What is cancer?
Cancer forms when a normal cell in the body loses the checks and balances that tell the cell when to divide. Cancerous cells divide faster and survive longer than normal cells, thus causing a tumor to form. Cancer cells then can detach from the main tumor, travel to another part of the body, and start to grow there, forming additional tumors. This process of cancer spread is called “metastasis.”
What is a veterinary oncologist?
Veterinary oncologists are veterinarians that have gone on to receive additional years of rigorous post-graduate training in the management of cancer after achieving the DVM degree. Veterinary oncologists also take a challenging board exam at the end of their training to complete their certification. Your veterinary oncologist will focus on the treatment of your pet’s cancer, and work together with your primary care veterinarian and with other specialists for the complete management of all your pets’ conditions.
How can cancer be treated?
There are a number of different types of cancer, each of which is treated somewhat differently. Furthermore, not every patient is the same and the treatment is tailored to the individual by your oncologist. Generally, there are five basic ways to attack cancer: surgery, radiation, chemotherapy, immunotherapy, and biologic response modification. Your oncologist will discuss with you which of these options should be considered to treat your pet’s cancer, and which specific procedures and medications are right for your pet.
What is tumor grade and tumor stage?
When cancer is diagnosed, additional tests are performed to grade and stage the cancer. This gives more information to your oncologist to allow the best treatment recommendations and make a more specific prognosis (probable outcome of the disease).
- Grading describes how abnormal the cancer cells look. Grading is done by a pathologist who examines tissue obtained by a biopsy. Grade is often associated with the behavior of the cancer and prognosis.
- Staging determines how far the cancer has spread within the body. Your oncologist will recommend a number of staging tests that are appropriate for your pet based on the type of cancer. Results of staging can affect prognosis and treatment choices as well as identify lesions to be monitored.
What is median survival time?
Your oncologist may give you a prognosis for your pet called a median survival time. A median survival time is the time point (for example, 1 year) at which half of the patients have passed away, and half are still living. These times are based on groups of animals with similar diagnoses and can be used to predict your pet’s likelihood of survival, however, it is impossible to give a specific prognosis for an individual animal as there is often a wide possible range around the median.
What does remission mean?
When cancer enters remission it means that we can no longer detect that cancer is present in the body. Unfortunately, remission sometimes does not mean “cure” (permanent eradication of the cancer).
Will my pet lose hair?
Generally hair loss is not a side effect for most dogs on chemotherapy. However, some breeds of dogs with continuously growing hair (e.g., poodles, Bichon Frises, Maltese, Old English sheepdogs, shih tzus, Lhasa apsos) may lose a significant portion of their hair. After chemotherapy it does regrow, although sometimes a slightly different color. Some dogs with “feathers” (e.g., golden retrievers) or “beards” (schnauzers, Scotties, Westies) will temporarily lose their feathers/beards.
Why does my pet need to have some fur shaved?
Generally, oncology patients need to have some fur shaved to help visualize the vein during blood draws, and to ensure the correct delivery of chemotherapy into the vein. Prior to an ultrasound, some fur may be shaved to allow good contact with the probe to get clearer images. Shaving is generally a cosmetic issue only and does not adversely affect your pet.
How will my pet’s life be affected by the cancer therapy?
Most patients continue to participate in all the same activities they did before the diagnosis and can lead their normal lifestyle. Veterinary cancer treatment protocols are designed to improve the quantity AND quality of life. Some pets do experience side effects during chemotherapy, but these are generally mild for most patients and can be managed at home. Unlike in humans, less than 5% of veterinary chemotherapy patients need to be hospitalized because of severe chemotherapy side effects. Fatalities from complications are rare. If a particular protocol is not well tolerated by your pet, we will discuss adjusting or changing the protocol to ensure your pet’s continued well-being.
Our goal is to make the chemotherapy visits to Pieper Veterinary as pleasant and positive an experience as possible. We are liberal with giving hugs and treats, so please let us know if your pet has any special dietary needs.
What are chemotherapy treatments like for my pet?
Most chemotherapy drugs are given by intravenous injection. Some injections are very quick, while others are infused over several hours. To ensure safe delivery of the chemotherapy drugs into the vein, a catheter is placed at each treatment. Your pet is gently restrained during the injection on comfortable cushioning by trained personnel in a quiet setting separate from the activity of the hospital. Restraint helps to minimize movement that could cause drug leakage and result in skin damage. Most pets take to the injections well. If your pet is anxious or struggles, we will talk to you about administering light sedation to reduce your pet’s stress.
Some chemotherapy drugs cause nausea and vomiting during administration. When these drugs are used, we always administer an anti-nausea medication ahead of time so that your pet does not feel sick. We recommend fasting prior to all chemotherapy appointments to reduce the risk of aspiration pneumonia if vomiting does occur.
Some owners request to be present during chemotherapy administration. Unfortunately, this is not possible for both your safety and the safety of your pet.
Why does my pet need complete blood counts so often during chemotherapy?
Frequent complete blood counts (CBCs) are necessary with most chemotherapy drugs. CBCs are done the day your pet is given chemotherapy to make sure the bone marrow has recovered fully from the previous treatment and that it is safe to receive the next treatment. CBCs may also be done on non-treatment days as a way to determine if adjustments need to be made to future doses and to determine if additional medications such as antibiotics need to be prescribed.
Can you detect cancer in the blood?
Generally, the answer is no, however, with some forms of cancer (leukemias and lymphomas) routine or special blood tests may be able to detect cancer.
Will my family and other pets be at risk from chemotherapy exposure?
Generally, the risk to other household members is low, however it is a valid concern. While your pet is receiving chemotherapy there are some simple precautions you can take to minimize your exposure to these products.
- When administering chemotherapy at home, always wear gloves when handling the medication.
- Chemotherapy should be kept away from small children, pregnant/nursing women, and immunosuppressed individuals.
- Chemotherapy capsules and tablets should never be broken or crushed.
- Chemotherapy is eliminated from the body primarily through the urine and feces, mostly during the first few days after administration, but also up to a few weeks later in very small amounts. If your pet has an accident in the house, wear gloves when cleaning it up. If your pet vomits within a few hours of receiving chemotherapy, the vomit should be treated as contaminated (wear gloves to clean up). Gloves should be worn when cleaning the litter box. Other cats may still share the same litter box if its scooped at least daily. When your pet eliminates outside, it should not be in an area where children play.
- The amount of chemotherapy in the saliva is unknown, so please discourage your dog from licking you, especially facial licking.
- Its okay for your pets to share the same water and food bowls if they are cleaned daily.
- You can still pet and hug your pet.
What do I need to bring to my first consultation appointment?
To get the most out of your visit, it is ideal for us to have as much information as possible BEFORE your appointment so we can completely review the case history and test results. Please request that your primary care veterinarian fax all pertinent reports to us ahead of your appointment. We also need to examine your pet in order to make the most accurate assessment and to formulate the most appropriate recommendations, so we do require that you bring your pet to the consultation appointment. We are unable to offer phone consultation to pet owners without examining your pet. However, we are able to discuss cases with your primary care veterinarian who can convey some initial information to you.
Can my pet continue routine preventative care while on chemotherapy?
Routine preventative medications should absolutely be continued during chemotherapy. Prior to starting chemotherapy, you should make sure that your pet is up to date on all the routine vaccinations. Recent evidence suggests that vaccinations can also be safely administered during chemotherapy, in contrast to the long held assumption that chemotherapy decreases the efficacy of vaccination or can make vaccination dangerous. Heartworm preventative and flea/tick preventative medicines should also be continued during chemotherapy to prevent potentially life-threatening infections that may require delays in chemotherapy treatment.
What about herbal and alternative treatments?
If you are interested in alternative medicine approaches to treating your pet’s cancer, we recommend seeking a consultation with a veterinarian certified in alternative medicine. In general, herbal medicines are not regulated by the government for quality and there are many considerations when using these medications. The potential for negative interactions with chemotherapies have not been well studied, so it is difficult to ensure that herbal medicines will do no harm.