoring for a recurrence of TCC during or after chemotherapy^{5, 6}.

UTI symptoms which can also indicate transitional cell carcinoma include^2,6:

• hematuria—blood in urine
• stranguria —straining to urinate
• dysuria—painful urination
• pollakiuria—unusually frequent urination

Breeds with a high risk for TCC include¹:

• Scottish Terrier
• Beagle
• Shetland Sheepdog
• West Highland White Terrier
• Wire Fox Terrier
• Australian Cattle Dog
• American Eskimo Dog
• Australian Shepherd
• Bichon Frise
• Lhasa Apso
• Parson Russell Terrier
• Rat Terrier

The Scottish Terrier is suspected to have a strong genetic predisposition as this breed has about a twenty-fold higher risk of developing TCC than other dogs². The other breeds listed are three to five times more likely to develop TCC². The exact cause is unknown, but other than genetic predispositions, environmental factors are suspected to play a role in TCC development².

How This Test Works

This test looks for a common mutation in what’s known as the BRAF gene. This highly sensitive test can detect the genetic material in as few as ten cancer cells¹. If that genetic material contains a mutation in a gene known as the BRAF gene, then other conditions which may be causing the symptoms can be ruled out and cancer can be definitively diagnosed and treated. This cancer is more common in some breeds of dogs and the Cadet BRAF test can be used for screening in predisposed individuals after the dog reaches the age of six years⁶.

Cancers It Is Commonly Used For

Detection and diagnosis of transitional cell carcinoma (TCC), also known as urothelial carcinoma (UC).

How to Get the Best Results

Follow the veterinarian’s instructions for urine collection. As this is a free catch sample, the test is straightforward. The sample should be stored at room temperature out of direct sunlight¹. It is recommended that the sample be collected in a clean container and then poured into the sample container for storage within fifteen minutes, followed by a gentle swirl to mix with the preservative solution.

While large dogs may provide the 40 ml required for the test in a single sample, multiple samples may be required from small dogs and those can be collected over two to three days⁵. Note that it is highly recommended that this be done with free catch urine and not cystocentesis, which is urine collection performed in a veterinary clinic using a needle inserted through the bladder wall. Cystocentesis will not provide as good a chance of catching the cancer cells and risks spreading cancer cells to new tissue if inserted through a tumor. Smaller volumes of sample are workable, but higher volumes increase chances of detection⁵.

Home Care

No specific home care needs to be done during the urine collection process.

Follow Up

There is no follow up care from the test itself, however there may be additional testing or treatment recommendations made based on the test result. While 85% of TCC are positive for the BRAF mutation, that leaves 15% that might go undetected by this test. Therefore, if the test is negative for BRAF but TCC is still suspected, your veterinarian may suggest that you follow up with the BRAF PLUS test, which can detect other common changes in cells that are associated with TCC. The BRAF PLUS test detects DNA changes in dogs with clinical signs of TCC that are not positive for the BRAF mutation⁹. Typically, this can be done on the same urine sample.

When to Not Use the Cadet BRAF Urine Test

This test is specific for TCC and will not be useful for any other cancer type.

Where to Get This Test

Your veterinarian can provide the laboratory test kit with instructions. The sample will be sent to a lab in the U.S. for testing.

Safety and Side Effects

There are no safety concerns or side effects for this test.

Cost

The exact cost of the Cadet BRAF test will vary depending on your location and the individual veterinary facility. Many charge approximately $400.