What is chemotherapy like for a dog?
March 12, 2010 1:26 PM Subscribe
What is chemotherapy like for a dog?
Our dog may have cancer of the liver for the second time in 1.5 years. The first bout was treated successfully with surgery, but the nature of this current round (it has still not been biopsied) would not indicate surgery.
She is a very old dog, at least 15, but is generally healthy and happy aside from moderate-to-severe arthritis (managed to some extent with Derramax). We are obviously a ways away from having to make a decision about treatment, and it's entirely possible that we'll find out the new growths on her liver are benign.
What I would like, though, is to gather information and discuss this with my wife as dispassionately as we can BEFORE we get any possible bad news. We are not inclined to trade quality of life for quantity of life, at least not dramatically so.
If dog chemo is as horrible as human chemo, I think the decision will be straightforward: we'd choose not to make her suffer through the treatment, instead making sure she's as comfortable as we can make her. But we have heard that chemo is not as horrifying for dogs, so that makes things more complicated.
My question is this: in your experience, what is chemo like for a dog, in day-to-day terms? Lots of suffering? I should note that she does not currently have any symptoms or pain whatsoever resulting from whatever is (or is not) wrong with her liver.
Our dog may have cancer of the liver for the second time in 1.5 years. The first bout was treated successfully with surgery, but the nature of this current round (it has still not been biopsied) would not indicate surgery.
She is a very old dog, at least 15, but is generally healthy and happy aside from moderate-to-severe arthritis (managed to some extent with Derramax). We are obviously a ways away from having to make a decision about treatment, and it's entirely possible that we'll find out the new growths on her liver are benign.
What I would like, though, is to gather information and discuss this with my wife as dispassionately as we can BEFORE we get any possible bad news. We are not inclined to trade quality of life for quantity of life, at least not dramatically so.
If dog chemo is as horrible as human chemo, I think the decision will be straightforward: we'd choose not to make her suffer through the treatment, instead making sure she's as comfortable as we can make her. But we have heard that chemo is not as horrifying for dogs, so that makes things more complicated.
My question is this: in your experience, what is chemo like for a dog, in day-to-day terms? Lots of suffering? I should note that she does not currently have any symptoms or pain whatsoever resulting from whatever is (or is not) wrong with her liver.
Disclosure: IANAV, and I've never had a dog that got chemotherapy. Most likely, you aren't going to have your dog's cancer cured by giving her chemo -- you'd be using the chemo to make the cancer a chronic illness instead of a terminal illness, to prolong her life as much as possible.
Some of our friends at the dog park have dogs who are on chemotherapy for various cancers. They seem very happy and energetic and don't seem to be suffering -- I have heard that the side effects for dogs are much less of a problem than in humans. The dogs who I know are on chemo have a pretty healthy appetite for treats, and are energetic and run and play with the other dogs at the park. They are elderly dogs (a 9-year-old Boxer and a 12-year-old lab mix) but not as old as yours.
First of all, most vets will only recommend chemo if they feel that the cancer is a kind that will respond well to chemotherapy, so it might not even come up.
In terms of side effects, you would need to watch for nausea and be a bit careful about germs, because the immune system suffers from chemotherapy. Quick Google searching suggests that 5-10% of dogs have severe side effects that require hospitalization though. I don't know if your dog's extreme old age would make her more likely to experience side effects -- I would ask your vet about it. You also might want to ask the vet if side effects are more likely because the cancer is in her liver -- after all, the liver is what breaks down chemotherapy drugs so that they don't make you sick, so if her liver function is compromised by cancer, maybe that could affect the chemotherapy? I don't know, I'm not a vet, but it might be worth asking.
Dog chemo is really expensive, though, and will most likely run into the thousands. Not to say that cost is the only thing that matters, but it does matter to many people. If it were me, I would most likely decide that 15 years was a pretty good run for an old dog and then have her put down when she showed signs of suffering.
posted by kataclysm at 1:51 PM on March 12, 2010
Some of our friends at the dog park have dogs who are on chemotherapy for various cancers. They seem very happy and energetic and don't seem to be suffering -- I have heard that the side effects for dogs are much less of a problem than in humans. The dogs who I know are on chemo have a pretty healthy appetite for treats, and are energetic and run and play with the other dogs at the park. They are elderly dogs (a 9-year-old Boxer and a 12-year-old lab mix) but not as old as yours.
First of all, most vets will only recommend chemo if they feel that the cancer is a kind that will respond well to chemotherapy, so it might not even come up.
In terms of side effects, you would need to watch for nausea and be a bit careful about germs, because the immune system suffers from chemotherapy. Quick Google searching suggests that 5-10% of dogs have severe side effects that require hospitalization though. I don't know if your dog's extreme old age would make her more likely to experience side effects -- I would ask your vet about it. You also might want to ask the vet if side effects are more likely because the cancer is in her liver -- after all, the liver is what breaks down chemotherapy drugs so that they don't make you sick, so if her liver function is compromised by cancer, maybe that could affect the chemotherapy? I don't know, I'm not a vet, but it might be worth asking.
Dog chemo is really expensive, though, and will most likely run into the thousands. Not to say that cost is the only thing that matters, but it does matter to many people. If it were me, I would most likely decide that 15 years was a pretty good run for an old dog and then have her put down when she showed signs of suffering.
posted by kataclysm at 1:51 PM on March 12, 2010
Also, I hope that whatever you get for a diagnosis and whatever treatment options you end up pursuing, that you and your dog have a wonderful time together until it's time for her to go.
posted by kataclysm at 1:57 PM on March 12, 2010
posted by kataclysm at 1:57 PM on March 12, 2010
My German Shepherd went through several rounds of different kinds of chemotherapy for canine lymphoma, beginning with the Wisconsin-Madison protocol. To be honest, it wasn't all that hard on her. Depending on which treatment she was getting that say, we'd either drop her off for her appointment or hang out in the vet's waiting room and look at other dogs, and then we'd take her home. She didn't lose her hair [well, she was my little german shedder, so no more hair than normal], have any problems with vomiting, or run into too many of the problems that are typically associated with human chemo. She'd be quiet for the evening and maybe for the next day, but by 'quiet' I mean 'not rip-roaring through the house like a crazy dog', instead just hanging out on her couch and ripping the fluff out of all of her animals.
Hers was a particularly nasty lymphoma, so two months after the W-M protocol she came out of remission and we went back on another set of different drugs. It was more of the same, really: vet visit, quiet puppy for a day or a day and a half, maybe a little bit of picky eating. Nothing major.
For the most part, she was her normal self. She still loved her toys and her walks and her people. Every once in a while she had to be coaxed into eating, usually after one particular drug, but there were anti-nausea medications to help with that, and the steroids definitely helped with that, too. She drank like a camel and tried to break into her dog food because of the steroids.
It's certainly not all fun and games -- and craven_morhead is correct, it's ungodly expensive -- but it's nowhere near as bad as I had imagined. I met a lot of chemo moms and dads at the vet, and we all pretty much came to that same conclusion. Depending on what other ailments your dog might have -- mine suffered from exocrine pancreatic insufficiency, which kind of turned out to be for the best during one treatment, because the drug might have affected her pancreatic function, if she had any -- it might complicate some things, but our oncologist took everything in stride.
Cost may be a factor for you: it was for some that we'd met. Because of the youth of my girl, we decided to give it a go. It ran thousands of dollars, but it gave us a year instead of weeks, and I'd do it again in a heartbeat.
Good luck, and please, MeMail me if you'd like to talk some more about it.
posted by alynnk at 1:58 PM on March 12, 2010
Hers was a particularly nasty lymphoma, so two months after the W-M protocol she came out of remission and we went back on another set of different drugs. It was more of the same, really: vet visit, quiet puppy for a day or a day and a half, maybe a little bit of picky eating. Nothing major.
For the most part, she was her normal self. She still loved her toys and her walks and her people. Every once in a while she had to be coaxed into eating, usually after one particular drug, but there were anti-nausea medications to help with that, and the steroids definitely helped with that, too. She drank like a camel and tried to break into her dog food because of the steroids.
It's certainly not all fun and games -- and craven_morhead is correct, it's ungodly expensive -- but it's nowhere near as bad as I had imagined. I met a lot of chemo moms and dads at the vet, and we all pretty much came to that same conclusion. Depending on what other ailments your dog might have -- mine suffered from exocrine pancreatic insufficiency, which kind of turned out to be for the best during one treatment, because the drug might have affected her pancreatic function, if she had any -- it might complicate some things, but our oncologist took everything in stride.
Cost may be a factor for you: it was for some that we'd met. Because of the youth of my girl, we decided to give it a go. It ran thousands of dollars, but it gave us a year instead of weeks, and I'd do it again in a heartbeat.
Good luck, and please, MeMail me if you'd like to talk some more about it.
posted by alynnk at 1:58 PM on March 12, 2010
Response by poster: Thanks everybody, and keep 'em coming. I don't know that there's a "right" or "best" answer here, because I just want to collect different perspectives. I appreciate all the thoughts and well wishes.
posted by Ignatius J. Reilly at 2:05 PM on March 12, 2010
posted by Ignatius J. Reilly at 2:05 PM on March 12, 2010
I treated a Basset Hound with lymphoma for 28 months with chemo...initially it was once a week, then once a month then tapered off even more that that. She responded well and went into remission right away. She had a great life during treatment, good appetite, perhaps a little feistier than she was in her younger years. She never seemed to suffer any side effects at all to be honest.
posted by vito90 at 2:07 PM on March 12, 2010
posted by vito90 at 2:07 PM on March 12, 2010
Years ago, I had a dog younger than yours who went through chemo. She tolerated it amazingly well, I don't remember any problems with side effects, and she actually enjoyed her visits to the clinic to have it done. We spent the money because she was such a great dog and we wanted her to have one more spring and summer, and she did.
posted by not that girl at 2:15 PM on March 12, 2010
posted by not that girl at 2:15 PM on March 12, 2010
Generally speaking, chemotherapy for dogs is prescribed/dosed under the assumption that you are buying time, not curing the cancer. The reason is that we know that dogs can't understand that they are miserable or in pain in order to get better later, and it would be considered cruel to put them through that. So the chemotherapy is administered at lower dosages than what would be given to a human where you are trying to wipe out the cancer completely.
When my dog was diagnosed with lymphoma at age 12, that is what we were told. Despite this, we chose not to pursue the chemo for a variety of reasons, and just kept her comfortable for as long as possible. If she had been younger and if we had caught the cancer earlier, we might have given it a go. I don't regret our decision one bit. She knew she was loved all the way through her last moments.
Best wishes to you and your pup. It's the hardest thing to go through.
posted by misskaz at 2:16 PM on March 12, 2010
When my dog was diagnosed with lymphoma at age 12, that is what we were told. Despite this, we chose not to pursue the chemo for a variety of reasons, and just kept her comfortable for as long as possible. If she had been younger and if we had caught the cancer earlier, we might have given it a go. I don't regret our decision one bit. She knew she was loved all the way through her last moments.
Best wishes to you and your pup. It's the hardest thing to go through.
posted by misskaz at 2:16 PM on March 12, 2010
I would add: based on our experience with Juno, as I remember it, absolutely the only reason I might not do chemotherapy with a dog again if it seemed medically advisable would be cost.
posted by not that girl at 2:17 PM on March 12, 2010
posted by not that girl at 2:17 PM on March 12, 2010
Vet here, but IANYV yadda yadda!
It depends on the actual protocol and specific drugs used, but yes, chemo for animals is generally not as "bad" as it is in humans. This is because (again, in general), much more aggressive drugs and higher doses are used in humans because the ideal end goal is usually cure. In animals, the end goal is usually palliation.
Take guidance from your vet oncologist - ask them many questions. Oncology in animals is an ever-changing field, and no two cases are the same, so it's difficult to compare people's individual experiences. Do think about her age, her temperament, your schedule, your finances etc. You will likely need 1-2 or more trips to the vet each week for months. How does she do at the vets? Will she be able to cope with all the car trips (thinking about the arthritis here), iv injections, blood draws, etc? Will someone be able to take her to these appointments?
There are lots of stories here already about successfully-treated lymphoma cases. That is one of the most "treatable" doggie cancers. Unfortunately, liver cancer is usually a "bad" cancer, and will likely have a worse prognosis.
Best of luck to you and your doggie, I hope you get a "good" diagnosis and you don't have to make any difficult decisions.
posted by peanut butter milkshake at 2:18 PM on March 12, 2010 [1 favorite]
It depends on the actual protocol and specific drugs used, but yes, chemo for animals is generally not as "bad" as it is in humans. This is because (again, in general), much more aggressive drugs and higher doses are used in humans because the ideal end goal is usually cure. In animals, the end goal is usually palliation.
Take guidance from your vet oncologist - ask them many questions. Oncology in animals is an ever-changing field, and no two cases are the same, so it's difficult to compare people's individual experiences. Do think about her age, her temperament, your schedule, your finances etc. You will likely need 1-2 or more trips to the vet each week for months. How does she do at the vets? Will she be able to cope with all the car trips (thinking about the arthritis here), iv injections, blood draws, etc? Will someone be able to take her to these appointments?
There are lots of stories here already about successfully-treated lymphoma cases. That is one of the most "treatable" doggie cancers. Unfortunately, liver cancer is usually a "bad" cancer, and will likely have a worse prognosis.
Best of luck to you and your doggie, I hope you get a "good" diagnosis and you don't have to make any difficult decisions.
posted by peanut butter milkshake at 2:18 PM on March 12, 2010 [1 favorite]
If you find out that the newest growths are indeed cancer, arrange a consultation with a veterinary oncologist. There are many chemotherapy protocols, and the type of chemotherapy that would be best for your dog depends on the type of cancer present. Each protocol comes with its own set of expected outcomes/cost/side effects, so what you can expect will vary greatly, depending on the type of cancer you are dealing with.
Best wishes to you and your dog, and I hope you get good news with the biopsy report.
On preview, seconding much of what peanut butter milkshake said.
posted by MagicDolphin at 2:27 PM on March 12, 2010
Best wishes to you and your dog, and I hope you get good news with the biopsy report.
On preview, seconding much of what peanut butter milkshake said.
posted by MagicDolphin at 2:27 PM on March 12, 2010
Response by poster: Thanks again, everyone. To follow up, we will definitely consult with an oncologist if the biopsy shows cancer, and I really appreciate everyone's input. It's good to feel like I have a better understanding of the options (that may be) available to us.
Part of the trickiness here is that we've recently moved cross-country away from a vet who we really felt took great care of our dog and treated us with respect, which kind of underscores how important the communication-with-the-doctor part of this whole thing is.
posted by Ignatius J. Reilly at 3:12 PM on March 12, 2010
Part of the trickiness here is that we've recently moved cross-country away from a vet who we really felt took great care of our dog and treated us with respect, which kind of underscores how important the communication-with-the-doctor part of this whole thing is.
posted by Ignatius J. Reilly at 3:12 PM on March 12, 2010
A friend of mine who is a vet says that the thing with dog chemotherapy is not so much the side effects as the fact that it doesn't "work". you get a few more months or maybe a year if you're really lucky. if you know that going in and truly accept it you are in the minority; most of her. clients spend money they don't have hoping for a miracle. she kind of hates treating dogs with chemo for that reason and usually advises against it in older dogs.
posted by fshgrl at 3:12 PM on March 12, 2010
posted by fshgrl at 3:12 PM on March 12, 2010
Our awesome dog is going through a new round of chemo, starting today. She's responded very well to the previous two rounds. She gets the chemo w/ anti-nausea and anti-diarrhia drugs. She becomes a bit slow and not hungry for a day or two, and then gets right back on her normal crazy train. No hair loss or other visible effects of the chemo. She'll be 4 next month, FWIW.
posted by dr. fresh at 3:41 PM on March 12, 2010
posted by dr. fresh at 3:41 PM on March 12, 2010
My dog has lymphoma, and we decided to do the chemo treatments. If the vet hadn't said this was very treatable cancer, I don't know if we would have gone through all of the expense/vet visits. Our dog is also only six years old, and it was tough to get the diagnosis because I always expected him to live at least 10-12 years.
In our case, he responded immediately and bounced back to his old self and didn't seem to have any side affects other than some hair loss (he's a 60lb irish water spaniel, so he had a lot of fluff to lose). The chemo he was given is called doxorubicin, and it was injected into his front leg every 3-4 weeks or so. He didn't seem to care about getting the injection at all. Each time they did the treatment, they also had to check his white blood cell count to make sure they weren't giving him too much or too little. Total cost per month ended up being about $450, and the total cost so far is over $1500. Even considering how effective the treatment was for the lymphoma, we did only three treatments instead of the recommended five. The way the vet explained it to us, the treatments keep killing off the fast-growing cancer cells. After the first few treatments, there is less of the cancer to kill off. Not sure if this is true for all cases of cancer. Doing the full five treatments would have been most effective, of course, but nothing would have cured the lymphoma.
The cancer recently came out of remission, and he started feeling bad again, kind of suddenly (wheezing, tired). There were a couple of options after that, which included a different type of chemo (cyclophosphamide) for about $200-300/month instead of $400-500/month, or just prednisone (a corticosteroid). Because of the expense, we chose to just do prednisone, which only cost us $7 for a couple of months supply. He bounced back to his normal self again, and is just now starting to show symptoms a couple of months later. The prednisone was surprisingly effective for how cheap it is. Switched from dry dog food to canned which he eats more of. It's all a bit of a roller coaster, but he has had a great quality of life through everything. It's not easy to go through all of the treatments, but I tried to go with my gut feeling. I had friends on all sides telling me to either take out a loan to cover the treatment, try holistic treatments, or to not spend a penny since the lymphoma wasn't ultimately going to be curable. I feel good about the compromise, but each person has to make their own decision based on their situation. It's not easy, but I'm still so glad I have dogs! They've made me laugh every day, and have been great companions over the years.
Also, in case it's helpful to you and since it helped me a lot, this post: what happens if we don't give our dog chemo was really helpful to me.
posted by belau at 4:05 PM on March 12, 2010
In our case, he responded immediately and bounced back to his old self and didn't seem to have any side affects other than some hair loss (he's a 60lb irish water spaniel, so he had a lot of fluff to lose). The chemo he was given is called doxorubicin, and it was injected into his front leg every 3-4 weeks or so. He didn't seem to care about getting the injection at all. Each time they did the treatment, they also had to check his white blood cell count to make sure they weren't giving him too much or too little. Total cost per month ended up being about $450, and the total cost so far is over $1500. Even considering how effective the treatment was for the lymphoma, we did only three treatments instead of the recommended five. The way the vet explained it to us, the treatments keep killing off the fast-growing cancer cells. After the first few treatments, there is less of the cancer to kill off. Not sure if this is true for all cases of cancer. Doing the full five treatments would have been most effective, of course, but nothing would have cured the lymphoma.
The cancer recently came out of remission, and he started feeling bad again, kind of suddenly (wheezing, tired). There were a couple of options after that, which included a different type of chemo (cyclophosphamide) for about $200-300/month instead of $400-500/month, or just prednisone (a corticosteroid). Because of the expense, we chose to just do prednisone, which only cost us $7 for a couple of months supply. He bounced back to his normal self again, and is just now starting to show symptoms a couple of months later. The prednisone was surprisingly effective for how cheap it is. Switched from dry dog food to canned which he eats more of. It's all a bit of a roller coaster, but he has had a great quality of life through everything. It's not easy to go through all of the treatments, but I tried to go with my gut feeling. I had friends on all sides telling me to either take out a loan to cover the treatment, try holistic treatments, or to not spend a penny since the lymphoma wasn't ultimately going to be curable. I feel good about the compromise, but each person has to make their own decision based on their situation. It's not easy, but I'm still so glad I have dogs! They've made me laugh every day, and have been great companions over the years.
Also, in case it's helpful to you and since it helped me a lot, this post: what happens if we don't give our dog chemo was really helpful to me.
posted by belau at 4:05 PM on March 12, 2010
I don't know how much I can add to this discussion, but after being diagnosed with a malignant nasal tumor, our old dog is currently undergoing chemo. The alternative would be to allow him to decline faster (we were told prognosis for his type of cancer, untreated, is on-average 3 months) or pre-emptively euthanize, neither of which were options for us. Ironically, aside from the thing in his head which is killing him, he is a perfectly healthy dog.
His stools are a little looser than normal, and he does have terrible gas (we are not sure if this is a side-effect of the medication or the super-mega-weight gain food we changed him to. maybe both). On all other fronts, however, he is his happy, playful, regular old doggy self. I'm glad we made this choice.
We give a pill (cyclophosphamide) once daily. The prescription costs about $100 a month, which is not a strain for us, luckily. He also takes a daily anti-inflammatory/pain reliever for suspected sinus headaches secondary to the tumor. We have to get periodic bloodwork to check liver and kidney functioning, and were told that intolerance would be revealed through testing rather than behavior most of the time. If after a couple rounds of testing he is showing good tolerance, we can discontinue the bloodwork unless he shows changes.
We do know that we are buying months here, not years. We were told that when things go downhill they will do so rapidly and nothing will be able to stop that. As for right now, we see slowing the growth of the tumor and staving off his eventual decline very much as a "quality of life" issue.
posted by lilnublet at 5:16 PM on March 12, 2010
His stools are a little looser than normal, and he does have terrible gas (we are not sure if this is a side-effect of the medication or the super-mega-weight gain food we changed him to. maybe both). On all other fronts, however, he is his happy, playful, regular old doggy self. I'm glad we made this choice.
We give a pill (cyclophosphamide) once daily. The prescription costs about $100 a month, which is not a strain for us, luckily. He also takes a daily anti-inflammatory/pain reliever for suspected sinus headaches secondary to the tumor. We have to get periodic bloodwork to check liver and kidney functioning, and were told that intolerance would be revealed through testing rather than behavior most of the time. If after a couple rounds of testing he is showing good tolerance, we can discontinue the bloodwork unless he shows changes.
We do know that we are buying months here, not years. We were told that when things go downhill they will do so rapidly and nothing will be able to stop that. As for right now, we see slowing the growth of the tumor and staving off his eventual decline very much as a "quality of life" issue.
posted by lilnublet at 5:16 PM on March 12, 2010
I have no personal experience to add to this, but there was a good interview on Fresh Air about a year ago about how to make medical decisions for your dog.
I hope this helps, and you and your dog will be in my thoughts.
posted by CarolynG at 6:26 PM on March 12, 2010
I hope this helps, and you and your dog will be in my thoughts.
posted by CarolynG at 6:26 PM on March 12, 2010
Seconding CarolynG about the Fresh Air interview - good stuff.
I am one of those people who, having seen people go through chemo had pretty much decided I wouldn't put my dog through it - especially since the dog wouldn't have any idea what was happening. It turns out that one of the most compelling things the vet in the Fresh Air interview said was that the very fact that the dog does not know it has cancer, does not have all of our baggage about the disease and the treatment that human beings have, is a blessing. There is no sense of dread for a dog or any animal going into chemo.
Just something to think about.
Good luck to you!
posted by nnk at 8:19 PM on March 12, 2010
I am one of those people who, having seen people go through chemo had pretty much decided I wouldn't put my dog through it - especially since the dog wouldn't have any idea what was happening. It turns out that one of the most compelling things the vet in the Fresh Air interview said was that the very fact that the dog does not know it has cancer, does not have all of our baggage about the disease and the treatment that human beings have, is a blessing. There is no sense of dread for a dog or any animal going into chemo.
Just something to think about.
Good luck to you!
posted by nnk at 8:19 PM on March 12, 2010
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posted by booknerd at 1:47 PM on March 12, 2010