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

A New Look Chemotherapy

Updated: January 4th, 2019

The usual way we have used chemotherapy, in both human patients and dogs, brings about toxicity risks that can be frightening for many.

This fear is a rational one.

The reason that the bad effects of chemotherapy are seen is a bit complex, but stems from what I believe are two main areas.



First, the usual strategy in using chemotherapy drugs has been to give the MTD, or the Maximum Tolerated Dose.  This translates into the idea that you give as much drug as you can up to, but not reaching, the point where it could cause heavy-duty side effects.

So when we give MTD’s, due to the fact that not all patients are the same, a fraction of them will experience the serious and sometimes even life-threatening consequences. These are the sensitive ones.

We should screen for the sensitivity.  We can take advantage of the test for the MDR mutation to assess for chemo sensitivity (see previous post and my e-book), before the chemo is started.

The second reason contributing to chemotherapy toxicity is because very little effort has been given, in particular in veterinary medicine, to actively decreasing side effects during chemo.


Get a copy of this webinar to learn more about the common chemotherapy protocols for dog cancer


In human medicine there have been some pharmaceutical advances, but very few veterinary oncologists are actively promoting things like coenzyme Q, carnitine, cordyceps, IP3, glutamine, or ginger during chemo.

I have am trying to make these more mainstream with this blog and The Dog Cancer Survival Guide, hoping that more veterinarians will promote decreasing chemotherapy toxicity.

Toxicity management is so important because we could use higher doses of our drugs (higher MTD’s) and improve our outcomes with less side effects.

In response to this need, a new facet has emerged from conventional medicine called metronomic chemotherapy.

Metronomic chemotherapy involves a very frequent, but low, dose of chemotherapy, especially with the use of the drug cyclophosphamide.

Metronomic chemo is different from traditional MTD chemo.  In traditional chemo we use high doses for short periods, and the time off between treatments lets the body rebound.

In metronomic chemo, the lower doses lessen the toxicity risks.


For more helpful tools and information, get a copy of the Dog Cancer Survival Guide


The guess behind the way metronomic chemo works is that it may prevent the new blood vessel cells that feed the tumor from working properly.  The cells lining the blood vessels may be dying off.

Metronomic chemo is being looked at for use in children, and the veterinary community has recently started getting interested too.

Does it work? It is really too early to say, as even the human trial data is sparse. But there is some promise and it could be worth a try.

I think the best candidates would be for those dogs with low grade (but real), or slowly growing cancers that are difficult to cure with surgery.

If the cancers are growing too rapidly, the slower effects of metronomic chemo would not be practical.

This is another option that should be considered for dogs.

Best to all,

Dr Dressler


Leave a Comment





  1. Neysha Dias on July 25, 2011 at 8:58 am

    Dear Dr. Dressler

    Benji was diagnosed with Osteosarcoma in Mai and had his limb taken away. We have changed his diet to your cancer diet and he recieves K9 Immunity and Cordyceps , ginger . I also put him on Spirulina for two months. He has had 3 Chemos ( carboplatin ) and will have the 4th and last one this week. After that he will recieve Metronomic Protocol which still has to be decided on. i was wondering if I could give him Chorella daily which helps get the toxins out of the system. Will it be contridictory to Chemo or M. Prot.
    Thanks for you amazing book. It helped answer many questions that the vets don’t really take time for.
    Thank you for your response
    Kind regards Neysha

  2. Mienki on January 27, 2011 at 1:05 am

    Dear Dr. Dressler
    I just received the news that my 12 year old, maltese poodle, Nala has eye cancer. My vet immediately prescribed Ciclosporin drops, which is chemotherapy. Is this the best treatment? Should I buy her sunglasses, will this also help. If chemotherapy is given and it is a mis- diagnoses, can it be harmful to her eye? thank you for your response.
    Mienki and Nala

  3. Joanne and Cassie in Ottawa CANADA on June 28, 2009 at 8:05 am

    I am glad that you touched on the subject of Chemotherapy. As I had written months ago my female border collie Cassie had a mast cell tumour on her hock of the front leg. When first examined by a vet they wanted to cut her leg off!!! How radical without suggesting something else.
    At any rate Cassie went through Chemo and she is now Cancer Free – keeping our finger crossed. She takes Dog Immune, Tueric Capsules and flax seed with pure yogurt on her food. Her food has no wheat or gluten products in it and is a holistic food. I believe that the tumeric is helping her a lot. Before I found the capsule I was mixing tumeric with that gooey stuff. But, she was not fond of it. She also gets four fish capsules daily and CoQ10 every other day.
    Regards,
    Cassie and Joanne

    • Dr. Dressler on June 28, 2009 at 8:42 am

      Good point!
      I will mention this in the webinar…
      D

      • Dr. Dressler on June 28, 2009 at 9:17 am

        FYI if you can’t be there at the airing time you can listen later as it is recorded,
        D

  4. A New Look Chemotherapy on June 21, 2009 at 11:39 am

    […] side effects during chemo. In human medicine there have been some … //–> More here: A New Look Chemotherapy //–> This entry was posted in Blog Meme and tagged actively-decreasing, because-very, […]

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