When the diagnosis of cancer came, it was devastating, something no one ever wants to hear.
I’d discussed treatment options and outcomes with the vet when we went in for the tests, so when the news came I had no hesitation in going with chemo, and in fact we started the protocol two days later.
I know some people say they would never put their dog through chemo, that may be an informed decision or it may be a knee-jerk reaction, I don’t know. Chemo for dogs is different, the doses are much lower and generally the side effects much less severe than for humans. The reason for this is that with dogs they’re not seeking to ‘cure’ but to put the cancer in remission. It’s about giving extra time, and it is expected that the cancer will return. Hopefully later. Much, much later.
The agreement with our vet was that if the side effects were too strong then the treatment would be discontinued. Just because you start the protocol doesn’t mean you have to continue, so with that in mind, there was really nothing to lose.
We were also ‘lucky’ because lymphoma, while highly aggressive if left untreated, also responds very well to chemo. In our case we caught it early, and so Willow has been in remission since her first treatment. And on Friday just gone (yesterday as I write this) she had her final treatment. Not that the war is won, the battle now is to keep her in remission for as long as we possibly can.
I want to share our experiences to try to help others going through the same thing. Before I start though, if you’re wondering would I do it again knowing what I know now. Yes.
What was chemo like?
Even though her side effects were comparatively mild, it has certainly been no picnic for her or us. It’s never easy when your fur-baby is unwell. The protocol she was on is called the CHOP protocol; it goes for six months and involves three different chemotherapy drugs plus prednisone (cortisone). Two of the drugs are administered intravenously, and the other is a tablet.
One of the first side effects was turning up her nose at food she used to enjoy. She was obviously hungry but didn’t want to eat what we were giving her. This is probably similar to what a lot of humans experience, where food either tastes like nothing or gets a metallic taste (or both). The answer to this is to have a variety of different things, and offer small portions to see what will take her fancy. Of course something she will eat one day, she might turn her nose up at the next, but happily eat again the following day. So the answer for us has been variety and a small taste first, just to see if she’ll eat it. Then feed more. We have also found while she might not be hungry in the morning, at dinner she’ll sometimes eat a full meal and then be snuffling around for more, so seconds, thirds or fourths are always given when she wants them – small amounts each time, we don’t want to make her sick!
Often when animals are feeling unwell and not interested in food, the recommendation is to warm it with the idea that a stronger smell will make it more appealing. This can have the opposite effect for an animal on chemo if their taste has been affected. I’m not sure warm cardboard or metal is any more appealing. The answer here can be to try the opposite, chill the food instead.
An upset tummy and nausea have also been on the list, usually the day after, or a couple of days after a treatment. Sometimes it’s just a complete disinterest in food, but there has also some vomiting, though it’s never lasted for more than twenty-four hours. It’s a distinctly different reaction to being hungry but not liking what’s on offer. When your dog actually turns their head away from the bowl, or is licking their lips, perhaps drooling a little, just leave it.
Do not pursue them with food, the last thing you want to do is create food aversion by forcing food on someone who just doesn’t want it.
Skipping a meal or two isn’t going to hurt. Offer little bits of food every few hours if you can, but take it away as soon as they show no interest.
Also get some anti-nausea medication from your vet to keep on hand for when you need it. Your dog still may not want to eat right away, but they’ll be more comfortable.
One indication of nausea Willow displays is pacing. When her tummy is upset and she can’t get comfortable she’ll pace around the house and try to get in behind furniture. She also paces when she’s too hot, but that is different – she isn’t trying to find somewhere to hide.
This brings me to the next side effect – hot flashes. Not only does she seem to feel the heat more in general, but at times she has hot flashes, where we can touch her and feel how much hotter she is. When this happens I wet her down and get her to lie in front of a fan or air conditioner then usually in a few minutes she’ll settle down. This is much easier if you’re lucky enough to have a dog that likes water. Willow absolutely, positively does not like getting wet but she will tolerate it when she is really hot. Generally it has meant keeping the house cooler than we normally would. Cooling mats have also been really useful, so I’d encourage you to get one or two for your dog to use.
Sterile hemorrhagic cystitis
The worst side effect was from the cyclophosphamide (which is a tablet) and that was sterile hemorrhagic cystitis. She was not only weeing and straining a lot, but you could actually see the blood. Our vet hadn’t come across this one before, but the oncologist told him it’s quite common, especially if the tablets are given in one dose, which they were. The preferred method is to spread the dose out over several days to reduce the chances of this happening. It’s not commonly talked about, but a lot of humans suffer from recurring cystitis during chemo. Sterile cystitis means it’s not caused by bacteria so antibiotics are of no use. The treatment is anti-inflammatories, and it also means changing to a different drug.
Willow already had arthritis, and I was feeding her turmeric (golden paste), which really seemed to help with her mobility. However turmeric can interfere with some chemo drugs and some of hers were on the list, so we had to stop giving it to her. Her stiffness and mobility were impacted fairly quickly so I tried other arthritis supplements, but nothing really helped that much, and as time has gone on her mobility has declined. She can still get around OK, but has trouble with stairs and drags her back legs a bit when walking (some days are worse than others). Joint pain is a known side effect in humans, and we’ve got her on arthritis meds from the vet for now, but we are hoping that things will start to improve as the side effects wear off, and we can start giving her turmeric again.
The final side effect she’s experienced has been having less energy. She’ll often be pretty quiet for a day or two after a treatment, but in general she runs out of steam more quickly. She’s still just as enthusiastic to get out and about, but tires more quickly. So the rule of thumb here is less exercise – shorter walks, briefer games etc. Take your cues from your dog on this. Of course feeling the heat more, plus it being summer haven’t helped with that either.
As I said in the beginning, she’s just had her last treatment, so once the effects from that wear off she’ll start to feel more like her normal self. I don’t know how long it’ll take, I know it can take some time.
I know reading the side effects it probably sounds pretty bad, but keep in mind they come and go. Overall I’d say she’s been just fine, her usual happy, affectionate self for most of the time, but in the last couple of months it has hit her a bit harder – a cumulative effect.
The thing I haven’t talked about is diet, what you can feed your dog to help fight cancer (if they’ll eat it) and what we plan to do to try to keep her in remission. That’s another post I think.
Hopefully, if you’re unfortunate enough to be in the same situation, this information will be of some use to you.