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

Metronomic Chemotherapy

Updated: May 15th, 2024

Traditional chemotherapy is moving in a new direction.

In the past, chemotherapy used a strategy called Maximum Tolerated Dose (MTD).  Simply put, this is giving the highest dose a patient can handle, ideally without an unacceptable risk of side effects.

The reason this strategy is used in cancer medicine is that the drugs we have available rarely cure a dog of cancer.

Therefore, to extend a four legged family member’s life, we want to try to kill as many cancer cells as we can.  When we use most chemotherapy drugs, however, they do not restrict their actions to cancer cells.

In other words, they are not truly selective.  They sometimes exert actions on the body cells, which can produce the side effects we wish to avoid.  These side effects can impact a dog’s quality of life, as well as yours.

This is the trade-off that is an occasional reality of dealing with these drugs.

For this reason, a detailed portion of The Dog Cancer Survival Guide is devoted to ways you can decrease the odds of chemo side effects in your dog.

Recently, there has been another strategy in helping dogs using chemotherapy.  This is called metronomic chemotherapy.

The goal of this approach is to try to slow the recurrence of the tumor, or slow tumor spread.

The way this is accomplished is by affecting the blood vessels that feed the tumor.  Metronomic chemotherapy uses lower doses than MTD’s, and also combines drugs that have anti inflammatory effects.

These drugs act on the lining of new blood vessels to help shrink the vessels.  We cut the supply of oxygen, sugar and nutrients to the tumor, and hopefully slow tumor spread.

Probably the most common combo includes cyclophosphamide and piroxicam, but this varies depending on the oncologist’s preference and the cancer.

It is interesting to note that the apoptogens in Apocaps have many of the same affects as these anti inflammatory drugs. Read more here, and here.

If you would like to consider this chemotherapy approach for your dog, it would be prudent to seek an oncologist’s input.

For more on strategies to help your dog fight cancer, see the Dog Cancer Survival Guide.


Dr D

Leave a Comment

  1. Robert on June 28, 2019 at 4:34 am

    My 9 year old rat terrier just had 2 small dermal hemangiosarcoma removed from side of chest. All labs normal and no signs of visceral hemangiosarcoma. Is metronomics treatment indicated for this case?
    Thanks, Robert

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