By David F. Kramer
Few diagnoses in the veterinary world bring more pain to a dog owner than one simple word: cancer. The mind instantly goes to the perceived harshness of chemotherapy, surgery or radiation treatments, the likelihood of remission, and the possibility of losing the battle altogether. And while conditions such as kidney and heart disease can be more difficult to treat and have a poorer chance of survival than some types of cancer, this doesn’t stop the specter of cancer from casting a dark shadow over your pet and family.
An obvious first question to a diagnosis of cancer in our dogs is simply, why? The truth is that there is often no definitive reason. While some cancers are more common in certain breeds and in a few cases, causative links to specific genes or toxins have been identified, for the most part luck plays the biggest role in determining whether or not your dog may one day be afflicted.
RECOGNIZING THE SIGNS OF CANCER IN DOGS
According to Veterinary Oncologist Dr. MJ Hamilton of Crown Veterinary Services in Lebanon, NJ, there are many signs that could be indicative of cancer. “Usually, we’ll see big changes at home. So things like decreased mobility, lethargy, changes in appetite, collapse, or inability to urinate,” says Hamilton. The specific symptoms that a dog develops depends on the type of cancer involved, where it is located, and how far it has progressed.
Hamilton, says a diagnosis of cancer comes from further testing. “Usually it’s during a workup that you’ll find it; either through an ultrasound, biopsy, or cytology.”
TREATING CANCER IN DOGS
When it comes to treating dogs with cancer, chemotherapy, radiation, and surgery are typically recommended either alone or in combination. Veterinary medicine has made some recent strides in other treatments, such as immunotherapy or antibody therapy, but these are less prevalent than the first line treatments.
The course of your dog’s treatment will be determined by your veterinarian or veterinary oncologist, and will depend on the type of cancer, as well as other factors. Whenever it is feasible, surgery to physically remove as much of the cancer as possible is usually part of treatment. Surgery may be the only type of therapy that is recommended, or it will be performed before or after chemotherapy or radiation therapy.
While chemotherapy is a blanket term for using drugs to combat disease, such treatments for cancer come in several forms. According to Dr. Joanne Intile, staff oncologist at the East End Veterinary Emergency and Specialty Center in Riverhead, NY, chemotherapy can be administered orally, intravenously, topically, subcutaneously, intramuscularly, intratumorally (directly into a tumor), or intracavitarily (into a body cavity).
Chemotherapy can be adjuvant: used after a tumor is removed in the hopes of killing the remaining or residual cancer cells; neoadjuvant: which is used prior to surgery to reduce the size of an existing tumor; or induction: which is used to hopefully bring about a remission for specific types of blood borne cancers.
The majority of dogs treated with chemotherapy don’t suffer much in the way of serious side effects. Most dogs will not lose their fur during chemotherapy, but some breeds (those with continuously growing haircoats like Poodles and Old English Sheepdogs) might experience some thinning of hair. Your dog might also experience temporary diarrhea or vomiting and have less of an appetite. Bone marrow suppression is another worry with chemotherapy treatments because it can lead to anemia and/or increased risk of infection. But these types of side effects are typically treatable. The Clinical Oncology Service at the Veterinary Hospital of the University of Pennsylvania estimates that the chance of “severe side effects… is estimated to be less than 5% of all pets receiving chemotherapy. With proper management, most animals recover uneventfully within a few days.”
Your vet will keep track of your dog’s progress through regular examinations, bloodwork, and discussions with you regarding what you observe at home. He or she may make changes in the dosage or choices of drug that are used for treatment based on how your dog responds to them.
Depending upon the type of cancer and how it is affecting your dog, your vet may recommend radiation therapy rather than chemotherapy.
Dr. Rick Chetney Jr., of VRC in Malvern, PA, is a veterinary oncologist who specializes in radiation treatments to fight cancer. “Radiation therapy is a localized therapy, like surgery,” says Dr. Chetney.
“It’s often used for tumors that we can’t surgically remove because they’re up against necessary structures such as the heart or brain. Chemotherapy is a systemic treatment—once we inject it, it goes all throughout the body battling microscopic disease when it starts spreading to other locations. Again, radiation is more localized.”
“A definitive radiation therapy protocol is given once daily—usually with between 16 and 20 daily treatments—so it takes about three or four weeks,” says Dr. Chetney. “An individual treatment takes about an hour and a half to two hours, and most of that time is spent waiting for the patient to become sleepy from the sedative, and then later to recover from the anesthesia. The treatment itself only takes about 5-10 minutes.”
Animals are given varying levels of sedation for radiation treatments, mainly to keep them still. There’s no direct pain from the radiation treatment itself although some discomfort, skin problems, or fatigue may be associated with its effects.
If you live close to your treating oncologist, you might be able to bring your dog to its daily radiation treatments. If distance is an issue, the animal can be boarded during the week for treatments and be permitted to go home to recuperate over the weekend.
HOW MUCH DOES IT COST TO TREAT A DOG FOR CANCER?
Once a cancer diagnosis is determined, among the first considerations is cost. Even with research into this topic, you may find very little definitive information. Consulting with your vet or oncologist will certainly help get you a ballpark figure, but he or she may be hesitant to nail down a specific figure since it’s impossible to predict just how your dog will respond to treatment.
Veterinary insurance is an option and many types cover cancer treatment (most likely partially)—but as is the case with people, rules concerning pre-existing conditions will generally prevent you from getting coverage once your dog has been diagnosed. Your veterinary oncologist will lay out a treatment plan and proposed rate, but there are many factors that can affect the eventual cost.
“It varies wildly, and it’s something I really can’t answer,” says Hamilton. “There are some cancers that are very affordable and inexpensive to treat, and others that really start to add up. Some cancers can be a couple hundred dollars a month, and others that start to add up into the thousands before you’re done. Everything is completely customized to that pet, what we know, and what the wishes of the family are.”
According to the National Canine Cancer Foundation, an initial visit to confirm a cancer diagnosis can be upwards of $200. Major surgery to remove a cancerous tumor deep inside the body, or that will require reconstruction, can start at $1,500. Chemotherapy treatments might range from $200 to $2,000, depending upon the type and severity of the cancer. Radiation therapy can range from $2,000 to $6,000 or higher. You will also need to factor in additional medications that might be needed—such as pain relievers or antibiotics—which could cost another $30 to $50 per month for an indefinite period.
NATURAL REMEDIES AND DIET FOR DOGS WITH CANCER
During and after treatment for cancer, dog owners might be tempted to look to the East for a different approach to medicine. One veterinarian who uses the Eastern approach is Dr. Patrick Mahaney of Los Angeles, CA, who specializes in natural and alternative treatments for pets. According to Mahaney, this type of pet care is imperative before, during, and after a cancer diagnosis.
“It’s crucial that all veterinarians and pet owners be attuned to whole-body health, especially when a pet is diagnosed with cancer and is going through surgery, radiation, or chemotherapy,” says Mahaney. “What’s not totally addressed in the veterinary oncology community is nutrition. We’re so dependent on processed, commercially available pet foods, primarily kibble, and really it’s not the ideal thing for any pet to eat. It’s fairly simple to make dietary changes to a whole-food based diet that can really benefit whole-body health.”
Mahaney is dubious of the current state of most available pet foods that make up the multi-million dollar pet food industry. It all begins, he says, with the concept of “feed grade” products that are welcome for animals, but judged unsuitable to be fed to humans. Mahaney believes in a life-long pet diet that consists of whole and human grade foods.
“Whole food feeding is key. Human grade ingredients have lower thresholds for certain substances that can be toxic—even carcinogenic. Mold-produced toxins (called mycotoxins), including aflatoxin and vomitoxin, can irritate the intestines, suppress the immune system, and are carcinogenic (cancer causing). You want to be sure that while your pet is being treated that their food is not going to further contribute to cancer,” he says.
While a diagnosis of cancer in your dog is by no means a certain death sentence, it’s sure to be a stressful time for both dogs and their families. Your veterinarian and veterinary oncologist will work with you to give you options for treatment and help walk you through any difficulties that come with it.