I spent New Year’s Eve at a friend’s house in sunny Sarasota.
A dinner guest arrived late, wearing her 4-pound dog around her neck like a fuzzy accessory. I don’t think the dog’s feet ever touch ground.
Five months ago, this adorable creature was diagnosed with lymphoma.
As if the owner had read the draft of this article, I listened as she described all the common fears and anxieties most pet owners feel when they hear the word “cancer,” followed by the word “chemotherapy.”
This owner ultimately could not live with the idea that her little Moonraker was not long for this world, and she decided to treat with chemo. Now, after five months of treatment, Moon is still doing great, has never had a bad day with her chemo, has a good appetite and yapped continuously during New Year’s Eve dinner because she wasn’t the sole center of attention.
The guests loved Moonraker but enjoyed human interaction as well. The host dog, Benjamin, also found Moonraker to be a bit of an attention hound. Come on, Benjamin, give the cancer patient a break. Oh, and I was summarily corrected by the owner when I addressed the sweet pup as Moon.
“She only responds to ‘Moonraker.'”
I apologized for possibly offending the pup and the owner. Moonraker adjusted her rhinestone necklace. The owner continued to fondle the dog instead of eating her dinner. Apparently, my slight was not too severe and they both shook off my faux pas.
The “C” Words
So, what if your vet comes back into the exam room, after looking at an X-ray or an ultrasound, and utters the dreaded sentence, “I think Mariah has cancer”?
Many pet owners, like Moonraker’s devoted owner, are devastated and rightfully so. But just as in human medicine, there have been great advances in treating cancer in pets in the past 10 years.
Although we may not be able to “cure” the cancer, it is possible that surgery, chemotherapy or radiation — or some combination of the three — can give your pet a great quality of life for many months or years to come. Most cancers can go into remission. Some forms of cancer are, indeed, curable.
The most dreaded word after cancer? For many, it’s chemotherapy. Many pet owners’ initial reaction to the suggestion of chemo is negative. “I couldn’t put her through that.” “I watched my mother die of cancer.” “It’s not fair.”
But look at the alternative. In many of these cases, if you choose to do nothing, your pet may be gone in a very short time.
“But I don’t want her to suffer,” my client says.
“Neither do I,” I reply.
If my clients’ pet has a kind of cancer that has a good chance of responding to treatment, I ask them to hear me out before they put both of their pets’ feet in the grave. My aim is to keep those feet hopping, all four, on earth, for some quality time.
What Exactly Is Chemotherapy?
Chemotherapy is the name given to the drugs used to fight cancer, the scheduling of when to give those drugs, and in what combination. This is called a chemotherapy protocol.
In human medicine, cancer treatment is often aimed at trying to achieve a cure. But even with humans, if the treatment is too hash or the particular patient too frail, there are alternatives, like palliative care. Palliative care can mean slowing down the progression of the cancer, and trying to achieve a good quality of life during that time.
With animals, although cure is sometimes achieved, our aim is to palliate the cancer and not make the animal suffer consequences of harsh treatments. Palliation means relieving the symptoms and reducing the suffering caused by the disease.
“But the side effects are worse than the cancer, Doc.”
This is not modern thinking. In veterinary medicine, we choose drugs and schedules aimed at causing little or no side effects.
If your pet has a bad reaction and does not tolerate the chemo, we can always stop, change drugs, lower the dose or change the schedule. Once you begin a chemo protocol, nothing says you have to continue. Owners have to have an active role in all decisions, ask questions, and consider pros and cons.
“She’ll lose her hair and be nauseous.”
This is not true. The drugs chosen by veterinarians do not make the fur fall out. Breeds that do not “shed,” such as poodles, may experience a thinner hair coat, but they do not go bald.
Some pets may experience mild GI signs from chemotherapy drugs. A few will get very sick. If your pet’s reaction is severe, then the drug never has to be used again. Most pets feel better in a day or two, experiencing mild anorexia or nausea. Occasionally, they need to come into the hospital and be hydrated and medicated.
“I can’t afford that!”
It is true that treating some cancers can be very expensive, particularly at a referral center. Talk about this with your veterinarian. Some chemo protocols are less expensive than others and can work very well. If your veterinarian is not comfortable administering chemotherapy, check out other hospitals that have a veterinarian interested in oncology.
And remember: The costs are spread out over many months. This is often an easier financial burden than when you are socked with a big bill all at once.
Lymphoma (lymphosarcoma) is one of the most common forms of cancer in dogs and cats, and also the most responsive to chemotherapy alone. There are numerous protocols and schedules available, based on factors such as cost, degree of side effects and visits to the vet.
Before you make up your mind not to treat, get all the information. You might be happily surprised.
Chemo in Conjunction With Surgery
Skin tumors, growths on the body arising from muscle, and mammary tumors (breast cancer) are common forms of cancer in cats and dogs.
The first line of treatment for these tumors is to surgically remove them. After surgery, chemotherapy can be used to prevent the tumor from returning, spreading (metastasis) or slowing this progression. Again, based on the kind of tumor your pet has, which you will know from the biopsy results, your veterinarian can offer you treatment options.
If there is a low risk the tumor may return, you might take an “active surveillance” approach. This means monitoring your pet very closely for any recurrence. This is analogous to very low-grade prostate cancer in men where surgery may not be warranted.
If there is evidence the tumor is aggressive, or is “metastatic,” meaning it is already in the lymph nodes, chemotherapy and/or radiation is recommended.
Information on cancer in pets is always changing and improving. Veterinarians may have very different approaches and experience treating cancer. If you are confused or just need more information, this is a good time to seek a second opinion, either from a board-certified veterinary oncologist or from a local veterinarian who has a special interest and experience in treating cancer.
Although I hope you never hear the bad news that your pet is afflicted, the good news is that cancer treatment is improving by leaps and bounds every day.
This pet health content was written by a veterinarian.