Dealing with canine cancer / Tratando con el cáncer canino

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Isabel Herrán

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By Jennifer Lord / Daily News Staff

Eleven years seems too short for a lifetime.

I had taken Riker, our obedience school-dropout Labrador retriever, to the veterinarian for what I thought was a simple medication adjustment. He had suddenly stopped eating, not that he displayed any symptoms of that when our veterinarian at VCA Northborough, Dr. Kathleen Scandora, started checking him out -- other dogs might be afraid of the vet, but for Riker, Dr. Scandora's the "cookie lady."

Dr. Scandora checked his eyes and gums, talked about possible liver problems associated with his epilepsy drugs as she worked her way down his body. Then her hands touched the area of floppy skin around his neck.

"Oh Riker," she said. "I don't like the feeling of this."

You're never prepared to hear the word "cancer" coming from a doctor. You especially don't expect it when it comes to the furriest member of your family, the one who isn't able to tell you just exactly when he started feeling sick.

But 50 percent of dogs who live past the age of 10 will be diagnosed with cancer. It could be a skin tumor, mammary (breast) cancer or lymphoma, but when it hits, pet owners find themselves facing decisions that need to be made quickly.

"Like with people, dogs and cats are living longer because of the care we give them," said Kim Cronin, a veterinary oncologist at New England Veterinary Oncology Group (NEVOG) in Waltham. "They are now living to the age when they can contract cancer."

A decade ago, the field of veterinary oncology was almost unheard of outside a few specialists at veterinary schools. If cancer was diagnosed at all, the discussion turned to end of life issues, not chemotherapy, radiation and surgical options.

But pet owners today are better educated, consider their pets members of their families and see no reason to deny their pets the options available to humans. If they can extend their lives by a year, even three, many pet owners consider the outcome worth the investment.

Laurie Kaplan, author of the recently released "Help Your Dog Fight Cancer: An Overview of Home Care Options," found herself in unfamiliar territory when her beloved Siberian husky, Bullet, was diagnosed with lymphoma. As a longtime animal writer and editor of Tufts University School of Veterinary Medicine's Catnip magazine, Kaplan was prepared to ask the right questions -- and do research well beyond what her veterinarian could tell her.

"Bullet was only 9 years old when he was diagnosed," Kaplan said. "If we had been dealing with an older dog, a dog with health problems...maybe I wouldn't have chosen chemotherapy. But that was my choice. It's impossible to say what's best for someone else. It's your dog: you know what's right."

Bullet went into remission by his second round of chemotherapy. In her book, Kaplan talks about the difficulty of convincing a dog to eat, of medication side effects and the importance of nutritional supplements.

There's a catch in her voice, also, when she talks about the joy of seeing Bullet outlive his diagnosis. Without chemotherapy, the average dog with lymphoma dies within a month of diagnosis. With chemotherapy, 50 percent survive another year and 25 percent survive two years or more.

Bullet outlived his diagnosis by four years and four months, when he died of kidney failure.

"It's always something," Kaplan said. "You kind of forget that. I was told that Bullet was cured, as much as he could be, and I had this feeling he was going to live forever. But no animal lives forever."


When my husband, Steve, and I decided to give each other a puppy shortly after our wedding, we weren't thinking about end-of-life decisions. We were just looking for a "practice child." We joked that if the dog turned out well, we'd consider ourselves ready to take on children.

Riker was the last puppy left of a purebred litter. The breeder opened the gate and a clumsy yellow puppy trotted out, tail wagging, full of affection. It was love at first sight, especially when he attempted to scratch his ear and completely missed.

Being first-time puppy parents, we proceeded to do everything wrong. Steve let the puppy sleep on the bed, reasoning "when he gets big, there won't be any room for him and he'll sleep on the floor." I spent the next 11 years fighting the dog for the covers. Dog hair covered our couches. And our kitchen table will forever bear the marks of Riker's teething stage.

One day, I came home from work to hear a strange wooshing sound and a puppy cowering in a far corner of the kitchen. It took me a couple minutes to find the chewed-off outlet to the ancient whole-house vacuum, called back to life by Riker's eternal curiosity.

He stole our socks, mooched our food. I once left a wedding shower gift on the table and came home to find wrapping paper everywhere and a dog chewing on a Henckel knife. We gained the upper hand by adding a dog crate to our kitchen, but lost it when we were unable to get through obedience school classes without a lot of...disobedience.

Just before I gave birth to our first human child, we had to deal with a crisis involving our canine one: Riker blew out a his anterior cruciate ligament and required surgery. He came through with flying colors, although the surgeon warned us that as he'd get older, arthritis would center itself around that leg.

Older? Riker wasn't going to get old.


Cronin opened her veterinary oncology practice four years ago. She knew there was a need, but was surprised to see how quickly her client base grew.

"We see probably over 1,000 new cases a year, about 20 to 30 new cases on a weekly basis, and there's about a two-week wait to get an appointment," Cronin said. "I have to say, the demand is there. People's attitudes used to be 'why go any further?' But those attitudes are changing. There are more vets who are willing to refer, more people who are willing to take the next step."

In New England, NEVOG, Tufts University and Angell Memorial Hospital are the places to go for veterinary oncology care. Cronin sees clients from as far away as Maine and New York, as well as one relocated client who periodically drives up from Virginia.

While dogs get cancer at the same rate as humans, there are some breeds that appear more prone than others.

"Some days you look in our waiting room and there are five or six golden retrievers," Cronin said. "That could be because goldens are a very popular breed, but they've also been bred for certain attributes. You don't know if that breeding also increased the risk for cancer."

Some cancers are preventable. There is a link between canine obesity and bladder cancer, breast cancer risks can be eliminated by early spaying and neutered dogs are no longer at risk for testicular cancer.

"(Breast) cancer is the second most common canine cancer, and it would go way down if people would just spay and neuter," Kaplan said.

There are also studies linking the use of certain types of lawn chemicals with lymphoma in dogs. A 2003 study by the Purdue University School of Veterinary Medicine found dogs who had been exposed to lawns and gardens treated with both herbicides and insecticides or herbicides alone to be at a significantly higher risk for some cancers.

"I personally believe that lawn chemicals are a huge factor in dog cancer," Kaplan said. "You wouldn't put your face next to the lawn after it has been treated -- and your dog walks on that lawn and licks its feet. Even if you don't treat your lawn, you don't know what your neighbor is doing. Or what he'll be walking on during a walk."

A few pet insurance plans cover the cost of cancer treatments, but the bulk of Cronin's clients end up paying out-of-pocket. Chemotherapy can run from $150 per treatment to $6,000 to $8,000 per treatment depending on the drugs required. A full course of lymphoma treatments can cost $4,000 for six months and radiation might run $4,500.

"If you look at what we do, we have the same equipment, the same medication as human cancer," Cronin said. "A lot of our clients look at it at as something that is just not a luxury. This is just something they feel they have to do. They don't go on vacation, they spend the money on their pets."

Kaplan has never felt the need to justify spending so much time and money on "just a dog."

"We are so totally responsible for our dogs," she said. "They're like children, but they're not going to grow up and go to college. We're responsible for every day of their lives, and (they) give it all back to us. I got to have four more years with Bullet. I wouldn't have missed that for anything."


Riker's life ended on May 4, just a few weeks after he was diagnosed with lymphoma.

We opted against chemotherapy. There are some things you just can't ask of an 11-year-old dog with epilepsy and arthritis in his hind legs. We put him on prednisone, a steroid, and for awhile the lymph nodes shrunk and his appetite returned.

Steve carried him up the stairs at night. He was unable to find a comfortable sleeping position and would breathe heavily and snore as the lymph nodes impeded his breathing. But there finally came a day when we knew he had had enough.

We made one last trip to the vet, to the same treatment room where I first heard his diagnosis. They spread a blanket on the floor and gave us some time to say goodbye.

We had been saying goodbye to him for weeks. It still didn't seem long enough.

Riker quivered his tail at the technician who gave him his last shot. He took a few deep breaths, then laid his head down and was still.


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