Bladder Cancer in Dogs

My English Setter, Ella, has been experiencing urgency and frequency in her urination patterns.  It was noticeable, then tapered, to somewhat normal, then back to noticeable.  I took her to the vet.  They took urine samples.  Lots of red/white blood cells; no bacteria.  It is possible that the abundance of the red/white blood cells occulted the bacteria, so she was placed on a course of antibiotics for 14 days.

The antibiotics have not helped the urgency/frequency.  She went back yesterday to see if they can grow a culture in her urine sample.  If not, then this means that she likely has bladder cancer.  While the incidence rate is reportedly low (2% of all cancers), this will mark my second English Setter with the disease.  English Setters are not a high risk breed, and I don't engage in any of the high risk environmental factors (herbicide/insecticide use) in my home. Further, I limit the use of insecticides (flea/tick control) on my dogs. 

While there are treatments for bladder cancer (surgery/drugs), none with much efficacy that gives a dog much more than 6 months to live.  Ella is 13-14 years old.  She is still active and happy, but f/u of urination a problem.  It is also hard to know how much discomfort a dog is in given their high tolerances for pain. 

Greta, a prior English Setter, had inoperable bladder cancer.  Her pain level could not be effectively controlled, and I made the decision to euthanize her, sparing her further discomfort.  That decision is likely in my future with my beloved Ella.  She has been one of the sweetest dogs I have ever owned.

As Ella's med treatment did not abate her symptoms, I'm not hopeful.  I've been lucky that my dogs have been able to lead a full and happy life. But the end times are hard to part with a devoted friend.