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

A Useful Discussion for Dogs With Cancer

Updated: October 5th, 2018

I received a question recently that involves a common situation for guardians coping with a dog cancer diagnosis.

So, to benefit everyone, I am including my answers here, in the hopes that you can apply the information to how you manage your dog with cancer.

This case is Almond, who is a 10 year female mix.  Almond’s guardian was advised to watch a growth to see if it increased in size.

I believe that, since half the dogs over the age of 10 will get cancer, that every mass should be checked with at least a fine needle aspirate.

We cannot tell if a tumor is malignant with the naked eye most of the time.  And we cannot tell if a tumor that is not increasing in size is not sending cells off to internal organs (metastasizing).

Almond’s guardian eventually had the growth removed and biopsied.  Good work. Always get that pathologist’s report so you have some idea of what to expect from this growth. Some are benign too, or some are completely removed with a single surgery.  So always get the biopsy report.

The path report revealed a grade 2 mast cell tumor. Now, it is true that all mast cell tumors have the potential to be malignant. But here we have general guiding information that this is an intermediate grade, meaning some aggressively spread and some do not. So we have a gray zone to deal with in what we can expect.

This can be frustrating. Luckily, for some cancers, there are further tests that can be done to pinpoint more accurately these gray zone path report.

Mast cell tumors, and other cancers, have something called mitotic index. This is the relative number of dividing cells that the pathologist sees on the slide. Higher mitotic index usually means faster growth and more aggressive behavior.

Generally, with grade 2 mast cell tumors, if the mitotic index is 5 or less, these tumors behave in a more benign fashion.

This means that the odds of spread are low after a proper surgery is done.  Having said that, we still need to realize that some of these can surprise us and spread.  But all told, most of these will be cured with a wide excision.

Wide excision means that a large swath of normal appearing tissue is removed around the lump (tumor).  This increases our odds of removing the cancer completely.

If we receive a diagnosis of mast cell tumor, or any cancer that has the potential to be life threatening for that matter, I always advise a wide excision around the tumor site, even if this means a second surgery.  Get the bad cells out if you can.

This would be a good thing for Almond’s mom to consider first, if the surgery was not initially a wide excision.

Almond’s treatment plan was discussed.  One of the first steps in dealing with dog cancer is to define what kind of person are you, as a guardian?  Is your priority life extension or life quality? Both? Most conventional steps, in particular chemotherapy and radiation, have life quality effects that are in proportion to life extension gained.

This means if we get better cancer responses, the odds of treatment side effects go up.

You must define what your priorities are.  Write it down. This will be your guide in how you make treatment decisions.

Next is the topic of what other steps should be taken.  Chemotherapy was brought up (we will get to this in a moment).  However, I wonder what about diet? Apocaps? Other supplements? Life quality enhancement? These are useful measures to take when a dog is producing tumors.

What about chemo? Well, getting data is a good thing.  We have looked at Palladia in a few posts.  By the way, please use the search bar to the right of this screen to search for specific cancer topics.

We see that 42.8% of dogs respond to this chemo drug, and that the response length averages, at most, 4.5 months.  Hm.  To answer whether or not this is a good gain, we must go back to that question: what kind of person am I?

How about side effects? Here is the data submitted to the FDA for approval of Palladia as a New Animal Drug at a dose commonly used in practice:

Dose:  3.5 mg/kg every other day

No of Dogs: 20

Side effects:

Diarrhea : 50%

Anorexia (loss of appetite): 40%

Vomiting: 5%

Fatigue  15%

Hind limb weakness: 15%

Neutropenia: (drop in the numbers of a white cell): 0%

Do these numbers hold for every dog?  Of course not. Twenty dogs were used.  These side effects may not happen, or other side effects could possibly happen that did not occur in these twenty dogs.

And perhaps the doses being used by a given oncologist are lower than the dose assessed here, which also would tend to lower side effects.

However, this is a guide, a starting point to assess what the side effects odds could be.

Now, Almond’s guardian has the data she needs.  Perhaps the benefits of Palladia are sufficient for her to treat her dog, taking into consideration the big picture, or perhaps not.

It all depends on the answer to the question: what kind of person am I?

For more information like this, read The Dog Cancer Survival Guide.


Dr D

Leave a Comment

  1. R & Sid on August 7, 2011 at 12:22 pm

    Our 6 year old dog (the best doberman in the world) was diagnosed with hystiocitic sarcoma in January and we were told that her time would be very limited. She had lumps removed from around her shoulders and started lomustine. The lomustine stopped working after only 3 doses and the lumps came back. We had her scanned and tested and the cancer still seems to be localized. So, she had these new lumps removed and has just started doxorubicin. We are now 8 months on from diagnosis and she is still here with a shiny coat and a wet nose (and by all accounts still baffling everyone!). How successful is doxorubicin in prolonging life and what would you recommend to help her through this much more grueling regime? Any help would be gratefully received. We just want to make sure that our angel of a dog has as much fun as possible for as long as possible.
    Thanks so much

    • DemianDressler on August 8, 2011 at 12:14 am

      Dear R and Sid,
      I am sorry to hear this about your dobey. There are different kinds of histiocytic sarcomas. Believe it or not, you are beating the odds already. In those that respond to chemo, median survival time is 6 months. However, these numbers should be taken with a grain of salt because they do not apply to individual dogs. I would strongly advocate the use of each tool we have- diet, apoptogens (Apocaps), immune support (beta glucans, active hexose correlated compound, etc) anti-metastatic supplements (modified citrus pectin, possibly doxycycline, omega 3’s, etc), and of course deliberate steps to daily increase life quality. You can search this blog and these are discussed in detail in the Guide. Also therein you will find info about Coenzyme Q and dexrazoxane to protect the heart from Dox’s cardiac effects.
      Please use veterinary supervision…

      Dr D

  2. Marsha R on May 14, 2011 at 2:16 pm

    I have a 10.5 maltese she will be 12 in Sept. has tcc bladder cancer. was put on proxicam 1.5 from local vet. bio was done to confirm through the Oklahoma State university a year and 5 months ago. Also taking her to holistic vet during this time as well. On March 31,2011 I started her on Neo 300 oral dose 1.8 she was really going down fast , Was doing as Dr. Foxs protical was telling the holistic vet to do. No pain meds and so on she cried all the time could not touch and so on a week before easter I stoped the neo . gave her body a week to rest then started back on the Proxicam and the standard process immunity. We noted so very large tumor , was told they was her rear mammary glands one vet said the lymp gland. they was going fast so Tue of this Week 05/10/11 the tumors (exterior) was both mammary glands and 1 lymp node. then internal they knew there was another one anddidn’t believe it to be the tcc bladder cancer. So when he went in it was one that had came through the wall and was resting on the bladder. He did not touch the bladder one for fear of seeding. the original area of cancer in bladder is in the neck . It has got larger but now lower so will not restrict flow. While he was in there he said the wall was like a liquid substance. (I live in a small OK. town this was even the first bladder cancer) to be treated all others was brought in to late. While she was in surgery her heart stoped 9 times . Thankfuly there does not seem to be any nero problems. After the surgery the next day we repeated the blood work almost all was very elevated. so he is giving 2 antibotics to cover it all. plus pain shot and IV every day then as I pick her up in the evening a penicilin shot. What do I need to be doing to rebuild her insides and keep her cancer even what maybe there and not know about at rest. Im a member of several yahoo groups and some of them said they use salvestrol platinum , I have it but my vet is not sure of it either. Please help not having children my heart is breaking. As in what I what. of corse a long life but I want it with quality.
    Thanks and God’s Blessings to you and yours
    Marsha R

  3. Angela on January 10, 2011 at 4:42 pm

    Hi, I have a basset hound and he is 12yrs old and was just diagnosed with Acanthomatous Epulis and surgery or radiation are the only options I was given in treating this. I purchased your book on dogs with cancer in hoping that I would find an alternative solution. Is this a type of cancer? Or is this something that can only be treated with surgery or radiation? It is very small and was removed with a 1cm margin, and now it is a matter of waiting to see if and when it grows back? I thought maybe some of your suggestions in your book may stop or slow the growth, any thoughts or suggestions would be greatly appreciated.
    Angela R.

  4. DemianDressler on January 10, 2011 at 1:38 pm

    Dear Joe,
    The protocol I use in my patients is to drop the NSAID to 1/4-1/2 of the labeled dose and start the Apocaps, while monitoring for any signs of digestive upset (loss of appetite, diarrhea, vomiting, etc). As always, all steps concerning the care of your dog should be done under veterinary supervision.
    Dr D

  5. Valerie on January 8, 2011 at 7:36 am

    In April 2010 our 9 year old GSD (Maya) was diagnosed with kidney cancer. We had the kidney removed and then began the process of looking at “next steps”. I did a lot of web research and bought the Dog Cancer Survival Guide. This really helped me come to terms with the diagnosis and provided me with a process to determine what we could and would do to help her. The diagnosis was “this … includes high grade renal adenocarcinoma and nephroblastoma.” There was tissue invasion and vascular invasion which warranted a guarded to poor prognosis. We discussed her condition with 2 oncologists. Each noted the rarity of the tumor and little information on effective therapy, both suggested treatment with Palladia and low dose Cytoxin, and both did not give us much hope for survival beyond 6-8 months. The oncologist at the clinic that removed her kidney was actually surprised that the cancer had not metastasized given the condition of the kidney at the time of its removal. We did not select the Palladia, Cytoxin route because of our perception of the narrow margin of safety and our dog’s fear of vet offices and fretful nature. We started with Apocaps and we also found Susan Blake Davis ( – a canine nutrionist. She has helped us craft a raw diet and provide a wide range of additional supplements that addresses our dog’s immune support, many allergies and protects her remaining kidney. So where are we today? It is now almost 9 months since the diagnosis. She appears well, has a hearty appetite, and is happy. The only issue we currently have is that she is a bit chubby. She really likes to eat and loves the raw food. We are realistic about her age and natural longevity. We set short term goals and view every day with her as a blessing. Thanks Dr. D. We will keep you updated on Maya!

  6. dianna champ on January 8, 2011 at 7:36 am

    My 16 1/2 yr old pot-bellied pig Olivia was diagnosed with squamous cell carcinoma. It originated in her jaw and inside her cheek. After the first surgery, it grew back and was removed again only 37 days later. It was very aggressive and her only option was palladia, which has never been used for pigs. She recently finished up 6 months of palladia about, 2 1/2 months ago. She is now 17 1/2 years old with no sign of cancer. While on the palladia, she did become anemic and a little tired, and now has some weakness in one of her back legs, but she is almost 18 yrs. old. For us, the palladia seems to have worked so far, with very few side effects.

  7. Roberto on January 7, 2011 at 7:54 pm

    Hello Dr. Dressler,
    my dog got a mast cell tumor removed when he was 8yo ( May 2009) , he is a pitt mix, the result it was grade 2 and my vet removed it with clean margin, after reading your book I decided to change the diet and give him the supplements,(all raw plus a veggie mist and bone meal to balanced it), no chemio or radiation.
    He was doing fine until last summer when he developed a very bad allergies ( food?)
    So after different food changes I stabilize him on a a raw turkey mix with bone, (Columbia River Natural)
    He is 70 lbs and he eats almost 2 lbs of food each day, how many pills does he needs, do I have to give them on full or empty stomach?

    Thanks Roberto

  8. Julie on January 7, 2011 at 5:36 am

    Just to give a positive story on Palladia – my gorgeous dog, who had a mast cell tumour removed by surgery, followed by radiotherapy but who couldn’t cope with Chemo (dangerously low levels of white blood cells) is doing brilliantly on Palladia. She has appeared physically well, bright and energetic all the way through. She is very fit and relatively young (5 now). After Chemo was abandoned she was monitored and eventually cancer was detected in her lymph, with an enlarged lymph node the evidence of it. After 6 months on Palladia the lymph node has not enlarged further and she still appears very well. She does, however, appear to be the exception. Other dogs treated by the specialist cancer clinic that we attend have not found the same benefit, but they do all seem to have had other health issues as well, not just a mast cell tumour.

  9. sandimarketing on January 7, 2011 at 5:31 am

    I was told Chemo isn’t effective for a mast cell tumor. I changed diet, gave supplements, including Chinese, didn’t have his leg amputated as suggested by Oncologist, and my dog still has 4 legs and is now 14, diagnosed @ 10. One Oncologist recommended radiation.

  10. Joe Sapp on January 7, 2011 at 3:58 am

    My 12 year old extremely healthy (otherwise) spayed standard poodle, Sydney, has squamous cell carcinoma originating in a salivary duct. Pathology of the resected primary tumor indicates a micrometasistis lest behind. After the resection a nodule appeared in a lung, to the surprise of the oncologist. A combination attack of carboplatin and piroxicam has not been able to stop the tumor growth, so doxorubicin is now being substituted for the carboplatin, continuing the piroxicam. I have read that Apocaps should not be given concurrently with an antiflammatory, which I believe the piroxicam is so I have not given the Apocaps. I feel that I may be holding back a “big gun” weapon, I desperately need to know if I should be giving the Apocaps. PLEASE COMMENT.

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