The Most Important Question in Dog Cancer Care
ByMany dog lovers arrive at The Dog Cancer Blog looking or information. There is a problem though, and I would like to begin to spread the word about the most important question in dog cancer care.
Here it is: What type of person are you?
To many, this may sound very bizarre, so give me a moment to explain myself. In the world of dog cancer care, there are very few “right” choices. The reason for this is that most of the real cancers are not curable.
When we navigate a course in disease management that focuses on balancing life quality, life expectancy, ethics, and the ability and resources of the dog lover, we find quickly that the waters are murky indeed.
The “retrospectoscope” (a made up tool that allows one to see future events as if they had passed) would provide 20-20 vision, but in reality we have no crystal ball to see the future. There are very few ways to know if our choices are the correct ones at the time we are making them.
For example, you have a dog that is 6 months shy of her average life expectancy based on breed or body weight (this data is in the Dog Cancer Survival Guide). She is afflicted with a cancer that has a median life expectancy of 10 months with chemotherapy (say, lymphosarcoma). This dog is close to her life expectancy, and there is no guarantee she will get the 10 months.
On the other hand, maybe she is one of the incredibly rare dogs that goes into a permanent remission (cure). Chemotherapy would have been a good choice.
She could though be one of the dogs that has a horrible drug reaction. Chemotherapy would have been a bad choice. (Incidentally, a test to help predict certain chemo drug sensitivities is the MDR 1 mutation test, very easy to do for your vet.)
So it is clear that we just don’t have the needed data to always know the best course for our dog’s care. What to rely on?
In conventional cancer care thus far, treatments with longer life expectancies yield increased side effect risks. This point is perhaps overlooked many times in decisions involving dog cancer care.
Now we get to that question: What type of person are you? Defining you, your canine companion’s number one health advocate, is the most important first step in a dog cancer treatment plan.
Since there is no “right way” (and by right way I imply that your personal ethics are incorporated in the plan), we need to establish some guidelines. First, is your priority life expectancy or life quality? What is your tolerance for risk? Can you live with some of the graphic realities of your choices?
What has been the way you have lived your life in the past? This is a very useful question. The answer can be illuminating when contemplating treatment decisions with your dog.
In the Dog Cancer Survival Guide, I outline three different types of people who range from accepting of aggressive procedures with the possibility of more serious side effects, to those who prefer to avoid side effects at any cost. This latter group will, out of necessity, often be forced to accept shorter life expectancies.
Pinpointing yourself somewhere in this spectrum will provide you with valuable insights in what to do for your dog. Remember, the right choices are usually determined with the “retrospectoscope”. Use what you know now about the type of person you are.
When you are tackling a tough decision about dog cancer care, first ask yourself, “What kind of person am I?”
Best to all,
Dr D
About the Author
Dr. Demian Dressler, DVM is known as the "dog cancer vet" and is author of Dog Cancer Survival Guide: Beyond Surgery, Chemotherapy & Radiation. Visit his blog and sign up free to get the latest information about canine cancer. Go to http://DogCancerBlog.com.
3 Comments
December 10th, 2009 at 12:39 pm
Excellent article. It is always such a hard decision. I think overall for me it is a quality of life. With Benji we had the surgery but the cancer would return at some time and at best within ten months. He developed other serious problems after the surgery – unrelated but requiring more intensive surgery and recovery. At this time the vet suggested it may be better for him to let him go now. Hard yes, heartbreaking yes, but I think it was the best for Benji as his quality of life would not have been what he liked
December 10th, 2009 at 5:51 pm
I had a 14 year old retriever dx with bone cancer in r front leg. Amputation and chemo was suggested. She was healthly in other ways. she was also a little overweight. We decided to manage pain and do nothing else except for the bisphosphonate tx. We did it one time and had the second scheduled. She was showing too much pain and I had her put to sleep the day afer the appt made for her next treatment. If she had been younger, I probably would have had the amputation. I know surgery could have spared her pain but possibleu opened too many doors for potnetial difficulties. Very tough decision in some ways; other ways it seemed like a no-brainer. Always second-guessing.
Had a dog have surgery to remove tumors on his chest. It spread like wildfire after surgery. I began second guessing myself about what if I had not had surgery. Damned if you do and damned if you don’t.
December 11th, 2009 at 2:19 am
I too think this is an excellent blog. I believe it is a difficult decision no matter which way one decided to go. My decision has been for quality of life. My little dog has a MCT on her left hind leg and I chose not to do any medical intervention, however I determined I would give her the best quality of life I could with the time I have left with her. She has lived past her life expectancy of 13 yrs plus months. She is now 14 yrs plus 2 months and 9 months past her diagnosis of cancer. She is on no pain medication at all, she walks morning and evening and besides dragging her leg because the cancer has encapsulated the muscles around her upper joint she appears healthy. Eating can be a problem at times so we’ve used the information from DR D’s book using baby food when necessary. I use the alternative vitamins and minerals as well as herbs suggested in DR D’s book. I crush these and put them in her doggy treats I make. I use Mega Red daily. I make sure to the best of my ability she gets no preservatives in her food and I cook everything from scratch. It is more work and probably more expensive however it is the route I’ve chosen and as a result I believe my little dog has outlived what she would have without my interventions. I have been truly blessed finding this site and getting Dr D’s book. Of all the research I’ve done and I’ve done a lot, the book and information here is the best!