Emergency Critical Care

What is a board-certified veterinary oncologist?

A board-certified veterinary oncologist is a veterinarian who focuses on managing cancer. In addition to completing undergraduate training and four years of veterinary school, a board-certified veterinary oncologist is similar to his/her human-medicine counterpart in that he/she has completed an internship and residency in the specialized field of oncology (an additional 3-5 years training). In addition to this extensive training, a board-certified veterinary oncologist must pass two rigorous examinations to achieve board certification from the American College of Veterinary Internal Medicine.

Why should I seek the care of a board-certified oncologist?

According to the ACVIM, “Specialists bring a greater understanding in the area of…oncology…and have a greater knowledge of the unusual, the uncommon, or rare in both large and small animals. In addition, a Specialist may have diagnostic equipment not generally used by your family veterinarian.”

Ask your veterinarian if the procedure or treatment requires a specialist. General procedures and therapeutics may be less likely to require someone who is board-certified. You and your pet may benefit from a specialist when

• Your animal’s disease is not routine, is complicated, or is undiagnosed after standard testing;
• You would like an informed, neutral second opinion of your animal’s condition;
• The outcomes of the current treatments are not going well or as expected;
• Your animal requires a sophisticated procedure that is offered by a specialty hospital;
• Your animal can benefit from 24-hour monitoring provided by a referral hospital.

What is cancer?

Cancer is a group of diseases characterized by uncontrolled cell division leading to growth of abnormal tissue. It is believed that cancers arise from both genetic and environmental factors that lead to aberrant growth regulation of a stem cell population, or by the dedifferentiation of more mature cell types.

The uncontrolled and often rapid proliferation of cells can lead to either a benign tumor or a malignant tumor (cancer). Benign tumors do not spread to other parts of the body or invade other tissues, but can sometimes be life threatening as a result of their location (e.g. benign brain tumors). Malignant tumors have the potential to invade other organs, spread to distant locations (metastasize), and become life threatening.

Cancer is the leading cause of death in pet cats and dogs in the United States; 50% of dogs and cats die of cancer.

How is cancer treated?

As with cancer in humans, cancer in pets may be treated with surgery, chemotherapy, radiation therapy, or a combination thereof. There are many types of cancer and the treatment approach will depend on the type of cancer and whether the cancer has spread. The oncologist will review the treatment options with you and help you decide on the best treatment option for your pet and your family circumstances.

What is chemotherapy?

Chemotherapy is the treatment of cancer with chemical agents (anti-cancer drugs) designed to kill or slow the growth of cancers. Many of the drugs used to treat cancer are derived from natural substances such as plants, trees, or even bacteria and are often the same drugs used in people.

What is the goal of chemotherapy?

The goal of chemotherapy is to control or eliminate the cancer while still providing the highest quality of life to your pet. Chemotherapy drugs sometimes do not cure cancer but rather control the cancer by killing cells and slowing the progression of the disease.

Will there be side effects of chemotherapy treatment?

Many people have experienced, either in themselves or in family members, the overwhelming side effects of chemotherapy in human cancer treatment. The vast majority of animals treated with chemotherapy do not experience these types of side effects. In veterinary oncology, our philosophy of treatment is different from that used in human medicine. While we have a very strong emphasis on prolonging life with cancer treatment, quality of life is paramount.

When are oncology appointments available?

Initial oncology appointments are generally available Tuesdays through Fridays. However, in cases that are more urgent, other arrangements may sometimes be made. Chemotherapy appointments are generally available Tuesdays through Thursdays, but again occasionally other arrangements can be made on a case-by-case basis.

How do I make an appointment?

Boundary Bay Veterinary Specialty Hospital strongly encourages animal owners to obtain a referral from their regular veterinarian whenever possible. This ensures the proper transfer of medical information, is beneficial to the animal and the specialty veterinarian, and will help your companion receive the best care possible.

A Boundary Bay Veterinary Specialty Hospital client care representative can be reached at 604-514-8383.

Does my pet need to be fasted for the initial oncology and recheck oncology appointments?

We recommend that you not feed your pet on the morning of the initial appointment. It is ok to give water. Please call for instructions if your pet is diabetic.

Does my pet need to be fasted for chemotherapy appointments?

Your pet does not need to be fasted for chemotherapy appointments unless specifically instructed.

What should I expect during my initial oncology appointment?

Initial oncology appointments are scheduled for one hour. When you arrive for your appointment, please check in with Reception. The receptionist will advise the oncology service that you have arrived.

An oncology assistant or technician will bring you into an exam room with your pet, complete a history form, and perform a check of your pet’s vital signs (such as heart rate, temperature, etc). The oncologist will then review the information and examine your pet. Once this is complete, the oncologist will go over the diagnosis (or any further testing that may be required to reach a diagnosis) and treatment options. Each option will be thoroughly explained so that you can make an informed choice for your pet.

A treatment plan will be prepared for you based on your pet’s specific needs. A treatment estimate will be explained and authorized by you prior to diagnostics or treatment.

We are often able to perform diagnostic procedures (such as biopsies, radiographs and ultrasounds) and treatments (such as chemotherapy) on the same day as your initial appointment, in which case you may be leaving your pet with us for several hours or for the day. Unless your pet requires surgery, it is unlikely that he or she will stay overnight. We are open 24-hours per day, so animals may be picked up in the evening if necessary.

What should I bring to my initial oncology appointment?

Please bring your pet, a copy of your pet’s medical records, radiographs (if applicable), and current medications. It is acceptable for your family veterinarian to fax your pet’s records and/or send digital radiographs prior to your visit.

What should I expect during my recheck oncology appointment?

Recheck appointments are scheduled for half an hour. Recheck appointments are often used to check the status of your pet’s overall health and to determine the status of the cancer. We often perform diagnostics such as bloodwork, recheck radiographs and recheck ultrasounds. In most cases, these procedures will be performed the same day as the recheck appointment, in which case your pet may need to stay one to four hours. Based on the results of these tests, we may recommend additional treatment or just additional follow-up visits.

What should I expect during a scheduled chemotherapy appointment?

Once chemotherapy has been selected as the appropriate treatment option, a chemotherapy protocol will be chosen which will lay out a drug regimen to be used for your pet. We will follow this protocol at each appointment. Sometimes protocols need to be modified or changed. We will inform you prior to any protocol changes.

Chemotherapy appointments may be made for a scheduled time. At the time of your appointment, you will be asked to fill out a form which will let us know how your pet is feeling, what, if any, medications need to be refilled, and if you have any questions or concerns.

Your pet will then be taken to the treatment area for a physical exam and required diagnostic tests such as bloodwork. If you have questions or concerns, the oncologist will talk to you after the diagnostic tests, but before treatment. Otherwise, the oncologist will administer chemotherapy as per the protocol or discuss with you any protocol changes that need to be made. Written discharge instructions will be provided and if you have any questions, you can discuss them with your oncologist.

What should I expect during a drop-off chemotherapy appointment?

Once chemotherapy has been selected as the appropriate treatment option, a chemotherapy protocol will be chosen which will lay out a drug regimen to be used for your pet. We will follow this protocol at each appointment. Sometimes protocols need to be modified or changed. We will inform you prior to any protocol changes.

Chemotherapy appointments can be scheduled as drop off appointments on the days that the oncology service is available. For drop-off appointments, you may drop off as early in the morning as you like (we are open 24-hours per day) and pick up in the afternoon. If you drop off before 9 am, your pet should be ready to go by 1 pm. Please be sure to let us know your estimated pick-up time. Your pet must be in the hospital by 2pm for a drop-off appointment. Animals that arrive between 9 am and 2 pm will be ready for pick-up by 5:30 pm, but can be picked up anytime before 11 pm without incurring a boarding charge.

At the time of drop off you will be asked to fill out a drop-off form which will let us know how to reach you, how your pet is feeling, what, if any, medications need to be refilled, and if you have any questions or concerns.

During the day, the oncologist will examine your pet, perform any required diagnostic tests such as bloodwork, and administer chemotherapy as per the protocol, or contact you if protocol changes need to be made. Written discharge instructions will be provided and if you have any questions, you can discuss them with your oncologist at the time of pick-up (before 5pm) or by phone.

Can I be with my pet during chemotherapy?

For your safety, we cannot allow you to be present during treatment. In most cases, the treatment is quick, your pet will be without you only for a short period of time, and patients usually handle their treatments very well.

How do I care for my pet once I am home?

Your pet’s activities do not need to be changed on the day of treatment or any subsequent days. The goal of therapy is to ensure that your pet can carry on with his or her normal life for as long as possible.

You will be given written discharge instructions after each appointment that will let you know if medications need to be administered, when your follow-up appointment should be, and if there are any other post-treatment instructions. You will also be provided with a chemotherapy handout, which discusses chemotherapy safety and what steps to take if side effects do occur.