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

What’s my dog’s prognosis?

Updated: November 22nd, 2018

Dog Cancer Prognosis

What are the facts about the my dog’s cancer prognosis?

Once you have been told the horrible news that your dog has been diagnosed with cancer, so many thoughts start racing around your head. One of the common questions I get is, “How long will my dog live, Doc?”

Despite all my training and experience as an oncologist, this is so hard to answer.

During my residency training I had to learn lots of numbers and statistics related to a cancer. I’ve discussed some of the common terms in a previous post, The Oncologist’s Perspective on Statistics: Part Three. In that post I discuss median survival times, response rates, metastasis rates. These are important facts to learn about for your dog’s cancer.

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How does treatment impact how long your dog will live — and how likely is he to respond to that treatment?

How high is the metastasis rate?

These are very complicated questions for an oncologist to answer. For example, for a low or intermediate grade soft tissue sarcoma (STS), incomplete surgical margins (aka “dirty”), make recurrence (the tumor regrowing in that same area) 10X more likely, and so additional surgery or post-op radiation is recommended if there is a recurrence. BUT … with low or intermediate STS, the metastasis rate (how often that tumor spreads to other areas of the body) is 10-15%, so chemotherapy, which treats the entire body, is not typically recommended. In contrast, let’s look at a high grade STS. For these tumors, the metastasis rate climbs up to 40% — so chemo may be recommended to delay metastasis.

That’s a lot of numbers to juggle, and if you’re a little confused, it’s because it’s confusing. And then there is this:

Numbers Are Just Numbers — Not Your Dog!

I’ve blogged before about how stats are helpful, but don’t predict the way individual cases turn out in that series on statistics, but I bring it up again because my cases this week drove this home, both good and bad.

Case: Osteosarcoma in Blackie’s Wrist

Blackie is a mixed breed dog with osteosarcoma (OSA) of his left metacarpal bone. This is one of the bones in the paw just below the wrist (carpus).

I met Blackie after his front leg amputation, and we reviewed all the stats for OSA.  Osteosarcoma is the most common bone tumor — 85% of dogs with cancer in the bone will be diagnosed with osteosarcoma.

Statistics tell us that three-quarters of these tumors develop in the limbs, with the front legs twice as likely develop this tumor.  The most common locations are towards the knee and away from the elbow – the top of the shoulder, the wrist, and the knee (bottom of femur or top of tibia). The metacarpal location is less common but it is reported.

Here are those numbers, or stats: survival times for OSA cases with amputation and no other treatment is about four to five months, with 90-100% dying by one year, and only 2% still alive at two years. In contrast, the median survival times for OSA cases with amputation and chemotherapy increase to ten to twelve months, with 20-25% of dogs are still alive at two years.

Get a copy of this seminar to learn more on how Osteosarcoma is diagnosed, treatment options, amputation, and more!

We also discussed that chemotherapy is well tolerated. 80% of dogs that receive chemo have no side effects. About 15-20% have side effects and most are mild and self-limiting — they recover on their own with little intervention – maybe some nausea and/or diarrhea, which is treated at home with meds or antibiotics. 5% or less are severe and may lead to hospitalization.

So back to Blackie. He had 3 doses of chemo, with very little side effects, but when he came in for his 4th treatment, he was not doing well. His legs were swollen and he was reluctant to walk. His right front leg was most significantly swollen, and considering he only has 3 legs, I was very concerned.

My training made me suspicious he had developed lung mets (metastasis) and a very uncommon condition related to that called HO, or hypertrophic osteopathy, which is when new bone develops along the shafts of long bones. HO is most commonly seen with metastatic disease to the lungs, especially OSA. Blackie’s chest X-rays confirmed the metastasis. Plus he had a skin met near his thigh and another met deeper under his skin by his right humerus.

This was only 3 months after his amputation! I took a few deep breaths before I went in the room to tell his dad that the statistics I gave him at the initial appointment had not predicted poor Blackie at all. His tumor has turned out to be way more aggressive than the statistics would have led us to believe. This week, we need to shift gears to make him more comfortable and see if we can slow the progression of the mets with a new therapy.

Case: Daisy Mae’s Splenic Osteosarcoma

The other case I saw this week where the stats were less than helpful was Daisy Mae. You can see her picture on my Dr. Sue Facebook page – she’s pretty darn cute!)

Daisy Mae was diagnosed with OSA of her spleen, called extraskeletal OSA (because it is outside the skeleton). It’s an uncommon tumor in the spleen (hemangiosarcoma and benign hemangiomas are more common). There’s limited data in the literature. In one report, the median survival time with surgery alone was 1 month, and 5 months with surgery plus chemotherapy.

After surgery, we decided to give Daisy Mae conventional IV chemo followed by anti-angiogenic oral chemo. This week she is 18 months out and tumor free at her checkup! I always say I love when I am “wrong”, and my patients outlive the stats.

For more helpful tools and information on Osteosarcoma, get a copy of the Dog Cancer Survival Guide and check out Chapter 32

Bottom Line: Use the Stats, Don’t Live By Them

So should you ignore statistics and published studies? Of course not! They can help you to make treatment decisions.

But you must realize that stats will never predict the individual. I personally hope your pet outlives the stats, but my advice — after all my training and years of clinical experience — is this:

Learn the facts, and then be hopeful.

Live longer, live well,

Dr Sue

Discover the Full Spectrum Approach to Dog Cancer

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  1. Rebecca McConnell on July 31, 2018 at 3:50 am

    Our 8 1/2 Doberman had a tumor over his eye which had already spread before removal. He also has auto-immune disease and has been on thyroid meds for years. We decided to forego chemo and to concentrate on diet using Dr D’s recommendations, Apocaps, and K-9 Immunity plus and a few other supplements – in order to keep him happy and comfortable. We gradually weaned him off the Apocaps and he’s been off a year. So far it’s been 3 years since the surgery and he’s about 11 1/2 to 12 yrs old. He is still on the diet, K-9 Immunity Plus, thyroid meds and supplements.

    • DogCancerBlog on July 31, 2018 at 7:02 am

      Hello Rebecca, thanks for writing and for sharing your story with us! 🙂 It sounds like your boy has an amazing support group and we’re so happy that you were able to gain another 3 years with your beloved boy!

      Warm wishes to you and your boy from all of us here! 🙂

  2. Teresa Bishop on July 10, 2018 at 8:49 am

    I have an 11 year old female lab. Her name is Angel. She has bone cancer in her back right leg (between the foot and ankle, per say. She has bone spurs in her back, hip dysplasia and she has a questionable spot on her lung. She is on Tramadol and Galliprant 2 x a day for each drug. This has been going on for 3 months now. She is not using the back leg any longer. She still eats good, chases the cat and barks at the cows next door. She is grunting, when she lays down, a lot more than she use to. The leg has a large hard knot where the cancer was found. She is such a sweetheart. I hate to see her like this. She is being fed rice, sweet potatoes, fish and veggies. She loves it. What do I need to watch for to make sure she is not suffering. 🙁

    • DogCancerBlog on July 11, 2018 at 6:51 am

      Hello Teresa, thanks for writing and we’re so sorry to hear about your girl! 🙁 It sounds like she has an amazing guardian. There are a few really great articles that we would recommend for you take a look at as they cover life-quality and pain.
      Here are the links:

      Your veterinarian may have some suggestions on what you could do to help manage the pain. A holistic vet may also be able to help you if you are doing a more natural or holistic approach to your girl’s health care plan 🙂

      Also, Dr. D suggests staying away from high carb vegetables, like potatoes, as they can break down quickly into simple sugars in the body and may end up feeding the cancer. If you haven’t had a chance to check out his Dog Cancer Diet, the link is below. You may find it really beneficial in providing a nutritious diet that promotes healthy cells and discourages cancer growth 🙂 https://store.dogcancerblog.com/products/the-dog-cancer-diet?channel=buy_button&referrer=https://www.dogcancerblog.com/?s=bed&variant=4884407491&

      We hope this helps Teresa!

      • Teresa Bishop on August 1, 2018 at 9:26 am

        Thank you so much for the information. She has more good days than bad, but I dread when the bad days over power the good. She looks at me and I could just cry because I know she has to hurt but her sweet face just wants me to pet her and at the same time her tail is just wagging……

    • JennaRose on July 26, 2018 at 2:17 pm

      My dog (Boerboel) has Osteosarcoma began beginning March. I was totally disgusted by what Tramadol did to her and tried it on myself. Within 10 – 20 minutes I was throwing up all over my kitchen. I have her on marijuana which she get before bed – She shares my bed. I just powder it in a coffee grinder and add almost a level .6 ml measuring spoon to her food. Have taken her off Previcox since having her wrist wrapped up in… See below: Previcox is poison! It will be my last resort. She still limps but with Previcox it blocks the pain signals and she runs on it and it causes a lesion and the bone swells. She’s limping without it but at least not walking or running on it to cause a further lesion. She’s happy, cheerful and still able to dream without it since I have her wrist wrapped in the compress it really seems to be helping her. I also find the castor oil also helps. I soak it into 3 layers of folded bandage and then wrap and
      gently seal it with plastic cling wrap which I then cut the foot part of an old sock off and then place it over the cling wrap. I’m giving her 100 g of freshly pureed aloe into which I blend an equal amount of honey to which I add a bit of artemisinin. I believe this has stopped it from spreading to her lungs (aloe). She gets curcumin in her food. No dog food. Gets Meat (mostly chicken breasts) and lots veggies. No carbs. Lots garlic and ginger with cayenne chili to move the blood to carry the cancer fighting bombs around her body, lots fresh lemon juice esp with her chicken and 10g baking soda twice daily. Testing pH of her urine with ph paper to make sure it remains at correct level. Into her water bowl I zest a small lemon then pour over a kettle of distilled purified boiled water (no tap water), stir, allow to cool then add a few drops hydrogen peroxide and some boron water – It tests alkaline using pH paper. See recipe below. She also get 500 mg vitamin C once daily. To make liquid Sodium Bicarb*

      250 ml sterile water
      5 mg (level teaspoon) Bicarbonate of Soda
      1 ml DMSO (Dimethyl Sulfoxide) — 99 % pharmaceutical grade

      Prepare 250ml of sterile water and add 5mg (a level tea spoon) of sodium Bicarb.
      pH should be between 8.5 and 9.
      Using a 5 ml syringe, measure 4 ml of the Sodium Bicarb solution into a small bottle and add 1ml of DMSO
      *Always add DMSO to water and NEVER add water to DMSO due to the release of heat..
      For all cancers you can just rub this on your chest and it will absorb through your skin and head straight to the tumour.
      Natural Remedies – Barbara O’Neill
      For Bone Spurs: You can use cold compress as the best signs diminishing remedy.
      5 g boracic acid powder (Not Borax) I use it for my depression it works!
      800 ml water
      Dissolve boron in body temperature water – No hotter
      Being in South Africa I am still waiting for her Bloodroot capsules and laetrile to arrive. I did have a friend bring some back from America and she has recently finished her 90 capsules. It did bring out a whole glove she had had in her colon / stomach for around 4 years which was the last time I saw the glove. She’s swallowed a lot of strange stuff in her years. If you try and get it away from her she just swallows it. All the small stuff like socks etc has to be hidden away to dry in spar room where she can’t get it.

      Wishing you good luck with your dog!

      • Teresa Bishop on August 1, 2018 at 9:28 am

        thank you for sharing all your knowledge. I just breaks my heart to see her limp around. She does let our neighbors cows know she does not like them….lol…..she seems happy…..I just hope she really is.

  3. Isabella on August 18, 2013 at 5:59 am

    My question is about our 11-year-old basenji. We found a bloody mass in his mouth and it turned out to be squamous cell carcinoma. He went through radiation and the tumor nearly disappeared. However, on his next checkup about seven weeks after radiation, the oncologist determined that the cancer had spread to the lymph nodes in his groin area. She is recommending Palladia, but I’m worried about the horrible side effects and the fact that it doesn’t seem to show great results. Is there a holistic approach that would help our dog? Thank you.

  4. Ivan Dryer on August 13, 2013 at 1:45 pm

    My 16-YO Cocker has long been undergoing chemo for a large sarcoma that is now stable. He also has a nonmalignant adenoma tumor under his tail that grew quite large, then began to bleed and suddenly to shrink (due to Apocaps?). It started bigger than a golf ball and is now the size of my last finger joint–and still shrinking daily. His regular vet was concerned that it could fall away entirely and bleed profusely, requiring emergency surgery. His oncologist said yesterday that this was unlikely, but since it still has blood supply at the base, continuing necrosis could still open a vessel–again requiring emergency surgery, which I want to avoid because he also suffers from congestive heart failure, and anesthesia could be deadly (not to mention that I can’t afford it). I wonder if this presentation is something you’ve experienced and what the outcome might be; might it just stop shrinking (I recall Dr, Dressler mentioning a case wherein a tumor simply vanished with no ill effects)? Thank you!

  5. Lyndsay on August 4, 2013 at 10:31 am

    I appreciate the information that was emailed to me, sadly though i am currently unable to pay for any treatment to assist my lovely staffie, but thank God for the P.D.S.A. in the UK. They have told me after xraying her she has a mass on her chest but due to her bone structure cannot define exactly but suspect cancer and have put her on steroids,they cannot afford ct scans etc,so have to cope with just basic equipment.Im gleaning any info i can to help her.I had bowel cancer and the tumour was too big to operate,however i was lucky and was offered a trial,i also read how ginger could shrink tumours and ate it a lot.the doctors were surprised at how rapidly the tumour shrank,operated and treatment was successful so can i give my dog ginger in her food and if so what amount? I would be very grateful for any advice you could give me.

    Many Thanks
    Lyndsay Bourke

  6. Sue on July 31, 2013 at 3:51 am

    My 9 yo shepherd mix, Abbie was diagnosed with squamous cell carcinoma of the tongue in Nov 2011. In Dec, she had surgery which removed a large part of the left side of her tongue, with clean margins. She had a couple of chemo treatments (carboplatin) and the SCC came back. More surgery, another round of chemo with bleomycin and on the last treatment she was examined again and the tiny red spot on her tongue was the SCC again! At no time did she stop eating or act sick.
    The oncologist said there wasn’t much more they could offer, maybe freezing
    the spot.
    But no guarantees. In a month, we could be facing the same scenario. I decided to stop putting her through any more. That was in July 2012. She is still with me. She is still eating although it’s a messy process. The tumor is quite large, but she doesn’t seem to be in pain. She takes pain meds and half a Previcox daily.
    The doctor thought it would be a few months and it’s been a year.
    She is now 11.5yo and each day she’s with me is a gift.

  7. Renee Peters on July 30, 2013 at 9:44 am

    Our 8.5 year old black lab/beagle mix diagnosed with fibrosarcoma of right front leg, this month. Path report says grade 3, mitotic index 1-3, large areas of necrosis, inflammation, poorly differentiated tumor with dirty margins. Surgical report says 2.5x2inch mass occupying sub-q space. Our sweet girl is very emotional and prone to occasional bouts of depression. She has not fully returned to herself since surgery so we will not be undergoing the suggested radiation treatments as we feel it would be too much of an ordeal for her. Alternative vet says her food, Fromm grain-free, game bird is fine. But am changing to whole food diet. Supplements he recommends are from Standard Process: Canine Immune System Support for

    immune system regulation, Organically Bound Minerals to support parasympathetic nervous system and adrenal gland function, ThytrophinPMG for thyroid gland support/regulation, A-F Betafood detoxification for liver and gallbladder, decongests liver. Dr.Xie’s Jing Tang Herbal Inc. ” Max’s Formula” Chinese herb to slow tumor
    growth. Alternative vet conducted exam and sad her thyroid is 7 out of 10 and liver 3 out of 10 so he wants to raise these. Blood work in May, prior to diagnosis showed liver amylase at 395 which is low. If you can please review for us as we are hesitant about planning supplements on our own. Thank you sooooo much for writing The Dog Cancer Guide, it has helped us immensely.

  8. Natalie on July 5, 2013 at 6:42 am

    My dog Rocket got his exam and the vet said that he was one of the healthiest dogs she had seen at his age (10 yr. Terv). She gave him his rabies shot and we went home. Within weeks, he developed a swelling at the injection site which the vet could not diagnose and then 2 months later she said it was sarcoma. I lost Rocket 6 months after the rabies shot when he had been pronounced very healthy. Had I not gone to the vet he would be alive today.
    I think the veterinarian community should have a standard that you don’t give a dog over the age of 9 yrs. a rabies shot without doing a titer test first that may delay the giving of the shot and perhaps protect the dog. Also, no vet would help him because they said it was too big. In that case I think that the owner should be given data on a true Ketogenic Diet instead of just a passing suggestion that the diet should be better. (He had a homemade diet with rice)

  9. Dona on July 4, 2013 at 10:00 am

    my 13yr old cattle dog has a tumor in his bladder he is on proxican Iwould like to know how long he has?

    • Susan Harper on July 12, 2013 at 2:26 am

      Hi Dona, I’m sorry to hear your dog has a tumor. Please understand there is no way to give you any sort of prognosis through a blog. Your dog is not a statistic with a pre-determined expiration date. But let’s work with this…. here are points you need to find answers to: 1. What is the diagnosis 2. Has your vet given you his or her opinion about possible treatments and a prognosis? 3. How is your dog… feeling OK, eating?, pooping well? 4. What king of diet are you feeding? 5. What is your priority for your dog? The book ‘The Dog Cancer Survival Guide’ by Dr Dressler and Dr Ettinger is the best source of information to help you navigate this journey and as you get the answers to the questions I’ve posed, you’ll be able to really be a champion for your dog and make decisions that you feel confident making. You need to take care of yourself through this, not only so you will stay healthy and well, but so you can give your dog the best care possible. There is so much you can do, and please don’t focus on what statistics might give you as an ‘end date’ for your dog. Your dog is an individual, and the happier and more comfortable you can make his or her life, the better your dog can handle whatever comes. Please check out http://www.dogcancerkit.com which is a great place to get the book. Take a deep breath. All the best, Susan from the Dog Cancer Support Team

  10. Scott on July 3, 2013 at 6:59 pm

    I hope this message find you well. I am sorry to interrupt you over the holiday. You have come highly recommended from several different sources. I apologize for the unorthodox manner in which I am contacting you.

    I have a 14 year old Golden Retriever named Biscuit.

    Starting almost 3 weeks ago Biscuit had a huge loss in appetite. It was difficult to get her to eat her regular food. This has happened before so we gave her chicken and rice and we figured we would give it a few days to see if it passed but it didn’t. Finally, last Monday we took her to her doctor. She lost about 7 lbs. They did a full blood profile, urinalysis, stool sample, and xrays of the chest and abdomen.

    The doctor said Biscuit was slightly anemic, her white blood cell count was slightly elevated, and her kidney count was slightly elevated. The xrays were inconclusive but the doctor saw a few things that were questionable and recommended we bring her in last Wednesday for an ultrasound of the abdomen. She put her on a 10 day round of antibiotics and pepcid.

    The ultrasound confirmed that she has 2 masses. One on her spleen and one on her liver. And that this is most likely what has been causing her distress. The doctor doesn’t recommend that we do anything invasive, mostly because the mass on her liver is inoperable. He said if it were just the spleen then it would be a consideration.

    Biscuit is 14 and I want to keep her comfortable and happy and as healthy as I possibly can. The doctor told us to continue with her daily routine and feed her what she is willing to eat. She seems to be doing better in the last few days. I am just afraid that things may change after she finishes the antibiotics.
    I brought Biscuit to an Oncologist who has recommended a CT to determine if it is worth it to do surgery.

    I spoke with another doctor who thinks that the mass on the liver is not as much of an issue as the mass on her spleen. He says that whether the mass on her spleen is malignant or benign it will eventually bleed out and he believes that the spleen should be removed. He said if its malignant and he removes the spleen that could give her an additional 3-6 months. If it is benign than this could save her life. I am very hesitant to operate because of Biscuit’s age and fragile state.

    What might you recommend for Biscuit?

    I’ve ordered Apocaps and Yunnan Baiyao. Might you be able to recommend what is best and proper dosages? Biscuit weighs approximately 65lbs.

    Any help or information you’d be willing to provide would be greatly appreciated

  11. kimberly on July 3, 2013 at 7:15 am

    What is mastesis?

    • Susan Harper on July 8, 2013 at 2:37 am

      Hi Kimberly, I think you mean ‘metastasis’ which basically means cancer spread. There are many, many variants to this and it can only be confirmed by a veterinarian performing xrays, blood tests urine tests, or other diagnostic tools. Spread is not good, but you need to have a confirmed diagnosis before getting too worried. I hope this helps. From Susan on the Dog Cancer Support Team

  12. KAREN LAWRENCE on July 3, 2013 at 2:41 am

    Thank you, for saying each case is individual !!!!!!!!!!!!!! WHEN I FIRST TOOK MY GREYHOUND TO AN ONCOLOGIST,( WILL NOT MENTION THE NAME), SHE SAID WITHOUT A BLINK,” HE IS TERMINAL, AND IF YOU SEE THAT HE IS IN PAIN, BRING HIM BACK, AND WE CAN DO AN AMPUTATION, AT ANY TIME!” She gve him a few months, did not really suggest anything else! I left that office angry and terribly upset!! (Sam had ostersarcoma in the lower wrist, of his right front leg)

    I took him to Blue Pearl, to another oncologist, which looked at him as an individual and treated him as such!! He has had an amputation, ( runs with his greyhound brothers), and 5 rounds of Carboplatin, ( donated by Ohio State University,greyhound trials), a protocol of Piroxicam, Furosemide, cyclophosphamide, k9 Immunity, Immunovet, Artemix and lots of love. (He is a happy boy.) It will be a year this August, since he was first dx.,clear and going strong !! I cherish each day I have, with my wonderful Friend!

    I use your book as a reference point and for anything that needs more defining!

    Karen and Sam