Difficult decisions
Should you treat your dog for cancer?
Your beloved dog has just been diagnosed with cancer. Your world is shattered. Take a deep breath and pause. You have big decisions to make. Only a few canine cancer situations require an immediate response. Usually you have time to think, talk with veterinarians, research options and consider what is right for your dog. You know your dog better than anyone else, and you are in the best position to make this decision. Consider their habits and personality, and learn more about this cancer.
Get an exact diagnosis
A definitive diagnosis can help in your decision-making. A histopathologic diagnosis — complete with staging or grading, and depending on the type of cancer — gives you the best idea of prognosis and potential survival time.
Consider complications
Research the projected behavior of the cancer, such as metastatic disease. Some cancers are so aggressive that even with a full treatment, most dogs will not live beyond another 3-4 months. For example, if your dog’s lungs are full of cancer spread from its primary site, your treatment options become extremely limited, and comfort care might be the best choice based on your dog's remaining quality of life.
Weigh the prognosis
Your veterinarian’s prognosis is based on their experience working with many dogs. While we tend to hope for the “best-case scenario,” realistically, that outcome only applies to a subset of afflicted dogs. For example, when you hear that the expected survival time with a certain type of treatment is 2-15 months, you might anticipate at least 5-6 months. Maybe you’ll get lucky and reach a full year. But there’s also a chance you may only gain two months.
Be realistic
Cancer treatments often come with multiple side effects. An aggressive cancer will require more intensive treatments, which may also come with a higher risk for serious complications. If you work outside your home, and your dog is left dealing with bouts of vomiting and diarrhea, it will not be pleasant for either of you. No one can guarantee which dogs will sail through treatment and which dogs may require extra hospitalizations and care.
Look at the whole health picture
Age and other health conditions come into play as well. If your dog has been battling congestive heart failure and a chronic kidney condition, then going full force to treat a cancer may be a lost cause. In addition, other associated health problems may limit your treatment options.
Putting it all together
“There are a lot of factors to consider when deciding whether to pursue a specific anti-cancer treatment for your pet. For some owners, these factors can include their pet’s personality and demeanor, as well as how well the pet travels and other family circumstances. Even if a specific anti-cancer treatment isn’t pursued, there are often palliative therapies that can help relieve pain, inflammation and nausea that can occur secondary to cancer,” says Dr. Kelly R. Hume, associate professor of oncology in the Department of Clinical Sciences.
If you’re torn about whether to treat your dog, ask your veterinarian for a referral to a veterinary oncologist, or even a second general practitioner if an oncologist isn’t available in your area. Don’t rely on social media alone. Check out university websites, veterinary websites and specialty oncology websites. Experts can provide the best-available information, but even they can’t predict exactly how your individual dog might respond to a certain treatment. If your dog’s cancer has already metastasized, there is no cure. Treatment would be aimed at providing quality of life for as long as possible.
And that’s what should be at the top of your decision-making list: quality of life. A few months of discomfort from cancer treatment may be worth it if the prognosis is that your dog may then gain years of healthy life. But a few months of discomfort to gain another month or two of quality time may not be the tradeoff you want.
“As an oncologist, I recommend treatment when the pet is likely to live longer with it than without it,” says Sue Ettinger, D.V.M. '98, a practicing veterinary cancer specialist.
You know your dog best
If they are not going to handle treatment well, get highly stressed and can’t be easily managed, then treatment may not be in either of your best interests. Keeping them comfortable, letting them enjoy the things they love and spoiling them during the remaining time be the best option.
There are palliative and hospice options for dogs who aren’t going to be treated for their cancers. Pain medications and prednisolone are commonly used to help keep dogs comfortable. Comfort care may include a more padded bed, ramps when movement gets difficult, special foods, more frequent but shorter walks, and more of your one-one-one time.
Remember that dogs don’t live for tomorrow. They live in the here and now. Do your research, talk to your veterinarian and trust yourself. Use both your heart and your head to decide what’s best for you and your dog. There is no wrong decision.
This article has been reprinted with permission from the Cornell University College of Veterinary Medicine’s DogWatch newsletter, published by Belvoir Media Group. When you become a member of the Riney Canine Health Center, you will receive a free subscription to DogWatch.