The Toxicity of Potent Dog Chemo Drug Doxorubicin
Dr. Demian Dressler is internationally recognized as “the dog cancer vet” because of his innovations in the field of dog cancer management, and the popularity of his blog here at Dog Cancer Blog. The owner of South Shore Veterinary Care, a full-service veterinary hospital in Maui, Hawaii, Dr. Dressler studied Animal Physiology and received a Bachelor of Science degree from the University of California at Davis before earning his Doctorate in Veterinary Medicine from Cornell University. After practicing at Killewald Animal Hospital in Amherst, New York, he returned to his home state, Hawaii, to practice at the East Honolulu Pet Hospital before heading home to Maui to open his own hospital. Dr. Dressler consults both dog lovers and veterinary professionals, and is sought after as a speaker on topics ranging from the links between lifestyle choices and disease, nutrition and cancer, and animal ethics. His television appearances include “Ask the Vet” segments on local news programs. He is the author of The Dog Cancer Survival Guide: Full Spectrum Treatments to Optimize Your Dog’s Life Quality and Longevity. He is a member of the American Veterinary Medical Association, the Hawaii Veterinary Medical Association, the American Association of Avian Veterinarians, the National Animal Supplement Council and CORE (Comparative Orthopedic Research Evaluation). He is also an advisory board member for Pacific Primate Sanctuary.
Updated: January 4th, 2021
Summary
Is your dog on doxorubicin? Here’s what you need to know about this potent, common chemotherapy agent.
Vets and veterinary oncologists use Doxorubicin (also called Adriamycin) in many different chemotherapy plans.
Common dog cancers treated with this drug include lymphosarcoma, hemangiosarcoma, other sarcomas, and carcinomas.
This is not a mickey-mouse drug. It is one of the main players in conventional dog cancer chemo treatments. It also has corresponding side effects that, from time to time, are heavy duty and should be taken into account.
NOTE: The reader should be advised that the purpose of this content is not to crucify doxorubicin. It has helped many dogs. Rather, this is information that should be in your head as an informed advocate of your dog’s health.
How Doxorubicin Is Given
Doxorubicin is given as an injection in the vein at the vet hospital. If the tip of the catheter used to deliver the drug is not in the vein (but still under the skin), the drug will end up in the tissues around the vein.
Doxorubicin is very toxic to living tissue when given in this way and will cause this tissue around the vein to die.
Doxorubicin Side Effects
In addition to injuries caused by bad injection technique — which are NOT common, but can occur — doxorubicin may also cause stomach upset, inflammation of the colon, and delay the regrowth of hair. Some dogs will develop allergic reactions during doxorubicin injections. It can also cause bone marrow suppression (anemia and low white blood cell and platelet counts).
It is known to cause damage to the muscle in the heart, in some dogs, which can be quite serious. Check out this abstract for more info on doxorubicin toxicity.
How to Mitigate Side Effects
In the next post, I will discuss the use of common, over-the counter-supplements that should be considered to help alleviate a big toxicity with this drug: heart damage…
And of course, you can find out more about this drug and every other chemo agent, in The Dog Cancer Survival Guide. Dr. Ettinger and I also cover multiple ways to support your dog with and without chemotherapy.
Best to all,
Dr D
Dr. Demian Dressler is internationally recognized as “the dog cancer vet” because of his innovations in the field of dog cancer management, and the popularity of his blog here at Dog Cancer Blog. The owner of South Shore Veterinary Care, a full-service veterinary hospital in Maui, Hawaii, Dr. Dressler studied Animal Physiology and received a Bachelor of Science degree from the University of California at Davis before earning his Doctorate in Veterinary Medicine from Cornell University. After practicing at Killewald Animal Hospital in Amherst, New York, he returned to his home state, Hawaii, to practice at the East Honolulu Pet Hospital before heading home to Maui to open his own hospital. Dr. Dressler consults both dog lovers and veterinary professionals, and is sought after as a speaker on topics ranging from the links between lifestyle choices and disease, nutrition and cancer, and animal ethics. His television appearances include “Ask the Vet” segments on local news programs. He is the author of The Dog Cancer Survival Guide: Full Spectrum Treatments to Optimize Your Dog’s Life Quality and Longevity. He is a member of the American Veterinary Medical Association, the Hawaii Veterinary Medical Association, the American Association of Avian Veterinarians, the National Animal Supplement Council and CORE (Comparative Orthopedic Research Evaluation). He is also an advisory board member for Pacific Primate Sanctuary.
my boxer was diagnosed with stage II hemangiosarcoma much like your dog Maggie and my oncologist,as well as the k-9 immunity rep (MD) i spoke to stated that there is no harm in giving both at the same time. He just finished his third round of chemo today and has been taking the supplements at the same time and has been doing wonderfully. if i were you i would just make sure you arent over doing it. If a vet isnt too keen on anything holistic, you should provide him with the printout for vets off of the k-9 immunity web site. immunomodulation therapy is done world wide and the principles make sense. There isnt a large subject pool for studies like there are for humans so noone truly knows. I would call aloha medical and ask to speak to the doctor (John) i believe is his name..
Our 10-year-old Golden retriever was just diagnosed with a Grade III Hemangiosarcoma in her speen. She had a splenectomy, and pre-op no other tumors were visible in her lungs (3-views via xray), liver, abdomen, heart, or kidneys (viewed via ultrasound). The splenic tumor, however, had hemmorhaged, though not fully ruptured. The liver biopsy came back clean except for evidence of some white blood cells that were a result of the spleen hemmorhaging. We were told her prognosis was 2-3 months with surgery alone, and 6-8 months with chemo.
yesterday, Maggie started her first dose of Doxorubicin. Our vet told us that we could not give Maggie ANY supplements or antioxidants except fish oil. Prior to the dox. I had her on a laundry list of 11 or so supplements, ranging from I’m-Yunity to K9 Immunity, Transfer Factor, CoQ10, Milk Thistle, IP6+Inositol, Colostrum, and an antioxidant “power pill” that has a list of about 20 different herbs and Vitamins.
My question: what can I give Maggie that isn’t contraindicated with chemo / doxorubicin? I read a study which stated that I’m Unity / Colous Versicolor mushroom (also in K9 Immunity) can help doxorubicin’s effectiveness not hinder it, with some cancers. My vet isn’t too keen on anything holistic, but I would like to try whatever i can. Please advise!
Dr. Dressler,
Our dog is a 5 yr old rotweiler.Our vet suspected that he has a leg tumor because his front leg (right) swell and he said that there’s no treatment for that but since I am an oncology nurse here in our place i will try to treat him same as for human treatment.Would you mind telling what is best remedy for our dog and what is the best drug for him coz it’s very hard for us to look at him suffering.Thank you and God Bless
Nicole
Dear Nicole,
well, you are correct. First you need a diagnosis, or at least a presumptive diagnosis. One contender would be osteosarcoma, very common in Rottweilers. You need a second opinion, big time. You need to have X-rays of both the leg and the chest. If it looks like a tumor without obvious spread, amputation is the first step. They do fine on three legs assuming no other major orthopedic issues. Then diet, supplements, maybe chemo…this is a very complex issue. You may want to tune in to this weeks webinar on the most common kind of bone cancer (osteosarcoma):
http://www.mydogvet.com
Best,
Dr D
Thanks Sarah! I know he is probably very busy, I was just curious because it does look like he had answered other posts so I wasn’t sure what to expect!
Hi Jenn, I’ve been looking at the blog a lot since my dog got sick. I don’t think the Dr. has time to answer all these questions. It’s just a blog. I had a very specific question so I signed up for his monthly seminar to get it answered directly. http://www.mydogvet.com is how I found it. Hope that helps.
I was wondering what your doctor said about Essiac?
Our 13 yr old Panda had surgery for Hemangiosarcomas on Dec 31, 2008 when her spleen ruptured. We are giving her IP-6 Max with Inositol, Maitake & Cats Claw along with Essiac, Vit E, Echinacea/Golden Seal, Flax Oil & Fix Oil. She is also getting a liver detox that contains Milkthistle. Her diet is Chicken breast with steam viggies.
We are choosing not to do chemo, because everything I read indicates it degrades the immune system which is what we are trying to up to fight the cancer. She had black spots on some organ that they removed with the spleen that the vet said floats like a jelly fish. Right before this, they were treating her for Pancreatitis so we are trying to be carefull with her diet.
That is fantastic!!
It is really great to hear. You are very lucky to have such a team. If every dog with cancer had access to this type of care we would be so much ahead of the game.
Congrats
D
We didn’t start the Milk Thistle until 2 weeks after the final Doxorubicin tx. At that time, we also started Vits. C & E, Fish Oil, IP6, Turmeric, Artemisinin, Yunnan Paiyao and her chemo maintenance meds of Cytoxan, Doxycycline, and Piroxicam (with a daily antacid to protect the GI from the Piroxicam). The Milk Thistle is given to promote liver health, as HSA can spread to the liver, thus another reason for the CoQ10, as HSA can spread there as well.
Mali’s spleen ruptured, so she had an emergency splenectomy. No evidence of spread was evident on chest x-rays and abdominal ultrasounds or seen during surgery. No further surgery or radiation was required. We started her Doxorubicin 2 weeks after splenectomy, given every 2 weeks.
She is 4yrs post her splenic HSA dx as of 12/24/08. While this survival success is not typical, anything is possible given the unpredictable nature of HSA. Who knows if the splenectomy alone removed the threat of the HSA or the chemo and/or chemo maintenance, and/or the supplements. We wanted to do everything for Mali, however everything may not have been right for her. I worked with her Vet and Onc to get an integrative approach of traditional meds and supplements that suited/complimented her overall health and her cancer protocol.
To answer your last question, our Onc was very open and informative about supplements. I emailed almost daily about alternative therapies (PawPaw, Neoplasene, SAHA, L-MTP-PE, Essiac) that I had read about and always got an answer or experience about them and reason for whether or not we used them for Mali. We also discussed acupuncture and hydrotherapy. I am very lucky to have great support from our Docs.
Hi Ilene,
Thanks for your comments and great to hear things are going well!!
One question for you about the milk thistle. Milk thistle does some very interesting things, very good things for dog cancers. These are totally independent of the liver “support” it provides. I was wondering first about what your oncologist thought of using a supplement with known antioxidant effects with doxorubicin, whose mechanism of action is pro-oxidant. Thus from an “onc’s” viewpoint there would be interference.
Another question I was wondering about is that the liver is not a site for doxorubicin toxicity. I am not saying that milk thistle is inappropriate, I was just wondering about the rationale you gave.
Finally, has your oncologist been informative with you about options outside chemo, radiation and surgery? The areas outside these three realms of conventional oncology seem to be lacking, as many readers have stated their oncologist have not provided much input in areas outside chemo, radiation and surgery. What are your thoughts?
D
It should be noted that when giving Doxorubicin, a Benadryl injection before administering chemo may prevent allergic reactions. Also, pre-treat meds for possible nausea and diarrhea can be prescribed to start on chemo day and continue for 5 days. The idea is to beat the cancer, not the dog. It may be better to pre-treat to prevent, as it can be much harder to get possible side effects under control once they start.
Ask your Onc about CoQ10 to promote heart health when giving Doxorubicin. Milk Thistle should also be discussed with your Onc to promote liver health. (Before starting any supplements, check with your Onc to make sure they do not interfere with the chemo’s effectiveness or have interactions between the supplements)
Blood tests between each treatment will help monitor your dog’s response to this chemo and may determine the timing of the next treatment. Fasting the night before chemo can give more accurate blood test results and may also help ward of chemo anemia.
Exercise may good after treatment to encourage drinking water, which may help flush the toxins faster. Always keep a chemo diary during treatments so you can let your Onc know of any reactions. Tweaking the protocol or even reducing the dosing of the Doxorubicin may be discussed to reduce side effects.
The above are just a few things we did when Mali got her Doxorubicin every 2 weeks for her hemangiosarcoma, which she handled beyond my expectations.
Always consult your Onc, each dog, each cancer and each protocol is different.