When a patient is receiving chemotherapy a common question that the family asks is whether they can still receive their normal vaccines, allergy medications, as well as flea, tick and heartworm preventatives.
These are all VERY good questions to ask. Below I've covered different classes of medications and whether they are safe to give concurrently with chemotherapy.
Flea, Tick & Heartworm Preventative
All patients should continue on their regular flea, tick and heartworm preventatives. These medications should be given year-round. Flea, tick and heartworm prophylaxis does not interfere with chemotherapy. Instead, these medications help to keep a cancer patient free from the many tick-borne diseases that exist, heartworm disease, and the burden and discomfort of fleas.
If your dog receives thyroid supplementation for hypothyroidism, you should continue this medication and continue to have your dog's thyroid levels checked regularly to ensure...
Hearing that your dog may have cancer is overwhelming. It often triggers a sense of panic accompanied by many different "what if" scenarios racing through the mind. The endless scenarios and questions about your dog's future play over and over again in your head...
Will he need surgery? How long will he live? Can he be cured? Does he really have cancer? Is he is pain? How much will this cost? Is it too late to get insurance? Do I even want to treat him? Is it fair to treat a dog that has cancer? Will he need chemotherapy - does that even work? Can I cure him with diet or supplements? Should I change his diet? Does my vet know what he's talking about? Should I get a second opinion? Could I have caused this? Could I have found this sooner? Should my vet have caught this sooner?
Often these thoughts begin racing as soon as you hear the word "cancer" and then you may realize that you just missed the last 10 or 20 minutes of your vet or oncologist explaining the diagnosis or next steps...
Most dogs tolerate chemotherapy very well. The majority (75-80%) will not have side effects, but a small percentage (20-25%) will develop soft stool or nausea approximately 2-4 days after receiving treatment. If early signs of nausea (such as decreased appetite, drooling, lip smacking) are recognized and treated appropriately, then vomiting can usually be avoided (which is the goal).
In most cases, we cannot predict which dogs will develop nausea or soft stool - we wish we could! However, some dogs carry a genetic mutation which makes them more likely to experience significant side effects from certain chemotherapy agents. Dogs that have this mutation, called the MDR1 mutation, shouldn't receive these "problem" chemotherapy agents or should receive them at a significantly reduced dose.
MDR stands for multidrug resistance. Dogs with an MDR1 mutation are unable to process certain medications normally, so they stay in the body for a longer time and the patient can develop signs of...
In most cases, there will be absolutely no evidence of cancer on routine blood work when a dog is diagnosed with cancer. If you find this surprising, you're not alone. My clients are constantly shocked when blood work was recently completed, interpreted as normal, yet their dog is diagnosed with cancer just a few weeks later.
Most cancers are diagnosed by detecting an abnormality on exam, x-rays or ultrasound, then performing diagnostics (tests) to determine why that abnormality is present. Let's dive into this a bit further...
If we find a skin mass on a routine exam, an aspirate (a sample of the mass using a needle) or biopsy (taking a piece of tissue from the mass) is needed to determine if the mass is cancerous or benign. If the mass is cancerous, we would not expect there to be any change in this patient's blood work.
If a patient is limping and radiographs (x-rays) of the leg show destruction of a portion of the bone concerning for a bone tumor, a bone aspirate is...
This is the third and final article in a series of three aimed at breaking down and defining some of the more common terms and concepts used in veterinary oncology.
The terms selected for this article all center around treatment and prognosis (how well a patient will do and how long they may live with a certain type of cancer or treatment).
I hope you find this article helpful.
Have any questions about this article or canine cancer? Feel free to email me at email@example.com.
Part 3 -
When a tumor is removed surgically, the surgeon should remove the tumor, plus a rim of (usually) 1-3 cm of normal-looking tissue around the tumor, in order to have a chance at removing all cancer cells in the area. Each type of tumor has a suggested measured margin (the surgeon can measure with a ruler) that the surgeon should...
This is the second article in a series aimed at defining some of the more common terms used in oncology. Having an excellent understanding of these terms will help you to make better decisions for a pet with cancer and will also help you to do a better job supporting friends and family members after a cancer diagnosis.
If you missed last week's article, you can check it out here.
The terms defined in this article will focus on the diagnosis of cancer.
Part 2 -
This is a simple procedure involving the brief placement of a small needle into a mass or organ to extract cells and establish a diagnosis. The cells are transferred from the needle to a glass slide using a syringe. The cells are stained using H&E, which makes them visible under a microscope. The slides are usually sent to a pathology lab for diagnosis by a clinical pathologist.
In many cases, an aspirate alone can yield a diagnosis. [Ex. If a lymph node is enlarged, a...
A cancer diagnosis in a pet, family member, or friend is typically overwhelming. We can become crippled by "worst case scenario" thinking as well as feelings of fear and anxiety. These feelings are normal, but they do nothing to help us to determine the best course of action or to ensure that our loved one receives the best treatment.
In order to decrease overwhelm and allow you to make the most educated decisions, you need to know what the oncologist (medical or veterinary) is actually talking about. Does your mind go blank when they use terms such as "histopath", "margins", "metastasis", "radiation", or "neoplasia"? If the answer is 'yes', you're not alone; read the next few articles in this series and you'll have these answers. If the answer is 'no', keep reading; I see many clients that have an inaccurate understanding of these terms.
Over the next few weeks, we're going to define some of the more common terms used in oncology, so you'll have a...
In my oncology practice in California, clients ask me about using CBD products on an almost daily basis. In California, veterinarians are currently allowed to discuss the use of cannabinoids with clients but it is not yet legal for us to make recommendations regarding their use. In other states, it is not yet legal for veterinarians to discuss or recommend the use of cannabinoids.
This places us in a difficult predicament. In my practice, I'd estimate that more than 70% of my patients are receiving cannabinoids. This is not due to my recommendation, but mainly due to my clients' research and the recommendations of their friends.
I am thankful to have had the recent opportunity to attend a lecture given by Dr. Dawn Boothe, DVM, Ph.D. She is a board-certified veterinary internist and clinical pharmacologist currently studying cannabinoids in dogs (amongst other things). I wanted to share some of the information that she provided so that we could all be more...
Does your dog have a skin tumor? Was he recently diagnosed with cancer or is he suspected to have cancer?
Are you interested in obtaining a second opinion from a board-certified medical oncologist to learn more about a recent diagnosis? Do you want to make sure that the prognosis you've been given is accurate? Do you want to make sure that you're up to date on the latest treatment options and that nothing is being overlooked?
If you've answered yes to any of the previous questions, the next step is to find an oncologist and book a consultation.
So what's that next step? If you're interested in a second opinion, where do you look and what do you ask?
Some oncologists will require that your dog has a diagnosis of cancer prior to scheduling your first oncology consultation. This would involve your primary care veterinarian taking samples of the tumor (either with an aspirate or biopsy) to obtain a diagnosis prior to the oncology consultation. This makes the oncology...
As an oncologist, I'm always looking for new and effective treatments that will help my patients live longer and healthier lives.
Electrochemotherapy (ECT) is not a new treatment, but it is effective. It's been a bit slow to catch on in veterinary oncology over the past decade. Only recently has the practice begun to pick up, with over 30 veterinary oncologists offering the treatment in the U.S. and one practitioner in Canada.
What are the indications for electrochemotherapy?
The most common indication for ECT is when a tumor is narrowly or incompletely removed, leaving microscopic tumor cells at the surgery site. In this case, a second surgery is always ideal, but sometimes there isn't enough skin available for a successful second surgery. If nothing is done, the tumor could grow back, sometimes as a more aggressive cancer (which we want to avoid). If a second surgery is not possible, our options are usually radiation therapy or electrochemotherapy.
Radiation is an...