Cancer. This topic can be sensitive, as well as confusing and frightening, especially when your four-legged best friend is involved. Your first instinct may be to gather information from every source, and friends and family will likely add their thoughts. Unfortunately, misconceptions abound, and many people apply what they know about human cancer treatment to pets.
To help us set the facts straight, we talked with one of our board-certified oncologists, and co-owner of Boundary Bay Veterinary Specialty Hospital, Dr. Sarah Charney, to give us the straight goods on the pet cancer treatment journey. Dr. Charney has been treating pets with cancer since 1999 and has also had her own pets with cancer.
“Oncology is a challenging and very interesting area because it affects all of us,” says Dr. Charney. “There is translational research that can be done – things we find out from animals that have cancer can help us treat people with cancer and vice versa. What motivates me is that I get to help people with something that is incredibly difficult – hearing the diagnosis of cancer has a gut-wrenching emotional response. I am able to help people deal with that emotional experience in a positive way, help them realize how blessed we are to have the time we have, and that we can buy more good time for those people and their pets, so that they can have more time to enjoy the relationship with their pet.”
Myth 1: The prognosis is always poor with a cancer diagnosis.
Truth: Every prognosis (the pet’s expected lifespan after being diagnosed with cancer) depends on the type of cancer and how advanced it is at the time it is diagnosed. Many cancers can be effectively managed for an extended period of time.
Myth 2: Like humans, pets will get sick, lose their hair, and have trouble with chemo.
Truth: Fortunately, pets do not have the same experience with chemo as humans! Often, the chemotherapy goal with humans is to cure the cancer or extend the patient’s life as much as possible. But for pets, who have shorter lifespans, the primary goal is to give them the best quality of life and the secondary goal is to extend their life. Pets should look and feel good during treatment. If the owner reports that the pet is not feeling well, the chemotherapy protocol is adjusted by modifying the dose of drugs, delaying treatment for a little bit, or changing to a different drug.
Potential side effects in pets include:
Gastrointestinal upset – if patients have gastrointestinal upset, they are given medications for nausea and diarrhea, and these are adjusted as needed.
Thinning of hair coat – dogs that shed do not lose their hair. Dogs that have continuously growing hair will have thinning of their hair coat. It’s a cosmetic thing, and the pets don’t usually seem to mind.
Low white blood cells – which may put the pet at risk of getting an infection. Regular bloodwork helps monitor any blood cell abnormalities.
While chemotherapy may not be side-effect free, carefully monitoring, preventing, and managing those side effects prevent the chemo from negatively affecting the pet’s quality of life. Multiple clinical studies that surveyed owners of pets on chemotherapy reported that 80-90% of these owners would choose chemo for their pets again.
Myth 3: Chemotherapy is the only treatment option for a pet with cancer.
Truth: Cancer is not one single disease – there are many, many different types. Some cancers respond well to chemotherapy, but some don’t. Depending on your pet’s cancer type, where it is, and other factors, other treatment options (I.e., surgery or radiation therapy) may be better. For pet owners not interested in aggressive treatment, there are palliative care and medical management options. The goal in these cases is to treat clinical signs and maximize quality of life. Ultimately, there are many different options that can be discussed and individualized based on your pet’s cancer, your pet in general, and your goals.
Myth 4: My pet’s daily activities will need to change during treatment.
Truth: Pets continue to live normal active lives during therapy. There are no restrictions on their activities. We have successfully treated police dogs, agility dogs, and assistance dogs who all have continued to perform at a high level throughout their treatment. With this in mind, you should expect your dog to continue to do all his normal activities while undergoing chemotherapy.
Myth 5: Cancer treatment is too expensive.
Truth: While it is true that chemotherapy isn’t inexpensive, the cost of chemotherapy can vary significantly depending on the protocol that is used. Additionally, financing options or pet insurance may be available to help owners fund their pet’s chemotherapy. Unless an owner has severe financial restrictions that completely remove chemotherapy as an option, an oncology consultation is always a good first step. The oncologist can work with the client to present appropriate treatment options, allowing the client to make an educated decision on the best approach for their individual pet and their financial situation.
Not every client will elect to pursue chemotherapy… and that’s okay! Our job is to present clients with the information they need to make an informed decision.
Myth 6: Lumps and bumps, especially in older pets, are almost certainly cancer. It’s better not to know and therefore, not to seek veterinary attention.
Truth: Not all lumps and bumps are cancerous. There are benign lumps and bumps, and there are malignant (cancerous) lumps and bumps. The only way to discover if a lump or bump is cancerous or benign is through an examination of the cells. Your veterinarian can collect a sample of cells via a fine needle aspirate or a biopsy. Then, the cells are reviewed microscopically, ideally by a pathologist.
In some cases, lumps and bumps can be safely monitored and will never affect the pet. Others can be treated with assorted options, depending on the final diagnosis. Despite the potential outcome, it’s recommended to have every lump or bump examined so you can make an educated decision as to the next best step for your pet.
Myth 7: My pet has been diagnosed with cancer, but he seems fine, so it’s okay to watch and wait.
Truth: Early detection and treatment is key to the best outcome possible for your pet. Surgery is less complicated with smaller tumors, and chemotherapy and radiation are more effective in the early stages of the disease. However, if your pet’s cancer is more advanced at the time of diagnosis, there can still be options to help maintain an excellent quality of life for a period of time. Treating your pet’s cancer while he feels good can improve the prognosis and response to treatment.
Myth 8: I’m too busy to pursue chemotherapy for my pet.
Most pets receiving chemotherapy will need to travel to a veterinary oncologist every few weeks for the duration of their treatment. This does require a time commitment from the owner, as it would be counterproductive to begin treatment and then have to discontinue that treatment before completion. However, even if an owner’s schedule will not permit routine intravenous chemotherapy, it may still be worth consulting with an oncologist to see if other treatments, such as at-home oral chemotherapy, could be beneficial.
Myth 9: A cancer diagnosis means immediate euthanasia to prevent suffering.
Truth: No one wants your pet to suffer, neither you nor your veterinary team, and your pet can still have a good quality of life after a cancer diagnosis. Your veterinary team will help educate you on your pet’s cancer, treatment options, what to expect, and a prognosis, as well as quality of life issues.
It can be very emotional to think about your pet’s death, but we recommend considering when it will be time to choose euthanasia before you’re ready to say goodbye. That way, you can make clearer, more rational decisions regarding your pet’s quality of life. We recommend using a tool like these:
Five Favorite Things Rule
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- Make a list of your pet’s five favorite things or pastimes.
- Example: My cat always lies on this spot in the windowsill. My other cats don’t do that, but I know it’s her favorite spot.
- Example: My dog’s favorite toy is his moose stuffy – he plays with it the most!
- When you notice your pet isn’t doing at least three of the five things on your list, it may be time to consider euthanasia. Why three out of five? If we wait until they’re not doing anything on the list, it’s likely that our pet may be experiencing significant suffering.
Quality of Life Scale
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- Use a Quality of Life Scale to assign your pet a number based on a list of categories such as eating, comfort, pain, and so on. Be honest. Calculate the sum and review the recommendations for that number.
- It’s best to do these scales regularly because most cancers don’t cause a consistent and steady decline. That way, you can differentiate between the first bad day after a great week or a bad day at the bottom of a weeklong steady decline.
Myth 10: My pet will let me know when it is time to consider euthanasia.
The Truth: Consider that your pet is bonded to you, and they don’t want to leave you. Pets don’t like showing their human when they’re not feeling well. In these situations, you will have the burden of responsibility of making that decision for your pet. It’s like a parent-child relationship, and while it hurts to have to make these tough decisions, it may become necessary to make that call for your pet.
Know that there’s never a perfect time to say goodbye to your pet. Some clients may think in hindsight that they said goodbye too soon. But just as many (if not more) think they waited too long. If your pet has a disease that is eventually going to make them feel even worse, consider that saying goodbye with their first bad day can be an incredibly loving and selfless thing to do. It’s a way of saying “I will never let you feel any worse than you feel right now.” It’s never wrong to say goodbye.
When you say goodbye on your own terms, you can let your pet enjoy the best day! For Dr. Charney, one of her favorite memories from her dog’s last day was letting her eat pork tenderloin! Dr. Charney was glad her dog felt well enough to eat and enjoy a goodbye meal before saying goodbye.
Final thoughts on Cancer and Cancer Therapy in Pets
If you have questions or concerns about your pet’s lump or bump, cancer, treatment options, or euthanasia, contact your family veterinarian. For those interested in visiting a board-certified veterinary oncologist, ask your family veterinarian for a referral to our oncology service.
If you are concerned about your pet’s condition and cannot wait for an appointment, you can also contact us directly. Without examining a pet in-person, our oncologists cannot give advice directly to you, but they are able to consult with your family veterinarian.
Learn more about our Oncology Service here.