When one looks at these forward-leaning claims, the problem is that they don’t rest in what is really going on now.  Okay, “about” to get better.  That would suggest that at this stage, in the present moment, things are the same.

And realizing this, it can be pretty bleak for many dog lovers dealing with canine cancer.

I have had people in my veterinary hospital tell my they have to choose between their dog’s food and their own.  Or their childrens’ needs and those of their dogs.

Indeed, for many, these dog days are ruff days (sorry, had to lighten it up a little…)

So, what to do when faced with the cost of caring for a dog with cancer?  In the Dog Cancer Survival Guide, there is a listing of sources of possible financial help. But today I wanted to  highlight what for many, has been a magic bullet.

The Magic Bullet Fund is a resource for people who are in need of financial help for their dogs’ cancer treatment.  The Magic Bullet Fund is a real-life, practical, well-orchestrated answer to a pressing need.

The process is fairly strait-forward.  One must apply, and then the applications are screened.  Approval is for funding is granted for those where treatment is hoped to yield at least a year or more of life.

Palliative treatment is viewed as yielding less than this, and these efforts are excluded from the Fund.  This means that if the treatment does not have a decent probability of adding a year to your dog’s life, you may not be approved.

The money is ear-tagged for care of dogs with cancer only, for people who are in real financial need.  The money is not used for research or other scientific pursuits, only to fund treatment.

If you would like to apply for assistance, or if you would like to make a contribution to help those in need, check out the Magic Bullet Fund:

http://www.themagicbulletfund.org

Best to all in these ruff days,

Dr D

Dogs with a cancer diagnosis should have their temperatures taken on a regular basis.  If a dog is on chemotherapy, it should be daily.  If your dog is acting ill and has cancer, even if not on chemo,  it should also be daily (and your canine companion should be seen by a vet).  If your dog is afflicted with cancer but is acting fine, it should be every few days or so.

Why does it matter?  Don’t we pay attention to fevers when a dog has an infection?

Well, in cancer management, body temperature is important too.  This is particularly true when a dog is on chemotherapy.  Many, perhaps even most, chemotherapy drugs are capable of a side effect called bone marrow suppression.

To understand what this means, we need to back up a little.  We know that white blood cells fight infection in our bodies, and our dogs’ as well.  One critical type of white blood cell is called the neutrophil.  This little guy matures in the bone marrow and is then released into the blood stream to fight invading microbes if they are present.

When a drug causes bone marrow suppression, one of the cell types that gets hit hard (suppressed) in the bone marrow is the neutrophil.  This translates into very low neutrophil counts.  When a dog’s body has low neutrophil counts, the usual degree of protection from incoming microbe invaders is lost.

A dog on chemotherapy with a fever coupled with low neutrophil counts is a medical emergency.  Microbes that are usually weak are able to gain access into the body under these circumstances and wreak havoc.  Strong germs are life threatening.

Even dogs not on chemo who are fighting aggressive cancers are prone to infection.  Cancers are able to create what is called immune compromise, which is when the immune system is “under the weather” compared to normal.  These dogs are susceptible to infection as well and should also have their temperatures taken every few days.

The normal body temperature of a dog is 100.5 -102.5 degrees Fahrenheit (you will find some variation in the reported normals, but this is one of the most common published ranges).  Note that this is the core body temperature, not the temperature of the skin. The skin temperature is not reliable and a dog who is “feeling warm” may not have a fever.

Remember that dogs who have just exercised have elevated body temperatures, and these will drop once the animal settles down.  So remember to take your dog’s temperature at rest.

If your dog has a fever, he or she needs veterinary attention!

Here is a little link on how to actually do it.  A digital thermometer or a glass one can be used.  I lean towards the digital thermometers as they more are difficult to break.

Remember to make a note on the packaging for future reference that the instrument is for dogs and not people….

Best to all,

Dr D

Palliation is defined as a reduction in the signs or symptoms of a disease.  Note that nowhere is the word “cure” used.

This is something many may have not heard before.  Chemotherapy in dogs, unlike in some cases of human medicine, is not geared towards a cure.  The toxicities resulting from “cure” doses delivered by vein or as pills are too high for our dogs.

So, it makes a lot of sense to do everything we can to lower toxic events, since  we are simply trying to make something better for a period of time.

In previous blogs I focused on things like chemotherapy timing (chronotherapy), which got very little response from readers (I found this puzzling).   We are talking about simply changing the time of day for the chemo treatment and getting much better outcomes.  Higher margins, less toxicity, no increase in cost or life quality reduction.  What more could one ask for?

Everyone likes the idea of supplements to help lower toxicities (L-acetyl carnitine, coenzyme Q-10, beta glucans, ginger, milk thistle, and others..).  Supplements are a hit.

Here’s another one that will need the cooperation of your vet or oncologist:

Suppose we want to get a chemo drug in high concentrations to the lungs.  Why the lungs?  Well, the lungs are the site of many secondary tumors which have spread from a primary location.  These are called pulmonary metastasis.

If your dog had, for example, a malignant melanoma in his toe, it could easily end up sending melanoma cells to the lungs to grow.  These cells are said to have metastasized to the lungs.

Sometimes tumors start in the lungs.  These are called primary lung tumors.  They are not especially common, much less common than pulmonary metastasis.

At any rate, it would seem logical to get the chemo drugs right to where the tumors are for a couple of reasons.  First, if you cluster all drugs, only about 5% of what is taken as an IV injection and only about 2% of what is taken as a pill actually gets to the lungs.  So very little ends up where you want it.

From a conventional medical standpoint, the more anticancer substance that arrives at the site of the tumor, the higher the desired  effect in that area.

Second, if you can target your potentially toxic chemo drug so it acts as a “silver bullet”, and avoids contacting non-cancerous (healthy) body parts, you can limit toxicity to those healthy body parts.

If a veterinarian or oncologist is presented with a dog having a lungful of cancer, one way to get the cancer fighting substance to the tumor would be to aerosolize it.   This is commonly done with asthma inhalers in human medicine (which we use sometimes in veterinary medicine too).

Aerosolization is simply making a substance able to travel in the air, as a vapor.  You mix your drugs in some liquid, dump it in a machine called a nebulizer, and out comes a moist mist with your drugs in the mist. Neat.

Lots of things can be aerosolized.  Antibiotics, antifungals, anti inflammatories, and more.  And yes, chemotherapy drugs have been aerosolozed too.

And we see results.  Here, here, here and here are a few of publications for you (and your oncologist) to check out if you are interested.  The results of the aerosolized chemo drugs were clearly better than those given by traditional routes.

The main barrier to entry? Equipment for delivery simultaneous with prevention of aerosolized chemo drugs in room air.  Nobody wants to be inhaling chemo drugs themselves.  However, if you or your oncologist is industrious, you can use the schematic provided in this link and build a set-up,  or have someone else make one for you.

Another possible resource is the use of a compressor set up described in the article about IL-2 and osteosarcoma metastasis.  A  Bunn 400A compressor from the John Bunn Company in Happauge, New York, was used with a Puritan Bennet Twin Jet Nebulizer from Puritan Bennet in Carlsbad, California.  A polyethylene rebreathing bag was used to cover the dogs’ muzzles.  These dogs were trained to receive the IL-2 administration via this route.

Please, if any have success with this information, let me know so it  can be shared with others.

Best to all,

Dr D

These particular folks segregate themselves into a single group…the “anti” people.

First, we have those who are very impressed with conventional veterinary care.  This is my background, so I see the appeal. Big machines, big words, big science, big studies.  Strong, powerful, reliable, reproducible.

And getting re-soundly beaten, mercilessly, by canine cancer.

Members of this camp tend to be “anti” herbs, supplements, dietary manipulation, and other forms of “hocus pocus” that don’t have multiple double blind, placebo-controlled studies done to support efficacy and safety.

The other “anti” people want to rely on things like homeopathy and acupuncture to cure their dog’s cancer.  They don’t want to “poison” their dog with anything that is not  “natural”.

Please, everyone, it is time to wake up!

First, to the “anti alternative” set (conventional care only):  have you taken a look at the efficacy data for chemo and radiation treatments of systemic cancers lately?  If you have, you will no doubt agree that the numbers, overall,  are abysmal.

And you guys, who don’t want to use anything that comes compressed in a tablet or in an injection vial, you need to wake up too (the “alternative people”).  If a certain conventional protocol can give your English Mastiff another year of life, you just extended your dog’s life 10-18% or something.  Suppose a human lived for 80 years.  This human’s life would be proportionally extended another 8 to 14 “human” years with this treatment!

On top of that , if you think that a little Carcinosinum under your dog’s tongue will cure the osteoarcoma making his leg swell twice it’s size, you are probably living in a dream.

Now,  let’s get a grip on the big picture. It is absolutely critical to balance efficacy with life quality, to weigh survival times with what is manageable, and to factor in personal ethical considerations and beliefs with guardianship.  Aspects like these are fundamental.

But, it is high time to avoid letting our rigidity, bias, and resistances get in the way of what can help.  Weigh all options, be flexible, formulate a plan choosing from all the of what is available, modify it as needed, and do it.

If you need help getting the structure and data you need to look at all these aspects of canine cancer care, from all angles, consider the Dog Cancer Survival Guide.

I wish you all the very best,

Dr D

So I thought I’d just add some fuel to the fire and give my readers some overall guidelines about mast cell tumors and chemotherapy.

As many already know, these cancers come in different grades (1, 2 and 3).  Grade 1 are almost always benign, grade 2 are intermediate (some benign and some malignant) and grade 3 are universally malignant.

Your vet will give you the grade following receipt of the biopsy report, which is completed by a path lab after submission of tissue from the tumor.

Wide excision (removal of a large swath of normal-appearing tissue around the tumor) cures many mast cell tumors.  Pretty much all grade 1, and about 90% or so of grade 2 mast cell tumors are gone permanently after wide excision.  Grade 3 mast cell tumors are candidates for chemo and possibly radiation and more as they will often come back and spread even after surgery.

The tricky guys are those grade 2 mast cell tumors.  Since some behave like benign tumors and some like real cancers, what are we supposed to do?

Well, the key is in getting more information about your dog’s individual tumor. There are a couple of bits of information that are valuable that can help you predict the behavior of your dog’s grade 2 mast cell tumor.

The single most important one is called the  mitotic index.  This is the number of cells that are actually dividing seen by the pathologist under the microscope.

The magical cut off is somewhere around 5.  This means that if the tumor has a mitotic index of less than 5, it usually will behave less aggressively and in my opinion do not require surgery, as long as you have clean margins on the removed tumor.

More than 5?  We need to now consider hitting these guys with the full spectrum approach (diet, supplements, chemo, and other strategies discussed in The Dog Cancer Survival Guide).

You may read about other markers (kit, AgNORs, Ki67) but these are much less useful than mitotic index.  If the mitotic index is around 5 though,  consider these other markers for more data.

By the way, not all vets may know about this stuff, so remember to be your dogs primary health care advocate and speak up!  You vet is the one who has to order this testing of the biopsy specimen from your dog.

The squeaky wheel gets the oil!

Best to all,

Dr D

Today’s post will likely be met with some skepticism from those immersed (and confined) to our Western medical approach.  So if this is your framework, please keep an open mind.  You will be pleased to know that the information here is taken from little known, but still Western, data banks.

I have recently been looking into some ways of decreasing some of the horrible effects of severe mast cell tumors in dogs.  Lots of talk these days about Palladia, but there is more you can do!

As many of you are well aware, these cancers are able to release, on an intermittent basis, large amounts of chemical signals that produce nasty effects on the body.  There are many different ones, and to avoid being utterly dull, here are just a few:  histamine, substance P, and heparin.

The one which we have traditionally focused on is histamine.  Histamine is the same stuff that our bodies, and those of our canine companions, release during an allergic reaction.

It does bad things like create swelling, redness, pain, blood pressure changes, vomiting, loss of appetite, acid stomach, and more.

Much of the sickness that dogs afflicted with mast cell tumors suffer from is caused by histamine excess.

Some focus has been placed on blocking the effects of histamine with various medications.  However, very little has been placed on cutting off the body’s supply of histamine.

This is an intriguing and quite novel approach to dealing with histamine excess, and to my knowledge has not been tried in dogs.   So here’s the info…give it a try, see if it helps the dog you love, and let our community know!

The basic story is you cut out foods that eventually end up increasing active histamine levels,  by hook or by crook.  Now, most of you know that carbohydrate restriction is important is helping with cancer generally.  I discuss details of the dog cancer diet at length in the e-book, The Dog Cancer Survival Guide.

Here’s a new twist for those caring for a dog with a mast cell tumor diagnosis, especially the more aggressive ones (Grade 2 and 3).

Turns out there is some cutting edge new research going on in human medicine about ways to combat digestive upset, depression, anxiety, allergies, asthma, and more.  Many cases of these syndromes involve excessive histamine effects in the body.  There are very few diseases like mast cell tumors in people, but we humans do suffer from a close relative of mast cell tumors called systemic mastocytosis.

Anyway, those in the inner circle promote cutting off the wellspring of histamine in the body by simply not eating foods that promote histamine levels. Why not use a similar approach for dogs with mast cell tumors, another condition with histamine excess?

The biggies are those foods that are fermented as a part of processing.  Dogs usually don’t eat or drink a lot of those (drinks with alcohol, the more “moldy” of the cheeses like blue, sauerkraut, and vinegar).

But…. there are some out there who feed their dogs tofu.  Be careful!  Practically speaking, tofu could be viewed as a histamine brick.

Another big no-no, if one were using this approach, is fish!  Bacteria in the intestine of fish are quite busy making a lot of histamine, and levels rise after the fish passes away (but before the remains are gutted for food).

Dyes in food and the benzoates (BHT, BHA, sodium benzoate, benzoic acid) are also excluded from the diet.  Read those labels!

Here is a link for more data.  Note that the items on the restricted list not only contain histamine, but also are more prone to causing mast cells to release their illness-causing histamine reserves.

I hope this helps-

Best,

Dr D

I wanted to touch base with you about some information from the real-life streets of veterinary medicine.

Occasionally I will get a question about the use of “black salve”.  This rather ugly looking ointment is in a group of medicinals called the escharotics.  An escharotic is a preparation that injures the tissue it is applied to, and creates a scab.  A scab is an eschar.

So the idea is you put the stuff on the external cancer, the ointment kills the cells that you presumably want gone, they die, and then slough off.

Most of the black salve preparations contain an “olde-time” active ingredient called bloodroot, or Sanguinaria candensis.   This plant contains some mighty strong alkaloids, including one called sanguinarine.  This is potent stuff folks.  Sanguinarine paralizes a pump in the cancer cell membrane vital to survival, and the cells die.

There is a really significant issue that you need to know before slathering your dog’s skin tumor with sanguinarine-containing goo.

The problem is, although it does a pretty good job of killing cancer cells, it is very tough to tell how far a given cancer has spread into the surrounding neighborhood (around the tumor) before applying black salve.   Why does it matter?

The reason this is so critical is that some cancers really spread radically.  They send cancer cell sheets out around the visible growth, but these spreading cancer cells are invisible to the naked eye.  Guess what happens when they die off (after some potentially severe inflammation and discomfort)?

The dead cancer cells slough, leaving in some cases large swaths of open tissue where the tumor cells used to be.  This can sometimes be a nuisance and other times a horror show (warning: graphic).

Bottom line?  I would never advise the use of any version of black salve unless it is under the direct supervision of a veterinarian, and even then, use caution.  Sometimes things turn out great, but there have been nightmares.

Best to all,

Dr D

Some, claiming authority in the area of supplements for dog cancer, are pushing Pau D’Arco.  Be careful, everyone!

Let’s look at Pau D’Arco.  This is the common name for a tea, capsule, liquid extract, salve or tablet from  Tabebuia impetiginosa, a tree common in South America, especially Brazil. The bark is used for these medicinal preparations.

Pau D’Arco does have a lot of postive test-tube  (”in vitro”) effects on cancer cells.  Unfortunately, lots and lots of compounds kill cancer cells in test tubes.  The clinical trials in people (”in vivo”, or in living bodies) have been mixed, with the most well-designed one (”Early Clinical Studies With Lapachol”) yielding little benefit.  Read more here.

The American Cancer Society does not like Pau D’Arco for use in people due to safety concerns.  One could make the claim that they are just part of the “machine” trying to keep miracle cures suppressed to aid Big Pharma.

Whatever your belief is, and few people could deny the force of Big Pharma’s strategic influence, the concern over safety and effectiveness is well-founded at this point.

What is the evidence?

Well, lapachol, an active component Pau D’Arco, is toxic to developing embryos in pregnant lab animals.  It also messes up fertility of male lab rats. Okay, granted,  most chemotherapy agents have similar effects, so Pau D’Arco cannot be tossed out on this basis alone.  It should never be used in breeding animals, obviously.

At oral doses necessary for required concentrations around cancer cells, Pau D’Arco caused vomiting, blood clotting problems, and diarrhea.  Well, these are not good either, but one could also state these side effects are seen with chemo too, and that would be a valid point.  Of course, it is no-brainer to state that Pau D’Arco should never be used before surgery, during wound healing, in animals with blood clotting problems, or with tumors that could bleed.

Pau D’Arco has hydroquinone in it.  This is bad stuff.  Not only is it carcinogenic (irony of all ironies), but it is toxic to vital organs too.  Read all about it here.  Well, again, the same could be said of some of our common chemo drugs.

So what really makes Pau D’Arco dicey?  One thing that is quite bothersome is a lack of batch standardization.  Not only do the lapachol and other components vary from tree to tree, but sometimes they are actually absent.

On top of that, sometimes the the trees from which the bark is taken are from different Tabebuia species.  The tree appears to be getting more scarce due to it’s reputation, and we are getting herbal preparations containing the wrong bark.

Finally, chemo drugs are used under strict veterinary supervision. Pau D’Arco usually is not.  Both have real side effect concerns. Substances with these possible adverse health effects should not be used by a layperson without supervision.

There is no doubt that Pau D’Arco should be studied more or used as a template for new drugs, since the active compounds in the bark may have merit. However, since it contains some things that could, from time to time, pose real health hazards, and the batches vary in composition (does your dog’s batch have a lot of hydroquinone???), it is a gamble that I cannot take with dogs I care about.

Please be careful of what you read!

For more information on herbs or supplements for dogs with cancer, check out The Dog Cancer Survival Guide.

Best to all,

Dr D

The fact is that in most cases these claims have not been established to the point where a “true” statement can be made.  I  put “true” in quotes because truth can be quite subjective, depending on the viewpoint of the believing person.

My version of something that is “true”  is:  a reliable correspondence in experience shared among the majority of people.   This means statements that are “true” can be relied upon most of the time to be the common experience we all share.

The problem with a statement that is true to one but untrue to many is that it can lead to false hopes.

In the world of cancer medicine this is a dangerous thing, since treatment choices often land in the gray zone of ethics and personal opinions.  False hopes lead to disappointments, failures, and errors.

As if that were not enough, false hopes are used to manipulate and prey upon those in emotional distress.  This is a common approach of the charlatan.

You are reading this blog.  Of course, you are searching for information.  This applies to you, so read on….

If your hopes are raised due to information you read or hear somewhere, it could be that the person disseminating the data honestly believes it is true.  Or at least wants to believe it is true.  This latter group can be ferreted out because they will often have a high degree of emotional charge when discussing the topic.

Emotional charge is different from compassion and empathy.  Someone feeling compassion or empathy will make you feel like they are focusing on you.  However, emotional charge in someone speaking to you demands an attention monopoly. It can be “positive” (fanaticism) or it can be “negative” (cynic).

So, what is the point here?  This is a blog about dog cancer, not about psychology.  The reason I am bringing this up is to help empower you in being your dog’s primary health care advocate.  As the person driving the ship, your job is to ferret out the data to help your dog’s well-being.  The first step is gauging it’s validity.

Identifying whether someone in front of you, on line, in publications, radio, TV or whatever, has a compassionate/empathetic viewpoint or a cynical/fanatical viewpoint can be priceless.

Being able to spot a fanatic or a cynic helps you sort the information you are receiving into “useful” or “questionable” groups.  These individuals provide information that is “questionable”. If you feel like you’ve gotten information that is “questionable”, get more data to substantiate or discount it before making it “useful” and acting on it.

Getting more data means more due diligence: second opinions, other sources of information, references, publications, analysis, and so on.

Being able to identify the fanatic or the cynic is very useful. This was one of the techniques I used in sifting through miles of cancer claims to produce the Dog Cancer Survival Guide.

Hope you use it to your loved dog’s benefit!

Best to all,

Dr D

When I say big gun, I mean that there are side effects and issues that you need to be aware of.  And some of you may have not heard this yet.  Since a goal of this blog and the Dog Cancer Survival Guide is to give you important information that you may have not yet heard, let’s look at Palladia.

When you give your dog Palladia, you should wash your hands with soap and water after handling.  Better yet, wear gloves.  This is because a small amount of Palladia could end up inside your body if you handle the medication with bear hands.  Like many chemotherapy drugs, toxicities are possible, and there is no reason to be exposed to these materials if you are not undergoing treatment yourself.

The drug insert suggest that you keep the bottle away from children.  Also remember to keep the bottle away from any other medication.  Sometimes medications can be confused by us grown-ups too, and drugs like these need to be kept in their own secure location.

If you are pregnant, I would not even handle Palladia due to the possible effects on developing babies.  The insert says that birth defects are possible if Palladia were taken during pregnancy.

Remember to never break or crush the tablets.  This is because the drug will aerosolize (become an airborne powder) and may be inhaled.

According to the manufacturer, the “waste” products of a dog taking Palladia should be put in a sealed plastic bag for disposal.  Gloves should be worn. This is fairly strait forward for feces, but I would assume urine is a waste as well.  Thus, I would consider active urinary metabolites of the drug to be possible.  Same with vomited material.

For vomit, bag it wearing gloves.  Urine would be tougher to collect in a bag, and skin contamination is a risk.  Thus I advise irrigating the urinated area well with water.  This implies that dogs on Palladia living in  homes with other dogs should be walked outside, separate from the others, for elimination of waste.  It would be considerate for others in the neighborhood for you to carry a jug of water to irrigate the appropriate areas, in addition to your ziplocks.

Whenever you embark on a treatment for dog cancer, be your dog’s number one health care advocate.  Get the full picture, weigh your options, and create an action plan.

All my best,

Dr D