When Pet families come in for a consultation with me after receiving a cancer diagnosis, they often ask Doc, what would you do if this was your dog?
I usually refuse to answer the question (with one important exception, which I will get to in a moment).
There are too many personal factors that go into the decision of what to do. In addition to the overall prognosis for that particular cancer, there could be other pre-existing conditions. It can become very complicated, and so much just depends upon the person who is asking.
Some Guardians want to be aggressive and take the treatment approach associated with longer survival times, even if it costs more, requires more visits to the oncologist, and has more side effects. Others dont. For example, when I tell some Guardians the median survival time for their dogs cancer is 18 months with treatment, they dont feel that is long enough while others will tell me that getting an extra three months is more than they hoped for.
What I would do for my dog likely not what you would do for your dog. I used to say I would have given Paige, my Labrador, a kidney if she needed it and it was medically an option. (She is no longer with me, but she did not need my kidney. And no, you cannot transplant your human kidney to your dog.)
I am pretty aggressive with medical options for my own pets. I am not afraid of some side effects from diagnostics and treatment when the side effect of not treating is worse (in my opinion). I am more likely to go for surgery, radiation, and/or chemotherapy for my dog than choose a palliative approach such as pain management only. But that is a pretty generalized statement. And again, my choice may not be the choice of the Guardian sitting across from me in the exam room with their dog by their side. So, in order to keep from projecting my personal feelings onto Guardians, I usually just refuse to answer that question.
Except when it comes to lymphoma. When it comes to lymphoma, I will share what I would do. For me, this is an easy choice: I would treat my dog with a CHOP multi-agent protocol.
This protocol is a cyclic protocol usually lasting 5 to 6 months. In each cycle, the protocol includes vincristine, cyclophosphamide, and Adriamycin (doxorubicin). In the 1st cycle (usually the 1st treatment), the dog may receive Elspar. Prednisone, a steroid, is also given orally daily for the 1st 4 weeks during the 1st 4 week cycle.
Why is it so easy for me to answer this question about treating canine lymphoma? For dogs with lymphoma, chemotherapy has such a significant and positive effect on not only how long a dog lives but how well they live. Typically, a dog lives only 1 month without treatment, and the median survival time with a multi-agent chemotherapy protocol is 13 to 14 months. And dogs tolerate treatment so well that their life is considered good to great by most Guardians in my practice during the protocol and after the protocol when they are in remission. Dogs with lymphoma treated with chemotherapy live longer and live well. So, yes I would treat my own dog for lymphoma with chemotherapy. No question for me.
Dr. Susan Ettinger, DVM,Dip. ACVIM
2. The Biggest Mistake Pet Owners Make-End of Life
If I had a big huge red pen and could permanently strike five words from the Standard Veterinary Dialogue, it would be this:
"You'll know when it's time."
The only problem is, this doesn't always happen