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

Chemotherapy toxicity in dog cancer: Acetyl-L-Carnitine (ALC)

Updated: January 4th, 2021

Chemotherapy agents are used to help slow the growth of tumors, improve life quality, and decrease tumor spread in dogs.  Although the doses used are less than in humans, toxicity of chemo drugs is still a concern.

The big problem is that things that decrease toxicity of the chemo drugs often will decrease the effectiveness of those drugs as well.  So we end up with an overall neutralization of the chemo drug effects, both good and bad.

Get a copy of the Dog Cancer Survival Guide for more helpful information and tools

One contender I’ve come across to help with chemo toxicity, and possibly with no reduction in chemo effect, is Acetyl-L-Carnitine.

This amino acid derivative was shown to reduce the nerve toxicity effects seen with platinum compounds.  The platinum compounds used in dogs are cisplatin and carboplatin, usually for osteosarcoma (bone tumors), transmissible venereal tumor, and mast cell tumors.

The nice thing was that, at least in rats receiving cisplatin, the Acetyl-L-Carnitine did not interfere with the effectiveness of the cisplatin.  Read more here. And here.

Doxorubicin (Adriamycin) can cause irreversible injury to the heart. This drug is used often with lymphosarcoma, hemangiosarcoma, other sarcomas, and carcinomas.  There is some new evidence that ALC is able to block this effect.  Here is the paper for your reference.

According to the University of Maryland, this effect may occur without decreasing the effectiveness of the doxorubicin.  Another study showed that there was a reversal of heart toxicity due to doxorubicin in rats without decreasing its effectiveness using ALC.

Side effects are minimal in dogs.  Some develop digestive upset (nausea, vomiting, diarrhea).

The lowest published dose is 1 gram twice daily.

As always, make sure you are in touch with your veterinarian and/or oncologist regarding any treatment plan in dog cancer, as the info here is not a recommendation for any individual, specific dog. Each animal needs to have its own case evaluation….

Hope this helps!!


Dr Dressler

Leave a Comment

  1. Virginia on September 24, 2009 at 12:37 pm

    I have a 12 yr. old bloodhound diagnosed with Lymphoma. We started chemo yesterday and she was throwing up today. We got an injection for her and will be giving her pills for her upset stomach. We were told that she has a 50/50 chance of making it one more year and 25% for 2 more years but no guarantees. The pricetag is approx. $8000. My question is this. Is it sensible to put her through therapy at this cost? She is our 3rd bloodhound, the other two only lived to age 8 so we are very please with Opal. She has been healthy her whole life which is another reason the vet said to go for it. Thank you for helping us with this decision and our beloved Opal. Oh and by the way, I lost my 10 year old corgi in June to Lymphoma and DM.

    • Dr. Dressler on September 27, 2009 at 7:36 am

      this is a tough question. You really need to ask yourself what your personal feelings are to clarify it. Are you someone who really would rather not have your loved dog experience any side effects from treatment? How about some mild to moderate side effects? If you are comfortable with mild to moderate (some) side effects, you should give the chemo another try, perhaps with a modified chemo plan. If not, then perhaps life quality oriented treatments with minimal to no side effects would be best. I will talk about this question more in this month’s webinar if you want to tune in. It will be recorded so you can listen later (
      Dr D

  2. Patrick on January 13, 2009 at 9:52 pm

    Dr. Dressler-

    Our dog Griffy was diagnosed with Lymphoma this past December. He has had four treatments on the Madison protocol and is up for Doxorubicin this coming Thursday. I am very concerned about the potential side effects of this drug, especially possible heart damage, and want to do everything I can to try prevent and/or alleviate them. Coenzyme Q10 has been recommended, but my wife has read about never using any antioxidants while a dog is being treated with chemo. Do you have any suggestions regarding this issue?


  3. Dr. Dressler on December 18, 2008 at 4:40 pm

    Kathleen, I must be honest here and let you know that usually the “recapture” period is shorter than the first remission. Translation: it will most often come back faster the second time.
    Please read the blog on life quality as well.

  4. Kathleen on December 17, 2008 at 2:58 am

    My 12 yr old dog started cancer treatment last March for lymphoma. Yesterday after being in remission for 4 months his cancer has come back. My husband and I want to do the right thing for him; which would be to retreat him, what are the chances of the lymphoma coming back again and are we making the right decision to retreat him. His health is good with the exception of the cancer returning.

    Please help us make the right choice for our beloved pet.

    Thanking you in advance,

    P.S. we have to make the decision today (this a.m.)

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