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

Critical Question when Weighing Dog Cancer Chemotherapy Options

Updated: November 15th, 2018

yes-no-chemotheraphy-decisionMany Guardians are faced with difficult decisions when facing a dog cancer diagnosis.  One of the toughest is whether to choose a treatment that seems more aggressive than others.

A guardian should first get an idea of whether the expectation of the treatment is worse than the treatment.  Many times dogs receiving chemotherapy treatment do not experience the side effects that would be imagined by a Guardian.

Generally, chemotherapy is better tolerated in dogs than it is in humans.  My colleague, Dr. Sue Ettinger, lives and breathes chemotherapy in dogs, as she is a full time oncologist at the Animal Specialty Center in Yonkers, NY.   We have discussed her impression of chemo side effects compared to the public opinion, and her feeling is that on average the anticipated side effects are worse than the real ones.

Having said that, it is true that chemotherapy is not a minor treatment, and a frank discussion of side effect odds and severity should always be had with your vet or oncologist.

The question of whether a treatment is too aggressive really has to do with what your dog (and you) gain from the treatment, compared to what you must pay or sacrifice.

For this reason, a critical question to always ask your veterinary professional is this:

“What is the gained life expectancy from this treatment?”  You must emphasize the word “gained”.  This is because the question is not commonly asked, although it should be.  Rather, Guardians usually ask some version of “How much longer does my dog have?”

Notice that these are different questions.  Gained life expectancy is how much more time a treatment can be expected (approximately) to give a dog, compared to without the treatment.  Life expectancy is how much time a dog will have with the treatment overall.

To explain further, let us consider two examples.  A dog with lymphosarcoma receiving chemotherapy only (no diet change, supplements, etc) has a median life expectancy of somewhere around 12-14 months with the best protocols.  This is a rough rule of thumb. So life expectancy, very roughly, could be 12-14 months from when we started chemotherapy.

This is very different from gained life expectancy.  For this, we have to know what the life expectancy would be without treatment.  In this case, a few months (maybe 3?).  So the gained life expectancy would not be 12-14 months with the best protocols.  It would be 9-11 months, since that is the difference between treatment and no treatment.

When you weigh the gained life expectancy against the costs of treatment for both your dog and you, and the odds of side effects, you will be on your way to answering whether a treatment is too aggressive or not.

For more ways to help you chart a course through dog cancer, check out the Dog Cancer Survival Guide.


Dr D


Leave a Comment

  1. Gail on September 22, 2012 at 2:42 am

    Our 10 year old male beagle, Finnigan, just had his first chemo therapy on Thursday. He has squamous cell nasal carcinoma. He had 18 rounds of radiation March (?) – May 2011, and another higher dosage of radiation earlier this year. The cancer is hideous has eaten about 2 1/2 inches of his bone, above his eyes, and now there is an open leision between his eyes. Our Vet has said that Chemo (Caroplatin) would be his best choice. So we have decided to try this approach. What I am scared of is finding out what Finnigan’s life expectancy will now be. I would do anything for any animal, but truth be known, it is ripping my heart out to know that he and millions of other animals suffer each and every day of their lives. I really am questioning if in fact their is a higher being. My mom passed Dec. 28, 2010…so I am really having a difficult time with anything and everything right now.
    Is there much success with this type of drug?

    Thank you for your time.

    • Dr. Demian Dressler on September 28, 2012 at 1:14 pm

      Dear Gail,
      i am very sorry to hear this.
      We need for you to get information from your onc. if you have not read the guide it would be a very wise choice right now.
      to get you started:
      Ask the specific questions you need to get the data for successful treatment plan analysis (difficult for me to comment on this case without of course seeing it). Another thing: have an oncologist dealing with the chemo if possible. my two cents.
      I hope this helps

  2. Gail on June 29, 2011 at 6:48 am

    My spayed female mixed breed is not quite 7 years old and has been diagnosed with GI Lymphoma. She had surgery and a growth was removed. Then we had chemo (CHOP protocol) but the cancer is growing and the lymph nodes are enlarged. I stopped treatment after a month. She is taking prednisone and eating mostly chicken. She does not seem to be in pain but has lost some weight and sleeps a lot. What can I do for her? (

    Thank you, Gail

  3. Eileen on June 22, 2011 at 3:58 pm

    I would be interested in your comments on Hydrazene Sulfate.
    Thank you.

    • DemianDressler on June 29, 2011 at 6:30 pm

      Dear Eileen, probably a good blog post but the short story is it helps humans with weight loss due to cancer but little to no history of use with dogs, so cannot yet be recommended. No evidence for tumor remission or increasing stable disease or lifespan that I know of.
      Dr D

  4. Donna E. Szlosek on June 20, 2011 at 2:38 pm

    I lost my dog 4 weeks ago — it was not the cancer that killed him — the oncologist at AMC in NYC was horrible and never took any tests — she wanted my dog to have chemo when he was sick — the chemo not only put him in the hospital for destroyed white blood cells ( at one time 11 at another time 1!!!!!) but destroyed his kidneys. For the last 6 mos. of his life we had to infuse him with large amounts of fluids under the skin plus extensive amounts of medications. My dog would have had 9 mos. to another year if it were not for Dr.Nicole Liberman at AMC in NY. No dog should suffer like this — no dr. should administer drugs like Dr. Lieberman did without first doing tests on the dog.

  5. Chris on June 7, 2011 at 9:57 am

    Also important to do chemo sensitivity testing… Our oncologist did NOT after our dog did an amazing recovery act to overcome a bleeding hemangeosarcoma on her heart that had ruptured. We had some amazing vets and the ER had Yunnan Baiyao and our holistic and conventional vets and specialists worked very well together.. unfortunately the chemo ended up doing something that caused kidney failure. It was such a shame that she suffered so much from the kidney failure and had fought so hard and overcome the hemageosarcoma (over a 4 month period it solidified and started to shrink and the cardiologist said it was no longer in danger of rupturing. I do think we had an amazing dog and we were very lucky with the very rare outcome, but really wish I had pushed harder to make sure that chemo sensitivity test was done before she was started on chemo. It’s just a simple blood test.)

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