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.
our 8 year old mix breed female was just diagnosed yesterday with Osteosarcoma of the scapula,30% cell growth in her lungs,and treated with Doxorubicin.They sought no point in taking her limp,but to try to extend her life.Shes been extremely active her whole life,ball playing,swimming,hiking,etc.She had been lame for 1 week!What can we do to make her life better?Diet?supplement?Is there any other treatment available?
Thankyou,
Meg
Dear Meg,
I am very sorry to hear about this. I would be talking to your vet about apocaps, artemisinin, and pamidronate, as well as tramadol, gabapentin, and 1/4 to 1/2 dose metacam (when used with apocaps). If the vet does not know about these things, you can get the info in the Guide.
I hope this helps
D
We are trying to weigh the option of chemo with Doxorubicin for our 13 year old I.G. Does anyone know the average cost of this drug therapy?
Dear Kevin
chemo costs vary from place to place. The best thing to do is get a written estimate from the oncologist….I would also educate yourself on more aspects of the decision. You should find out about the gained life expectancy (not just survival time), also rough risks of side effects, frequencies of trips in, time for follow up care and cost of follow up appointments. The Guide has a listing of sources of possible funding for your pet’s care too if you are interested.
Hope this helps
D
My 10 year old golden retriever was diagnosed with hemangiosarcoma 3 weeks ago. He had a normal chest xray and abdominal ultrasound so we proceeded with splenectomy and chemo. However, 5 days after his first treatment with adriamycin he had a terrible event in which he stumbled, collapsed and started
rolling around violently, We rushed him to the vet. They were unsure whether
this was a seizure or a fainting episode and started him on phenobarbitol.
Are there are any cases of chemo causing seizures or are we stuck with the diagnosis that the cancer has spread to his brain?
Should we take a chance with a second chemo treatment?He has since had
a normal neuro exam and his blood count 4 days after the event was basically
normal. Thanks for you help.
Dear Susan,
I am sorry to hear about your Golden. One other possibility is cardiac disease secondary to the adriamycin. Another is an unusual manifestation of an allergic reaction to the adriamycin, which is possible (hypotension due to anaphylaxis). Are you working with an oncologist with this? So no, brain metastasis is not the only possibility.
I typically start phenobarbital after 1 seizure monthlly, 6 clusters yearly, or worsening or severe seizures. I might pursue a bit more inquiry before jumping right to the phenobarb, personally.
There are ways to help with chemo toxicity using supplements that are discussed in the Guide, and don’t forget diet, apoptogens, immune support, and the rest of the beneficial full spectrum steps. Please get veterinary and oncologist supervision.
My 7 yrs old GSD was diagnosed last week with high grade Hemangiosarcoma of the spleen. No evidence of spread noted. It was bleeding and required emergent surgery with a transfusion. He pulled thru well! Now trying to decide between first doxyrubicin, the low dose drugs, or to just start with the cyclophosphmide/piroxicam. Any help would be appreciated.
Dear Selena
I am sorry to here about your Golden. The first step in we discuss in the Guide is deciding what your priorities are with conventional care. More longevity means higher odds of side effects with chemo. I assume a splenectomy has been performed. You need to ask your vet- what is the added life expectancy with the protocols that are being suggested for your dog? Notice we are talking about added life expectancy, not life expectancy. What are the odds of side effects? What will these look like for my dog? What is the financial cost? How will the treatment look (what is involved in the care)? This is the data collection stage that is so important. These should be written down and considered based on what your priorities are and your tolerance for side effects. We do not have a “right” treatment for systemic canine cancer since we don’t yet have a cure, which would be the “right” choice. So it becomes a question of guardianship and your values, not a medical choice per se. I would suggest you take the time to read the Guide which helps clarify some of these ideas. Don’t forget to include other treatments that may help: diet, apoptogens, immune stimulants, anti metastatic supplements, and life quality steps. Consider also yunnan baiyao. You can also search for information using the search bar in the upper right of your screen.
Best,
Dr D
My 9 year old Boxer, Gracie, was diagnosed with hemangiosarcoma about a month ago. We did the first round of doxorubicin at the Univeristy of Madison, and the first few days went great. However, the third day after her treatment things started to changed. She collapsed while we were taking a walk, and she started to collapse a few times a day afterwards. She had two cardiac evaluations prior to treatment, and nothing showed that she wouldn’t be a good candidate for this drug. She was put on an anti-aarythmic was made matters worse so we took her off of it. Since going off the heart medication she was she not collapsed. She still doens’t seem herself though. She doesn’t run and play like she used to, she gets tired easily, and for some reason gets very shakey and pants a lot, espciallly in the morning before she eats. I have asked all of our vets what they think this could be from, and nobody can give me an answer. She was a happy, healthy, energic dog before we started chemo and now she’s really changed. She’s due for her second round of chemo this week and we have no idea what to do. Does anybody know what causes this shaking (which is like a shiver if you get cold)? It usually doesn’t last long and goes away after she eats. Also, it almost always happens in the mornings????
[…] to itself. First came the big whamee, the megadoses of chemotherapy, five doses over 10 weeks of Doxorubicin (adriamycin). I feel bad for the human species; chemotherapy does some pretty harsh things to you. It’s […]
My great dane that I love was told that she migth have cancer in her leg after an x-ray done, chest x ray was clear. Still waiting on the blood result but at this point I don’t want to get a biopsy done, what are my options?
A side note about Doxorubicin AKA Adriamycin)
>>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.<<
During my dogs first chemo treatment on October 28th, 09- the syringe slipped while being flushed. Unfortunately the Doxorubicin mixture was deposited around the surrounding tissue. Her skin has sloughed off down to her muscle. (inside area of upper front leg)
The four remaining chemo treatments have been shelved until further notice.
She had several laser treatments and clinical study Platelet Rich Plasma PRP Treatments. Last Wednesday her veterinarian preformed a surgical flap procedure that covered about 85% of the exposed muscle. We are now working with antibiotics to ward off infection. We have been to the vet between four and six times a week for the last five weeks.
Please take time to educate yourself on the risks of cancer procedures and how they may effect you and your family pet.
My 10 yr old golden has been diagnosed with hemangiosarcoma but it was in her rt front leg in the muscle belly. The vet questioned the lab due to the unusualness of this location but they feel they are 90% correct. We amputated and her cath site was a mess and the incision was not only ugly but developed necrotic tissue and tomorrow she has to be put under again to have the tissue removed and restitched. We are living in London now and I have shaken confidence in her doc as a result of this, and a bad experience with the biopsy. the biopsy site burst and was weeping and the dog in intense pain and the vet dismissed it and i had to pay another more local vet to come to the house and change her pain killer, clean the site, place her on antibiotics and even call the next day to assess hospitalization. Now these vets are suggesting dox as a treatment and checked with a friend about the protocol instead o bringing in an oncologist liason. would love and input as i am drained after all this to date and really need good info and peopke who will talk to me inteligently vs dismiss me so i can make good choices for my dog.
Dear Jill, Doxorubicin is an accepted choice for chemo for HSA. You should go to a university or specialty center. Get your dog’s heart checked out first. Read about chronotherapy to time the treatments if possible. Also I would use the supplements in the Dog Cancer Guide, in particular curcumin/luteolin….as well as the CoQ and acetyl-L-carnitine (and diet, etc…)
Best,
D
in addition it stands to reason that the same way every person has different genetics and body responses to the disease process, so may each dog respond differently. The majority of people out there dont have thousands of dollars to spend on their dogs, follow through with a better diet, and keep to protocol. So it would suggest that the more things that you can change that are within your control., just as with a human, the better the chance for recovery. An oncologist for a human can never truly say someone is cancer free, they can ony say with regard to remission that there are no visible signs of cancer. So never give up hope, there are cases where dogs have lived for a few years with this, so even if it is a small percentage, why cant our dogs be the ones that are fortunate. Diet is super important as is positive energy.