Kill Those Cancer Cells!

Do you remember a special dog I wrote about named Mikey? He had a big spleen we had to remove because it was big and bleeding. Unfortunately, it was found to be enlarged due to hemangiosarcoma, a type of cancer of vascular organs. It had spread to at least one lobe of the liver, too, so just removing the spleen wasn't going to help him for long. Mikey is fortunate to be owned by a very loving human who wants to do the very best for him. After consulting with veterinary oncologists, we decided to start Mikey on a course of chemotherapy after he healed from surgery.

Now the principle behind chemotherapy is simple: kill those wandering cancer cells that were left behind after surgery. But the drugs used to do this can be very toxic to the organs of the body and their otherwise healthy cells. So there can be a fine line between effective doses (killing the cancer cells) and toxic ones (those that could make the patient ill.) We certainly don't want the treatment to be worse than the original disease.

We probably all know humans who have undergone chemotherapy themselves. It can be very nauseating, patients often lose a lot of weight, can have their hair fall out, or experience other side effects from the drugs. It can be difficult to know if these are really side effects from the drug or a progression of the cancer disease itself. Dogs are usually pretty tolerant of most chemo drugs. Even still, we take precautions like administering anti-nausea medications prior to giving the chemo agents. Mikey is a pretty sensitive dog-he goes through episodes of being picky about his food, anyway, and this second dose of chemo is really making him nauseous. Despite the anti-nausea medication, he has vomited and he just isn't eating yet, and it is going on day 4. I am going to check him over this afternoon and see if there is anything else going on.

Dogs rarely lose their hair due to chemotherapy. I used to say"never" but many years ago I had a very sweet, beautiful Standard Poodle patient with a soft tissue sarcoma that actually did lose all her hair after the very first dose of her chemo drug! It was quite a shock. I called the veterinary oncologist and they assured me that poodles were the exception and yes, it would grow back in just like human chemo patients. There weren't any wig makers for poodles that I knew of, though.

Nutrition can be an important part of fighting cancer. Mikey is on a prescription diet called N/D for "neoplasia diet." It is formulated to keep his cancer-stressed body healthy while starving those constantly dividing cancer cells. Some people choose to formulate their own homemade diets for this purpose, but we are so lucky that we have the prescription diet folks do it for us now!

Most chemotherapy is administered in rounds or specific protocols depending on a few things. Staging a cancer can really help decide which protocol will give the optimum results, and even this means different things to different people. For some owners, it is the longer survival time. For others, it is the best quality of life-good palliative care, pain control. Aspirating or taking samples from regional lymph nodes can help determine if the cancer has spread in the body. Radiographs or ultrasound can search for evidence of this metastatic disease. We only had to look around when we had Mikey's abdomen opened up to visually identify the affected liver. We did take chest radiographs, though and at the time, they appeared free from tumors. We chose a chemotherapy protocol where his drug is administered intravenously during a day in the hospital once every 21 days for 5 times. He wouldn't have to stay over in the hospital unless there were any complications from the drug or from the cancer itself, and so far, other than his nausea, he is doing remarkably well.

Prior to most chemotherapy regimens, we draw blood to test the complete blood count of the patient. We want to be sure the medications and/or the cancer isn't suppressing the immune system or affecting the patient's ability to handle the next round of therapy. Because of this testing, the hospital stay, the cost of the drugs themselves, the pre-medications, the special diet and supplements, treating cancer can be extremely expensive for a pet owner. Of course, there are no guarantees of success when we are dealing with such a serious condition as cancer. Mikey's owner knows all this. She is far from wealthy, but her love knows no bounds. She is hard at work, raising money to help continue his care. We have searched to find the least expensive source of his medications, and treatments every 21 days rather than weekly sure does help. He is one lucky dog! We all should be loved that much.


Peace,
DrReneigh