Cancer Therapy: Is it the Right Choice for Your Pet?

Last week, in honor of Pet Cancer Awareness Month, I provided some pointers for constructively dealing with the diagnosis of cancer. This week I will deliver information about the treatment of cancer and tips for determining if a pet is a good candidate for such therapy.

Treatment Options

The three most common treatment methods used to treat animals with cancer are surgery, chemotherapy, and radiation therapy. Often only one type of therapy is needed to effectively treat the cancer. For example, a small solitary mass might be cured with surgery alone. Not uncommonly, a combination of treatments is most beneficial. Chemotherapy or radiation therapy may be recommended as an adjunct to surgery to destroy any cells that may have spread outside of the surgical incision.

Whether or not various complementary/alternative therapies such as Chinese herbs, homeopathy, or acupuncture are capable of chasing away cancer cells is controversial. Most veterinarians agree that what they do best is help support the patient’s overall health and mitigate any side effects of cancer therapy.

How does your veterinarian know which treatment plan is the best choice for your dog or cat? First, she needs to know which type of cancer she is dealing with. This is accomplished by evaluating a sample of the abnormal cells under a microscope. An experienced pathologist at a commercial veterinary laboratory typically performs this testing. Additionally, determining the stage or grade of the disease (how aggressive and widespread the cancer is) via blood and urine testing and imaging studies allows your vet to know which treatment makes the most sense.

Making the Choice for Your Pet

Diagnosing and staging the cancer is typically the straightforward part. Determining whether or not to treat one’s four-legged family member is often the more challenging piece of the puzzle. If ever you find yourself squaring off with this decision, strongly consider consultation with a veterinarian who specializes in cancer therapy (a board certified oncologist or internist). In no way does such a consultation obligate you to proceed with treatment. Rather, it is an opportunity to gather a bunch of useful information that will assist you in your decision-making process.

Now, here are some important thoughts and questions to consider when the diagnosis is cancer:

Is your pet’s personality well suited to the recommended therapy?

If your dog or cat is a pushover for anyone and everyone who provides an ear scratch and a treat, he may relish weekly chemotherapy appointments. On the other hand, if he turns into a quivering quaking emotional wreck as soon as you turn into the vet clinic parking lot, perhaps he’d be better suited to a chemotherapy protocol that involves appointments spaced farther apart. You may not really know how your dog or cat will respond emotionally until you’ve made the first few visits.

Is your own schedule flexible enough?

Many chemotherapy protocols initially involve once-weekly visits. Rarely are evening or weekend appointments available. If radiation therapy has been recommended, you may need to drive a consider-able distance to a treatment facility. Radiation therapy is typically administered daily, Monday through Friday for three or more consecutive weeks. Many radiation facilities offer the option of boarding their patients during the workweek and then sending them home for weekends.

Is it financially feasible to proceed?

Combination chemotherapy protocols, radiation therapy, and many surgical procedures are “big-ticket” items. Remember, some chemotherapy is almost always better than no chemotherapy. Don’t by shy about discussing your budget. Your veterinarian can use this information to create a treatment protocol for your pet that provides “the most bang for the buck.”

Is treating your pet’s cancer reasonable for you from an emotional point of view?

For those who have experienced the ravages of cancer therapy either for themselves or a loved one, it may be impossible to consider such treatment for a family pet, no matter what reassurances are provided. And that’s perfectly okay. Remember, whether or not to treat your pet’s cancer is always a truly personal choice.

You can call it quits at any time!

When you say, “Yes” to chemotherapy or radiation therapy, all you are really committing to is the very next treatment. If ever you don’t like what you see you can call it quits. Sometimes, simply knowing that this “out clause” exists gives people the wherewithal to give cancer therapy a try.

Focus on the quality rather than the quantity of life.

When I counsel people about the potential pros and cons of cancer treatment, I describe the three goals of therapy as, “Quality of life, quality of life, and quality of life.” There’s no doubt in my mind that we fail our patients miserably when we achieve “quantity” (longer life) only.

Enjoy the “honeymoon.” 

Even when a fabulous response to therapy is achieved, it’s difficult for some people to enjoy this time because their minds are so preoccupied with the underlying diagnosis. Keep in mind that those happy, playful, loving pets of ours don’t simply vanish because they have cancer. Even with their disease, they are wonderfully adept at “living in the moment.” When an animal undergoing cancer therapy behaves in a glum fashion, it’s important to consider that they may be responding to the way their favorite human is feeling. If you opt to treat your pet’s cancer, be prepared to enjoy the honeymoon!

Have you ever said, “Yes” to cancer therapy for one of your pets? If so, were you ultimately glad you did so?

 

Best wishes,

Nancy Kay, DVM

Diplomate, American College of Veterinary Internal Medicine
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Author of Your Dog’s Best Health: A Dozen Reasonable Things to Expect From Your Vet
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot and Your Dog’s Best Health.   There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot and Your Dog’s Best Health are available at www.speakingforspot.com, Amazon.com, local bookstores, and your favorite online book seller.

 

 

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11 Comments on “Cancer Therapy: Is it the Right Choice for Your Pet?

  1. Shorty was diagnosed with lymphoma high grade in his colon/rectum. Upon attempting to get a sample his colon disintergrated & was rushed into surgery to save his life.
    This was touch & go for almost a month. He then was given a choice of treatments do nothing & he’d live maybe 6 months, take prednisolone alone & have maybe a year, go with wisconson protocol & preds & do 1 year straight with a chance after 10 months the lymphoma may return.
    I should add his surgeon was exceptional he got all of the mass & surrounding tissues were found to be clean & free of cancer.
    My baby made it through his 1 year chemo protocol with flying colors he had very little to no side effects [ 1 seemed to make his bowels sluggish & 1 gave him soft stools.
    My baby made it through the therapy & a year and 1/2 after therapy.
    He did pass away thanksgiving morning [I am still grieving] I still don’t feel the cancer came back because his ultrasounds were always clear of masses.
    But I wanted to let others know I had another cat Danny diagnosed with lymphoma but his was not operated on & he did not respond to chemo as vets had hoped he would. He died 3 months after being diagnosed

    I think each animal like people respond differently I have told people to think over their decision it is a lot of taking care of them that is involved.

    Shorty was 12 1/2 when he was diagnosed & died just turning 15. Danny was 15 yrs old at time of diagnosis.

    I hate cancer I wish there was a cure

  2. I’m dealing with nasal lymphoma in a 15.5 yr old cat. All of my cats seem to live a long time so the age is not the issue. 2 sets of bloodwork within 2 months show she’s in good shape. After dealing with what looked like a horrible infection for a couple of months with lots of noisy breathing (several changes in antibiotics, nasal wash with C & S (Pasteurella), 2 sets of X-rays), I decided I had to do more diagnostics because she wasn’t near quitting. 1200 bucks later (after already spending over a thousand) a rhinoscopy in a specialty clinic showed lymphoma. Official biopsy finally came back, backing up quick slide diagnosis by vet surgeon. I was given 4 options – radiation and chemo (2-2.5 yrs) at a cost of 6-8 thou, Madison chemo protocol (12-18 months) 4 thou, oral meds (4-6 months), prednisolone plus Lomustine or chlorambucil, don’t know cost, or Prednisolone alone (2 months). He told me lymphoma was weird and could disappear after one chemo treatment. Geez, how could I not do it then? I talked to the vet who discharged me after rhinoscopy when the biopsy came in and I repeated that statement to her. She said, yes, you can get remission with one treatment, but you have to keep giving chemo to keep her in remission. Oh. A bit of truth is always welcome. Grrrrr. She also told me that in reading studies (who can get full text studies from the vet world w/o forking over 30 bucks a pop?), one has to be careful – that time from diagnosis to death is different than time from appearance of first problem and death. An article in an Irish vet journal had a more realistic range of survival times. And 2.5 yrs was not mentioned. I think it was more like a yr. plus. She first started sniffling, sneezing in mid-Jan, so I think she’s done pretty well to get this far. On top of that my cat was getting so sick of being pestered she wouldn’t even want to be in the same room with me. What kind of life is that? You can rapidly push a cat over into the “I ain’t staying here, I don’t care what you say!” frame of mind. Since this is one of my cats raised by a feral mother (who left the planet a month ago at an estimated age of 17-18), it’s always been a problem picking her up off the floor. I’m reduced to pouncing on her wherever she’s resting, which makes her paranoid. Don’t blame her, but I have to get daily meds into her. Still, she’s not ready to quit. So I think I’ll try the chlorambucil and pred. Best case scenario is to try something more heavy duty like radiation/chemo combo for a few treatments to get the lymphoma on the run, then switch to oral meds. BUT, that would require CAT scans I’m sure (which so far I’ve refused), which are a thou a pop. (Recently I read a report which showed average cost of CAT scan in US is $1,400 and in Canada $124 – but doubt I could get my cat on national health insurance plan!) Anyway, read an ancient study (1971) which did in vitro tests with cancer cells and chlorambucil to see if they were susceptible. I doubt there’s any viable cells left from the biopsy. Too bad. Of course they’ll think I’m nuts even mentioning this, but doesn’t that make sense, to see if this drug (which is a relative of mustard gas and has to be handled with gloves) would actually work in this case? Lomustine is much harsher on the body – can cause liver issues, so it’s considered a rescue treatment. Really aren’t they all rescue treatments? MEanwhile, since the vet whose case this is has been on vacation all week, I’m still waiting to talk to him, which should be today. I tried to pry some answers out of the other vet, but she deferred to him. Bah. I could have had a consult and gotten meds by midweek and we’re still waiting.

  3. I opted to treat a dog I rescued witha new form of chemotherapy, a humanized DNA vaccine (Oncept) for lingual malignant melanoma. It was prohibitively expensive… but there were zero side effects and the literature indicated it could offerup to two years of healthy living. I read all the scientific literature I could find and based my decision on this. I have no idea how long my dear Cheech had the cancer as we had just rescued him two weeks before we recieved the diagnosis. We had agreed to be foster parents but when my vet told me it was melanoma, I knew no one would pay for this new treatment so we kept him. The total coast between two surgeries and all the chemo was baout $8K. I sold my beloved classic motorcycle and racked up my Care Credit card. And it was worth every penny. We got siz beautiful months with our boy before it spead to his lungs and hewasn’t able to breath when he layed down. We were hoping to be the lucky ones who got two years but without this drug he would have only had 1-3 motnhs. He was happy and healthy up unitl the last two weeks, when he took a turn for the worse. He was only six years old, a chow corgi mix.. he touched me like no other dog, even though we only had six short months, his death shook me to the core. He was a very special dog and I am so thankful to my wonderful vet for informing me of this new treatment and my wonderful oncologist for taking such good care of him. He had been abused when we took him, didn’t know how to play or what a doggie bed was. But by two months he was playing and nesting in a bed fit for a king. He was sweet, laid back and always calm…. the perfect dog… we had six months of pure joy…

  4. MyTibetan Terrier had stage two cancer. We live in El Paso and took him to Tucson to a board certified oncologist after he had surgery to remove the tumor. He received radiation for two weeks and returned to us a cancer survivor. He lived another five years happy and healthy. It was wildly expensive and worth every penny. It’s not always the right decision, and then I knew nothing about cancer but we had very good advice from several veterinarians. His breeder asked me not to put him through anything he really couldn’t understand and I promised her that I wouldn’t. Oncology has come a long way and even further since his treatment.

  5. Yes, my amazing Border Collie, Molly! She was diagnosed by you, Nancy on 3/11/10 with Transitional Cell Carcinoma (TCC – Bladder Cancer) at the age of 10 1/2 years old. She beat many odds and fought hard right up until the end. Over the course of nearly 3 years, she had 6 different chemotherapy drugs, fought off pneumonia, had a urethral stent placed when the tumor blocked her ability to urinate. During it all, I don’t think she had more than 7 bad days, I don’t think I can say that about me! She played Frisbee, did Agility, and played with her Jolly Ball.

    The cancer never metastasized. The tumor responded well to treatments for a period of time with the mass reducing in size, then the cancer would get “smart” and we would change drugs. During the last 6 months she had no chemo as we had used all the drugs known to work on TCC, and a couple of others. We instead pursued alternative therapies including acupuncture and homeopathy. The tumor was static during that last 6 months. At the end the tumor started slowly bleeding and we were unable to stop it. After trying everything we could during that last 2 weeks, including a transfusion to buy time to give the meds a chance to work. Molly passed peacefully and with dignity, head in my lap, eyes connected to mine, surrounded by love on 2/26/13, just 2 weeks shy of the 3 year mark since diagnosis.

    I went into debt on 4 different credit cards and will be paying them off for a while, but she was worth every penny, and I would do it all again! She was, and will always be, my heart dog. I miss her terribly every singe day.

  6. Just wanted to say that as terrible as chemo is for human beings, it was a walk in the park for my dog, Bonnie Mabel. She spent 2.5 years taking chemo pills regularly, with very occasional visits to UC Davis Vet Med. She had chronic leukemia and the chemo allowed her to live years longer than she would have.

    And these were high quality years. She was lively and happy and playful and could still jump over an 8 foot fence. Eventually, her leukemia turned into acute lymphoma and she was gone within two weeks, but she had a good, long run, entirely due to the chemo.

    It was not cheap, but it was not that expensive. Whatever your observations about human chemo, it is important to throw those out in terms of animal chemo.

  7. About the flexible schedule paragraph, one time I got my jury duty postponed because I had to take my cat every other Monday for her chemo treatments.

    About the honeymoon paragraph, I totally agree and a great example is in Dr. Allen Schoen’s book, “Kindred Spirits” with a chapter about a dog with an incurable cancer given weeks to live who lived over a year by his humans being loving, happy, and playful with him, not sad.

  8. You should also research whether or not the recommended treatment is typically effective for the type of cancer that your pet has. My dog had a rare form of cancer four years ago. He was only 4 years old at the time. (He survived Hurricane Katrina and who knows what he waded through or ate. He was not in good shape when rescuers found him.)

    After having an enormous tumor removed from his abdomen, his oncologist recommended chemotherapy. She told me my dog had only 6 months to live. I was shocked. Devastated. But I considered a lot of the things in this article. My dog didn’t enjoy going to the vet. It was stressful for him. He wouldn’t like going to the vet for IV chemo. There was a pill form, but he also didn’t like taking pills.

    His form of cancer was rare not only in dogs, but in humans, too. But, from what little (human) research I could find, I learned that chemo was not effective. This was the most important piece of information to me.

    I decided against chemo. If he only had six months to live, I wasn’t going to make him spend it forced to take pills or have IV treatments that he would hate. I especially wasn’t going to make him do that when the research said it probably would not benefit him.

    Instead, I spent those six months making sure that every single day was the best day of his life, however long that might be. That was what I could do for him. Six months later, he was still healthy. He recovered quickly from his surgery. He enjoyed extra trips to the park, extra treats, toys, and new, organic dog food.

    Last year, three years after his diagnosis and surgery, my dog was still healthy and going strong. He’d had follow-up abdominal ultrasounds every six months for those three years, and last spring he was officially cleared. No regrowth. I don’t know if my efforts to “green” his environment have directly contributed to that, but they couldn’t have hurt.

    He will turn 9 years old this August. My advice to other pet owners is to do the research, including looking at what happens with humans who have the same type of cancer. Then, be your pet’s advocate.

  9. We did opt to treat our 11 1/2 year old Rottweiler’s cancer that started in her spleen. First we removed the spleen and then the vet talked us in to chemotherapy. He said that dogs do not get sick like humans. Totally untrue. Our poor dog was weak and nauseated and vomited daily. The cancer which totally kept her from swallowing receded but she was exhausted and miserable. Then the vet admitted that she would have to stay on the treatment indefinitely. She was a proud, strong girl who never had accidents in the house or even vomited. She was humiliated by the vomiting. Her quality of life was zero. We took her back to the vet at the t ime her next chemo was scheduled and asked that she be put to sleep. We held her as the needle came and until the light left her eyes. We NEVER would do chemo again.

  10. We did opt to treat our 11 1/2 year old Rottweiler’s cancer that started in her spleen. First we removed the spleen and then the vet talked us in to chemotherapy. He said that dogs do not get sick like humans. Totally untrue. Our poor dog was weak and nauseated and vomited daily. The cancer which totally kept her from swallowing receded but she was exhausted and miserable. Then the vet admitted that she would have to stay on the treatment indefinitely. She was a proud, strong girl who never had accidents in the house or even vomited. She was humiliated by the vomiting. Her quality of life was zero. We took her back to the vet at the t ime her next chemo was scheduled and asked that she be put to sleep. We held her as the needle came and until the light left her eyes. We NEVER would do chemo again.Kimatic

  11. I started fostering after my neurotic dog died. She was my first dog and I was very overinvolved with her because she was so nutty. My vet found a lump on the roof of my first foster’s mouth while intubating her for something else. She biopsied it and it was squamous cell carcinoma. The rescue group agreed to try treatment since it was found so early. Unfortunately it was a part of the mouth that was inoperable, so we tried radiation. It didn’t even slow the tumor down so we quit after two treatments. She died exactly 4 months after I took her in, 2 months after the tumor was found. By then the tumor was so huge she couldn’t swallow even mashed up food. I’m very glad the group tried with her because I couldn’t have stood to lose her without trying. At the very least losing two dogs in five months was hard to bear.

    Then recently I took in a foster that had difficulty urinating, and it turned out to be transitional cell carcinoma. I had just come into some money so I decided to spend some on a trial treatment for her at Purdue. I had just lost my very very sweet cocker, the first dog I’d adopted after losing my other one. Again, I couldn’t give up. The Purdue Oncology department are staffed from top to bottom with absolute saints. I do believe the treatment bought Twiggy some time and the way they stayed on top of her UTIs (comes with the territory) brought her quite a bit of comfort too. I wound up losing her after only six months, but I was able to give her two families – my housefull of misfit dogs and the people at Purdue who loved her to bits. At the very end I had a moment of regret for letting them use her for study, but she was so happy even on her last day it didn’t faze me. I let them do a necropsy on her and cultivate some of her tumor cells for future study. Knowing those cells didn’t respond well to two very good chemo drugs made those cells all the more important, I hope. I don’t regret the experience at all and I hope that some of her cells and all of her ultrasound images and blood work results will live on forever and help other dogs (and maybe people) in the future.