I get a lot of questions about how to be safe around chemo drugs administered at home (for example, during metronomic chemotherapy). Here are some of the most frequently asked questions, and my answers:
Is my pet safe to be around?
Yes, your pet is safe to be around after treatment. Being around family members – human and other pets in the home – is an important part of your pet’s life. Enjoying normal activities together – including petting, hugging, and kissing – are all safe. However, the excretions (urine, feces, vomit) from pets receiving chemotherapy can be hazardous. It is therefore important to minimize our exposure to chemotherapy, and common sense precautions should be taken.
If you are administrating oral chemotherapy at home
If you are administering chemo at home, please follow these precautions.
- Keep the medication in the vial, and do not store it in the kitchen.
- Ensure children and pets do not have access to the drugs.
- Do not eat, drink, or chew gum when giving the medication.
- Do not crush or break the pills or capsules.
- Wear unpowdered latex or non-latex gloves when handling the medication.
- Some medications, like Palladia are coated, and you can handle the pills without gloves. However, the coating breaks down when the pill gets moist. So if your dog spits out the pill, please put on gloves prior to picking up to readminister.
- Dispose of the gloves promptly, and wash your hands thoroughly after administration.
Clean up after your pet
My primary safety concern is for people who are mixing and handling chemotherapy agents. For those of you who are bringing your dog home after a chemotherapy session in the hospital, there is less risk, because you are handling the urine and feces. Sounds gross, I know, but the metabolites in chemotherapy drugs have been broken down by the patient’s body by the time they reach the urine and feces. These metabolites are far less active than the original drug was. So, it’s a safer scenario than the one above. Still, please use common sense precautions and follow good basic hygiene.
- Wear gloves for handling of feces, urine or vomit (i.e. if they have an accident in the house/apartment, cleaning the litter box) for at least 72 hours after treatment.
- Soiled bedding should be washed separately and go through 2 wash cycles before being used again.
- Use detergent to clean floors, carpets, or countertops. Wear gloves when cleaning.
- Accidental exposure: Wash skin thoroughly. If your skin becomes irritated, contact your physician.
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What it my other pet eats the poop of the dog getting chemo?
But this happens, sometimes, right? So how much should you panic?
It depends on the chemo drug. Some are excreted mostly in the urine, like cyclophosphamide. (That’s why it’s good to encourage your pet that gets this to pee on grass, where urine will drain quickly.) If your dog has had a treatment with one of these drugs, the likelihood that another dog will literally ingest it is rather small.
But some drugs, like vincristine and doxorubicin, are metabolized and excreted in the feces. If your dog has just had one of these drugs in a chemotherapy session, and your other dog (or any other dog) comes along and eats it, yes, there is a risk that dog would get a smaller dose of the broken down chemo metabolites.
For example, if a patient’s canine companion ate all the patient’s feces over a 72 hour period it would ingest about 30% the original dose, of which much would be destroyed in the gastrointestinal tract and pooped out. Remember it is not unchanged chemo drug being excreted, but metabolites, and the risk is relatively low.
So again, use common sense precautions to minimize exposure. Which basically means pick up your dog’s poop as soon as it is released.
What if I’m Pregnant?
If you are pregnant, trying to become pregnant, are breast-feeding, are immunosuppressed, or are taking immunosuppressive medication:
- Please avoid contact with any chemotherapy drugs.
- Also, please avoid contact with your pet and your pet’s waste for a minimum of 72 hours after chemotherapy has been given.
- Talk to your physician.
Live Long, Live Well
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.
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