When Cancer Strikes: Prepare Ahead for Decisions Based on Fact, Not Fear

by

Janine Adams

The Bark, Winter 2002

The moment arrives when your greatest fears are confirmed and the veterinarian pronounces the dreaded words "cancer" or "malignant." Time stands still for an instant. Then you're flooded with emotions and - depending on your particular emotional makeup - you may or may not be able to continue with a coherent conversation. At the moment you most need your sensibilities to be as sharp as a knife so that you can ask important, probing questions about your dog's health, your mind (along with your stomach) is swirling.

As hard as it is to think about cancer before you actually have to face it, you'll do your dog a service to learn about the dreaded disease while your dog is still healthy. With any luck, you won't need the information. But if you are faced with a diagnosis, thinking about it in advance can help you avoid making any rash, emotional decisions.

In this internet-connected world where a dog lover can have literally hundreds of dogaholic friends, it can feel like cancer is hitting dogs at an alarmingly high rate. But canine cancer may not be more prevalent than in days gone by, just more visible. With guardians who are more in touch with every nuance of their dogs' health, earlier cancer detection methods, and the simple fact that dogs are living longer, cancer is being diagnosed more often, says Robin Downing, DVM, owner of Windsor Veterinary Clinic, P.C., in Windsor, Colorado, and author of Pets Living with Cancer: A Pet Owner's Resource (AAHA Press, 2000).

According to the American Veterinary Medical Association (AVMA), dogs get cancer at about the same rate as humans do. The risk of cancer increases with age, though young dogs are certainly not immune.

Preventing cancer

There are few hard-and-fast rules about preventing cancer in your dog. Compared with human cancer research, not a lot of research is done on causes of cancer in dogs, so it's hard to pinpoint ways to avoid it. Spaying and neutering eliminate the possibilities of cancer in the reproductive organs that are removed, and spaying is known to reduce breast cancer substantially, if performed before the first heat cycle. Beyond that, many holistic vets feel that keeping your dog's immune system healthy through good nutrition, while minimizing your dog's exposure to toxins, is your best bet to avoid cancer.

What toxins? Think about the things that go directly into your dog's body: food, water, medications, vaccinations, flea and tick preventatives, for example. Feeding a high-quality diet, free of chemical additives or preservatives (like BHA, BHT and ethoxyquin, which are fairly common in pet foods) is a good start. Many holistic vets recommend feeding a natural diet of raw (or cooked) meat and vegetables to keep the immune system in tip-top shape. Raw, meaty bones are advocated as a species-appropriate food. William Konrad Kruesi, DVM, of Cold River Veterinary Center, a holistic practice in North Clarendon, Vermont, says that a cancer prevention diet for dogs should contain some of the elements of one for humans: fresh vegetables, essential fatty acids and a multivitamin every day. "It's a little extra insurance against things that break our bodies down."

Supporting the immune system (leaving it free to fight off cancer) by minimizing medications‹thinking twice about "just in case" antibiotics and not giving heartworm or flea or tick preventative in months where mosquitoes, fleas and ticks aren't an issue (or considering non-chemical ways to deal with these pests) are a good way to start your dog on a healthy lifestyle that just might help him dodge the cancer bullet, holistic vets say.

The practice of annual revaccination, in particular, needs to be scrutinized. It is implicated in immune-related problems. And it could also be contributing to cancer, says Dr. Kruesi. "We have overvaccinated our pets and this has become a challenge to their immune competence," he says. Vaccinations exaggerate the animal's immune response, taking the body away from what it should be doing‹helping to cope with allergens in the environment and surveilling against cancer. Overvaccination preoccupies the immune system, busying the body with making antibodies where it doesn't need them, says Dr. Kruesi. "Given the assumption that cancer is a breakdown of immune function, we have to look at whether we as veterinarians are inadvertently modifying normal immune function through vaccinations."

In a study whose preliminary results were presented at the "Genes, Dogs and Cancer: Second Annual Canine Cancer Conference" hosted by the AKC Canine Health Foundation in September 2002, Larry Glickman, VMD, Ph.D., professor of epidemiology at the Purdue University School of Veterinary Medicine, measured the environmental risk factors for bladder cancer in the Scottish terrier, a breed that is at high risk for the disease. So far, the researchers have found that certain factors, like daily or weekly exposure to lawns treated with chemicals, the application of the older generation of flea dips and collars (not the newer "spot ons"), being overweight, and having a close relative with the disease, increase the risk of bladder cancer in Scotties. Factors that were seen to decrease the risk included eating cruciferous vegetables three times a week or more, daily intake of a vitamin supplements (especially vitamins C and E), and past use of non-steroidal anti-inflammatories. When asked whether the results would be generalizable to other cancers, Dr. Glickman replied, "We won't know until we study it. I would guess that it is the tip of the iceburg."

Whether or not you're able to help your dog avoid cancer, you might be able to help him beat it. As in humans, the earlier the cancer is diagnosed, the more successful treatment can be, so paying close attention to your dog's health and seeking veterinary care when something worries you might be the most important thing you can do to see that your dog doesn't succumb to cancer. (See the side bar for the AVMA's top ten signs of cancer in dogs and cats.)

When the diagnosis comes

When you get the dreaded diagnosis, don't panic. "Don't jump to decisions prematurely," advises Dr. Downing, who urges you to make fact-based, not fear-based treatment decisions. If your veterinarian discusses immediate euthanasia, unless your dog is on death's door (can't move, is not eating or drinking), take the time to make a reasoned decision. "Rarely do we have to make a decision right away," says Dr. Downing. "If your intuition is that the animal is not about to die, it is perfectly appropriate to seek a second opinion."

You'll need to work quickly, because time is of the essence, but take the time to gather information. Get a second opinion or talk to a veterinary oncologist if that feels right. Talk with people who have perhaps been through the same experience.

A second piece of advice that Dr. Downing gives to people at the time of diagnosis is to get a notebook and a pen and begin writing everything down. Write down all your questions. Bring the notebook with you to vet appointments and write down everything that is said. At home, take note of how your dog is doing on a daily basis: his appetite, elimination habits, energy levels. Be sure and note whether he vomited and if he did what it looked like. All this information, which is difficult to keep in your head, is important to your veterinarian.

Jot down your feelings and emotions, too, suggests Dr. Downing. "There is nothing more intimate than dealing with a being whose life is threatened by illness," says Dr. Downing. Think about the things you've always wanted to do with your dog and, if your dog is feeling well enough, do them, write about them in your notebook, and check them off your list. This journal will be a lasting record of this experience with your beloved dog.

Treating cancer

While cancer is the leading natural cause of death in dogs and cats in the U.S., a diagnosis of cancer is not necessarily a death sentence. According to the Animal Cancer Center at Colorado State University's College of Veterinary Medicine and Biomedical Sciences, cancer is the most curable of chronic diseases.

Sometimes that cure comes in the form of a knife. If a localized tumor is surgically removed, a dog can become cancer-free. For more advanced cancers, the mainstay of conventional cancer treatment is chemotherapy and radiation, usually following surgery.

Dr. Downing (whose own dog died of old age four years after being diagnosed with bone cancer and treated with surgery, chemotherapy and radiation) encourages people to set aside images of gut-wrenching side effects of chemotherapy that they may have seen in people. "We have a very different philosophic approach in dealing with chemo in animals than in humans," says Dr. Downing. "We don't take animals to the brink." In animals, cancer therapy involves control of the tumor and control of the disease and keeping micrometastasis suppressed. In humans, it's "cure at all costs," says Dr. Downing. Veterinary oncologists (and dog owners) put a high value of quality of life of the patient and chemotherapy is meant to extend high-quality life, rather than cure.

Because the doses of chemotherapeutic agents are lower, compared with humans, and because animals don't anticipate becoming ill from chemo, the adverse effects of chemo in dogs are usually lower. And if the drugs make the dog feel very bad, they're changed. "We don't just watch the animal get sick because we are following a protocol," says Dr. Downing. "If my patient gets sick from the treatment, I'm not doing something right."

Diet is an important part of cancer treatment. Research indicates that simple carbohydrates and sugars fuel cancer growth. Since the primary ingredient in almost all kibbles is grains, a modification in a kibble-fed dog's diet is probably in order if he's diagnosed with cancer. A prescription cancer diet, Hill's n/d, is available in canned form. Or you can prepare a grain-free diet for your dog at home.

Alternative treatments

As in human medicine, alternative and complementary cancer treatments are available when conventional treatments aren't appropriate or desired. Dr. Kruesi treats cancer patients first with a diet of whole foods ("We should really consider that a part of cancer therapy"), followed by nutritional supplements to address underlying imbalances. He counsels clients to stop using any chemicals on the dog (heartworm preventative, flea and tick chemicals, vaccines) and uses homeopathic remedies and herbs to detoxify the dogs. Then he seeks to treat the tumor through a variety of therapies, adapted from human alternative cancer treatments. These include:

• Antioxidants, such as Vitamin C and milk thistle;
• Immune support, through the use of glandular supplements (made from bovine glands, such as spleen and thymus);
• Immune stimulants, to help degrade tumor cells and cope with secondary infections. These take forms such as medicinal mushroom extracts, echinacea, and aloe juice;
• Inhibitors of angiogenesis (new blood vessels, essential for tumor growth), from natural sources like shark cartilage and morning glory extract
• Poly-MVA, which uses the metal palladium to change the electrical charge of the cancer cells, slowing the growth of cancer. He points out that palladium can be toxic to the kidney and Poly-MVA must be used with caution.