A lover of a dog with cancer needs to come up with an plan that makes sense. The first step in any plan is arming oneself with answers, or data that relates to the situation.
There are two basic areas that we need to focus on. The first is what can we do to maintain or improve life quality. The second is what can we do to improve lifespan.
Life quality can be looked at by breaking down, or defining, the joys in your dog’s life.
How many are there? Some joys include eating, drinking, physical exercise, social relationships with humans or non-human animals, satisfaction of normal bodily functions, the pleasure in overcoming manageable challenges, play activities and creative expressions of self, and having a healthy consciousness.
So there are eight big categories. Maybe you have more for your dog.
In gauging life quality, how many of these eight are gone? How many persist? In which direction does the scale tip? How do treatments interfere with each of these?
Go ahead- count them! How may are there? How many are not? What is the bottom line?
An analysis using numbers can really help clarify where our dog’s happiness is at a given point in time.
What about the choice of whether to treat using a given technique (radiation, surgery, or chemotherapy)? Numbers really start to matter, because we are in the realm now of life extension, longevity, life quantity. And we are in the realm of life quality too, because treatments have side effects that can lessen happiness.
Oncologists use a figure called median survival time to talk about how long a patient has with a given cancer type at a given stage in progression. This just means, “how long does my dog have?”
What is your dog’s median survival time without treatment? A very central, important number. I gave the present median survival times for all the cancers that are published in the Dog Cancer Survival Guide, since this is such a pivotal question.
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What about efficacy of treatment? By how much is this median survival time expected to be increased, using a given type of treatment? This means, “how much more life do I get?”
You need to be armed with this information!
Now let’s widen back and look at the big lifespan picture. How long would a dog without cancer be expected to live? You can find average lifespans here. I talk more about lifespan determination in the Guide as well.
So if we have a dog who has already reached his or her average lifespan, not even considering the cancer, how aggressive do you want to be with treatment? Likely not that aggressive, unless your dog is particularly vital and vigorous.
One question could be, “why are we trying to extend life when if we are at the departure time anyway”?
If, on the other hand, you and your vet feel that your dog is particularly vital and vigorous, perhaps being more aggressive would make sense.
Speaking of aggressive treatments, what is the estimated rate of side effects that would be considered serious or life threatening (heart and kidney failure, or nervous system injury, bone fractures, severe pancreatitis, spontaneous bleeding, etc)?
How about those that are not life threatening but that affect life quality (lethargy, loss of appetite, diarrhea, mild bladder inflammation)?
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Are you comfortable with those odds, those risks, of a given treatment? You will be the one dealing with them more than your vet or oncologist!
How many minutes or hours in the day do you have to give to care for your dog? As a guardian, how much time can you devote to cancer diet preparation, supplement dosing, self-esteem building, social enhancement, trips to the vet, and so on?
Being honest and specific can help you make a plan that is right for you. 30 minutes two times a day? 5 hours a day? 10? What is the truth?
Put that time in your day planner!
Even if the numbers we are dealing with are approximate, this kind of thinking can be very helpful for dog lovers.
Being your dog’s primary health care advocate involves collecting information. Do the best you can in this area so you can rest assured that your decisions are the best they can be.
Numbers can be your friend.
Sending my best to all of you,
Dr. Demian Dressler is internationally recognized as “the dog cancer vet” because of his innovations in the field of dog cancer management, and the popularity of his blog here at Dog Cancer Blog. The owner of South Shore Veterinary Care, a full-service veterinary hospital in Maui, Hawaii, Dr. Dressler studied Animal Physiology and received a Bachelor of Science degree from the University of California at Davis before earning his Doctorate in Veterinary Medicine from Cornell University. After practicing at Killewald Animal Hospital in Amherst, New York, he returned to his home state, Hawaii, to practice at the East Honolulu Pet Hospital before heading home to Maui to open his own hospital. Dr. Dressler consults both dog lovers and veterinary professionals, and is sought after as a speaker on topics ranging from the links between lifestyle choices and disease, nutrition and cancer, and animal ethics. His television appearances include “Ask the Vet” segments on local news programs. He is the author of The Dog Cancer Survival Guide: Full Spectrum Treatments to Optimize Your Dog’s Life Quality and Longevity. He is a member of the American Veterinary Medical Association, the Hawaii Veterinary Medical Association, the American Association of Avian Veterinarians, the National Animal Supplement Council and CORE (Comparative Orthopedic Research Evaluation). He is also an advisory board member for Pacific Primate Sanctuary.