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

The Right Time for Chemotherapy Drugs for Dog Cancer?

Updated: December 19th, 2018

I have been posting on what a huge issue timing can be when it comes to dog cancer treatments.

In conventional cancer care, this area is utterly overlooked, except in Europe (especially France) and only a couple of spots in the US.

Why does it matter?

Well,  dogs (as well as people, other animals, plants, algae, and “lower” life forms) have different things happening at different times in a 24 hour day.

This means that, universally, there are certain processes going on in the morning, afternoon, and night.

These processes influence the handling of drugs in the body very, very significantly.  When you are talking about chemotherapy, this matters enormously.

Chemo drugs can have toxic effects, more so than most other drugs.  If we can use them at certain times of the day when their toxicity is lower, we gain massive treatment ground!!

I spoke with the father of American chronotherapy, who gave me his best wisdom on the topic.  Now, the times he came up with may not be in available publications, at least not yet.  He was giving me the information so I could help dogs at my practice.

So, this information is from me.  I am choosing to share it with you because I think that if these guidelines are followed, like the studies in rats and humans, we see massive side effect reduction, and better effects in dogs with cancer!

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

Please understand this whole science is new, and for most Americans, pretty much unheard of.

So don’t be surprised when your vet or oncologist has no clue what you are talking about. But please rest assured, like everything in this blog, chronotherapy is not whoo-hoo mumbo jumbo. It has been demonstrated in good quality scientific studies.

Here they are*:

CCNU (Lomustine) : 4 PM +/- 2hours
Doxorubicin (Adriamycin): early AM
Platinum Drugs (Cisplatin, Carboplatin): 4-6 PM
Corticosteriods (Prednisolone, Prednisone, Dexamethasone, Triamcinolone): early AM
5-FU: middle of the night
Cyclophosphamide: early AM
Vinca Alkaloids (Vincristine, Vinblastine): Mid-Day

*based on human and rodent studies.

Use this information and share it with your vet or oncologist!


Dr D


Discover the Full Spectrum Approach to Dog Cancer

Leave a Comment

  1. Charlene in WI on November 24, 2018 at 8:11 am

    Palladia for MCTs: unknown?

  2. Margaret Sheehy on August 2, 2018 at 2:21 pm

    Is there a best time for Palladia?

  3. Nancy Walker on April 19, 2018 at 1:36 am

    Hi Dr. D.,
    I see these comments are pretty old. Has there been any updates for the timing of administration of Palladia?

  4. Sonali on April 19, 2011 at 10:02 am

    Dear Doc,

    I have a 15 year old lab in great shape except for the Nasal Cancer that she is fighting. I have her on 75 mg of Palladia and 10mg of Piroxicam and pain pills
    ( 100 mg of Tramadol every 8 hours). She has been on it for approximately 45 days and it has been either losing its efficiency as of two weeks ago or the cancer is out-pacing the meds. I have consulted the Oncologist and discussed switching medications to Mastinib but am not sure whether to try or not. Also, I have received some info that Hemp Oil has been very effective with human cancer but don’t know about its effects on canines. I have also found out that Canines have some adverse reactions to Hemp so I am trying to find more info.
    My dog’s nose swelling is almost at 75% of the swelling she had before I started her on Palladia. Can I use Hemp oil to help my dog?
    Thank you for any advice you can give me.

    • DemianDressler on April 20, 2011 at 5:40 pm

      Dear Sonali,
      I am not impressed with the anticancer effect or evidence, from a clinical standpoint, of hemp oil. Trust the oncologist on the chemo selections. Might be time for proper diet, immune stimulants, Apocaps, artemisinin and Neoplasene oral and nebulized. These steps should be under veterinary supervision. Background can be found in the Guide. MIght be time to add gabapentin or amantadine and maybe switch from piroxicam to deramaxx to see if these help with pain. Again, have a vet involved as their are some interactions that have to be handled. I hope this helps,
      Dr D

  5. Katherine on April 11, 2011 at 10:39 am

    Palladia is so new, it’s hard to find much information on it! (and even less for osteosarcoma).
    Any idea what time of day might be best for administering Palladia? I’ve been thinking before bed, at least a few hours after dinner, so that any immediate nausea effects will occur while he’s sleeping, but I don’t know if that fits with the chronotherapy idea. If there’s no chronotherapeutic recommendation for Palladia, might the recommended time for another anti-angiogenic apply?
    (And an aside: do antioxidants work against Palladia as they can against other chemo drugs?)
    I know you’re swamped, but if you get a chance…
    Thank you!!
    Katherine & Silas (of the mystery cancer)
    p.s. I ordered Apocaps last night — looking forward to implementing them. Would I use them only on the day I give Palladia, since on the alternate days he’d be getting Rimadyl? My vet is no help where such things are concerned.

    • DemianDressler on April 13, 2011 at 10:01 pm

      Dear Katherine,
      there is no chronotherapy data concerning Palladia that I am aware of, so I think avoiding nausea at least makes good sense. Antioxidants at high doses theoretically may interfere with pro oxidant chemotherapy drugs. At this time I do not know whether there is a net increase in pro oxidant molecules as a consequence of this drug. Thus if we are relying on it’s use a central, I would certainly keep any anti oxidants down to low levels needed for maintenance in diet only. Yes, I would avoid giving Apocaps on the same day as Rimadyl. Under supervision from your vet, you could try tapering the Rimadyl and adding Apocaps as an option.
      Hang in there. We have to do the best we can in situations like this. Be a solder.

  6. Lenise Mitchell on July 6, 2010 at 7:10 pm

    Dr. Dressler,

    Quickly, are you familiar with dogs given Rubodoxcin for nasal sarcoma? My 11 yr. old GR recently completed 20 treatments of radiation – 4 month post CT scan shows no changes at all. She continues to experience severe breathing problems and nasal bleeding. Now I’m getting oncological recommendaitons for chemo on what is considered to be a non-chemo sensitive protocol. Please let me know if you have heard of this being successful.


  7. Robert Black on July 4, 2010 at 11:20 am

    My Bull Terrier of only 3 yr. old had a lump in the side of his neck which I discovered on the fourth week of June 2010. I took him to our Vet. that day and took him to the vet. They did a asperation shot on the lump and sent it to the lab. It came back unfounded. Then on July 2nd 2010, we took Ikaika back to the vet. because he felt real warm and I was worried about him being sick. He had a high Temperture which the doctors treated him with IV solution to lower it. That worked.Then since the other test came back unfounded I asked the doctor there to do another which he did. He called us on the next day stating that it came back with the Lympma from the lump on his neck. Of course I broke down hard and so did my family. They gave him Cyclophosphamide to treat this with.Perdizone.
    Do you feel he has a good chance at beating this? Or what would you reccomend for me to do. He is like my shadow and he is like baby here also. Can you please help us on what you feel if any a better treatment. We are not rich people but we love this dog as part of our family and want to do anything we can to beat this also.
    Please Help.
    Robert B
    ( Washington State)

  8. Joanne Fountain on May 1, 2010 at 8:01 am

    Hi Dr D
    My cairn has multiple cutaneous plasmacytoma, i am about to undertake chemo with her which i believe will be melphalan (phenylalanine mustard). I have done some research on scientific studies and the greatest tumor reduction and remission was achieved in rats when the drug was administered ‘at the onset of darkness (activity)’.
    Please can you give me an indication of what time of day this would be for a dog.
    Thanks for all your help, you have made such a difference.
    (London, UK)

  9. nicole on January 23, 2010 at 10:37 am

    I have seen several ads for K9 Immunity. What do you think of this product? Is it a gimmic?

  10. Suzanne on January 13, 2010 at 10:51 am

    Is vinblastine a platinum drug? Or would a different time be more suitable?

    • Dr. Dressler on January 22, 2010 at 11:19 pm

      Dear Suzanne,
      Vinblastine is a vinca alkaloid, and may be best given mid-day.
      Best of luck
      Dr D

  11. Mel on November 5, 2009 at 3:05 am

    What would be the best time of day for melphalan (pill form)??

  12. Carol on January 25, 2009 at 9:36 pm

    My girl had “breast” cancer (lymphoma?) – and we opted for the chemo. It appeared that the tumors grew more when we did the chemo. After 2 sessions – I asked what was I “buying” – how much more time. I was told, a couple of weeks. My pup was only 9 years old – I was looking for an answer of a couple of years at least for the energy, money and effort we were putting into it.

    Question: WHY would the vet encourage me to do chemo when he felt we were gaining VERY little????

    • Dr. Dressler on January 30, 2009 at 7:45 pm

      Carol, I am sorry that the chemo did not work. Vets sometimes will just recommend what is in the medical book. You just reach for your hammer when you are a carpenter. Chemo is what we are trained to offer, and so we do it.
      I am sorry things are not going well. Check out some of the outside-the-box options in this blog.