What Makes DogCancer.com Special?

While Dog Cancer Blog provides in-depth articles, book excerpts, and practical advice, DogCancer.com expands on this foundation with:

• A Broader Range of Expertise: Learn from a team of over 40 veterinarians and veterinary oncologists, each contributing their unique perspectives on cancer treatments, care strategies, and the latest medical advancements. Every article is medically reviewed to ensure accuracy and relevance.
• Expanded Topics: From cutting-edge cancer treatments to holistic care options, nutrition, and emotional support, DogCancer.com covers it all. Whether you’re exploring dietary adjustments or researching the latest in immunotherapy, you’ll find the answers you need.
• Ease of Access: With a clean, intuitive design, DogCancer.com makes it simple to find the information that matters most. Whether you’re seeking articles on the signs of cancer, treatment options, or end-of-life care, the platform is designed to guide you seamlessly.

Visit DogCancer.com now to explore this wealth of resources.

Familiar Experts, Fresh Insights

DogCancer.com continues to feature beloved contributors like Dr. Demian Dressler, the Dog Cancer Vet, and Dr. Susan Ettinger, a leading veterinary oncologist. Their foundational work remains central, but it’s enhanced by the voices of dozens of additional experts. This diverse team ensures you’re getting the most comprehensive and up-to-date information available.

For example, alongside Dr. Dressler’s groundbreaking insights into the Full Spectrum approach to cancer care, you’ll find:

• Articles on emerging treatments written by practicing veterinary oncologists.
• Step-by-step guides to managing side effects from chemotherapy or radiation therapy.
• Advice on maintaining your dog’s quality of life during every stage of their journey.

Why Trust DogCancer.com?

Every piece of content on DogCancer.com undergoes medical review to ensure it’s accurate, trustworthy, and actionable. With so much information available online, this vetting process helps you feel confident in the advice you’re following.

Start Your Journey Today

Whether your dog has just been diagnosed with cancer or you’re looking for ways to support their care, DogCancer.com is here for you. The expanded expertise, medically reviewed articles, and easy-to-navigate design make it a must-visit resource for dog lovers facing the challenges of cancer.

Ready to learn more? Click here to explore DogCancer.com.

Frequently Asked Questions

Is DogCancer.com free to use? Yes! All the resources on DogCancer.com are free, ensuring every dog lover has access to expert advice.

How is Dog Cancer Blog different from DogCancer.com? Dog Cancer Blog focuses on key insights from Dr. Dressler and Dr. Ettinger. DogCancer.com builds on this by featuring contributions from over 40 experts, covering a wider range of topics in even greater depth.

Can I find end-of-life care information on DogCancer.com? Absolutely. DogCancer.com offers articles on recognizing the signs of a dog nearing the end of life, managing pain, and ensuring your pet’s comfort and dignity.

Take the next step in your dog’s cancer care journey. Visit DogCancer.com today for expert advice and support when you need it most.

The post Expanding Your Dog Cancer Knowledge: Discover DogCancer.com appeared first on Dog Cancer Blog.

No one likes it when their dog is vomiting. It’s gross, and could mean he’s sick.

So, when do you need to worry about your dog vomiting?

Why Is My Dog Vomiting?

The most common cause of vomiting in dogs is eating something that they shouldn’t have. Garbage, an entire turkey carcass, underwear… the list is endless.

And while it isn’t pleasant, it is usually transient and nothing to worry about. Your dog will throw up once or twice, but should otherwise seem happy and healthy.

Other potential causes of vomiting include:

• Eating or drinking too quickly
• Diet change
• Intestinal parasites
• Acid reflux
• Medication side effect
• Bacterial infections
• Toxins and poisons
• Bloat
• Pancreatitis
• Kidney disease
• Liver failure
• Some viruses
• Cancer

While cancer can cause vomiting, it is a fairly uncommon cause. The time to start wondering if your dog’s vomiting is related to cancer is if he is also losing weight rapidly.

Dog Vomiting: When to Worry

An isolated incident is usually nothing to worry about. But if your dog continues to vomit three or four times in a day, or throws up once a day several days in a row, it is time to call your vet.

Call your vet if:

• Your dog throws up 3-4 times in a day
• Your dog throws up several days in a row
• There is blood in the vomit
• Your dog is trying to vomit but nothing comes up
• There are other symptoms of illness as well as vomiting

The other time to be concerned is if your dog is acting sick or has other symptoms as well as vomiting. Here are some symptoms to be concerned about:

• Diarrhea
• Dehydration
• Abdominal pain
• Distended or swollen abdomen
• Pale gums
• Losing weight

If your dog shows any of these symptoms and is also vomiting – even just once – it is time for a vet visit. Vomiting PLUS diarrhea is an emergency because your dog can get dehydrated really quickly.

Dry heaving without throwing anything up is also an emergency – this can indicate bloat, a condition where the stomach fills with gas and can twist.

Also, any time that YOU are concerned about your dog throwing up is an okay time to call your vet and ask for advice.

Dogs with Cancer and Vomiting

While vomiting is not a common sign of cancer, it is more worrying if your dog with cancer throws up.

This could be due to the havoc that progressing cancer wreaks on the body, but it can also be a side effect of cancer treatments and medications.

If your dog with cancer vomits, think about any changes that were made recently. Ask yourself:

• Did he start a new medication?
• Did he just have a chemo treatment?
• Or did you change his diet or add a new supplement?

All of these things can cause vomiting. Call your vet or oncologist with your observations.

If your dog is already on an anti-nausea and anti-vomiting medication like Cerenia, any vomiting is worrying. This means that whatever is causing your dog to feel sick is overriding the medication.

How to Treat Dog Vomiting

For mild cases of vomiting in an otherwise healthy dog, vomiting can often be managed with fasting and feeding a bland diet for a day or two.

Start by withholding all food and only offering small amounts of water at a time for several hours. If your dog does not throw up, offer a small serving of something bland, like boiled chicken or plain cooked rice. If he keeps that down, he can have a little more in another hour.

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If your dog is sick or has been vomiting persistently, he needs to be seen by your vet to figure out what is going wrong. Exact treatment will vary depending on the cause, but your pup will probably get subcutaneous (under the skin) fluids to help with hydration and an injection of Cerenia to stop the vomiting and help him feel less pukey.

Ondansetron (brand name Zofran) is also sometimes used to stop vomiting in dogs, but Cerenia is FDA-approved for dogs and generally works better. Cerenia is also available in a tablet form that you can give at home.

Antacids for Dog Vomiting

Excess stomach acid can sometimes give your dog acid reflux, especially when her stomach is empty. Some dogs will throw up a small amount of yellow bile first thing in the morning – this is a common sign of acid reflux.

Over-the-counter antacids, such as Pepcid, Pepto-Bismol, omeprazole, or even good old Tums can help keep your pup’s stomach acid under control. Always talk to your veterinarian before giving one of these medications, to make sure that you are giving the right dose and that it won’t interfere with any of your dog’s other meds.

An even easier solution that works for many dogs is to give her a snack! Even one biscuit just before bed and/or first thing in the morning can help to keep a little food in her stomach and prevent that upset tummy.

Tips for Cleanup

As a dog owner and a vet tech, I’ve cleaned up my fair share of dog puke. Here are some of my favorite tips for cleaning up the mess.

Catch the vomit. If you hear that tell-tale urp noise, either move your dog to the nearest hard floor or toss a towel or large bowl under her face. Tile and laminate are much easier to clean than carpet, and towels can be tossed in the washing machine.

Rinse rugs and towels before putting in the washer. Your washing machine isn’t going to like chunks. Scoop up any semi-solids into the trash, and then rinse rugs and towels in the tub, sink, or outside with a hose before popping them in the washing machine. This will also help to prevent any clothing in that load from being stained by bile.

Pick up solids first. Pick up any solid or semi-solid vomitus with paper towels or a rag and dispose of them in the trash. I will confess that if my dogs throw up food and want to eat it back down, I usually let them.

Blot, don’t wipe. Getting the liquid vomit out of your carpet is the tricky part. Wiping or scrubbing can force vomit particles deeper into the carpet and make the mess worse, so stick to blotting. Blot with a clean paper towel or cloth, and repeat until the cloth comes back clean. A slightly damp paper towel can also help to get up extra mess.

Fight odor and stains with a cleaning spray. Once the area has been thoroughly blotted and is mostly clean, I like to spritz with a carpet-safe cleaner and repeat until the stain is totally gone. I really like the Nature’s Miracle cleaning products, but we also have a variety of natural cleaners available in our online shop and Molly has a recipe for a carpet-safe vinegar spray.

Follow the instructions on the bottle for any premade cleaning products, and always spot-test before dousing your whole carpet.

Steam cleaning can help too. I had a senior dog with pancreatitis and mild urinary incontinence, and my carpets were taking a beating. Many hardware stores and even some pet supply and department stores will rent out carpet cleaners for a reasonable price so you can give your entire carpet a good thorough cleaning. I took the plunge and bought a Bissell ProHeat 2X Revolution Max Clean Pet Pro Full-Size Carpet Cleaner, and have been very happy with it. Tip: vacuum the carpets thoroughly first so you don’t gum up the carpet cleaner with dog hair.

Dr. Nancy Reese, DVM, PhD gives her insight on vomiting in dogs during this interview with Dog Cancer Answers:

You can read the full transcript on the episode page.

Please subscribe to, rate, and review Dog Cancer Answers in Apple Podcast or on your favorite pod-catcher. It really does help the show!

Paws and wags,

Kate

PS: Feel free to share this article or the podcast itself with your veterinarian and their staff.

Have a Great Question for Dog Cancer Answers Veterinarians?

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Resources

Homemade Cleaning Supplies That Are Safe for You — and Your Dog With Cancer

Cerenia: An Option for Dogs with Vomiting

Natural Cleaners

The post Dog Vomiting: Everything You Need to Know appeared first on Dog Cancer Blog.

To start the new year off right, we spoke with Dr. Kendra Pope and Dr. Trina Hazzah, two of the four (you read that right!) integrative veterinary oncologists in the U.S. to get their take on dog cancer treatments now… and things they are excited about for the future.

I’ve got the highlights of our conversation for you here, or you can listen to the full conversation through the Dog Cancer Answers podcast.

An Integrative Approach

Many dog lovers have long wondered when dog cancer treatment will embrace a more integrative approach.

According to Dr. Pope and Dr. Hazzah, the time is now!

General practice vets and conventional veterinary oncologists are becoming more and more interested in integrative and holistic treatment options to help their patients. In fact, Dr. Hazzah and Dr. Pope have been invited to participate in a panel discussion at an oncology conference this coming fall.

The time for an integrative approach to dog cancer treatment is now!

Some integrative options have already worked their way into standard cancer care:

Yunnan baiyao, a proprietary herbal remedy from the Yunnan province of China, is now frequently recommended for dogs with hemangiosarcoma to prevent or limit bleeds. The increased acceptance of Yunnan baiyao is partly thanks to clinical trials done by the University of Florida.

Mushroom polysaccharopeptide products such as Im-Yunity (c) are often used to support the immune system in cancer patients. The increased acceptance of Im-Yunity is partly thanks to clinical trials done by the University of Pennsylvania.

The goal of using these and other integrative dog cancer treatments is to improve quality of life. Some therapies target cancer directly, while others can work together with conventional treatments to support your dog’s body and health.

Clinical Trials for Holistic Treatments

Vets like data.

And that’s a good thing! You don’t want to spend time and money on a treatment that doesn’t work.

One of the best ways to evaluate a treatment, to make sure that it works and is safe, and determine the ideal dosage is to do research studies and clinical trials.

Things that work great to kill cancer cells in a test tube don’t always translate to working in a real dog body. Clinical trials are a great place to see how well something works in real dogs.

We already know that clinical trials are an important step in bringing pharmaceuticals to market. Applying that template to herbals and other holistic treatments is a great way to help vets see the value of these therapies and also standardize dosing.

The catch, of course, is that clinical trials are expensive.

Why Clinical Trials are Expensive

Dr. Pope explains that designing a high-quality clinical trial for an herbal remedy is not as simple as designing a trial for a pharmaceutical drug. There are a couple reasons for this:

1. Drugs usually consist of one compound doing one thing, while herbs are made up of many compounds that work together.
2. The goal of many integrative treatments is to improve quality of life, which can be more challenging to evaluate than survival time.
3. Herbs occur naturally, so they aren’t as attractive financially.
4. Some high-interest remedies, such as cannabis, have legal complications that still need to be worked out.
5. The concentration of plant compounds can vary by location and growing conditions.

But there is progress! Dr. Pope loves using herbs to treat her cancer patients and is actively working on clinical trials to show other vets and oncologists just what these treatments can do.

While herbal clinical trials are unlikely to be funded by big drug companies, funding is available from the National Institute of Health. Trials can also be publicly funded by dog lovers.

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Holistic Dog Cancer Treatments

The beauty of an integrative approach to dog cancer treatment is that it considers treatment options from both sides of the aisle.

Dr. Pope mentions that conventional treatments, such as chemotherapy, radiation, and surgery, are often valuable for life-saving measures for sick dogs with cancer. Herbs don’t work overnight – they need time.

Where she and Dr. Hazzah find the more holistic dog cancer treatments shine is in the long game. These therapies provide improved quality of life and help to keep patients happy and healthy longer.

The Whole Picture… Or Rather Whole Plant!

While an herb is a single plant, that plant is made up of lots of different compounds.

For example, Dr. Hazzah mentions that cannabis has over 750 compounds. And while some of those compounds have shown promise on their own, botanicals often have an additive effect where multiple compounds work together to get better results than each of them alone.

So in order to truly evaluate botanical therapies, the entire plant needs to be used and studied.

This of course makes clinical trials more difficult to design.

But in the meantime, it is important to remember that real-world evidence has value too. Many herbal remedies have been around for centuries, and things that don’t work usually don’t stick around.

Genetic Testing and Dog Cancer

One thing that Dr. Hazzah is very excited about for the future is genetic testing.

Her dream is to be able to customize treatment to both the individual patient and that patient’s individual tumor. Genetic tests can reveal mutations that might impact which treatments will work best, or what weaknesses that patient has that need to be supported.

We are already starting to see customized medicine entering the veterinary field. Companies like FidoCure make treatment recommendations based off of genetic testing, and the melanoma vaccine is made specifically for your dog’s tumor.

“I think as things get more precise there’s going to be points where we’re not going to have to do CTs and MRIs and, and x-rays every three months, we’re going to be able to do a blood test and be able to figure out, if there’s cancer recurrence, where it is in the body.”

~ Dr. Trina Hazzah

Many of these options can be expensive, at least up front. But knowing the best treatment plan from the start can be more cost-effective in the long run.

“How do you compare shooting in the dark versus knowing what you’re really needing to attack?,” says Dr. Hazzah. “From a diagnostic perspective, I think as things get more precise there’s going to be points where we’re not going to have to do CTs and MRIs and, and x-rays every three months, we’re going to be able to do a blood test and be able to figure out, if there’s cancer recurrence, where it is in the body.”

It Takes Time

The embrace of integrative dog cancer treatments isn’t going to happen overnight.

Dr. Pope says that studies have shown that, on average, it takes 17 years of research to change clinical practice.

What does this mean? It means that it takes time to convince people that trying something new is worth the risk and really will work better than a preexisting treatment.

The current inundation of vets everywhere exacerbates this problem. If a vet is exhausted from trying to keep up with a huge caseload, he or she is less likely to be spending time learning about new options.

If a vet is exhausted from trying to keep up with a huge caseload, he or she is less likely to be spending time learning about new options.

This can feel frustrating. But the bright side is that this tendency prevents vets from jumping to new treatments willy-nilly without considering them carefully first… which could cause your dog to miss out on a proven treatment.

While we let integrative vets like Dr. Hazzah and Dr. Pope work their magic and educate their peers, you and your dog can still benefit from emerging therapies.

Consider consulting with a holistic veterinarian or oncologist to work with your conventional vet as a team, or ask about clinical trials that your dog might get to participate in.

Find a Vet Who Shares Your Values

Dr. Hazzah and Dr. Pope both emphasize the importance of having a veterinary team that you trust and that shares your values.

Depending on your personality, you might want to dive in and tackle cancer aggressively, or you might prefer a more palliative approach. It is important that your vet and/or oncologist knows your goals for your dog, and that you have a similar intensity.

When it comes to choosing a veterinary care team, trust your gut!

Consulting with an integrative veterinary oncologist is easier said than done because there are only four of them in the U.S. But there are many more holistic vets, and you can likely find one in your area who can work together with your regular vet to come up with the right balance of treatment options for you and your dog.

And if something doesn’t feel right, trust your gut, Dr. Hazzah advises. You are your dog’s best advocate, so your comfort with their care is important.

You can read the full transcript of the conversation on the Dog Cancer Answers page.

Paws and wags,

Kate

The post What’s New in Dog Cancer Treatments: Integrative Oncology Going Into 2022 appeared first on Dog Cancer Blog.

Many of us dog lovers get upset if our dog is shaking. Is she in pain? Is she afraid? Do I need to call my vet?

This symptom can be caused by a variety of emotional and physical states, but the good news is that cancer is not a common direct cause.

Little dogs in particular can be the most prone to shaking and quaking… and often it is not due to a medical reason.

Let’s dive into why your precious pup is trembling.

Why Is My Dog Shaking?

Many things can cause a dog to shake and tremble. Here are some of the most common potential causes:

• Stress or anxiety
• Cold
• Pain
• Neurological disorders
• Electrolyte imbalance

Stress

This is one of the most common reasons for a dog to quiver. She might be afraid of a thunderstorm, or of your very tall neighbor who came over for dinner for the first time.

Dogs have much better smell and hearing than we do, and may start reacting to something upsetting before we even know it exists. Dogs have been known to pick up smoke detector beeps from several apartments over, or gunshots from a distant field.

She also might be anticipating something bad that has happened before.

For example, whenever my mom cooked pork chops when I was growing up, they always set off the smoke alarm just when they were perfectly cooked. Our dogs learned that the smell of pork chops meant the smoke alarm would go off, and started reacting to that smell before the alarm had even started.

Cold

Dogs shiver when they’re cold just like us.

Small dogs and dogs with short or thin haircoats will get cold much more quickly than large or super furry dogs. Most Malamutes and Huskies are happy as penguins out in a blizzard, but a Chihuahua or a 9-week-old puppy will probably start shivering about when we do.

If you think your dog might be cold, try turning the heat up a little bit or setting her up with a nice cozy sweater.

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Pain

Dogs also may shake when they are in pain.

If your dog is painful, she will probably be hunched up with a tense body posture. She may be reluctant to socialize, or refuse food.

Neurological Disorders

Neurological disorders and nerve damage can also cause trembling.

In these cases, the shaking will often occur when your dog is in a specific position (such as sitting or turning to the left) or is trying to do a specific action (such as picking up a toy off the floor).

Some causes of neurological shaking include:

• Trauma to a nerve – will usually cause shaking in a localized part of the body depending which muscles that nerve controls.
• Brain or spinal cord tumor
• Shaker Syndrome – tremors throughout the body that start around 1 or 2 years old, most common in small white dogs. Thought to be an autoimmune disorder.

Treatment will depend on the exact cause. Nerve damage is often treated with anti-inflammatory medications, rest, physical therapy, and laser treatments. Shaker Syndrome usually responds to the steroid prednisone.

Electrolyte Imbalance

Electrolyte imbalances can cause your dog’s cells to not work properly. In some cases this can cause tremors.

Vomiting is a common cause of electrolyte deficiencies, but not eating, an imbalanced diet, kidney disease, and diabetes are other potential causes.

Side effects from chemotherapy could potentially result in an electrolyte imbalance.

Your dog’s vet can check her electrolytes with a simple blood test, and can correct any deficiencies with fluids (given under the skin or intravenously) and medications if needed.

Know Your Dog

You know your dog best!

Consider the context when she is shaking.

• Is something happening that might stress her out?
• Could she be cold?
• What does her body language look like?
• Do the tremors happen in specific situations?
• Has she been vomiting, not eating, or showing other symptoms of illness?

In many cases, the dog is simply worried about something that is or might happen. Removing the trigger will help her relax, or you can try something like a Thundershirt to help with situational anxiety.

But if things just don’t seem to add up or this is a new behavior for your dog, a vet visit might be in order.

Dr. Nancy Reese, DVM, PhD had some good information on how to tell why your dog is shaking during this interview with Dog Cancer Answers:

You can read the full transcript on the episode page.

Please subscribe to, rate, and review Dog Cancer Answers in Apple Podcast or on your favorite pod-catcher. It really does help the show!

Paws and wags,

Kate

PS: Feel free to share this article or the podcast itself with your veterinarian and their staff.

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The post Why Is My Dog Trembling and Shaking? appeared first on Dog Cancer Blog.

You read that right – Laverdia for dogs is a PILL that can help treat lymphoma!

While lymphoma is one of the more treatable dog cancers, we are still always on the lookout for treatments that can help the unlucky dogs that either don’t respond to current options or don’t have access to them.

Laverdia is a new treatment, so we don’t have all the answers about when it works best yet.

Let’s learn more about this pill and how it may fit into dog cancer care.

A Pill for Lymphoma

Laverdia Ca-1 (verdinexor) was originally developed by a company working on human cancer treatments. When it turned out that this drug works better in dogs, the company Anivive Lifesciences picked it up and started working toward full FDA approval.

This chemotherapy drug is a coated tablet. Owners can give it at home twice a week with three days in between each dose.

Because it is chemo, you do need to handle the tablets with care. Do not break, crush, or dissolve the tablets, and if one gets wet, put on chemo-resistant gloves before touching. Wear gloves when handling the treated dog’s urine, vomit, or feces too.

Conditional Approval for Laverdia CA-1

As of 2021, Laverdia is conditionally approved by the FDA. This means that it is proven to be safe for dogs and has a “reasonable expectation” of efficacy (working).

It is now entering the clinical trial phase where doctors can prove that it is consistently effective against lymphoma in real dog patients.

If you have a dog with lymphoma or another disease and are interested in participating in clinical trials, check out the clinical trials page on the Anivive website. The next study for Laverdia will be starting in approximately spring 2022.

Right now, Laverdia can only be used in dogs with lymphoma while it is still in clinical trials. If it attains FDA approval, veterinarians will be able to use it off-label for other canine cancers. The company also intends to do studies using it for other cancers.

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Laverdia Ca-1 Mechanism of Action

Laverdia is a “targeted therapy,” meaning that it specifically targets cancer cells and is unlikely to harm normal cells.

The cells in your dog’s body naturally contain tumor suppressor proteins, which do exactly what you would expect: stop tumors. These proteins trigger apoptosis, natural cell death, if a cell’s DNA becomes damaged.

To keep things in balance, the transport protein XPO1 binds tumor suppressor proteins and removes them from the nucleus of the cell.

Cancer hijacks this system. Cancer cells produce tons of extra XPO1, which then binds to and removes the tumor suppressor proteins so that they can’t stop the cancer by triggering apoptosis genes.

What Laverdia (verdinexor) does is it binds to the XPO1s. If the XPO1 binds to Laverdia, it can’t bind to tumor suppressor proteins!

This allows the tumor suppressor proteins to stay in the nucleus and do their job: triggering apoptosis to destroy the cancerous cell.

Gained Survival Time

Here are some numbers from North Carolina State University:

• 12 months: median survival time for a dog with B-cell lymphoma who receives traditional chemotherapy
• 1 to 2 months: median survival time if only treated with oral steroids (usually prednisone)

Dogs who do not receive treatment typically only live a short time, as little as a few weeks.

Dr. David Bruyette, DVM, DACVIM, Chief Medical Officer of Anivive Lifesciences, says that they have been seeing survival times 50% longer for dogs treated with Laverdia in addition to low-dose prednisone compared to just getting high doses of pred.

In addition, a third of the treated dogs in the initial studies had survival times of 9 to 10 months when treated with Laverdia! They are not yet sure why some dogs do so much better, but further studies will hopefully help to answer this question and others.

Laverdia for Dogs Side Effects

Like any drug or supplement, Laverdia can have side effects.

According to Dr. Bruyette, side effects are typically very mild. The most common side effects are decreased appetite, vomiting, diarrhea, and lethargy.

Does Laverdia Replace CHOP?

“CHOP” is the acronym for the chemotherapy protocol developed at the University of Wisconsin to treat canine lymphoma. CHOP is the gold standard lymphoma treatment option, and 70-95% of dogs respond when it is used

In a conversation for Dog Cancer Answers, Dr. Bruyette says, “We’re not looking to replace CHOP.” Instead, Laverdia was designed to be an extra (and hopefully soon FDA-approved) treatment option.

The goal for Laverdia was to help three sets of patients:

• Dogs who don’t respond to the CHOP protocol
• Dogs who come out of remission after initial treatment with the CHOP protocol
• Families who can’t afford traditional chemotherapy

Another possibility that researchers will explore in further research is working Laverdia into various CHOP protocols as an extra rotation.

Laverdia for Dogs as a Bridge

Since the onset of the COVID pandemic, it can be difficult to get in to see an oncologist.

With the clock ticking after getting a lymphoma diagnosis, having to wait to see an oncologist is extremely stressful…

… and could be fatal for your dog, because lymphoma left untreated takes a life in a matter of weeks.

Veterinarians often want to start prednisone right away, but oncologists wish they wouldn’t, because if chemo is started later, the pred makes CHOP less effective.

The good news is that, unlike pred, starting Laverdia ahead of time does NOT make chemotherapy less effective!

This means that if you want to pursue chemo but are unable to get an oncology consult right away, your regular vet could prescribe Laverdia to start treating your dog and tide him over until you can start chemo. Your dog will still get the full benefit of CHOP when he starts.

Laverdia also works as a bridge if you are trying to decide if you want to do chemo or not.

Laverdia Cost

The makers of Laverdia wanted to make it more affordable than traditional chemotherapy so that it can be more accessible.

As of the end of 2021, treatment with Laverdia costs approximately $200 per month.

Laverdia Reviews

Dog Cancer Answers did an episode on Laverdia at the end of 2021 and spoke to Dr. Bruyette as well as oncologists Dr. Megan Duffy DVM, MS, DACVIM, and Dr. Craig Clifford DVM, MS, DACVIM.

We wanted to know how Laverdia has been performing in the field.

So far, Dr. Duffy has primarily used Laverdia in patients who have failed other treatments. These dogs have not responded to Laverdia either.

Dr. Clifford has used Laverdia in a couple different scenarios and is seeing favorable results. The best response was in a dog with cutaneous lymphoma whose sores completely healed and went away.

Both oncologists pointed out that we are still learning where Laverdia best fits into lymphoma treatment. We will learn more as oncologists and general practice vets continue to use it in their patients, and as clinical trials evaluate how it works in different situations.

You can listen to the episode below:

Please subscribe to, rate, and review Dog Cancer Answers in Apple Podcast or on your favorite pod-catcher. It really does help the show!

Paws and wags,

Kate

PS: Feel free to share this article or the podcast itself with your veterinarian and their staff.

Have a Great Question for Dog Cancer Answers Veterinarians?

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The post Laverdia for Dogs: A Pill for Lymphoma appeared first on Dog Cancer Blog.

Blood in dog stool is something that makes us dog lovers panic. But there is some good news! Isolated episodes of a little bloody stool is nothing to worry about, and it is only rarely a sign of cancer.

Causes of Bloody Stool in Dogs

Bloody stool can be caused by a variety of things, ranging from simple and easy to fix to more sinister.

Here are some potential causes, with the most common in bold:

• Parasites (most commonly Hookworms or Giardia)
• Ate something he shouldn’t have
• Straining from prolonged diarrhea
• Infected anal gland
• Obstruction/blockage
• Clotting disorder
• Stomach ulcer
• Irritable bowel syndrome
• Internal bleeding
• Stomach, intestinal, or anal gland cancer

What to Do if Your Dog Has Bloody Stool

If your dog just has a little bit of blood in, or on, the stool and is otherwise acting totally normal, it is probably nothing to worry about.

Should it happen more than once within a day or two, drop off a fresh stool sample at your vet’s office. The poop will be checked for parasites and can be sent out to a lab for even more in-depth parasite testing.

You can also send a photo of your dog’s poop to your vet to put in your dog’s file.

When to Be Concerned

Bloody stool is more likely to be a problem in these situations:

• The stool has a lot of fresh red OR old black blood
• Bloody stool occurs frequently
• Your dog is also vomiting
• Your dog is straining to defecate
• Your dog shows signs of abdominal pain or discomfort
• You see pale or bluish gums
• Your dog is generally acting sick and unwell

If any of these symptoms are present in addition to bloody stool, your dog should be examined by a veterinarian.

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Getting a Diagnosis

Which tests your vet runs will be based on your dog’s exact symptoms and how sick he is, but here are some options:

• Fecal analysis
• Blood tests to check organ function and clotting
• A special fecal test to evaluate blood in the stool
• Abdominal ultrasound
• Radiographs (X-rays)
• Endoscopy to look inside the GI tract

Can I Treat Bloody Stool at Home?

If your dog’s only symptom is a small amount of blood in or on his stool and he is otherwise perky and healthy, you can monitor him at home.

For mild cases of diarrhea, fasting your dog for 12 hours or so (no food or treats) gives his GI tract a break. Then offer a bland diet, such as plain boiled chicken and plain cooked rice, for a few days.

You can also give your dog a probiotic to help normalize his GI tract. Probiotics intended for dogs are very safe, and can be used as needed or every day.

If the bloody stool continues or gets worse, or if your dog starts showing other symptoms, it’s time to call the vet.

For more information, you can listen to this podcast episode featuring Dr. Nancy Reese, DVM PhD:

You can also read the full transcript on the episode page of Dog Cancer Answers.

Please subscribe to, rate, and review Dog Cancer Answers in Apple Podcast or on your favorite pod-catcher. It really does help the show!

Paws and wags,

Kate

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Transitional cell carcinoma (TCC) is the most common dog bladder cancer. Let’s go over the most important things to know about this cancer.

Transitional What? TCC Explained

Your dog’s urinary tract is lined with some really cool and unique cells called transitional cells. Transitional cells are called transitional because they change depending upon what’s happening in the area.

They can stretch and then bounce back to their normal form. This is is why your dog’s bladder can expand to hold urine! Transitional cells expand like the walls of a balloon to accommodate urine, and then bounce back to their small form when the urine empties.

Transitional cell carcinoma is when these cells become cancerous.

Transitional cells are in the bladder, of course, but they also line the ureters and urethra.

Ureters are the tubes that bring urine from your dog’s kidneys to his bladder. The urethra is the tube that takes urine from the bladder outside of the body.

All of these tubes connect with the bladder in a region known as the trigone.

While TCC can arise anywhere, it’s most commonly found in the trigone area, which is one of the reasons it’s hard to treat.

Risk Factors

Any dog can get transitional cell carcinoma, but the are some genetic and environmental risk factors. Female dogs are more likely to get it than males, and obesity increases risk as well.

Breeds who are at high risk for developing TCC include:

• Scottish Terriers
• Shetland Sheepdogs
• Beagles
• Collies
• West Highland White Terriers
• Airedale Terriers
• Wirehaired Fox Terriers

While Scotties are the most commonly affected dogs, there is some good news! A study found that feeding vegetables at least three times a week decreased the rate of TCC in Scottish Terriers. Broccoli for everyone!

Environmental factors that increase the risk for TCC include:

• Exposure to insecticides
• Exposure to herbicides
• Spaying
• Topical flea and tick medications
• Treatment with the chemotherapy drug cyclophosphamide

Remember, there are many causes of cancer, and some of them we can’t avoid. No one can live in a bubble.

But these are the KNOWN factors that may increase risk in dogs.

Symptoms of Transitional Cell Carcinoma

Unfortunately, many of the symptoms of TCC look very similar to a urinary tract infection. Symptoms include:

• Frequent urination
• Urinating small amounts
• Straining to urinate
• Blood in the urine
• Secondary urinary tract infection
• Symptoms recur after treating for UTI
• Inability to urinate (obstruction)

These are all symptoms of urinary tract infections, too, which are much more common than TCC.

Often, dogs don’t get diagnosed with TCC until after they have been treated for UTI’s and the symptoms don’t go away.

Bladder cancer is often painful, and many dogs have a constant urge to urinate. This can be frustrating for dogs and humans!

NOTE: If your dog is unable to urinate at all, this is an emergency. The buildup of waste products inside the body can be fatal within a matter of days. If you’re reading this because you notice your dog is not able to urinate, take her in for an emergency vet visit right now.

Diagnosing TCC

As mentioned above, dogs with transitional cell carcinoma frequently come into the vet for a suspected UTI.

Once they are treated, owners notice they don’t improve on medications … or immediately start showing signs again once they finish treatment.

If this happens, or if your dog is a high-risk breed for TCC, your vet will recommend additional diagnostic tests.

Urinalysis

The first step is almost always a urinalysis. This is when your vet examines your dog’s urine under a microscope to look for abnormal cells, bacteria, and crystals. The urine will also be tested for its pH and the presence of proteins or glucose.

Bladder Tumor Antigen Test

This is a special test that looks for tumor proteins in your dog’s urine. There are very few false negatives – so if your dog tests negative, she almost certainly does not have bladder cancer!

There is a risk of false positives, however. This is because the protein in the urine due to a UTI or kidney failure can also trigger the test. So if your dog tests positive, she will need additional testing to confirm the diagnosis.

CADET BRAF Test

This is another special urine test that looks for a mutation that occurs in most TCC tumors. For this test, there are very few false positives – so if your dog is positive, she very likely does have TCC.

There can be some false negatives with this test because not all TCC tumors have the BRAF mutation.

Cystocentesis

A cystocentesis or “cysto” is when your vet or a technician uses a needle and syringe to take a sterile urine sample directly from your dog’s bladder. Your dog will be placed on her back or side, and a long needle inserted into the bladder.

While this sounds terrifying, it is actually really quick and dogs tolerate it very well!

Your vet will do a cysto if she wants to confirm the presence of a UTI or wants to send out urine for a culture and sensitivity test to identify the exact bacteria causing the problem and the best antibiotic to kill it.

If your dog might have TCC, however, your vet may not want to do a cysto. Some studies have shown that there is a risk of “seeding” the tumor and spreading cancer cells along the path that the needle takes. Other studies have not shown this to be the case. Here’s a good article from Dr. Dressler about this nuanced subject.

Bloodwork for TCC

Blood tests won’t tell if your dog has transitional cell carcinoma or not.

But they will give your vet lots of info about your dog’s overall health.

Your vet will be especially interested in your dog’s kidney health – if her kidney values are out of whack, she may be in kidney failure.

Kidney failure alongside TCC complicates things, and may change your thinking about treatment — so it’s good to know about it.

Radiographs (X-rays)

An X-ray is a quick way to get a look at your dog’s bladder. For the best results, her bladder should be pretty full at the time of the x-ray. This lets your vet see as much of the bladder wall and the space inside the bladder as possible.

Tumors are not always visible on X-ray, but bladder stones will be if your dog has them.

Ultrasound

An ultrasound is a better way for the veterinarian to look at the bladder wall because it shows soft tissue better than x-rays do. Again, the bladder should be full to give the best view.

Ultrasounds are also useful to check the abdomen for signs of metastasis, or cancer spread.

Biopsy

In some cases, your vet may recommend getting a biopsy of the tumor once it has been found.

This can be done via cystoscopy or passing a tiny fiberoptic cable with a camera and little grippers up the urethra into the bladder, or it can be done surgically. Both of these procedures will require anesthesia.

Staging the Cancer

If your dog is diagnosed with TCC, your vet will also “stage” the cancer. This tells you how severe your dog’s condition is at this time.

Stage T1 is a superficial tumor.

Stage T2 is a tumor within the bladder wall.

And Stage T3 is a tumor that is invading surrounding organs and tissues.

As with most cancers, lower stages come with a better prognosis. The average survival time for Stage T1 with treatment is 6-7 months.

Treatment Options for Dog Bladder Cancer

The “standard of care” treatment for dogs with transitional cell carcinoma is chemotherapy combined with a nonsteroidal anti-inflammatory drug (NSAID).

NSAIDs

Non-steroidal anti-inflammatory drugs are a mainstay of transitional cell carcinoma treatment.

Why? Because they do two things: make the dog feel better and sometimes shrink the tumors.

Piroxicam, a human NSAID, is the best-known option for dogs with TCC, but other NSAIDs like deracoxib (Deramaxx) or meloxicam (Metacam) work too.

An NSAID provides palliative control even by itself, which means that it just makes your dog feel better even when it doesn’t fight the cancer.

NSAIDs also work alongside chemo, surgery, or radiation, so using one doesn’t mean you can’t use those other treatments.

If your veterinarian wants to start your dog on an NSAID immediately, those are a lot of good reasons to do it!

Chemotherapy

According to Dr. Susan Ettinger, DVM, DACVIM, in the Dog Cancer Survival Guide, “Chemotherapy treatments can prevent recurrence, prevent or delay metastasis, and extend survival times.” Chemo can be used alone, or in addition to surgery and/or NSAIDs.

Chemo drugs commonly used for TCC include:

• Mitoxantrone – this along with an NSAID is the gold standard for TCC, with median survival times of 12-14 months!
• Doxorubicin
• Carboplatin
• Cisplatin – should not be given with an NSAID due to the increased risk of kidney damage
• Chlorambucil

Most of these drugs are given via injection, so treatments do require a vet visit.

Chlorambucil, on the other hand, is an oral medication that can be given at home.

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Surgery

Surgery may play a role in bladder cancer treatment, but it can’t do the job alone.

The bladder is a very unique and important organ, so the surgeon may not be able to remove the entire tumor without permanently damaging your dog’s urinary tract. If the tumor is located at the trigone, or the spot where all of the different tubes come into the bladder, surgery may not be possible at all.

What surgery CAN do is debulk the tumor, making it smaller. A smaller tumor means less discomfort for your dog, plus less risk of obstruction. And it can also help other treatment measures work better.

If your dog has a urinary obstruction, surgery can also be used to place tubes that allow urine to bypass the blocked area. These procedures can have a lot of complications, including urinary incontinence, so it is important to discuss all of the potential outcomes for your dog’s case before jumping in.

Radiation

Radiation therapy isn’t commonly used for bladder cancer because it can potentially damage the bladder wall and prevent it from working properly. It might be an option for some cases, though, depending upon the location of the tumor. Your oncologist will let you know if it’s an option.

Diet and Supplements

As with all cancers, implementing a low-carb diet rich in vegetables can help to support your dog’s immune system.

There are also lots of supplements that can be beneficial in your dog’s fight against cancer. Some options for TCC include:

• Cordyceps mushroom to protect the liver and kidneys during chemo
• Coenzyme Q10 to protect the heart if treating with doxorubicin
• Apocaps CX to support natural cell death
• Fish or krill oil to combat inflammation
• Modified citrus pectin to help slow metastasis

Lifestyle Modifications

There are plenty of studies that show that lifestyle modifications to reduce stress and increase happiness are important. Dr. Dressler recommends things like ensuring a dark sleeping space, fresh air and exercise, and play sessions. Training challenges can help keep a dog interested and motivated, too.

Bottom Line on TCC in Dogs

There is no cure for dog bladder cancer, but treatment can extend survival time and dramatically improve quality of life.

Unfortunately, bladder cancer hurts. If you’ve ever had a UTI, or even just really had to pee, you understand how uncomfortable it could be for your dog.

That’s why no matter what, whether your dog is a candidate for surgery or not, you can always give an NSAID to relieve discomfort. Chemotherapy is also often part of the treatment plan.

Additional things that you can do at home include giving supplements to support your dog’s immune system and feeding a low-carb diet.

Paws and Wags,

Kate

Further Reading and Resources

Here’s a good podcast episode where a listener asks a question about TCC:

Full transcript available on the Dog Cancer Answers website.

Evaluation of the effect of dietary vegetable consumption on reducing risk of transitional cell carcinoma of the urinary bladder in Scottish Terriers

CADET® BRAF and CADET® BRAF-PLUS

Metronomic administration of chlorambucil for treatment of dogs with urinary bladder transitional cell carcinoma

Dog Cancer Diet

Recommended Supplements for Dogs with Cancer: The Most Important Supplements in Order of Importance from The Dog Cancer Survival Guide

Can Needle Biopsy Spread Cancer?

The post Transitional Cell Carcinoma: The Most Common Dog Bladder Cancer appeared first on Dog Cancer Blog.

It is scary when your dog is bleeding! How to stop dog bleeding depends on where and how bad it is.

Sometimes bleeding is a minor thing that can be handled at home, but other times it requires immediate veterinary care.

Let’s break down some different scenarios.

My Dog is Bleeding: Is it an Emergency?

Dog bleeding is an emergency if:

• There is a lot of blood and an artery may have been cut
• The bleeding doesn’t stop within ten minutes
• There is a large wound
• It is a result of trauma (such as being hit by car)
• The dog is lethargic

More minor injuries, such as a toenail that got ripped off, a cut ear, or a bleeding sore, can usually be dealt with at home or at least wait for normal business hours.

If you are unsure, call your vet! They can talk you through your dog’s exact symptoms and will likely have you send them a picture so they can better gauge the urgency.

Tools to Stop Dog Bleeding

How you stop dog bleeding depends on where the injury is and how bad it is. Some of these methods are probably already in your house, and others are good ones to put in your first aid kit.

Gravity

If the wound is on your dog’s leg or paw, elevate it! Raising the injured area above your dog’s heart will help to slow the bleeding.

Styptic Powder

Styptic powder, also frequently referred to by the brand name Kwik Stop, is a handy powder that works great for bleeding dog nails and other small wounds.

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To use it, dab a little of the powder on the bleeding area and apply gentle but firm pressure. It usually works very quickly!

This is a great product to keep on hand for “oops” moments when trimming your dog’s nails.

Silver Nitrate Sticks

These sticks are another option for bleeding toenails and other small cuts.

The tip of each stick is coated with silver nitrate and potassium nitrate, which chemically cauterize the area.

To use a silver nitrate stick, apply the coated tip directly to the bleeding nail and hold it in place for a few seconds until the bleeding stops. Rotate the stick for increased coverage with heavily bleeding nails.

These do sting! Because of that, the styptic powder is usually the preferred tool for many dog lovers.

The sticks will also stain your skin black if it comes in contact with the tip. This stain will fade over a couple weeks.

HemaBlock

This product is great at stopping bleeding, and can cover wounds up to 30 square centimeters in size.

While it’s use is probably overkill for a bleeding toenail, HemaBlock is a great addition to your first aid kit if you like to take your dog hiking or he has a talent for getting into trouble.

HemaBlock can even be used inside the body, and your vet might use it during surgeries.

It is usually available in powder form but can come in syringes for easier application. Apply the powder directly to the wound and apply gentle pressure until the bleeding stops.

HemaBlock can be purchased through veterinary pharmacies.

Flour, Corn Starch, and Ivory Soap

These three common household items will also do in a pinch for minor bleeding.

Use flour and corn starch just like you would styptic powder, covering the bleeding area and applying firm gentle pressure.

With ivory soap, you can hold the bar right against the tip of your dog’s bleeding toenail.

Yunnan Baiyao

Yunnan baiyao is an herbal blend from the Yunnan province in China. The exact formula is a closely guarded secret, but this remedy can be helpful for internal bleeding.

We don’t understand exactly how it works, but it appears to activate platelets.

It can also be applied topically to a bleeding area.

Stopping or slowing internal bleeding is especially useful for the cancer hemangiosarcoma.

Yunnan baiyao can elevate liver values over time, so it is important to consult with your veterinarian before starting this supplement and to keep up with monitoring bloodwork.

Bandages for Dog Bleeding

Just like in human first aid, applying pressure is a cornerstone of stopping bleeding.

A bandage is often necessary for a wound that is bleeding either heavily or persistently.

Nonstick pads and gauze are the ideal supplies for bandaging a wound, but a clean cloth will do in a pinch.

Cover the wound and apply direct pressure.

If your dog bleeds through a bandage, don’t remove it! Add another layer and keep applying pressure.

Dr. Nancy Reese, DVM, PhD, warns that applying too much pressure can damage the tissues. If the skin around where you are pressing is turning white, you are probably pressing too hard.

Do not lift the bandage to check if the wound has stopped bleeding. 

This can disrupt the clot that has started to form, especially if it has clung to the bandage. Even if it had stopped bleeding, it might start bleeding again after you lift the bandage and rip away the fledgling scab.

If your dog bleeds through the bandage, apply another layer – do not remove the original bandage.

Once again, taking away the first layer can disrupt clot formation and cause the healing to start over again.

If you’ve taken first aid, you may know how to make a tourniquet, but tourniquets should be used with caution.

It is easy to tie them too tight, and cutting off circulation completely can do more harm than good in the long run.

Instead, there are pressure points in your dog’s armpits and groin. By applying pressure in these areas with your hand, you can often slow bleeding in the legs safely.

Surgery and Blood Transfusions for Dogs

If your dog has a tumor on her skin that is prone to bleeding, surgery is often the only way to resolve the issue long term. Get that unhealthy tissue out of there!

Surgery is also a common strategy for hemangiosarcoma, especially if the tumor has been found before your dog has a major bleed.

If the tumor is on the spleen, the entire spleen will usually be removed.

Blood Transfusions

Blood transfusions are sometimes necessary if your dog has lost a lot of blood or is anemic and not producing her own blood cells.

Dogs have blood types just like us, but they have their own system with over 12 different blood groups!

The good news is that only one canine blood group is really important: Dog Erythrocyte Antigen 1.1 (DEA 1.1). This is what is usually tested for when your dog is blood typed.

The other good news is that while knowing your dog’s blood type before a transfusion is ideal, you can usually get away with a single transfusion no matter what.

Problems start if your dog is given a second transfusion and she has developed antibodies in response to the first transfusion.

If your dog is likely to need multiple transfusions, your veterinarian will recommend blood typing both your dog and any potential blood donors to make sure that they match as closely as possible.

Types of Bleeding in Dogs

Bleeding Dog Nail

Bleeding dog toenails are usually not an emergency. Use styptic powder, flour, corn starch, or ivory soap to staunch the bleeding, and keep your dog still.

Moving around can disturb the clot and make the bleeding start again.

If your dog broke his nail completely, call your vet to schedule an appointment. Dangling pieces will need to be yanked off and your dog might need antibiotics to prevent infection.

Bleeding Dog Paw

A shallow cut on your dog’s paw may heal on its own, but deeper cuts should be examined by your veterinarian.

Cuts on paws are not an emergency unless they are bleeding profusely.

Paw pads take a while to heal, so it is important to keep your dog quiet and to protect her paw with either a light bandage or a bootie.

Bleeding Dog Ear

There are a lot of blood vessels in the ear, so they bleed a lot, but these wounds are usually not an emergency.

Applying pressure and keeping your dog still (no head shaking!) will encourage the blood to clot.

In many cases, once you get your dog cleaned up you may find a teeny tiny cut, often at the tip of the ear. It’s amazing how such a tiny cut can bleed so much.

Bleeding Dog Tail

Like ears, tails love to bleed, and getting them to stop can be challenging.

If your dog hurts his tail, it will need to be bandaged. Shorthaired dogs in particular are prone to “happy tail,” where every time they wag their tail they whack it against something and start it bleeding again.

Depending on the severity, a bleeding tail might be an emergency. It is definitely a good idea to get your veterinarian involved, as getting tail injuries to heal is difficult because of how much dogs move their tails and how little protection they have in that area.

In severe cases, amputation may be the only way to resolve chronic bleeding on the tip of your dog’s tail.

Nosebleeds

Nosebleeds are not particularly common in dogs and are always a cause for concern.

If your dog’s nose is bleeding, definitely call your veterinarian and find out what the problem is.

Causes include a foreign body (something lodged in the nasal passages) and nasal tumors.

Nosebleeds are always a cause for concern.

Nasal tumors are often fragile, and are particularly prone to bleeding if your dog sneezes.

The best treatment is to remove the source of irritation. This might mean surgery to remove a foreign body or radiation to obliterate a tumor.

Cuts

Dogs can think of all kinds of creative ways to hurt themselves. If the cut is small and only bleeding a little, you can probably treat it at home with a light bandage and time.

For large or heavily bleeding wounds, your dog should be seen by your vet. She may require sutures to close the wound, and antibiotics might be in order too.

Clotting Disorders

Clotting disorders are when your dog’s blood isn’t functioning properly and she can’t form clots.

Some of these conditions are inherited, while others can be acquired autoimmune problems.

The telltale sign of a clotting disorder is frequent and severe bruising. These dogs will also bleed longer from minor wounds than normal dogs.

There are blood tests that can be done to evaluate your dog’s clotting ability, and your vet can prescribe medications to control the problem.

Bleeding Tumors

Tumors on the surface of your dog’s skin can be prone to bleeding.

Abnormal protrusions are easy to catch on things and damage, and cancerous tissue is not healthy, so it is often fragile.

The best way to stop bleeding from a superficial tumor is to have the tumor surgically removed.

If that is not an option, you can use a protective bandage to cover the tumor so that your dog is less likely to knock against it and make it bleed.

Internal Bleeding

Internal bleeding usually occurs due to trauma from being hit by a car or attacked by a larger dog.

Even if your dog doesn’t have any visible injuries, always go to the vet if your dog is hit by a car.

Damage to internal organs can be life-threatening if it is not caught quickly.

Symptoms include weakness, lethargy, and pale gums. All of these symptoms warrant veterinary attention.

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Hemangiosarcoma

Hemangiosarcoma is cancer of the blood vessels.

These tumors frequently cause the affected vessel(s) to rupture and bleed.

Hemangiosarcoma can affect the skin, in which case you might see severe bruising or active bleeding during a bleed, but most commonly affects internal organs.

The spleen, liver, and heart are the most common sites for hemangiosarcoma inside the body.

When a tumor inside the body causes a bleed, you probably won’t see the blood. Instead, you will notice that your dog is weak and lethargic, and may have pale gum color.

Prevention is the Best Medicine

The best way to stop dog bleeding is to prevent it in the first place!

Avoid trauma by keeping your dog on a leash when outside. This will protect him from roads and getting into trouble roaming the countryside.

If hiking over rough terrain, consider booties to protect your dog’s paws.

For shorthaired dogs with long, whippy tails (we’re looking at you, Great Danes), be extra careful when closing doors so that you don’t catch their delicate tails.

And if your dog has a protruding lump or bump, protect it with a bandage while you pursue surgical removal.

We interviewed Dr. Reese on this topic. The video version of the podcast is here:

You can also read the full transcript on the episode page of the Dog Cancer Answers website.

Please subscribe to, rate, and review Dog Cancer Answers in Apple Podcast or on your favorite pod-catcher. It really does help the show!

Paws and wags,

Kate

PS: Feel free to share this article or the podcast itself with your veterinarian and their staff.

Have a Great Question for Dog Cancer Answers Veterinarians?

Call the Listener Line at 808-868-3200

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Your dog made it through surgery. You’re relieved, you’re exhausted… but now what? How do you take care of your dog after surgery?

Most of us are so worried about the surgery itself that we don’t think about the recovery period afterward.

But don’t worry – with some patience and persistence, your dog will be back to normal in a matter of weeks.

And here’s a spoiler: the two most important things you can do to help your dog heal quickly are to keep a cone on her and prevent her from running or jumping.

The First Night After Dog Surgery

Expect your dog to be groggy and tired – after all, she just had surgery!

It can take a while (even a couple days) for dogs to work all of the anesthesia out of their system, especially for sick or senior dogs.

Hanging out at the vet hospital is also not the most peaceful experience, so your dog is in need of a good nap.

Some medications can also cause grogginess. Opioids are the best-known for this, but the drug gabapentin can also cause sedation.

Some dogs who take gabapentin have no trouble at all and are bright and active. Others are totally wiped out.

The good news is that even if your dog is one who experiences sedation from gabapentin, most dogs adjust to it within a few days and stop having that effect.

Why Hasn’t My Dog Pooped After Surgery?

Your dog should urinate the first night after she has surgery, but not pooping is nothing to worry about.

It’s normal for a dog to not poop for four or five days after a surgery! There are a few reasons for this.

Anesthesia can cause some dogs to become constipated.

Also, remember that your dog skipped a meal, so there is less food in her system anyway. Many vet clinics also recommend giving just a small meal the night after surgery.

It can also be tricky for your dog to figure out how to position herself to defecate, especially if the surgery was on her leg.

Give your dog a couple days to poop, but if she hasn’t gone within the first four or five days after surgery, give your vet a call.

All About Dog Surgery Incisions

Your dog’s incision(s) will go through a couple different stages as it heals.

What Is Normal:

• Clear, thin discharge the first few days after surgery
• A small amount of bloody discharge the first few days after surgery
• Bruising around the incision (especially on light-colored dogs)
• Slight redness in the skin around the incision
• Mild crusting

What Is Not Normal:

• Thick discharge that looks like pus
• Persistent discharge
• Heavy bleeding
• Persistent bleeding
• Red skin that feels warm to the touch
• Lump under or near the incision
• Open incision
• Heavy crusting
• Dark, dead-looking skin or sloughing

Healing Time

The surgeon or veterinary technician will tell you how long your dog will need to wear her cone before her stitches come out.

The typical healing time for most incisions is 10-14 days.

However, in areas with a lot of motion, such as your dog’s back or over a joint, or if the skin is really fragile, it can take up to 21 days to heal.

Don’t worry if your dog has a long incision – incisions heal from side to side, not end to end, so a five-inch incision will heal in the same amount of time as a one-inch incision.

Suture Removal

For routine surgeries, the suture removal is usually free or a nominal fee, and is quick.

A veterinary technician or assistant will take your dog, look at the incision to make sure everything looks ok, and remove the sutures. Your dog will not need sedation or anesthesia.

If the tech has any concerns, he or she can get a veterinarian to look at the incision.

For cancer patients, the suture removal may be combined with a recheck exam with the veterinarian. This is so that your vet can see your dog directly, and talk to you about how the healing process has gone.

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Use the Cone!

Whether you choose a standard plastic Elizabethan collar, a soft cone, or a bodysuit, protecting your dog’s incision is absolutely imperative.

It only takes a second for your dog to lick or chew her incision and open it up.

Plus, dog mouths aren’t exactly the cleanest place on earth. Licking the incision could cause an infection.

The cone should be on at all times unless your dog is under direct supervision (being in the same room while you watch TV doesn’t count). This means overnight too!

Even if your dog doesn’t seem to show any interest in her incision, stick with it. It will often get itchy when her hair starts to grow in after a couple days.

We know the cone is annoying, and we know your dog doesn’t like it. But if your dog damages her incision, healing will take even longer.

If your dog damages her incision, healing will take even longer.

One of my dogs had a small cyst removed from her toe. Literally one stitch. While her cone was off, I stepped around the corner to turn off a light. Remember when I said it only takes a second? That’s all it took for her to remove that stitch.

That was on a Saturday night, and I didn’t really want to do the emergency vet thing. So I bandaged her foot up, and it had to heal on its own.

What should have taken 10 days took a full month, with bandage changes every day.

Use the cone or an alternative that protects your dog’s incision!

Restricted Activity

This is the other hard one for many owners after their dog has surgery.

Restricted activity means:

• Leash walks only (not on a retractable leash)
• No going outside off-leash, even briefly
• No running
• Avoid stairs as much as possible (and always on a leash and controlled)
• No rough play
• No getting on and off furniture
• Confined to a crate or small room in the house

Your veterinarian will tell you how long your dog needs to be kept quiet, along with any special restrictions for your dog’s case.

Surgeries that involve a leg, especially if the incision is over a joint, will require the strictest lockdown.

If your dog is really high-energy, your veterinarian can prescribe a sedative to help keep her calm during the healing period.

A Healing Incision is Like Gluing Something Together

A healing incision is like when you glue something together.

If you apply the glue, line up the pieces, and then immediately start wiggling them, the glue will never bond. Your item will remain broken.

Your dog’s body is trying to glue the incision back together. If she is constantly running around, jumping, and being a nut, the incision will not be able to heal.

Even worse, she could tear her stitches through her skin, causing the incision to open up.

Leash walks only means leash walks only – if your dog is outside, even in a fenced yard, she should be on a leash.

This is why your dog has to be on a leash at all times when outside, even in your yard.

We believe that your dog is normally very good, we really do.

But all it takes is one squirrel.

And as your dog tears off across the yard or down the street, she could be ripping open her incision.

And you know what’s less fun than keeping your dog quiet after surgery?

Paying to re-do the surgery a second time, and starting back at day one.

No one wants that to happen, including your vet!

Keeping Your Dog Confined in the House

Restricting activity is just as important inside the house as it is outside the house.

Here are some options:

• Play pen or exercise pen. These pens are portable and flexible, making them a nice item to have even when your dog is healthy. For little dogs, you can get a fabric pen, but for large dogs we recommend a tall metal pen for extra stability.
• Small room.  Use baby gates to keep your dog in one room. This is a good option for large dogs. Just don’t forget to remove or block off furniture so she can’t jump on and off!
• Leash. If you don’t have a lot of space or if your dog gets stressed out by confinement, a leash is an easy fix. Your dog can go with you from room to room and lounge while you work or hang out. A six-foot leash is perfect – retractable leashes give too much freedom.
• Crate. When in doubt, go with the good ol’ crate. Ideally choose a large crate so your dog has room to maneuver a little, and keep in mind that your dog may need some help turning around with her cone on.

If your dog normally sleeps in bed with you, you will need to make sure she can’t jump off the bed in the middle of the night. Solutions for this include having her sleep in a crate next to your bed, or using an exercise pen to barricade your bed and turn it into a giant crate.

You can also teach your dog to use a ramp to get on and off the bed. If she isn’t already 100% reliable with the ramp, you will still need to barricade other access points so that the only way she can get on or off the bed is by using the ramp.

Things That Can Go Wrong

Seroma

A seroma is a fluid-filled pocket under or near the incision. They usually feel a little soft, and the skin will look normal. Sometimes there might be clear discharge from the incision. Seromas are not infected, and usually just happen because the dog has been too active.

To resolve the seroma, your veterinarian will likely recommend being stricter with activity restriction as well as alternating warm and cold compresses to encourage the fluid to disperse.

Open Incision

An open incision is concerning because that gap can allow tissues and organs to slip out of your dog’s body, or allow bacteria to get in.

Neither of these are good.

If your dog’s incision opens up, your vet may need to resuture it. Small gaps may be allowed to heal on their own.

Expect a course of antibiotics to prevent or resolve infection.

Infection

While rare, even a properly closed incision can sometimes become infected. Signs of infection include red, irritated skin, skin warm to the touch, and possibly lethargy.

Your veterinarian will prescribe antibiotics to treat the infection.

Fracture

For surgeries involving bone, being too active too soon can lead to fractures.

Healing bones aren’t as strong as healthy bones, and they can break if too much stress is put on them.

A fracture would likely mean additional surgery to repair the fracture.

Hemorrhage

In rare cases, a dog could have uncontrolled bleeding after surgery.

This might be due to a clotting disorder, the dog being too active and tearing sutures, or a blood vessel inside the body not being properly closed during the procedure.

Depending on the location and severity of the bleeding, your dog might need emergency care and/or surgery to stop it.

When to Be Concerned

Call your vet if you notice:

• Open incision
• Heavy bleeding
• Thick discharge
• Persistent discharge
• Angry, red skin that is warm to the touch
• Lump under or near the incision
• Lethargy that either persists or returns after a couple days
• Vomiting
• Diarrhea

If you have any questions about your dog’s incision, you can also often take a picture and send it to your vet through their email or to a hospital cell phone.

Lab Results

If you opted to send out your dog’s tumor for a histopathology report, it will be a couple days before you get those results.

The turnaround is typically 5-10 business days, but may vary depending on your location.

Why the wait? The sample first needs to get to the lab, then they have to process it. This usually involves cutting very thin slices that can be looked at under a microscope and staining them to make different cell structures stand out.

Then the results have to make their way back to your veterinary hospital and on to you.

Takeaways on Caring for Your Dog After Surgery

• Expect that your dog won’t feel her best right after surgery, but will improve over the next couple of days.
• Use a cone or other protective device to prevent your dog from licking or chewing at the incision.
• Follow instructions for activity restriction to the letter. Be strong – it is worth the hassle to get your dog healed up quickly!
• If you are unsure, send a picture of the incision to your vet.
• Schedule a suture removal appointment if needed.

Two weeks might feel like forever, but before you know it, your dog will be back to normal activity!

You can watch the video recording of my conversation about post-operative care with Jim on Dog Cancer Answers here:

You can also read the full transcript on the episode page of the Dog Cancer Answers website.

Please subscribe to, rate, and review Dog Cancer Answers in Apple Podcast or on your favorite pod-catcher. It really does help the show!

Paws and wags,

Kate

Further Reading

Getting Your Dog Ready for Surgery

Day of Dog Surgery: Timeline and What to Expect

PS: Feel free to share this article or the podcast itself with your veterinarian and their staff.

Have a Great Question for Dog Cancer Answers Veterinarians?

Call the Listener Line at 808-868-3200

The post How to Take Care of Your Dog After Surgery appeared first on Dog Cancer Blog.

Why would timing matter for chemo treatments for dog cancer?

As it turns out, the time of day that a drug is given can affect how well it works, and how many side effects it causes.

When a drug is given can affect how well it works and how many side effects it causes.

And this concept can apply to ALL medications and supplements that your dog takes, not just chemotherapy.

About Time

Your dog’s body has a daily routine – get up at a certain time, eat, sniff around, play, eat some more, go to sleep at the end of the day. You’ve probably heard this phenomenon described as a circadian rhythm or biological clock.

At different points in the day, your dog’s body (and yours!) is going through specific tasks. Some of these tasks include:

• feeling hungry
• feeling sleepy
• raising and lowering blood pressure
• raising and lowering body temperature
• adjusting hormone levels (including melatonin)

Certain processes occur in the morning, while others occur at night during sleep.

Does your dog seem to have psychic powers to know when it’s time for breakfast and dinner? That’s his biological clock at work.

Clock Genes

These routines are controlled by clock genes that are turned on and off by the sun/dark cycle. Signals from the eye go to the brain and tell a part of the brain (the suprachiasmatic nucleus) which pathways to turn on or off. Day/night is the main control of the clock genes, but other things like eating have effects too.

Changing up your regular sleep schedule can knock these processes off-kilter. This is part of why you don’t feel so great when you make a dramatic change. And when you don’t feel good, your body isn’t working properly…

… and you are more susceptible to a variety of illnesses and problems.

There can also be issues with the clock genes themselves. Abnormalities in the clock genes not only mess up your dog’s schedule, but they can also increase cancer risk. Research has also shown that some cancers specifically turn off genes that control circadian rhythms. This allows them to grow and replicate whenever they want.

Back in 2017 researchers Jeffrey C. Hall, Michael Rosbash, and Michael W. Young won the Nobel Prize in Physiology or Medicine for their work on circadian rhythms. This stuff is pretty cool!

Chronotherapy for Dogs

Because your dog’s body is focused on different tasks at different times of the day, how he responds to a medication can vary!

Most dog owners have had to time a medication based on when their dog eats. Some meds have to be given on an empty stomach, while others need to be given as part of a meal.

This is basic chronotherapy, but it’s just the tip of the iceberg.

As well as timing medications to prevent stomach upset, in some cases it can also be possible to improve absorption, improve response to therapy, and decrease other side effects (such as low platelet counts and cancer cachexia).

Studies are also underway trying to develop drugs that can reset biological clocks and get them back on schedule. This would rob tumors of one unfair advantage!

Most of these studies are not in dogs, but cancer in dogs has many similarities to cancer in humans. Discoveries made in one species often apply to the other!

Minimize Side Effects for Dogs, Increase Chemo Effectiveness

If you are able to pin down when the best time to give a medication or have a treatment done is, the side effects go way down.

Your dog’s liver adjusts certain proteins throughout the day, which can change how well the liver metabolizes medications.

This means the dog will be able to handle a higher dose of the treatment, which is fantastic. Veterinary medicine has always focused on getting the maximum chemo and radiation doses without toxic effects to the rest of the body. Bigger doses mean more palliation (decrease in signs and symptoms). They also mean longer life expectancies.

And fewer side effects keep both you and your dog feeling better during treatment.

Get the eBook for $9.99

Best Time for Chemotherapy

A variety of studies have started looking at when different chemotherapy drugs are most effective.

Some of these results may seem to contradict each other. This could be due to how the studies were set up, other medications the subjects received, or the species being evaluated. For studies involving rats, remember that our morning is the start of their sleep time.

We still have lots to learn! But these are just a few of the completed studies looking at chronotherapy.

5-fluorouracil (5-FU) and Carboplatin:

• Several studies in humans with colorectal cancer using both 5-FU and carboplatin had good tolerance and survival times when the 5-FU was given overnight and the carboplatin peaked at around 4pm.

Cisplatin:

• A study in humans with ovarian cancer showed that cisplatin was safer and more effective when given at 6:00pm.
• Humans with lung cancer were less likely to experience side effects when treated at 6:00pm.
• Rats given cisplatin at 5:00am were less likely to develop nerve damage.
• Rats were less likely to have hearing loss if cisplatin was given in the middle of the night (active period for rats).

Cyclophosphamide:

• A study in mice found that the presence or absence of genes that control circadian rhythms impacted toxicity.

Doxorubicin and Cisplatin:

• A study in rats with plasmacytoma looked at both doxorubicin and cisplatin. The doxorubicin was found to be safest and most effective when given toward the end of the night, while cisplatin was best when given toward the end of daytime. Remember that rats are usually active at night and sleep during the day.
• A study in humans with breast cancer found that doxorubicin was less likely to damage the heart if given mid-morning. This is when melatonin levels are at their lowest.
• A study in humans found that doxorubicin was less likely to cause bone marrow suppression if given during the night.

Temozolomide:

• A study in humans found that patients with brain cancer given temozolomide in the morning lived longer than those who took it in the evening.

Not Just Chemo

Chronotherapy concepts don’t just apply to chemo drugs!

In fact, the time of day can make a difference for a wide range of medications, and even supplements.

A review published in the Polish journal Medycyna Weterynaryjna in 2006 looked at a variety of medications commonly used in veterinary medicine.

Here are some of their findings:

• Diazepam: Best absorbed in the morning
• Gentamycin: Can be given any time
• Hexobarbital: Better absorbed in the evening
• Ketoprofen: Best absorbed in the morning
• Midazolam: Can be given any time
• Theophylline: Best absorbed in the morning

Pain Medications

Nonsteroidal Anti-inflammatory Drugs (NSAIDs) may provide the best pain relief and better bone healing when given during the day.

Steroids give the best relief for asthma patients in the morning, but provide more relief for rheumatoid arthritis patients when given in the middle of the night.

Supplements

Apocaps: Best absorbed and most effective when given between 10 and 11 AM and PM. That doesn’t work with your sleep or work schedule? Give it one hour before or two hours after a meal instead.

Curcumin: Its ability to trigger cancer cell death is impacted by circadian rhythms, but more study is needed.

Radiation

A study in mice showed that radiation therapy is also impacted by the time of day. Timing radiation with the patient’s circadian rhythm can increase survival times.

And a review of several radiation chronotherapy studies in humans found better outcomes when radiation was done in the morning.

Surgery

Yes, we’re serious – the time of day that surgery is done might be important.

Researchers compared tissue damage after heart surgery in almost 600 people. What did they find out? Patients who had heart surgery in the afternoon were less likely to have heart damage than those who had surgery in the morning. This is wild!

Why Isn’t Chronotherapy Part of My Dog’s Treatment Plan?

Chronotherapy may or may not be factored into your dog’s current cancer treatment plan. There are a couple reasons for this:

One: There is still a lot to learn.

While all of the above is really interesting, chronotherapy is a complex issue. There are a lot of moving pieces. It’s going to take a while before we have definitive answers on when the best time to give each drug is.

Also, the “best time” may not only vary from drug to drug, but from disease to disease and species to species. Doxorubicin might be most effective against lymphoma at a different time of day than it is most effective for osteosarcoma.

Other medications that a patient is getting will also affect how well a drug works.

There are endless possibilities that can impact the ideal time to give any single drug, and it will take a while to sort all of those out.

Two: It can be difficult to implement chronotherapy.

Chronotherapy can be impractical, too – for both owners and veterinarians.

Veterinary hospitals can only see so many patients in a day and usually have limited business hours.

If they have twenty dogs all getting the same chemotherapy drug that is most effective when given at 9am… there may not be twenty teams of staff available to accommodate that demand at that time.

And drugs that are best if given in the middle of the night can be an issue too. Even 24/7 emergency hospitals don’t usually schedule non-emergency appointments at 2am.

Your work schedule or travel ability can also limit when you can take your dog in for treatments. Oral medications given at home are easier to accommodate, but even those might be difficult to squeeze into your workday.

The Takeaway

Chronotherapy is a really exciting branch of medicine. We are learning that giving medications according to the patient’s biological clock can increase effectiveness and decrease side effects.

That said, there is still a long way to go. And even when we do know the “best” time to give a drug for a particular illness, that might not be a realistic option.

We expect chronotherapy will slowly work its way into veterinary medicine, but if it doesn’t fit with your dog’s treatment plan, don’t worry.

We live in an imperfect world, and are all doing the best we can for our pets with what we have. As we learn more about how circadian rhythms affect drug metabolism in dogs, we will be able to use it more to help our beloved pets.

Paws and wags,

Kate

Further Reading and References

A Chronopharmacological Study Related to Doxorubicin Based Bone Marrow Suppression

A Time for MYC: Metabolism and Therapy

DogCancer.TV: Cancer Cachexia and Dog Cancer- When Your Dog Won’t Eat

Chronotherapy in veterinary medicine

Chronotherapy with 5-fluorouracil, folinic acid and carboplatin for metastatic colorectal cancer; an interesting therapeutic index in a phase II trial

Chronotherapy of Non-Steroidal Anti-Inflammatory Drugs May Enhance Postoperative Recovery

Chronotolerance for cisplatin ototoxicity in the rat

Circadian chemotherapy for gynecological and genitourinary cancers

Abstract 1772: Circadian control of cell death in glioma cells treated with curcumin

Cisplatin-based chronotherapy for advanced non-small cell lung cancer patients: a randomized controlled study and its pharmacokinetics analysis

Combined Systemic Chronotherapy and Hepatic Artery Infusion for the Treatment of Metastatic Colorectal Cancer Confined to the Liver

Control of a murine plasmacytoma with doxorubicin-cisplatin: dependence on circadian stage of treatment

Daytime variation of perioperative myocardial injury in cardiac surgery and its prevention by Rev-Erbα antagonism: a single-centre propensity-matched cohort study and a randomised study

Does the Time of Radiotherapy Affect Treatment Outcomes? A Review of the Literature

How to Ruin Cancer’s Day

Increasing doxorubicin activity against breast cancer cells using PPARγ-ligands and by exploiting circadian rhythms

Influence of dosing times on cisplatin-induced peripheral neuropathy in rats

Mathematical modeling of PDGF-driven glioblastoma reveals optimized radiation dosing schedules

Medicine’s secret ingredient — it’s in the timing

Nobel Prize Winning Research, Once Again, Can Help Your Dog

Sleep, Dog Cancer, and Melatonin

Temozolomide chronotherapy in patients with glioblastoma: a retrospective single-institute study

The Days and Nights of Cancer Cells

Time for chronotherapy? Clock genes dictate sensitivity to cyclophosphamide

Timing Matters: Circadian Rhythm in Sepsis, Obstructive Lung Disease, Obstructive Sleep Apnea, and Cancer

The post Chronotherapy: Timing Chemo Treatments for Dog Cancer appeared first on Dog Cancer Blog.