Recurrent pyuria is associated with shorter progression-free survival in dogs with bladder urothelial carcinoma.

Recurrent pyuria (≥3 episodes) is an independent negative prognostic factor for progression-free survival in dogs with bladder urothelial carcinoma.

This retrospective cohort study evaluated the prognostic significance of pyuria in 51 dogs diagnosed with bladder urothelial carcinoma (UC) between 2010 and 2025. Pyuria was defined as ≥5 white blood cells per high-power field on urine sediment examination. Dogs were stratified by pyuria frequency (0, 1–2, or ≥3 episodes) and tumor size (<3 cm or ≥3 cm). Progression-free survival (PFS) and overall survival (OS) were assessed using Kaplan-Meier curves, log-rank tests, and Cox proportional hazards models. Dogs experiencing ≥3 pyuria episodes demonstrated significantly shorter median PFS compared to the nonpyuria group (175 vs. 365 days). This association persisted in multivariable analysis after controlling for total number of urinalyses performed, with ≥3 pyuria episodes identified as an independent negative prognostic factor (HR 3.57; 95% CI, 1.27–10.04). Dogs exhibiting pyuria at initial diagnosis also had shorter median OS than those without pyuria (353 vs. 531 days). Dogs with both initial pyuria and frequent recurrent pyuria (≥3 episodes) during treatment showed the poorest PFS outcomes. The 1–2 episode group did not differ significantly from the nonpyuria cohort. These findings parallel observations in human urothelial carcinoma literature and suggest that recurrent pyuria may serve as a readily accessible, non-invasive marker of disease progression in canine UC, potentially guiding monitoring frequency and treatment decisions in clinical practice.

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