Featuring Demian Dressler, DVM and Susan Ettinger, DVM, Dip. ACVIM (Oncology), authors of The Dog Cancer Survival Guide.

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Prejudice in Chemo Side Effect Treatment for Dogs

Bias (prejudice) is an important issue in medical treatments being withheld.  Some of these treatments may have benefit, and dog cancer is no exception.

Managing the side effects of chemotherapy is an important part of cancer care.  Chemotherapy is most commonly delivered at the Maximum Tolerated Dose (MTD).  This means the highest doses that the patient can handle are given so that we get the highest kill rate of cancer cells.  When MTD’s are used, some side effects can be inevitable.  Different dogs are more or less sensitive to side effects of one drug or another.  At least some of these are due to genetic differences.

One of the most common chemotherapy drugs used is doxorubicin, also called Adriamycin.  This is an injectable drug used in chemo treatment for common cancers, such as lymphosarcoma, hemangiosarcoma, and many others.

This drug has benefited many dogs with cancer.  However, like any medical intervention, side effects must be handled. Other treatments having possible side effects are acupuncture, homeopathy, herbs, diet changes, supplements, and so on.  However, it is definitely true that due to the doses of chemotherapy drugs used, side effects using these medications are generally much greater in severity than “alternative” treatments.

One of the most serious side effects of doxorubicin is heart toxicity. As a result, dogs that may be prone to the toxic reactions (and possibly other dogs as well), should receive treatment steps to protect their hearts when receiving this medication.  The Guide covers over-the-counter supplements that can help.  However, there is an FDA approved drug that is used to protect the heart from doxorubicin’s effects called dexrazoxane.

Now, here’s the rub. One of the ways this medication works is through its antioxidant effect. Almost all conventional veterinarians advise against the use of antioxidants, across the board, when combined with chemotherapy.  There have been many posts on this topic here in this blog. It is not nearly as strait forward as one would guess, given the blanket “anti” position our profession holds towards the combination.

The more one looks at these issues, the more clear it becomes that there are rarely “always” and “never” rules that are accurate in medicine.  There are only actions and results, some being desired and others not.  Realizing this basic truth allows us to avoid our own prejudices in what we use to help pets (and people for that matter), and thoughtfully select from a larger menu of helpful treatments.

Those who wish to read more about further available treatments will appreciate the Guide.

Best,

Dr D

 

About the Author: Demian Dressler, DVM


Dr. Demian Dressler, DVM is known as the "dog cancer vet" and is author of Dog Cancer Survival Guide: Full Spectrum Treatments to Optimize Your Dog's Life Quality and Longevity. Visit his blog and sign up free to get the latest information about canine cancer. Go to http://www.DogCancerBlog.com.

  • Jeannette Botza

    what are your feelings with giving acupuncture to a dog who is being
    treated for Hemangiosarcoma. Is it helpful or can it cause side effects?

  • http://www.twinheartphoto.com Diane Nicholson

    My concern would be more with the medical professionals being biased by the drug reps or straight from the industry. Learning about chemicals via a highly motivated salesperson is inherently suspect.

    I’ve researched and used homeopathy for 40 years and have never heard of side effects. Can you provide a study?

    Likewise, what side effects are presented with acupuncture?

    Thanks.
    Diane

  • Joanne

    Dear Dr. Dressler:
    Our dog – who is a Border Collie and now nine years old had her first bout with Chemo about three years ago to rid her of a mast cell tumor on her foot which could not be operated on. She did excellent with no side effects for three years then the cancer returned. She again had Chemo with NO side effects. We give her flax seed on her food which is Halo, EFA capsules – two per days and also two capsules of Tumeric. She also get two spoonfuls of Yoghurt per day. I do not know if all of this helps but it certainly seems to. She went for three years without the cancer returning. Hopefully we will have her for another three years or possibly longer. Each time we had the Chemo it cost us more than $5000.00 Canadian. It is very expensive but worth it when you are saving your very Best Friend. That is if you can afford it. I recommend Chemo highly to anyone who can afford it. Our dog had Lomustine and Vinblastin. After she was finished the chemo she was given Prednisone and Denamarin to protect her kidneys. As I said she is doing very well. We are very pleased with the results she has attained.
    Regards, Joanne

    • Dr. Demian Dressler

      Great news Joanne!
      Best
      Dr D

  • Rosalie

    Dear Dr. Dressler,

    My dog Chilly, a 9-yr old cocker spaniel, is suffering from B-Cell Lymphoma Stage IV. It was first founded on 5 Feb when she ran into a pesticided bushes with all her lymph nodes on neckside got swollen. I rushed her to vet at night time and he said that it was Lymphoma. I suspected that was not true and thought it was allergy. Now it was confirmed by 3 vets after biopsy & ultra-sounds etc… I wonder if I should start the chemo to extend her life or just let her eat what she likes and spend the rest of her life. I don’t know how long she will live without treatment. However, I am very scared the chemo would shorten her life and kill her…I need to take her to the vet for chemo on 18 Mar. What should i do??? This is a very difficult decision…

    Best,
    Rosalie

  • http://www.twinheartphoto.com Diane Nicholson

    Thanks for the studies. I see however, that the conclusions were that both acupuncture and homeopathy adverse reactions are rare and tend to be mild. Both modalities are considered safe.

    They seemed to lump “aggravations” in with other side effects whereas the former are often a wanted sign and show that it’s the correct remedy.

    This is as opposed to chemotherapy which is toxic with many dangerous side effects. With humans, up to 25% of those using it die from the treatment itself. Granted, sometimes it takes awhile and maybe that is where dogs seem to do better; they don’t live long enough to have some of the effects, like more cancers.

    What I do wonder about however is, since the scientific community insists that there is no validity to homeopathy, that there is no “drug” in the remedies whatsoever, just simple sugar pills, why are they also not saying that said adverse reactions are simply placebo caused?

  • Hari

    Dear Dr. Dressler,

    Recently my golden retriever (age 10.5, weight 80 pounds) was diagnosed with osteosarcoma. We chose not to pursue amputation and chemotherapy (we did elect to give her the pamidronate drip).

    I have read your book and have purchased the apocaps and have been cycling with artemisnin (5 days each). Upon giving her the artemisnin (200 mg per day), the tumor size has actually reduced (on her front right leg, wrist area).

    However, our dog also takes rimadyl (150 mg) and in your book you say not to give the full dosage of apocaps (which should be 3 capsules 3 times daily, net 9 capsules a day for my dog’s weight) if the dog is taking rimadyl.

    How many Apocaps should we give her daily (currently we give her 4 when we are cycling apocaps, 2 capsules twice daily)?

    Also, is it Ok to give her zeolites concurrently with the apocaps and/or artemisnin? (In your book you say Apocaps should not be given with anti-oxidants although from what I have read zeolites work differently than typical antioxidants).

    Thank you very much.
    Your book has really helped me.

  • Elisa

    My Boxer’s ECG revealed a singular ventricular premature arrhythmia. The oncologist recommended we hold off on the Adriamycin due to the the related breed cardiac toxicities. Two weeks later he relapsed ,he was given a subcutaneous injection of Elspar and 65 mg of CCNU . Three weeks later his CCNU dose was reduced . I think not going forward with the Adriamycin was a huge mistake.

  • Jeannette Botza

    What metronomic therapy would you recommend for a 12 year old poodle
    who was diagnosed with hemangiosarcoma, and how much longer does it extend the
    dogs life to not opting for it. We have finished 4 sessions of Adriamyacin

  • Scott

    We got the confirmation of lymphoma for our dog Rusty late last week. We’ve gone back and forth on doing the chemo and we’ve decided to go for it. He’s 12 and functionally closer to 7/8 and the vet commented last fall he had the teeth of a 6 year old. He was my pace dog as we ran 2-3 miles every other day. Needless to say the runs have been a lot lonelier as of late. We may never get back to that, but I look forward to a nice long walk again or maybe something a little more brisk in the near future.

    I’ve purchased The Guide and we’re on the diet as much as he’ll handle and most of the supplements. The ginger really makes a difference. He’ll be starting on the Wisconsin Protocol with vinchristine on Monday.

    He’s a Carolina Dog (sometimes called the American Dingo) who literally walked out of the woods one day and into our lives. There’s very little research (if any at all) on how these rare breeds do with chemotherapy; let alone dogs who came out of the wild like he did. So we’ll just go from here. I will say knowing what I know now if I had to do it over again, he would have never touched dry dog food and been on the wild dog diet his entire life.

  • Scott

    Dr D, Dr E-

    Rusty had his first treatment with vinchristine today. It went well and of course there is a however and some questions to this if y’all can answer. I got lectured today about the use of any supplements (at this time) during chemo and was advised not to use the K9 Immunity or the K9 Transfer; that their efficacy had not been determined in any clinical research they knew about. In fairness, I was told that prescribed supplements would be okay after 5 weeks of treatment. I received another lecture the bland/wild dog diets are okay but are not desirable and have no long term efficacy (there’s that word again) in treating cancers. Another word of caution that ginger would not help. I was then advised to purchase the N/D diet from Hill’s as it was the only one that had any clinical backing. I didn’t bother to bring up Turmeric (let alone Apocaps) or any of the other agents at that point. I’ll look in The Guide again, was there any clinical research about the K9 products? I didn’t get specifics, but I was told his baseline numbers were really good and yes, I credit that in part to the K9 products. I am highly unlikely to purchase the N/D diet considering the by products in it and Rusty would sooner volunteer himself for a bath than eat canned food.

    I love my Vets. Don’t get me wrong and I wouldn’t put my dog’s life in any other hands. I am going to be struggling against an orthodox mindset that if it isn’t in a book or peer reviewed, it’s junk. I hate to give any kind of supplement behind the back of my Vet(s), but that looks like a position I may be in. Any advice???

    Thanks

    Scott

    • Dr. Demian Dressler

      Scott
      unfortunately the logical paradigm used with conventional care apparently does not apply to nutraceutical supplements. We do things frequently in conventional care without large scale double blind placebo controlled studies. Dr. Ettinger and other oncologists will frequently use chemo drugs in ways that have not been studied this way. So you are dealing with a population of medical professionals who actually have not investigated what is in the Guide in a critical way and have not come to the understanding that things can help even we we do not have access to double blind placebo controlled meta studies. There is also a lack of understanding that this position is a double standard, and usually a lack of true scientific objectivity (i.e. bias). Once our community starts to become more educated and these newer ideas penetrate the conventional wisdom, there will be little resistance. There are certainly data out there showing benefits through mechanisms that are common to all cancers, and successes seen clinically as well.
      So that’s my rant for the day- I hope this sheds some light on what you have witnessed.
      Best
      Dr D

  • ROSE

    MY 10 YEAR OLD PUG HAS LIVER CANCER SINCE NOVEMBER AND IS TAKING DENAMARIN & C-VT URSODIOL DO YOU RECOMMEND THESE?