Radiation is a big gun in dog cancer therapy.  There are many out there that would not even consider it….to hardcore, too scary.  And honestly, many times they might be correct.  But in some cases radiation should be at least considered.

For many it is out of the question.  No nearby cancer referral center, no veterinary university, no money.  But for those that live fairly close to a facility that offers this modality, it is an option.

Why do people opt for radiation for their dogs? What is the point?

Radiation is to help dogs that have cancers that are hard to cure. These cancers either never go away, or go away with treatment only temporarily.  So people consider it as another way to increase their dog’s life expectancy or to hopefully improve life quality.

Radiation is used to decrease the tumor cell burden (kills certain types of cancer cells), in very few cancers can cure them.  More and more frequently, it is used to help with tumor pain. If a tumor cannot be removed with surgery (inoperable), radiation can be an option as well.

What cancers are very sensitive to radiation (where radiation can kill a lot of the cancer cells)? Lymphosarcoma is a biggie, perianal adenoma/adenocarcinoma, neuroblastoma, plasmacytoma, and transmissable venereal tumor.    Some other cancers that are moderately sensitive (radiation helps a bit) are nerve sheath tumors (hemangiopericytomas), fibrosarcomas, and histiocytomas.

Radiation can help control pain with osteosarcomas in dogs.

So that’s a bit of the good.  Let’s look at the bad in the next blog post.

Best to all,

Dr Dressler

One of the things I realized in my quest for defining what I’ve coined a “full spectrum approach” to treating cancer is personal bias.

I am not talking about racial or sexual discrimination of course.  Rather, something I realized that we all carry within us, and I include myself in this, is the presence of viewpoints that condemn before investigation. 

Condemnation before investigation is a concept that was put forth by William Haley, a British philosopher and theologian in the 1700’s, and later attributed to Herbert Spencer. The idea is that something is immediately criticized before actually checking it out first to see if there is merit.

The danger in this process is that limits the options we have in treating dog cancer.  Branches of medicine tend to be divided between conventional (allopathic, Western, etc.) which is your chemo/radiation/surgery,  and alternative, which tends to lean towards deficiency correction, nutrition, mind/body, homeopathy, Chinese medicine, and is a general catch-all for what is “not” Western.

Here’s the problem: one finds that members of one group, more often than not, poo-poo the other group. Without really checking it out first. Condemnation before investigation. 

How many times have a heard an “alternative” dog owner tell me that antibiotics are “bad”? How many times have I heard a colleague blow off the idea that the pet food a dog eats can affect his long-term health?  That herbs are silly? How about that surgery is just a bad idea? No real evidence that acupuncture does anything? 

These viewpoints are rooted in the same mental process that produces racial prejudice and bigotry against women.  They are belief systems arising from indoctrination, reflexive responses, peer pressure, fear of criticism, and attachment to the ego.

There is only condemnation of the other perspective or person.  No investigation. No allowing of a “what if…”

When medical people do this, options that could be used to help save a dog with cancer are never explored, the mind is never really allowed to do its job, and we are faced with resulting survival statistics that are garbage.

The key is investigation and avoiding our attachment to certain viewpoints.  Only in this way can we create new ideas and evolve at a decent pace.

I am hard at work on a manuscript that attempts to avoid this partisan approach to medicine, and uses a Full-Spectrum approach to create a comprehensive plan for dogs with cancer. 

Cancer, whether in canines or people, can be snuffed out.  The key is really considering the possibilities…allowing that cure and non-toxic remissions to exist as real possibilities…and avoiding condemnation before investigation.

Best to all,

Dr D

I have been focusing a bit on osteosarcoma, since this is a common cancer.

This info applies to any big surgery involving cancer in dogs though.  I thought that a few bits of vet-only knowledge would be nice for dog owners.  That way you can discuss the important topic of pain control at the time of a major cancer surgery.

Before the procedure, you might want touch base with the vet about pain control. Pain is a major negative in life quality.

Different vets will have different ideas on pain control.  Those those a bit more on the ball will most definitely be giving pain control a priority.  

More modern vets will use a CRI, which is a Constant Rate Infusion of pain controlling drugs. This is a nice thing to do. It means the drugs are constantly flowing into the body through the IV.

Some will give an epidural, which is an injection of pain controlling drugs into the fluid around the spinal cord. Another nice technique to use in combo with other drugs.

Many use a Fentanyl patch, which is a fairly good way to control pain.  You have the patch applied to the dog a day or so before the surgery and it releases fentanyl through the skin. I like to combine it with some other agents for pain control.

My opinion is that one or more of these be used for major cancer surgeries, along with injections of other drugs as needed after the surgery.

Good options for take-home meds are sustained-release morphine and tramadol.  These should be combined with some anti inflammatory like metacam or possibly deramaxx or rimadyl.

Some vets really into new stuff will start the dog on Gabapentin before surgery, or possibly amitriptyline. You can start these days before surgery and they can help with pain control in combination with other drugs.

Drugs I don’t like for real pain in major dog cancer surgery? Buprenex (buprenorphine), only a moderately strong drug, not a big enough gun in my opinion.   Torbugesic (torbutrol) in dogs for take-home pain control is too wimpy and too short-acting.

So, the take home message? First, control that pain!  Multimodal analgesia, or using different ways to accomplish pain control is where it is at.

So be your dog’s health advocate and make sure pain is under control.

Best, 

Dr Dressler

In the last post, I focused on looking at life quantity, or lifespan, in considering amputation for dogs with osteosarcoma.   Let’s focus on life quality issues and amputation.

Often the first question that arises is, “But will my dog be able to have a normal life on 3 legs?” Everyone, the answer is almost always yes. 

There are two big things to factor.  First, are you available to assist your dog in walking during the recovery period? The remaining limbs need to strengthen to support the extra weight.  This can take just a few days in a lean, young dog, or it may take a few weeks in an older or overweight one.

The second things to factor in is other problems that could affect the weight bearing, like arthritis, hip dysplasia, old ligament tears, back or neck problems, and so on.  The presence of other orthopedic issues can slow or complicate things a little and should be discussed with your vet.

Usually, most dogs are up and hopping around whenever or wherever they want to within 1-3 weeks.  They really do just fine once their strength builds.  It can be hard to watch but many times when people are depressed about it, they start to look at the dog and realize, “Wow..my dog actually seems pretty happy!”

They just seem to move on with life and live in the moment, which is a good lesson for all of us to learn from our dogs.

During recovery, you will need to help your dog learn to walk on three legs.  This is really pretty simple. you just need to help them support their weight during walking.  This can be done with a commercial sling you can purchase, or with a towel looped under the belly or the chest.  You just lift some of the weight and they will hop right along.

Remember in males that you will need to position the towel away from the sheath for urination or you will have a wet sling and a unhappy boy!

You will want to provide a surface that is not slippery to walk on.  Ramps can help get up in some cases too.

You should work on keeping your dog lean.  Being overweight has a whole collection of bad effects in dogs with cancer, and bone cancer is no exception.  Additionally, the extra load makes it harder to move around.  Another issue to remember is that being overweight increases the risk of injury in the remaining limbs due to increased wear and tear (arthritis, cruciate ruptures, and more).

Activities that required four legs can always be modified.  Dogs will learn to live how they can and they adjust, just like we do.  If you watch them, they will derive as much pleasure in their new life as they did before. The limits of what they can do change, not the limits of how happy they can be.

Let’s look at the surgery itself and preserving as much life quality as possible with pain control in the next post.

Best to all,

Dr Dressler

Hi Everyone.

Osteosarcoma is a common cancer in the dog.  Most of the time it occurs on the long bones of the legs in large breed dogs.  And most of the time a veterinarian or veterinary oncologist will recommend amputation of the affected leg.

You will likely have some strong feelings about it, as one who loves a living, breathing being facing the removal of a limb.

This is a heavy duty question.  Since it has a lot of emotional charge for those interested in preventing pain and suffering, it can be a hard choice.  The choice warrants careful contemplation to make sure you are able to cope with the situation.

At least two factors should be  considered. The first is life quantity, which is also life expectancy.  The second is life quality, which of course is how good  life is.

Let’s look at life quantity first, or life expectancy.

First, get an idea of the average life expectancy of your dog.  Be careful with this.  These numbers are just averages, just like they are for people.  There is an excellent review of dog life expectancy  here.

Once you have ascertained what a dog’s potential life expectancy is, you need to weigh how much more time are we looking at for your dog.  Your vet can help with this by discussing the impact of your pet’s individual health problems.

We want to see whether, at the time of diagnosis, your dog has already reached the expected life length for most dogs like yours.

If your dog is close to what one would expect for average life length, the motivation or payoff for the surgery should be considered carefully. If your dog is not yet there, one might consider going ahead with the surgery.

It should be noted that most dogs with this kind of cancer do not survive beyond a year, with amputation alone (read more here).

However, this does not mean that your dog will pass away within a year, as you have access to continued treatment from your vet, oncologist, and the information contained here.  There will be more in upcoming publications being edited right now.

One last intangible is your particular dog’s personality.  Some dogs just have this will to live, and sometimes one can perceive this pretty clearly.  They just want to keep going.  They are driven.  This will to live, a tenacity, boosts lifespans.   Remember to consider this factor too.

That’s life quantity.

This is the first step. Next we look at life quality on three legs.  We will look a little at the surgery itself, some issues that affect life quality on three legs, and more.

I will post more on this issue in the next entry.

Regards,

Dr Dressler