Archive for the ‘Pain Management’ Category

Great News on the Canine Cancer Front

Sunday, November 17th, 2013

In honor of November’s National Pet Cancer Awareness Month I would like to share some “hot off the press” wonderfully optimistic news with you. Dr. Nicola Mason from the University of Pennsylvania School of Veterinary Medicine has been researching a new way to treat osteosarcoma, an aggressive and fatal form of bone cancer that has an affinity for growing within the leg bones of large and giant- breed dogs.

Until now, treatment of osteosarcoma has consisted primarily of amputation (removal) of the affected leg with or without chemotherapy. In spite of such aggressive treatment, inevitably tiny clusters of cancer cells eventually grow into metastatic tumors that ultimately become life-ending. Approximately 60% of dogs die within one year of the diagnosis.

A new approach

Dr. Mason’s innovative approach to treating dogs with osteosarcoma involves “cancer immunotherapy” in which the patient’s own immune system is triggered to target and kill tumor cells. In order to use a dog’s immune system to treat osteosarcoma Dr. Mason devised a vaccine consisting of bacteria that have been modified to express a protein called Her2/neu. This protein is known as a “growth factor receptor” and is found on a variety of different cancer cells, including some canine osteosarcoma cells. You may have heard of Her2/neu before because it is commonly associated with breast cancer cells in women. The concept behind the vaccine is as follows: The bacteria stimulates the dog’s “immune system soldiers” to seek out and destroy the bacteria along with cells that express Her2/neu (osteosarcoma cells).

Outcomes to date

Thus far, Dr. Mason has treated 12 dogs with osteosarcoma following amputation and chemotherapy. The dogs received the vaccine once weekly for three weeks. Side effects of the vaccine were minimal. All that was observed was a mild, brief fever following vaccine administration.

The preliminary results have been immensely encouraging. The first vaccinated dog, Sasha has a survival time of 570 days thus far. Two other dogs vaccinated at the beginning of the study are alive and cancer free more than 500 days post diagnosis. Other dogs who were vaccinated more recently are still doing well. These are truly fantastic results.

What comes next?

Some dogs with osteosarcoma are not good candidates for amputation primarily because of neurological or musculoskeletal issues in their other limbs. Treatment options for these dogs are aimed at reducing the pain associated with the tumor. Dr. Mason plans to begin including some of these nonsurgical candidates in her osteosarcoma vaccine study.

Additionally, Dr. Mason is contemplating learning if what she has developed would be an effective means for prevention of osteosarcoma. Certain breeds (Rottweilers, Irish Wolfhounds, Great Danes, Saint Bernards, Doberman Pinschers, and Greyhounds, to name a few) are particularly predisposed to osteosarcoma. It will be fascinating to learn if the osteosarcoma vaccine will effectively prevent this horrific disease in high-risk individuals.

The research results gathered thus far represent a monumental success in cancer treatment and provide significant hope for a disease previously associated with a grim prognosis. Kudos to Dr. Mason for her stunning work! If your dog has osteosarcoma and you are interested in participating in Dr. Mason’s studies, contact her at 215-898-3996 or by e-mail at nmason@vet.upenn.edu.

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.

 

 

Hospice Care for Pets

Sunday, July 8th, 2012

Photo Credit: © Tonya Perme

Over the years I’ve counseled many thousands of clients as they’ve struggled with end-of-life decision making for their pets. For many of those years, clients who expressed opposition to humane euthanasia for moral, philosophical, emotional, or religious reasons created quite a conundrum for me: my professional obligation to ease patient suffering seemed incompatible with their convictions. Fortunately, over time, I’ve become wiser, and have embraced the means to reconcile what is best for the patient when euthanasia doesn’t feel like the best or the right choice. The resolution for this moral/ethical dilemma is hospice care, also referred to as palliative care. In fact, nowadays, I discuss both hospice care and euthanasia as reasonable options whenever helping a client figure out what makes the most sense when their beloved pet’s life draws to an end.

Just as in human medicine, veterinary hospice care is selected for patients with terminal illness. And just as in human medicine, veterinary hospice care emphasizes physical and psychological comfort for the patient along with emotional support for the family caring for their loved one.

The venue for veterinary hospice is within the home with family members and friends providing the bulk of care. Typical tasks include turning from side to side, assistance with urination and bowel movements, carrying, frequent bathing, preparation of special diets, and administration of medications and supplemental fluids. Hospice can be a monumental task as round-the clock care is usually necessary. And for larger immobile dogs, a team effort is necessary for lifting and moving, and to keep them clean and free of bed sores. Terminally ill pets are quite capable of “lingering” so it is not uncommon for hospice care to last for weeks or even months.

Health care professionals- veterinarians and veterinary technicians- pay visits as frequently as needed to ensure that that the patient is relaxed and pain free, provide moral support for family members, and coach care providers on various tasks including how best to recognize symptoms of pain and anxiety.

While providing hospice care can be emotionally and physically draining, it can be a richly rewarding endeavor, especially when pain and suffering are well managed. This period of “closure” can create precious memories that feed and nurture the soul, giving everyone involved the strength to withstand that final goodbye.

If you are interested in hospice care for your pet, be sure to spend some time selecting the veterinarian to guide you on your journey. He or she should be a super compassionate person with a large arsenal of pain management options and a willingness to come to your home as often as needed. Be aware that some hospice vets firmly believe in “until natural death do us part” whereas others support their client’s choice for euthanasia should it arise during the course of hospice care. When hiring a veterinarian to assist you with hospice care for your pet, be sure to sort this issue out in advance.

To learn more about hospice care for pets I encourage you to check out The Nikki Hospice Foundation. Their Third International Symposium on Veterinary Hospice Care will be held later this month (July 20-22) at the University of California, Davis. This is a conference geared for veterinarians and nonveterinarians alike. If you are interested in increasing your knowledge about hospice care for pets, this is the place to be!

Another awesome resource is the International Association of Animal Hospice and Palliative Care . Their annual conference will take place in Denver in early November. Can’t make it to Denver? Take advantage of the webinars offered by this terrific organization.

Have you ever been involved in hospice care for a pet? If so, I would love to hear your impressions.

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.

 

Pain Management 101

Friday, September 4th, 2009

My husband and I just returned from a wonderful stay at a dog-friendly campground. We encountered just about as many dogs as we did people! We made some new friends including Buddy, Sierra, Milo, Otis, Judd, Lexie, and Homer (please don’t ask me to recall the names of their humans). Our next-door neighbors were Milo and Otis, two middle-aged black Labradors. When these goofy brothers weren’t off on family hikes they spent their time meandering about with sticks in their mouths and checking our campsite in case we managed to “misplace” any food items. By day three, I observed them to be exploring less and lying around more. I also noticed that Milo was favoring a front leg and Otis was showing discomfort in his hind end. When I mentioned my observations to our neighbors (I cannot seem to keep my mouth shut in such situations), they told me that Milo and Otis both have arthritis and their stiffness and soreness was predictable in response to their increased activity level. They routinely gave them pain medication (the equivalent of aspirin or ibuprofen for us) as soon as arthritis symptoms became apparent. In fact, they had administered their first dosage that morning. These poor folks had no idea that such innocent comments would prompt a mini-lecture from the likes of me! Here is what I explained:

Whether for ourselves or for our pets, the ideal time to treat predictable pain is before it begins. Investigational studies have documented that pain can induce a “kindling effect”. In other words, low-grade pain has the potential to self-ignite into a flare-up of pain that is more severe, therefore more difficult to control with medication. Far better to take proactive measures (medication, acupuncture, rehabilitation therapy, glucosamine, chondroitin sulfate, etc.) before the onset of predictable or anticipated pain than it is to attempt to douse the discomfort once it has already “caught fire”. It’s also important to keep in mind that many dogs, particularly those with stoic demeanors, may not demonstrate any overt symptoms until their pain has progressed well beyond what would be considered mild.

I suspect that my new friends Milo and Otis will be far more comfortable on their future camping trips! I must confess here- I also counseled their humans on the benefits of weight loss (both dogs were chubby) as a means of benefiting their arthritis pain. Those poor people certainly got more than they bargained for! Does your dog predictably become stiff or sore following increased activity? If so, please share what you do to prevent the discomfort.

Now, here’s wishing you and your four-legged best friend good health! 

Dr. Nancy Kay
Specialist, American College of Veterinary Internal Medicine 

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. 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 is available at Amazon.com, local bookstores, or your favorite online book seller. 

Join our email list – http://speakingforspot.com/joinemaillist.html

Look for us on Twitter – http://twitter.com/speakingforspot

Become a Fan of Speaking for Spot on Facebook

Listen to Dr. Kay’s interview – A Veterinarian Advises “How to Speak for Spot” on NPR’s Fresh Air with Terry Gross