Our nearly-8 year old BMD, Mick, has just finished a course of 7
chemotherapy treatments. He has done very well, and you should advise your
friend NOT to withold chemo. therapy only because of the potential side
effects.
There are lots of other considerations. Remember that chemo. for
doggies is not meant to "cure", it is meant to prolong good quality of life
by inhibiting tumour growth and minimizing tumour symptoms. For this,
there is the price of "side effects". This "price" is much "higher" in
people, since the aim is cure. Much higher doses of drugs are used,
stronger drugs are used, and the sometimes dramatic side effects are
treated very aggressively. Many of these side effects (eg.: end-organ
failure such as anemia, kidney problems, liver dysfunction, etc.) cannot be
treated as well in dogs. So doses are lower... .
The delivery method of a "chemotherapy" drug is important; for
CNS/brain tumours, chemo. in humans is sometimes delivered directly to the
brain through the cerebro-spinal fluid. This reduces some of the systemic
side effects. You should know however that chemotherapy, by any route, for
brain tumours is not very effective, at least in humans. Radiation therapy
is often the choice -- has your friend been given this option? It should
be explored.
If the tumour was "benign", what is the reason for chemotherapy? Was
all of the tumour removed? Sometimes tumours that are pathologically
benign can be "malignant", that is cause severe illness and death, if they
grow or recur in a delicate and important location within the brain.
Radiation can also be used as a prophylactic therapy; again, chemotherapy
is not so good for this in people. The next question is the drug, or
drugs, chosen. The common side effects are related to the GI system
(nausea, vomiting, diarrhea), the hematologic system (anemia), and the
immune system (risk of infections). Chemotherapy can cause damage to
specific organs (heart, kidneys, liver) but usually in higher doses.
Sometimes there are specific allergic-type reactions as well. And doggies
can be just plain fatigued by these drugs.
Dogs do not loose their hair with chemo., in the doses given.
Whiskers can fall out, and hair that has already been shaved may not grow
back full for a long time.
Any nausea and/or vomiting that occurs is usually of a short duration.
Be aware that drugs to control nausea make BMD's very groggy and woozy --
more so than other breeds. We found this out the hard way and it was very
upsetting to us until we realized what was going on. Diarrhea and anorexia
can occur too, but again was tolerable for us, and Mick! In between
therapies, feed your doggie! Build up some weight, and strength. In this
"acute" situation, stick with familiar, basic food. And remember that if
your doggie likes certain foods or treats that might not be as nutritious
as others, or that might contain some preservatives or such... well, we
decided to give Mick what he liked and wanted, and not what we thought was
best. He really enjoyed this, and we were buoyed by his reaction. And if
you should face a remission and the hope of longer term survival, you can
go back to theoretically health diets. Homeopathic and naturopathic
products can be helpful -- probiotics for the effects of antibiotics and
chemo. on the gut, etc. You won't cure or induce remission with these, but
they can be useful adjuncts. Keep an open mind, but if you are going to
treat cancer, use the most powerful agents available as well.
After anywhere from 7 to 14 days, blood counts can be reduced. With
the low doses given to doggies, this does not usually produce significant
anemia, but it does contribute to some lethargy. And effects build-up over
six or seven courses. Transfusion of blood is possible, but I am not aware
of any specific therapy in dogs to increase the hemoglobin concentration --
similar to (human) erthropoietin.
Of the chemo. drugs, steroids like Prednisone or Dexamethasone
(Decadron) can actually make your dog feel better. It promotes the
appetite (as well as urination!) and seems to induce a little feeling of
"well-being", especially when other symptoms are not bad. With brain
tumours, steroids are given routinely to reduce swelling of the brain, and
your friend's dog should be taking this medication. If not, ask why! In
addition, headaches, especially after surgery, are common with people; the
doggie should be on some kind of regular analgesic (anti-pain) medicine.
In the face of uncertainty, I would suggest that you go ahead with
one treatment, and see how it is tolerated. Your vet. should be able to
help you judge whether the side effects, if any, are worse than the
symptoms of the disease or the prospect of a recurrence. If a specific
symptom (like uncoordination, or weakness) can be improved with chemo. --
go for it!
Just to let you know, I am a physician and I work at the Montreal
Neurological Hospital/Institute, so in addition to my experience with Mick,
I have some knowledge of the CNS and brain tumours -- in people though,
almost exclusively.
My heart goes out to your friend, whose companion and friend suffers
from this serious condition. I hope my advice helps, and feel free to
contact me if you would like more information. And no matter what, give
that doggie some hugs and rubs and scratches from myself, Mick, and my own
companion Helen.
Fred. Salevsky
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