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

Is It Wrong To Treat Dogs for Cancer?

Updated: October 11th, 2018

There has been a lot of press and debate lately about the high costs of veterinary medicine. Being in New York, I’m thinking of several NY Times articles.

On the front page on April 5th, there was the article “New Treatments to Save a Pet, but Questions About the Costs.”

This article highlighted the advances in veterinary medicine and the associated high costs, including bone marrow transplants for dogs with lymphoma at NC State, urinary stents for blocked kidneys or bladders, and radiation therapy for brain tumors. These procedures can cost $10,000 to $15,000, and total bills may exceed $25,000 for all medical care. There are also advances in diagnostic tests such as CT scanners and MRI imaging. These tests (including anesthesia) can cost $1,000-2,000.

There were over 300 comments posted by readers before the paper closed comments. Clearly, this article generates a lot of interest and many opinions.

These debates appear from time to time. Last September a client of mine shared his experience with his dog Newman, who had tumors in his lung and brain, in the NY Times Well blog. Chemotherapy was less grueling for dogs that for humans, he wrote.

In the comments on his post, debate erupted when a human doctor commented:

“Awful and wasteful when there are so many *humans* unable to afford chemotherapy. The entire pet industry, for which we spend something like 11+ BILLION dollars in the US is sick when we have 44 million uninsured humans and hungry children in poverty. Priorities.”

The ethics debate continued on April 9th in Room for Debate: One Sick Dog, One Steep Bill

So what do I think?

I don’t believe people should feel guilty about spending money on their pets, nor do I believe it is unethical to spend money (a lot or a little) on pets.  You can spend your money on whatever you choose. If a Guardian wants to pay $15,000 for treatment of their pet’s cancer, it is their choice. Spending that money is no less ethical than the purchase of a new car, a new computer, or a dream vacation. We all have a choice.

I am not suggesting treating a dog is a good choice if the pet’s bill interferes with one’s ability to pay bills, to feed the children, or to support the family.

But choosing to treat your pet does not deny money for human health care, as some seem to argue in these comments. If we spend less money on pets, is that money somehow going to support human healthcare? Our society just doesn’t work that way.

I agree that adequate health care for all humans should be a priority, but I don’t understand the argument that we should spend less on our pets in order to achieve better human health care. It is not that simple.

So yes it bothers me to read that that treating our pets is “deplorable” when poor people do not have health insurance or adequate medical treatment, and that treating animals indicates moral decline of our society. I guess it bothers me because treating pets is personal for me. And it is also personal for each Guardian and each pet.

As a vet, I am obligated both ethically and legally to provide all available treatment options to the pet Guardian. This will range from aggressive and often expensive options, alternative protocols, palliative plans, no treatment, and in some cases, euthanasia.  I cannot make assumptions about what one can afford or is willing to spend. One’s background, upbringing, religion, past experience with pets or family or one’s own health may all play a part in the decision making. The decision will be very different for each Guardian.

How would you feel if you were willing and able to pay for a treatment for your pet, but it was not offered to you because the vet assumed you would not or could not pay for treatment? The decision to treat is a balance between quality of life, the benefits of extending it, the cost of treatment, and the Guardian’s financial situation.  Vets cannot decide what to offer nor make that decision for you.

These are such difficult decisions, and there is no one-size-fits all solution. For example, I know of Guardians who were upset that they were advised to euthanize because their dog’s cancer was not treatable. They were never even given the option to treat. The lack of options was upsetting to them.

And yet, my job as a vet is to tell you that NOT treating is always an option, too. While some Guardians are upset when I mention not treating, others tell me they wish their own vet had encouraged them to at least consider euthanasia, rather than to continue aggressive treatment.

I am often asked what I would do about a dog’s diagnosis, if this were my dog. It’s almost impossible to answer this question. It’s not a decision that a vet can, or should, make for you. The best I can do is to provide medical information, my expertise, guidance, and support. I have to give you everything I know, so that you can make the decision. Client empowerment is an important part of my practice, and an important part of why I chose to join Dr. Dressler in co-authoring the second edition of The Dog Cancer Survival Guide. It’s an extremely empowering book.

So these articles will continue to appear from time to time, and the debate about ethics, costs, and treating sick pets will continue. Part of my frustration is that these articles often leave out the alternative, less expensive options, many of which are FREE and are covered at length in our book. They paint my work and your life as a Guardian into little boxes, rather than acknowledging how complicated treating cancer is.

It does not have to be all or nothing when treating your pet. I recommend you seek a second opinion and hear ALL the options. And I hope people can remember what is right for you and your pet is not necessarily right for the next Guardian and her pet. When someone else makes a decision about how to treat, it does not reflect on anyone else. Everyone makes their own choices for their own reasons.

If you are dealing with dog cancer, get The Dog Cancer Survival Guide for a much more empowering experience. You can find out all the options and get actual reassurance that treating according to what you feel is best is not only OK, but one of your major responsibilities as a dog owner. If you’re not in charge, who is?

Discover the Full Spectrum Approach to Dog Cancer

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  1. StraitSam on July 29, 2014 at 11:18 am

    My 8 year old Shiba Inu was diagnosed with mesthelioma in January of 2014.
    She has been receiving chemotherapy since and have recently been told that the cancer is now spreading into her stomach. They also believe that the chemo may have done damage to her kidneys. I was given her swan song at the last vet visit, no more chemo and no more draining of fluids from her chest & stomach. She is losing muscle mass and considered to be in a fragile state.
    I received a call a few days later and was told that Palladia would help prevent fluids from accumulating in her internal organs. They said it could buy her a few more months.
    From what I read on the drug, it appears loaded with side effects and can’t find any postive reason why the vet would recomend this drug.
    Hate to just let her go, but sometimes, the sun is just not shinning

    • Susan Kazara Harper on July 30, 2014 at 1:16 pm

      Hello, I am so sorry to hear that your Sheba is having a rough journey. That is a pretty rare cancer… do you know where it is focused? Chemotherapy has to be powerful to do any good, but unfortunately that also means there can be side effects. You are right about Palladia, there are many potential side effects, and one of those is damage to the stomach. If Sheba is feeling that delicate, you have a big decision to make. Are you consulting with a vet oncologist? Or is your vet getting advice from one? Perhaps the best thing you can do it to take a slow, deep breath, and clear your mind. Step back from the emotion for a moment, and write down your questions for your vet. They may be things like *Why are you recommending Palladia? What about the published side effects? *Is there any other way to control the fluid build-up without using such a powerful drug? And then, put your notes aside and take another breath and talk with Sheba Inu. Heart to heart. Ask her what she wants. Are you using any nutraceuticals such as Apocaps. They may help her during this time, and help her immune system to its best. And nutrition is vital. The Dog Cancer Diet will help sustain her. When the sun doesn’t shine on us, we can only find beauty in the clouds. We are all hoping for the best for you both. Your vet can give you technical information, but you and Sheba are the ones to decide.

  2. Andy on August 19, 2012 at 5:13 pm

    I think everyone should provide at least basic treatment for their pets, which is to me is paying for doctor’s visits and reasonably priced drugs. I don’t care if other people spend 6 million dollars to make a bionic dog. I am probably in the lower to middle of the pack when it comes to what I will spend on a pet. There has to be a high probability of acceptable quality of life afterwards and low probability of recurrence for me to even consider any surgery or expensive treatment. Even then, I lean towards letting nature take it’s course.

    My last dog was about 15 and was pretty sick and showed signs of pain. They thought it was cancer but weren’t sure. Lots of costly testing would have been necessary at a minimum, to proceed. I decided to euthanize and she suffered far less because of it.
    My current dog has low platelet counts and the cause of it can be treated by steroids. He has a chance of dying in the next 2 days. A blood transfusion may help get him through if he starts bleeding. It’s an expensive procedure.. He is proceeding well now. The steroids themselves are saving his life right now. He has no pain from this illness.

    • Dr. Susan Ettinger on August 27, 2012 at 3:58 pm

      Andy,
      Thanks for your thoughts. There is no wrong or right answer – it’s clearly very personal and complicated.
      Good luck with your dog with the low platelets.
      All my best, Dr Sue

  3. The Ethics of Cancer Treatment For Dogs | CANCER BLOG on August 13, 2012 at 10:41 am

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  4. Phyllis Boyd on August 12, 2012 at 8:00 am

    My 7.5 yr old smooth fox terrier has been Dx with TCC…bladder cancer. So far symptoms are some blood in urine, drinking a lot of water and urinating a lot…as well as some straining when he does this. No mets seen anywhere from xrays and ultrasound tests, but doc says its concerning that cancer is close to ureters and I am worried about blockage in the near future. We chose to treat medically…no chemo, and doc put him on Rimadyl. He’s only been on it a few days–and I am a little worried about some side effects I have read about it–watching him closely. My questions are 1: is Rimadyl the best med because I have been reading that Piroxicam is more frequently prescribed? 2: does it make sense to consider stenting if the time comes soon and he is otherwise feeling well– or do we try to accept the fact that he is prob months away from death anyway– and euthanize? Horrible for us to consider the option, but I don’ t want to see him suffer, and we are not flush with money so costs are a factor. So far, just the tests to diagnose him were $1500. Appreciate any advice…so sad these past few days to know our loving Hershey is so sick, because he seems so happy and full of life.

  5. Jane on July 25, 2012 at 7:12 am

    Dear Dr Dressler,

    My vet suggested to start Fox on predisone since we were worried about doing chemo on him. So I agreed but worry that we don’t have a confirmation of what is wrong with him. She said she would not do anything different so why put him through a biopsy. She also has him on Clavomax and the other day started him on Doxycycline because she thought he might have kennel cough. I don’t know what to do — she is a new vet my vet retired and she bought the practice. I don’t know what to do — since he started the Doxy his lymph nodes are back to normal. So could it be something else or am I just wishing? If he has lymphoma I understand he will die in 2 months and I want to prepare myself for the worse. Please help — if it were your dog what would you do? Thank you for any advice

    • Dr. Demian Dressler on August 1, 2012 at 2:12 pm

      Dear Jane
      two options to consider:
      1. Cancer
      2. Not cancer
      These are very different. The concern with chemo was what? In other words, if you have confirmed lympho, you can then consider chemo (with its advantages and disadvantages). THere are other options to consider for full spectrum cancer care in addition to chemo however- many more tools to use or consider (in the Guide). If you rule out cancer, you have a whole different fact pattern. The question and actionable data dictate choices far above and beyond pred or no pred.
      I’d stop playing around with this and get a diagnosis, personally.
      I hope this helps
      Dr D

    • Dr. Susan Ettinger on August 10, 2012 at 9:19 am

      Jane,
      IF Fox is on pred, which treats lymphoma, and the doxycycline, which treats tick borne disease – the other main thing that causes mutliple enlarged lymph nodes, and the nodes are normal now, we still don’t know the diagnosis. Pred works very well for lymphoma but response times are shorter, usually 2-3 months. If chemo is not an option, consider other options are discussed in the Guide. Also we do not recommend full dose Apocaps when dogs are on pred. Good luck to you and Fox!
      All my best, Dr Sue

  6. Jane on July 19, 2012 at 8:57 am

    I have a 3 year old Papillon and found a golfball size lump on his neck. The vet said she thought it was lymphoma and did a fine needle aspiration. Well his blood work came back his white blood cell count was high but the fna came back “inconclusive” — something about the cells being dead. They did the fna again and the results were the same. The vet still seems to think he has lymphoma and said we could try predisone or chemotherapy. From my understanding if not treated he will die in 3-6 weeks, if we do the predisone he may live 2-3 months and chemo he may live 1 year. He is a big baby — he is afraid of his own shadow and pees if I yell at one of my other dogs. I cannot see putting him through chemo but I know if I start the predisone it will hinder trying to do chemo later. The vet said we can try another fna on a lump we just found in his groin area. What should I do? I love my dog so much and want to do what is right for him — so do I just assume it is lymphoma or is there a chance it could be something else. Any insite would be greatly appreciated.

    • Dr. Demian Dressler on July 24, 2012 at 9:17 pm

      Dear Jane,
      I would not start chemo with an inconlusive fine needle aspirate. Get a lymph node biopsy done on two different nodes. Chemo is big guns and may have side effects and cost to all…so confirm first, IMHO
      Dr Dressler

    • Dr. Susan Ettinger on August 10, 2012 at 9:09 am

      Hi Jane,
      If an aspirate is inconclusive in a suspectedlymphoma case, I recommend removing the lymph node for biopsy. While aspirates typically confirm lymphoma, in some cases you need to biopsy. I am taking care of a dog with the same issue. Biopsy is more likely to provide the diagnosis.
      And most dogs do very well on chemo. I hope you will read more about it in the Guide and check out my posts on chemo. There are quite a few.
      waveco.com/what-i-would-do-for-my-dog-with-lymphoma/
      waveco.com/the-oncologist%e2%80%99s-perspective-on-chemotherapy-and-gastrointestinal-gi-side-effects-part-one/
      All my best, Dr Sue

  7. Michelle Marsh on June 5, 2012 at 11:58 am

    Our 2yr old puppy has cancer. At first they thought she had valley fever, but when the medication didn’t work they did another x-ray and a soft tissue biopsy and sent it to a pathologist they said it was cancer. We then took her to an oncologist for both a second opinion and to find out what our options were. I am very sickened by the amount of money vets charge to treat our pets and the fact that the first thing they want to do is chop the limbs off. Breakdown (our puppy) has it in her right hind knee. She appears fine otherwise. We cannot afford the 1000 plus dollars for an amputation with no guarantee it will extend her quantity of life! Not to mention it would be about 400 or so dollars to do a bone biopsy to find out what kind of cancer it is for sure. They suspect Osteo but we don’t have the money to find out for sure, nor do we want to put her thru more pain to find out. So far we have tried marine plankton, and NuVet supplements along with medication for her pain. She has Novox along with Tramadol and something else I can’t think of right now for the pain twice a day. Not sure what to try next. Her leg swelling appears to be getting larger and it is hard and warm to the touch. The thing is that I am a widow with 2 kids and major debt and I don’t have money to spend here there and everywhere but I want to save our puppy. Any suggestions would be helpful. It has been 2 months since her diagnosis.

    BTW if I had unlimited funds I would pay whatever it took, but that is not the case. I have THE most loveable BEST dog I have ever had except she has cancer and I don’t have many options. I would do clinical trials if there were any available or I wish I could find someone that could help us. I have already lost my mom, my father in law and my husband to cancer and now I have to lose our puppy too? It just doesn’t seem fair.

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