Oftentimes, it’s easier being on “this side” of the examination table as a small animal veterinarian.  Yes, it’s true that I have the unique opportunity to see a vast array of different breeds of different ages, all of which are coming from different backgrounds and lifestyles.  But, the commonality that they all possess is that they belong to families who care about their health and well-being.  Why else would people be spending the time to bring their dogs in to see me?

Because of the strength of the human-animal bond, it’s fairly easy to make recommendations about preventative care: vaccinations, year-round heartworm prevention, routine blood work, year-round flea and tick prevention, annual physical exams, etc.  People want to make sure that their dogs remain as healthy as possible.  Even with fairly common chronic illnesses, such as diabetes, hypothyroidism, and osteoarthritis, dog owners are usually “gung-ho” about instituting treatment, as long as they understand what that treatment entails and as long as the treatment falls within their financial capabilities.

What becomes exceedingly more difficult is trying to have a conversation about canine cancer.  It almost always represents the elephant in the room, the “c” word, a topic that no one wants to talk about.  Who really would?

Broaching the subject of canine cancer is always a little bit difficult.  No one wants to hear that their dog has cancer.  I have had much easier conversations with people about treating canine diabetes (which is always a lifelong, expensive commitment) than I have had about canine cancer.  The stigma alone that surrounds canine cancer is pretty profound.  It oftentimes equates with death in people’s minds.  Because of this thought process, I oftentimes may lose people completely when I start talking about treatment options.

While I respect pet owners’ ultimate decisions regarding treatment for their beloved companions with cancer, sometimes, I feel that those decisions are being made hastily without having all of the facts to begin with about canine cancer treatment.

If you are reading this blog, it’s likely that you have been touched by canine cancer in some way.  Perhaps, your own dog has cancer.  Perhaps, you have a family member or friend experiencing a cancer diagnosis with his/her dog.  Perhaps, you have a past history with canine cancer in your household.  Whatever the case may be, you are searching for more information about canine cancer, either in a general sense or in a purposeful sense (to gain more knowledge about a specific form of cancer).  To make your decision about canine cancer treatment a little bit easier, I would like to share with you some of the top misconceptions that pet owners generally have with regards to both canine cancer and its treatment.

Canine cancer equates to death!

Sometimes, when an owner is made aware that his/her dog has cancer, the only thing that he/she can think about is the possibility of that beloved companion dying.  Cancer as a whole has been designated such a horrific disease in the human world – and rightly so – that many pet owners, in their minds, equate cancer with a death sentence.  While there are many forms of canine cancer that almost always ultimately lead to their deaths – lymphoma, hemangiosarcoma, and osteosarcoma, for example – dogs may be diagnosed with cancer that is potentially curable with appropriate treatment – low-grade mast cell tumors and soft tissue sarcomas, for example.

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Certain types of skin and subcutaneous tumors (and even certain types of mammary tumors) may be curable with surgery alone!  If surgery alone isn’t curative, chemotherapy and/or radiation therapy may be able to keep your dog’s cancer in check for a period of time.

For those types of cancers that do not have a known cure, treatment (in the form of surgery, chemotherapy, radiation therapy, homeopathy, etc.) may delay illness for a period of time (depending upon the type of cancer diagnosed).

It is rarely the case that a cancer diagnosis (especially if made early on in the course of the disease) leads directly to the death of a dog without any treatment option being available to improve that dog’s quality of life.

My dog will be sick all the time if I choose to treat him/her!

Many people, when faced with a cancer diagnosis in their dogs, tend to visualize a forlorn, vomiting, bald dog hooked up to IV lines when he/she is receiving chemotherapy.  Most of us unfortunately know other people who have experienced significant side effects secondary to their cancer treatments.

While it is possible for dogs to experience side effects from cancer treatment, these side effects do not typically occur as frequently or with the same intensity as they do in humans.

In order to dispel the fear that our dogs will be too sick while undergoing cancer treatment to enjoy their lives, we must first understand what side effects they may encounter to begin with.  This highly depends on what type of cancer your dog has and what treatment options are available for that particular type of cancer.

For cancer whose main form of treatment involves surgery (for example, a low-grade soft tissue sarcoma), the most common “side effects” that a dog may experience include: pain after surgery, poor incisional healing (secondary to infection or reduced tissue integrity), bleeding issues, and problems associated with anesthetic recovery.

  • Post-operative pain can be alleviated by appropriate pain and anti-inflammatory medications.
  • Poor incisional healing is fairly rare but can occur, especially if the tumor being removed is quite large.
  • The risk of poor anesthetic recovery is higher for older and more sickly patients. However, appropriate pre-anesthetic diagnostic tests (such as bloodwork, urinalyses, and chest x-rays) may help to reduce this risk by guiding the veterinary team to pick the safest anesthetic drug protocol for your dog.

For cancer whose main form of treatment involves chemotherapy (for example, multicentric lymphoma), the most common “side effects” that a dog may experience include: inappetence, lethargy, vomiting, diarrhea, and neutropenia (low white blood cell count).

  • The scenario of a vomiting, lethargic, dehydrated dog spending days in the hospital away from home is what most people fearfully conjure up in their minds when they hear that the best treatment option for their dog is chemotherapy.
  • In actuality, 80% of dogs develop no side effects from receiving chemotherapy!
    • Of those 20% that do develop side effects, most have mild side effects that they get over on their own. Less than 5% actually need to be hospitalized secondary to severe side effects.
      • Most hospitalized dogs are dehydrated and neutropenic (have a low white blood cell count). Once they are treated for both of these things, most dogs recover within 1-2 days.
    • Anti-nausea medications, anti-diarrhea medications, antibiotics, and appetite stimulants are all used to combat these side effects. Sometimes, these drugs are used pre-emptively to reduce the chance that these side effects will even occur at all.
  • While we would absolutely love to cure cancer in dogs with chemotherapy, that is rarely the ultimate goal. We strive to greatly improve a dog’s quality of life for as long as possible by keeping the cancer in remission or at bay for as long as possible.  Thus, smaller doses of chemotherapy are used in veterinary medicine as compared to human medicine.  This is, in part, why dogs experience less side effects from chemotherapy than people do.

And, for cancer whose main form of treatment involves radiation therapy (for example, certain types of nasal tumors), the most common early-onset “side effects” that a dog may experience (depending on location of the treatment) include: hair loss, skin ulceration, sores in the mouth, corneal irritation/ulcers, and problems associated with anesthetic recovery.  Late-onset “side effects” (that a dog may experience anywhere from 1 month to 2 years after radiation therapy) depend upon what part of the body has been treated but may include bone/ligament damage, nerve/spinal cord damage, blindness, kidney injury, or the development of another form of cancer.

  • Approximately 80% of dogs will experience some type of early-onset side effect from radiation therapy.
    • Lubricating/soothing ointments are used to reduce the discomfort associated with these radiation therapy side effects.
  • Approximately 5% of dogs will experience some type of late-onset side effect from radiation therapy.

My dog is too old to be treated!

Age itself is not a disease.  Many senior dogs, if their screening tests (bloodwork, urinalysis, chest x-rays, abdominal ultrasound, etc.) look good, will tolerate cancer treatment very well!

Treating my dog will be too expensive!

It is very true that cancer treatment, depending on what is involved, can be quite expensive.  While removal of a low-grade mast cell tumor from your dog may incur on average $500-1,000 (depending on pre-surgical testing and the cost of the surgery itself), treatment of multicentric lymphoma may incur on average $5,000-10,000.

It is important to realize that certain types of canine cancers (such as lymphoma) have a variety of treatment options to choose from.  Yes, they will have varying degrees of effectiveness, but usually there is at least one form of treatment that is affordable for the pet owner.

There are also many organizations dedicated to assisting families financially with cancer treatments for their pets.  Most of them have an application process and guidelines on how families are chosen to receive financial assistance.

There are even specific pet insurance companies that cover medical expenses associated with canine cancer.

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Since the tumor isn’t growing, I am going to wait on treatment for now!

While taking the “wait and see” approach is always an option, it is typically not recommended when dealing with a known cancerous tumor.  We do not have a crystal ball that tells us if and when that cancerous tumor is going to grow and how big it eventually is going to get.  A cancerous tumor may remain the same size for years and then begin growing rapidly, or it may grow rapidly right from the time of diagnosis.  If it is possible to remove the cancerous tumor before it rapidly grows, the more successful the outcome will likely be.  A pea-sized, cancerous tumor is usually much easier to remove than a lemon-sized, cancerous tumor!

Ultimately, it is your decision on whether or not to have your dog undergo cancer treatment, whether that may be surgery, chemotherapy, radiation therapy, or a combination thereof.  There is no wrong decision when it comes to cancer.  Cancer, oftentimes, is unpredictable.  It may not always “play by the rules.”  Average survival times are just that – an average.  It’s definitely okay to say no to treatment.  But, veterinarians want to make sure that you are saying no for the right reasons and not because you are worried about the misconceptions that were just mentioned above.  Do not be afraid to ask your veterinarian questions before you make a decision.  That is what he/she is there for . . . to help you make an educated decision that will lead to the best quality of life for both your dog and for you.

References:

“Chemotherapy Myths and Misconceptions” – VLOG 42 – YouTube – Dr Sue Cancer Vet

Dressler, D. – The Dog Cancer Survival Guide – Pages 111-143; 2011

Other Articles of Interest:

Intestinal Tumors

10 Warning Signs of Cancer in Dogs

Common Chemotherapy Side Effects