What is chemotherapy?
Chemotherapy drugs are compounds that are toxic to cancer cells. Chemotherapy may be given as an IV injection or an injection under the skin. It can also be given orally.
How does chemotherapy work?
Cancer cells generally multiply very rapidly. Most chemotherapy drugs work by damaging the ability of these rapidly growing cells to divide, eventually killing them.
What are the benefits of chemotherapy?
Chemotherapy is used by veterinarians to treat cancers in four basic but different ways:
- Chemotherapy is the most effective single treatment for some types of cancer, offering the best opportunity for remission while at the same time preserving a good quality of life. For example, lymphoma, also called lymphosarcoma, reacts well to chemotherapy.
- Chemotherapy is often recommended after the surgical removal of a malignant cancer. The purpose of chemotherapy in this setting is to prevent recurrence of the cancer at the original site and to prevent it from spreading (or metastasis). Examples of cancers in which chemotherapy is routinely used in this way are canine or feline malignant breast cancers and malignant bone tumors in dogs.
- Chemotherapy may be administered to some animals while they are also receiving radiation therapy for the treatment of their cancers. Some chemotherapy drugs are effective in this situation because they increase the ability of the radiation to kill the cancer cells.
- Occasionally, chemotherapy will be used alone for the treatment of cancers that are not amenable to surgical removal or radiation therapy or have already metastasized. In most of these cases, the goal of treatment will not be to cure the cancer but rather to improve the patient’s quality of life temporarily by reducing pressure, bleeding or pain.
Should I make changes to my pet’s lifestyle while receiving chemotherapy?
- Drastic lifestyle changes to your pet’s daily routine are not necessary during chemotherapy treatments. At times, certain pets may experience a bit of lethargy or low energy on the day of chemotherapy and for a few days afterward. Let them be your guide; if they don’t feel like doing something, don’t force them, but if they feel up to it, go right ahead. We have patients that continue to perform well in their agility trials, swim, or keep going on their hikes. If you have any questions regarding holistic supplements, please ask either an Oncology nurse or your Veterinary Oncologist.
Are there risks or side effects involved?
Chemotherapy is very well tolerated in most dogs and cats. Most patients experience only mild side effects to chemotherapy that will last for a few days, and many will improve on their own. About 5% of patients can experience more moderate to serious side effects, and less than 1% can have more severe/fatal side effects.
Dogs and cats generally tolerate chemotherapy much better than human patients. The two side effects encountered most commonly in canine and feline patients are toxicity to the gastrointestinal tract and toxicity to the bone marrow. Normal cells in both of these areas divide very rapidly and are, therefore, more susceptible to the toxic effects of chemotherapy. Most patients will experience this side effect at least once or twice during their course of chemotherapy treatment, but the symptoms are usually mild and can be overcome with supportive care at home. We have effective medications that can help minimize the most common side effects and help your pet through them more quickly.
When the cells of the bone marrow are affected, the result may be more serious. The precursor cells that produce the white blood cells necessary to fight infection are found in the bone marrow. If these cells are damaged, the patient’s white blood cell count may drop low enough to result in an increased susceptibility to infections. White blood cell counts of all canine and feline chemotherapy patients are monitored carefully but rarely will a cat or dog receiving chemotherapy develop a life-threatening systemic infection. The only way to successfully treat these infections is to admit the patient to the hospital and administer intravenous antibiotics.
Hair loss in cats and dogs receiving chemotherapy is usually very minor, with some notable breed exceptions. If you own a Poodle, West Highland White Terrier, Old English Sheepdog, Schnauzer, Puli, Lhasa Apso, Shih Tzu, Bichon Frise, Yorkshire Terrier, Maltese, or curly-coated terriers such as an Airedale or Welsh Terrier, you should expect that your pet will lose a significant amount of hair during the initial stages of chemotherapy. However, the hair that is lost will grow back after your dog’s course of chemotherapy has been completed or once treatments are being administered less frequently. Cats usually do not lose any hair, although many will lose their whiskers. Coat fullness or texture may change with chemotherapy.
What should I do if my pet starts vomiting or having diarrhea while receiving chemotherapy?
- If your pet starts to experience vomiting, please withhold food and water for 6 to 12 hours and then reintroduce small amounts of water first. Then, if no vomiting is observed, you can offer small amounts of bland foods such as boiled chicken with rice or a bland specialized intestinal diet. Gradually reintroduce your pet’s normal diet.
- If your pet is having diarrhea, offer an easily digestible bland diet as mentioned above and gradually reintroduce your pet’s normal diet.
- If provided by the clinic, please administer an anti-vomiting or anti-diarrhea medication as indicated by your Veterinary Oncologist. If none is available, please contact our clinic.
- If your pet’s vomiting or diarrhea is severe, is accompanied by an elevated temperature (>103F), or your pet is lethargic/weak and not feeling well, please contact ACCC. If it is after business hours, please contact your veterinarian or the closest emergency clinic.
What should I do if my pet is experiencing a medical emergency after hours?
Our Oncology nurses are available to assist with urgent consultations through our after-hours consultation service (954) 527-3111 at these times: Monday, Tuesday, and Wednesday: 6:00 pm to 7:00 am and on Saturdays: 8:00 am to 4:00 pm.
If your pet is having an urgent medical situation outside of regular business hours or outside of our after-hours consultations, you will need to bring your pet directly to your closest emergency clinic or contact your primary care veterinarian. Do not wait for an email response to an urgent medical situation. Our email is monitored during regular business hours only.
Because visits to an emergency clinic are not uncommon while your pet is receiving cancer therapy, you’ll want to plan in advance by identifying the emergency clinic closest to your home.
Our ACCC Veterinary Oncologists are not available after regular business hours, on Sundays, or on Holidays, and we have developed relationships with the local emergency clinics to care for our patients when we are not available.
What should I do if my pet has an “accident” in the house?
If your pet has a urinary or stool accident in the house during the first 72 hours after receiving chemotherapy, we ask that you wear gloves for clean-up to protect you from the small amount of chemotherapy that is excreted through your pet’s bowel movements and urine during that period.
- Soak up as much of the liquid as you can with an absorbent paper towel.
- Clean the area with an adequate amount of water, allowing it to sit for several minutes, and then use a cleaning product as you would normally.
- Place stool from the outside yard in a plastic bag and dispose of it in your garbage.
While cleaning out a litter box, wear gloves during the first 72 hours after receiving chemotherapy. If using a flushable litter, you may continue to place urine and stool in the toilet for disposal. Otherwise, use a separate garbage bag each time before placing it in the regular trash.
What should I do if my pet has been licking the leg where the chemotherapy was administered?
Some chemotherapy drugs can be extremely irritating to the subcutaneous tissues if there is leakage outside the vein during injection. Examples include the chemotherapy drugs Vincristine, Adriamycin, and Mustargen. Severe inflammation, ulceration, and swelling can occasionally be seen. However, this complication occurs infrequently because all chemotherapy drugs are carefully administered.
Please call our clinic to speak with an Oncology nurse at your earliest convenience for assistance. Next, please discourage your pet from licking the area by having your pet wear an Elizabethan collar when unsupervised. Licking can cause unwanted lick granulomas or aggravate a potential chemotherapy leakage injury. A nurse will ask you if you notice any signs of redness, irritation, or swelling at the site. Any of those signs may be an indication that some of the chemotherapy may have leaked outside the vein. In the best interest of your pet, we will request that you make a quick appointment so your Veterinary Oncologist can examine the area.
Do I have to separate my pet from other members of our animal family after their treatment?
The chemotherapy is eliminated mainly through your pet’s urine and stool within the first 72 hours of treatment. It is safe for your pets to drink and eat out of the same bowls, play with the same toys, and sleep on the same surfaces.
Can I still vaccinate my pet, apply flea/tick products or give heartworm preventative?
Yearly administration of vaccinations at your primary care veterinarian does not have to stop during your pet’s chemotherapy treatments; however, we recommend consulting with the Veterinary Oncologist before proceeding with any vaccines. We do ask that if your pet will be receiving any vaccinations, please do it on an “off-week” of chemotherapy. Additionally, heartworm, flea, and tick products do not interfere with or cause any known side effects during your pet’s cancer treatments. You can always talk to your Veterinary Oncologist if needed for further guidance.
Can my pet go to a boarding facility, and are there any special requirements?
Boarding your pet at your regular veterinarian or a kennel while you are out of town is safe during your pet’s chemotherapy treatment. If your pet will be receiving at-home chemotherapy medications during the time of boarding, please check with staff members to be sure they are comfortable with safely administering chemotherapy pills. If there are any questions, please let them know they can call to speak with an Oncology nurse.
There will be children interacting with my pet; what precautions should I take?
During the first 72 hours after receiving chemotherapy, you do have to be cautious with children. The main concern would be if the child somehow came into contact with some of the urine or stool from your pet due to the possibility of a small amount of chemotherapy excretion.
I am currently pregnant or planning on parenthood soon. Are there any precautionary measures that I should be taking while my pet is receiving chemotherapy?
During the entire length of pregnancy, a woman should take several precautionary measures to ensure that no pregnancy complications arise from their pet’s chemotherapy treatment. While cleaning the litter box or picking up after your dog may seem like a simple daily task, it is one area in which you may come into contact with residual chemotherapy drugs. It is advisable to have your spouse or a significant other clean up after your pet after their chemotherapy treatments. If your pet will be receiving at-home oral chemotherapy medications, please have another responsible adult administer the medication. There may be some residual chemotherapy on the pills or in the vials, which a pregnant woman should not touch. If you have any further questions, please do not hesitate to ask an Oncology nurse or your physician.
What measurements should be taken when administering oral chemotherapy at home?
If you are administering chemotherapy at home, you should take the following special precautions:
- Wear non-powdered latex gloves (not vinyl) when handling chemotherapy
- Do not crush or break the pills
- Wash your hands thoroughly after handling the drugs
- Dispose of the gloves immediately into the garbage
- Please keep the medicine in the vial in which it was provided to you
- The medicine bottles should be stored as directed, away from children and pets
Is chemotherapy expensive?
Treatment of cancer with chemotherapy can be costly. It involves the use of the same drugs used to treat human cancer patients, and many of these are expensive. Included in that investment is the expertise your pet will receive from highly trained healthcare professionals. The exact cost of chemotherapy varies with the size of the animal, the number of treatments, and the drugs being administered. The projected cost of your pet’s individual treatment will be discussed in detail with you prior to the start of any plan.
What happens after treatment is over?
Your Veterinary Oncologist or your regular veterinarian need to examine your pet periodically after chemotherapy is over, usually at one- to two-month intervals. This schedule will allow potential problems, such as recurrence of the cancer, to be detected before they become too advanced. Treatment options will be more numerous and have a greater potential for success when problems are identified early.
Finally, it is vital to understand that most cats and dogs receiving chemotherapy have an excellent quality of life both during and after treatment. It is often possible to provide many additional months, or sometimes even years, of a happy life with chemotherapy. The vast majority of owners report that they have no regrets about their decision to pursue chemotherapy for their pet.
What expectations should I have from my cancer care team during treatment?
The Care and Safety of all our Animal Patients is our primary concern during cancer treatment. We will address your questions and concerns with a prompt phone call from one of our highly skilled Oncology nurses. Phone calls will be triaged based on the urgency of the medical situation. You may be asked to bring your pet to an ACCC location, your primary care veterinarian, or your local emergency clinic for your pet to be evaluated by a veterinarian if we are not able to fully assess their medical needs by telephone. Multiple phone calls and emails with the same question will not take priority over urgent medical situations.
We strive to deliver cancer care in a timely manner, though during your pet’s treatment, there may be times when there is a delay in service. We will notify you of the delay and work with you to find an optimal solution so your pet can receive care.
ACCC will provide continuity of care for your pet while they are receiving cancer therapy. There may be times during cancer therapy that you will see a different Veterinary Oncologist. Rest assured that all of the Veterinary Oncologists at ACCC have a system in place so that continuity of patient care will not be compromised.
