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  1. My Dog Has Cancer. Now What?

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    Sheltie

    My Dog has Cancer. Now what?
    by Dr. Alison Rhoades, DVM
    Midlothian Animal Clinic

    Frequently, a cancer diagnosis makes everyone in the family feel helpless. After deciding on a treatment plan, owners often want to know what they can do to help keep their pet comfortable during treatment.

    First, let’s talk about nutrition. A nutritious diet will help your pet’s body have the energy it needs to fight cancer. There are prescription diets available designed for cancer patients. They are high in protein to help prevent muscle loss, and supplemented with fatty acids to help reduce chemotherapy side effects. These diets are also designed to be pretty tasty for animals who may have a poor appetite. Many animals are also able to stay on their current food, as long as it is of good quality. If there is a day when your pet’s appetite is not good, sometimes tempting them with chicken and rice or scrambled eggs will get them eating and still be bland enough for a sensitive tummy. There are also medications available to control nausea in cancer patients.

    Second, we encourage regular but not strenuous exercise. Many pets are able to continue their current level of exercise, but bear in mind they may tire faster.

    Third, they may continue to be around other dogs that you know are vaccinated and not ill. We discourage visits to dog parks and other places where large numbers of dogs congregate since our pet’s immune systems are not as able to fight off infections while they have cancer.

    Lastly and most importantly, enjoy them and love them. Some cancers are curable, but many are not. While your pet is being treated hug them a little longer, bring them their favorite treat, let them get on the bed. The time we have with them is precious.

  2. Common Misperceptions for Cancer Therapy in our Companion Animals

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    Golden with IV

    Common Misperceptions for Cancer Therapy in our Companion Animals
    By Dr. Monika Jankowski, DVM, DACVIM, Veterinary Emergency Specialty Center

    Cancer. It’s a word that sets off a variety of emotions in all of us. We may see characters in movies portraying severe sickness from chemotherapy treatment or know of acquaintances undergoing treatment with chemotherapy. The majority of us have perceptions regarding chemotherapy treatment in people. And naturally, this gets carried over to our companion animals. One of the most common misperceptions of cancer treatment in our pets is that chemotherapy will make them sick as it does with people. They will have extreme nausea, vomiting and diarrhea, and no appetite. Another common misperception may be that all therapy takes several hours to administer. Another common misperception is that our pet’s fur will all fall out and they will become bald. Probably the biggest concern that most people have is that chemotherapy will give all pets a very poor quality of life.

    The reality is that our companion animals handle chemotherapy and chemotherapy administration very well with a very low percentage of animals becoming sick. We can see 95-97% of all cases having a completely normal lifestyle with almost no vomiting, diarrhea, or decreased appetite. In those cases where we do see some side effects, the majority of those can be symptomatically treated at home with anti-nausea or anti-diarrheal medication. There are few cases that require hospitalization.

    The majority of our treatments are delivered in a very short time span. The overall time from when these pets walk in the door, to the time they leave the facility, is generally 30 minutes or less. We use a temporary catheter to deliver these drugs into the veins, and the amount given is very small. There are some drugs that may take a little longer to give, but the overall time is still less than 30-60 minutes.

    Dogs and cats also hardly ever lose their fur. They can lose their undercoat and they can lose their whiskers, but they grow back once chemotherapy is discontinued. There are some breeds that do have hair coats similar to people. This means they have a continuous hair growth cycle. Those dogs will generally lose their hair, but it will grow back. Some breeds with continuous hair growth cycles can include Old English Sheepdogs, Poodles, and Bishons.

    The bottom line is that quality of life is the most important. We want our patients feeling well, going on hikes, playing ball, or simply being the couch potato they love to be. Our goal is to keep our pets at home with their owners and not to hospitalize them for chemotherapy side effects. We tend to achieve this goal in the majority of our cancer patients.

  3. Why Should I Consult an Oncologist?

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    Senior Dog

    Why Should I Consult an Oncologist?
    By Emily J. Skovira, DVM, MS, Residency Trained in Internal Medicine
    Dogwood Veterinary Internal Medicine

    Cancer affects a significant number of dogs and cats; it is one of the leading causes of death in the aging pet population. As our understanding of cancer advances, we often are able to improve the length and quality of life for pets with cancer. Similar to the diagnosis of “infection” which is a very broad category of diseases, “cancer” is also a very broad category. While the term “cancer” is often associated with fear and a shortened lifespan, there are types of cancer that are associated with long term remission and some even with a cure. Treatment recommendations and prognosis is dependent on obtaining a specific diagnosis and often the grade of the tumor. Grade is a more objective evaluation of the observed behavior of the tumor and may provide more information on the expected disease progression and/or rate of progression. In addition, there are molecular tests available for several tumor types that can provide further information to direct treatment options and provide prognostic information.

    Your pet’s primary veterinarian, internal medicine specialist, surgeon, or other specialist may recommend consultation with an oncologist. As an internist, it is not uncommon for people to tell me that if we obtain a diagnosis of cancer then they are not interested in treating their pet. The perception is that quality of life for a pet with cancer is poor and there is not much that can be done. This perception frequently does not correlate with reality. Treatment options may be divided by the goal of therapy including “definitive therapy”, where the goal is to eradicate the disease, or “palliative therapy”, where the goal is to improve the patient’s quality of life. A range of options are available including surgery, definitive chemotherapy, definitive radiation, palliative radiation, metronomic chemotherapy (small doses of chemotherapy given daily), and immunomodulatory therapy such as the melanoma vaccine, symptomatic therapy, and surveillance.

    The majority of veterinary patients treated with chemotherapy do not experience the side effects that are common in humans receiving chemotherapy. The benefits of chemotherapy usually far outweigh the risk. The goal during treatment is for your pet to feel better or at least normal during treatment. In patients that develop side effects associated with chemotherapy, it may be possible to change the dose and/or type of chemotherapy or prescribe medications to manage the side effects.
    A veterinary oncologist is a veterinarian that has done advanced training after becoming a veterinarian. Prior to obtaining board certification, the veterinary oncologist must pass a rigorous examination process to confirm that they have the knowledge required. The veterinary oncologist has extensive knowledge of treatment options available and a network of other oncologists with whom they may consult. Their knowledge of this topic far surpasses the knowledge of other veterinarians. Even if you do not think you are interested in pursuing therapy, I strongly recommend consulting with a veterinary oncologist so that you are fully informed regarding your pet’s prognosis and current treatment options including palliative care.

  4. When Is It Time?

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    Senior dog frolicking in water
    Things to Consider When Making End-Of-Life Decisions for Your Pet

    By Dr. Lori Elliott, DVM

    Shady Grove Animal Clinic 

    The price we pay for loving a wonderful creature with a lifespan far shorter than ours is the hurt of saying good-bye. The end of our pet’s life comes more often with our gentle help, than it comes naturally.  Natural death can be slow and painful to the pet and to the family.  However, advances in veterinary medicine allow control of a pet’s pain and anxiety while assisting in gentle passage from this life.  This is referred to as euthanasia.

    There are two major categories of conditions that lead to consideration of euthanasia – chronic or longstanding and progressive disorders, or acute illnesses in which decisions must be made quickly.  Examples of chronic conditions are progressive heart disease, kidney insufficiency, geriatric debilitation, and many forms of slowly progressing cancer.  Examples of acute diseases include pathological fractures of limbs affected by bone cancer, ruptured internal tumors, and blood clots or stroke. 

    With acute illnesses, often the pet is making the decision rapidly before our eyes.  To alleviate pain or suffering, the decision needs to be made immediately.   If we cannot successfully treat the illness now, we owe it to our pet to let them go peacefully, even though it is really difficult to say good-bye.

    For chronic illnesses, the difficulty is the timing of euthanasia.  Should euthanasia be planned this week, next week, or next month?  Usually, there is no right or wrong answer.  However, in my personal and professional experience, we more often wait too long and later regret the delay. Again, it is really difficult to say good-bye.

    For pets with chronic illnesses, it is important to look at the pet’s quality of life. Dogs and cats live for today – they do not have the ability to think of the past or the future.  I sometimes have families list all of the pet’s favorite things: eating, playing fetch, going for walks, following a family member around, grooming or keeping good hygiene, etc.  How many of these things are still enjoyable to the pet? 

    Some people need a more analytical process to know when it is time.  For these folks, I recommend having two jars side by side in a prominent location.  One jar is labeled “good”, the other “bad”.  Each day, the family assesses the quality of the pet’s present status and drop a coin, marble, or candy in the jar representing the pet’s status that day.  When the “bad” jar begins to surpass the “good” jar in contents, it makes it very clear that the balance of quality of life has shifted, it is time to think of allowing a peaceful passage.

    When faced with decisions for a pet with a chronic or terminal acute illness, it is essential to communicate with your veterinarian.  He or she will help guide you while helping to control your pet’s discomfort.  Your vet will discuss the actual process of euthanasia, answer your questions and discuss means of handling your pet’s remains; burial, cremation, etc.

    The most difficult decision we make regarding our pets is when to say good-bye.  I frequently tell my clients (and I have told myself each time I personally face this loss) not to let the end of their pet’s life – this decision- be larger than the life shared.  As sad as the last day together seems, it is merely one day of the hundreds or thousands of days you shared with your pet.  Through the sadness and tears, celebrate all of the wonderful time shared and the true blessing your pet was to you!

  5. Laser Therapy

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    parkcentreanimal_laserdog[1]Laser Therapy
    by Dr. Courtney Belden, DVM
    Central Virginia Veterinary & Acupuncture

    Laser therapy is a relatively new type of treatment that can be used for a myriad of conditions.This treatment is non-invasive and can be used in conjunction with other treatments and medications. Laser therapy utilizes light energy to stimulate cells and in so doing, it increases healing, aids in circulation, provides local pain relief, and decreases inflammation. Laser therapy is most commonly used for arthritis, soft tissue injury, post-operative healing, wound management and many more conditions. It can also be used for acupuncture by replacing the traditional needles with the light energy from the laser.

    Laser therapy can be used in cancer patients to provide palliative care. Palliative care is another term for providing relief of the pain, symptoms and stress of serious illness. Because laser therapy is such a great pain reliever and is non-invasive, it can be very useful in cases where all other options have been exhausted and palliative care is needed. This type of treatment should only be used with the express consent of the treating veterinarian as the effects on cancer cells have not yet been determined. Please be sure to discuss any and all treatments with your veterinarian.