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How To Assess Pain and Quality of Life in a Dog with Cancer

Making sure that our patients are comfortable and have a good quality of life is a top priority for an oncologist. 

As a dog owner, you play a large role in helping your dog achieve an excellent quality of life, whether he has cancer or not. You know your dog best and spend the most time with him, so you're in the best position to notice subtle changes that might suggest he's not feeling well. Your job is to learn common signs related to a decrease in quality of life (pain, nausea, etc.) and report any changes to your oncologist (or veterinarian) so they can help decide if intervention is warranted.

Most cancers do not cause pain, however, plenty of cancers (and other conditions) can cause a dog to feel terrible and have a poor quality of life. Clients always ask if their dog is in pain, but they rarely ask how I think their dog feels overall or about their dog's quality of life. We need to reframe the question a bit and instead of just inquiring about a dog's pain level (as...

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Early Detection - The Key to a Better Prognosis for a Dog with Cancer

One of the best ways to help ensure a better prognosis for a dog that develops cancer is to make the diagnosis early, while the tumor is small and before cancer has had a chance to spread. This, of course, is easier said than done but is certainly not impossible.

The key is to first recognize a change, either in how your dog appears externally or how he is acting/feeling, then choosing to act on it (call your vet) if it doesn't resolve in a day or two.

If you find that your vet is not able to determine an exact cause for your dog's problem (ie. cannot make a diagnosis), seek out the care of a specialist. If cancer is suspected, see an oncologist. If your vet is not sure why your dog isn't feeling well, start with an internist. 

If a dog has cancer, he will have the best prognosis if a diagnosis is made quickly. If you find yourself repeatedly seeking help for the same thing and it isn't improving, get a second opinion. 

Many types of cancer cause obvious external changes...

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Vaccine Against Canine Cancer Clinical Trial - Learn How To Enroll

This week I had planned on shedding some light on when it might be appropriate to consider euthanasia for a dog with cancer. I've decided to postpone that article in order to share some exciting news with you.

Recently, a vaccine was created by Arizona State University researcher Stephen Johnston that is aimed at preventing canine cancer. If effective in dogs, Johnston hopes that it may one day help prevent cancer in people.

Three veterinary schools are participating in the trial (University of Wisconsin, Colorado State, UC Davis), which intends to enroll 800 dogs. Colorado State and UC Davis are still accepting patients; the University of Wisconsin is fully enrolled as of June 3, 2019.

The dogs must fit the following criteria:
-Age: between 6 and 10 years of age
-Weight: at least 12 pounds (5 kg)
-No history of previous cancer
-No significant other illness that could result in a life span of fewer than 5 years
-No history of previous autoimmune disease
-No current treatment...

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Is Humane Euthanasia Humane?

We dread the day when we have to say 'goodbye' to our four-legged best friends. If your dog is getting older or has cancer or another illness, this might be on your mind more frequently.

We always hope that they will pass peacefully in their sleep. This way, there's no pain and we don't have to make the gut-wrenching decision about when to elect euthanasia.

When a dog is diagnosed with cancer, one of the most significant fears that family members have is whether or not their beloved pet will suffer in "the end". It's important to remember that in veterinary medicine we have control over when a pet is euthanized. If you monitor your dog very closely, you can elect euthanasia before they suffer at all. Your veterinarian, oncologist, or palliative care vet can help you make this decision and decide when the time is right. 

It's also important to remember that the process of euthanasia is quick and painless if done correctly. Most families feel that it's a much more...

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Is It Safe To Combine Chemo, Vaccines & Other Medications?

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. 

Thyroid Supplementation
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...

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6 Steps To Get The Most Out of Your Oncology Consult!

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...

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The MDR1 Mutation - What it is and why you need to know!

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...

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Can A Blood Test Detect Cancer in Dogs?

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...

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Help! What Are They Talking About? (Part 3)

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). 

If you haven't had a chance to read the previous articles in this series, you may want to do so now. Here are the links: Part 1, Part 2.

I hope you find this article helpful. 

Part 3 - 

(1) Margins:
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 achieve in order to obtain complete tumor removal. For benign tumors, 1 cm should be adequate. For soft tissue...

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Help! What Are They Talking About? (Part 2)

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 - 

(1) Aspirate:
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...

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