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

Common Dog Cancer Mistake: Doing Too Many Diagnostic Tests Before Seeing the Oncologist

Updated: October 5th, 2018

Dog Cancer Mistake - Paying for Tests You Don't Need

How many diagnostic tests should you pay for, and who should do them?

When you first hear your dog has cancer, you may panic and feel that everything must be done, and now. It’s true, cancer is an urgent situation, and it’s a great idea to find out as much information about your dog’s cancer as is possible.

But how many diagnostic tests should you have your vet run, and when?

The answer to this question depends on many factors and there is no one-size-fits all advice I can give you.

Conventional Treatments Require Diagnostic Tests

I can tell you this: if you think you’re going to opt for conventional treatments (surgery, chemotherapy, radiation) you should budget for diagnostic tests. That’s because we need diagnostics in order to plan out and use these treatments.

After your vet tells you the devastating news that your pet has cancer, he or she may recommend you do some imaging tests, most commonly chest X-rays or abdominal ultrasound. This is called staging, and it is looking the cancer elsewhere to see how far advanced it is. With blood work and urine, which are always necessary, all of these tests may cost over $1000. For example, I sometimes see lymphoma patients who are told these ALL need to be done before they come see me.

They may not necessarily need them, though.

What If You’re Not Going to Treat Your Dog with Conventional Treatments?

If you’re not going to use conventional treatments, whether because of budgetary reasons or personal preferences, getting all of these diagnostics done may feel like wasted money and time. This is too often the case in my own practice, when I see new clients who have reams of tests for me to review … but then realize they can’t or don’t want to treat their dogs with my tools.

It’s particularly sad and frustrating when clients have already spent their whole budget on diagnostics. Many would have used that money to treat, had they known beforehand that the diagnostics weren’t all necessary for their dog’s situation.

Get an Oncologist Involved Early

An oncologist can help you decide which tests to run in the first place, if you bring them on board early in the process. When you get that first fine needle aspirate result, that is probably the best time to bring someone with my experience onto your team. Why?

Because I can give you a realistic idea of what you’re up against based on my own experience. All I do all day is review lab results for cancer — so I can often save you time and money in the long run. And yes, you can bring someone like me in even before the biopsy is done — and certainly immediately after.

Depending on the case and the cancer, I will discuss with patients the pros and cons of eliminating certain staging tests.

For example, if a dog with  lymphoma is having difficulty breathing, I will strongly encourage we get the chest X-rays. But for other cases, we may skip certain tests and apply those funds towards treatment.

As another example, if we are going to do a CT scan of the head for an oral or nasal tumor, we can also do a CT scan of the chest, which is more cost-effective than doing a separate X-ray to look for chest spread. (Most veterinarians have X-ray machines, but few have CT scans.) If you came to me with a dog with a nasal tumor, I would hold off doing an X-ray and instead use the CT scan. This saves you money and gets us a better chest image to work with.

I wish there were a “checklist” of tests and treatments I could give out to make this whole process easier, but there just isn’t. Every case, every budget, every dog, every owner is different. That’s why …

It’s OK to Wait to See the Oncologist

Every cancer case is different, and what is important to test in one case may be irrelevant in another. Just as you would wait to see a human oncologist to get diagnostics done for a mass on your own body, it’s OK to wait to do diagnostics until you see an veterinarian oncologist. (Or if you live in an area with few or no oncologists, ask for your vet to do a phone consult with one.) Specialists like me can adjust the staging tests we recommend based on your dog’s case and your budget and personality.

Cancer is expensive to treat even if you just make the dietary and supplement changes we recommend in The Dog Cancer Survival Guide. For the vast majority of us, every dollar counts … and an oncologist can help you spend each one more wisely.

Susan Ettinger, DVM. Dip. ACVIM (Oncology), Dr. Sue, Dr Sue is a boarded veterinary medical cancer specialist. As a Diplomate of the American College of Veterinary Internal Medicine (Oncology), she is one of approximately 400 board-certified veterinary specialists in medical oncology in North America. She is a book author, radio co-host, and an advocate of early cancer detection and raising cancer awareness. Along with Dr. Demian Dressler, Dr. Sue is the co-author of The Dog Cancer Survival Guide: Full Spectrum Treatments to Optimize Your Dog’s Life Quality and Longevity.

Discover the Full Spectrum Approach to Dog Cancer

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  1. Peter on December 8, 2018 at 4:24 am

    My dog was excessively licking herself so I brought her to my vet who sad. First it was a UTI. Then tests came back and they said no it’s Gastritis. Then. No. It’s her back. They prescribed prednisone. But no changes as she got a little worse
    I then brought her to an. Internist who said he could not find anything. I then brought her to a neurologist
    Who did a MRI and 6000.00 worth of tests and said her blood work was perfect and her back was pristine
    But my beautiful lttle Shorkie still seemed to be getting worse. Backward walking. And crying out in pain
    I brought her to a third hospital who again found no answers
    I even had a vet acupuncturist come to my house a few times with a lot of hope. But still no improvement
    I then brought her to a fourth specialist who manipulated her legs and felt her back and said
    It is not her back. Then 6000.00$$. Later. She tells us our little girl had cancer through her body
    I was devastated and angry that these other incompetent vets put my girl through so many tests only to be finally told the worse
    Am I correct in my thinking how wrong this whole thing was?

    • Molly Jacobson on December 10, 2018 at 3:01 pm

      Hello Peter, thanks for writing, and we’re so sorry to hear about all that awfulness. Unfortunately, the fact is that diagnosing problems is the HARDEST thing medical professionals do. Many illnesses present with the same symptoms up front, and treating for the most common conditions and then trying something else if that doesn’t work isn’t all that unusual. Of course, we all want our veterinarians to “get it right” the first time. But that’s just not always possible. While we sit back helpless, trying to keep our dogs safe and well, it can look like they are incompetent. But sometimes it’s just really hard for even the best-trained specialists to figure out what is wrong. This is true for humans, as well, but it is really much harder for veterinarians, whose patients do not speak our language. It sounds like you did absolutely everything you could do, and I’m sure that your little girl knew she was well loved and cared for. I’m so sorry you and your family and your pup had to go through all of this. Warm wishes to you.

  2. Susan Kazara Harper on June 23, 2015 at 8:09 pm

    Robeal, We are a couple of weeks down the road, and I know that’s frustrating. Doing our best to keep up with the posts. What is your situation? Sometimes we don’t know whether we’re comfortable with a vet until we start the vet/client relationship. Just remember, even if you start treatment and then feel that you and a vet are on different roads, you can make changes. Be very clear going in of the type of relationship and information you want. Everything is your decisions. Also remember there are loads of variables with ay diagnosis. Grade of the tumor is only one. Good luck!

  3. Robeal on May 28, 2015 at 10:13 am

    We just received a diagnosis for Lymphoma in one of our dogs. How do we balance the urgency to start treatment vs. finding a good oncologist/team? Everything that we read expresses the urgency to start treatment as quickly as possible, so we don’t want to “waste” days looking for a oncologist who we are comfortable with?

  4. Jennifer Costley on October 1, 2013 at 3:13 am

    This is great advice, makes so much more sense than throwing everything you have into trying to find out what is going on, even if the answers have no impact on treatment. We were lucky to have a team of oncologists with the same philosophy so we could focus on what really matters – getting our dog better.

    • DrSueCancerVet on October 2, 2013 at 3:06 pm

      Jennifer, thanks for your comment. Love to hear that you have a great team of oncologists for your dog. Live longer, live well!

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