Dog Focus Features

A Question Of Time - By Emily Tanner

A Question Of Time - By Emily Tanner

A Question of Time
by Emily Tanner

Is Chemo the right Choice for you and your Dog?
Firstly, if you are reading this with a view to trying to decide if you should embark on the chemotherapy journey with your dog then I am sorry that you are even in this position. Finding out your precious friend needs this level of treatment to survive is a truly upsetting and daunting prospect BUT it can be highly effective and, if administered correctly and sympathetically, doesn’t come with nearly the level of side effects experienced in humans.

Our story starts back in the summer of 2021. My dear Italian Spinone Pebbles, who was 7 at the time, was really struggling with the heat, more so than her older brother and much younger niece. She declined very rapidly and upon a quick dash to the vet we found she had fluid on her lungs and because of this a simple scan was impossible to see what was going on. I had lost my first Spinone very suddenly at exactly the same age to cancer and so was prepared for the worst but as a result of that I immediately opted for referral to a specialist and a full CT scan.
Pebbles was seen the next day and unfortunately it was discovered that she had a huge, incredibly aggressive T-Cell Lymphoma Tumour in her chest cavity (hence her difficulty breathing).
From first symptoms to CT scan was 5 days so I cannot stress to you how quickly these things can progress. Now Pebbles situation was pretty much worse case scenario, the tumour was inoperable and due to its aggressive nature, it was very well advanced, however, and this is the bit that shocked me, sometimes those types of cancer respond the most successfully to chemo.

My choice to start chemo with Pebbles was actually not a choice at all, without it she would have perhaps lasted a few days due to the rapid growth of the tumour on her windpipe and lungs. As with any treatment there are always risks but with our beloved pets there are also many choices to make and it’s our job and duty to make the right choice for our dog and also ourselves as owners.
There are many many different treatment options out there depending on diagnosis, dog temperament, budget and circumstance so there really is no one size fits all but what I’m going to tell you about is the LOPP Regime, known as the Gold Standard of Chemo treatments for Lymphoma in dogs. It is a 24-week protocol consisting of 2 different drugs, with 2 weeks on and 1 week off, it is a huge commitment and not for the faint hearted at all. With this in mind there are a few questions to ask yourself and these should all be discussed with your specialist before embarking on any course of chemo treatment.

Firstly, how will your dog cope with the treatment and the multiple invasive trips to the vets?
The first thing my vet said to me when considering chemo as an option was that Pebbles was an “Ideal Candidate” for it. An ideal candidate for chemo is basically a dog that is not fearful of new places or people, can be examined without stress or aggression, loves outings and trips in the car and is happy to have many pills wrapped in ham!!! If the treatment is going to cause more stress than the benefits it’s going to give your dog then, in my mind, it should not be pursued and there are many other rescue regimes and drugs that can be given to keep you dogs stable for as long as possible depending on the diagnosis.
Any side effects are generally minimal compared to humans and short lived, the most common are sickness, diarrhoea, lethargy and loss of appetite. Pebbles did not lose any fur but long-term steroid use can cause hair thinning and some skin sores. Be prepared for the fact that the quality of their coat and ability to be groomed as normal may change. Every dog is different and will respond in different ways, taking note of their symptoms and general behaviour will really help when you discuss with your dog’s oncologist vet about how the treatment is going so they can adjust the dosage accordingly. At the beginning this can all seem very over whelming along with everything else that you must remember so I kept a note in my diary of the key essentials that you will probably be asked at every vet visit – ask yourself is he/she peeing, pooing, eating drinking, walking, relaxed and happy?

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Can I afford the treatment?
It is horrible reality to have to consider, “Can I afford to keep my dog alive”? But it is a reality and something you should think carefully about. Chemotherapy on the scale that Pebbles had, was and is incredibly expensive – the basic LOPP Regime for 24 weeks without encountering any other complications, hospital stays, or additional medication is in the region of £12,000. Insurance may cover all or part of it, but a lot of owners are either not insured or do not have cover to that extent. We were incredibly fortunate that I had not only chosen to keep Pebbles insured that year (I was questioning cancelling it due to the fact she had never been ill!!!) but I had also changed insurers which gave her a lot more cover. Pebbles total cost of treatment over the course of the 2 in half years she fought Lymphoma was some £28,558.00……of which our insurance company kindly settled £21, 945.
In short, I will never even question dog insurance again (something that I could write a whole separate article on!). Other considerations/hidden costs include petrol costs (traveling long distances every week to your specialist oncologist can mount up), potential loss of earnings due to attending numerous vet appointments and caring for your dog and additional food costs if you have to change their diet/cook more appealing food to get them to maintain weight. I am very fortunate to work for myself and have a flexible working pattern which meant I could work from the vets reception area and juggle Pebbles appointments to suit her.

Have I got the time and mental capacity to cope with what’s to come?
I’m not going to lie, when you first embark on a treatment plan akin to the LOPP regime it is overwhelming, daunting, and exhausting. If you are pregnant, immune suppressed in any way or you are undergoing cancer treatment yourself, then going down this road should be considered very carefully as dogs’ urine, faeces and saliva are toxic for a certain period after each treatment. The level of risk is minimal but still something to consider if you have small children or other dogs that are prone to “clearing up” after their house mates.
Your diary will suddenly get taken over by specialist/vet visits, who are potentially quite a distance from you at least once a week, juggling work, kids, home life, pill schedules, diet, additional care and the worry and stress of side effects and treatment plans can take its toll. The feeling of constantly having to monitor you ill dogs behaviour can be exhausting, I am a worrier and was literally desperate to do anything to help Pebbles stay with me longer.

You may be thinking at this point – why on earth would I put myself and my dog through this ?
Well, on the flip side of everything that I have just written, what you get in return is phenomenally rewarding.
In every 3 week cycle Pebbles had probably just 2 days where she felt off colour due to the chemo itself, which would simply mean she needed a quiet day, a smaller slower walk and her appetite would reduce. 2 days out of 21 is not a bad ratio, the rest of the time you honestly would not know that there was anything wrong with her.
In terms of side effects, the most came from the steroid dosage she had to be on for the length of the regime. Too high a dose and she would become slightly incontinent, too low a dose and the chemo wouldn’t be given the best chance of success. It’s all a massive balancing act and a good oncology vet will work with you on managing the symptoms v quality of life.

At the end of the day this particular cancer, we knew, was not curable, Pebbles treatment was about giving her longer with us, but at the same time being as well as possible. I remember asking my vet how much exercise I should be giving Pebbles at the start of her treatment, and she simply said, “As much as Pebbles wants” – and that was the first sign to me that we were very much in Pebbles hands/paws, she would be our guide on how much she could cope with, what she wanted to do and when.

Chemotherapy gave us an additional 2 in a half years with our girl. Something I will be eternally grateful for. She taught me more than anybody else ever could about how important it is to live in the moment and how to embrace every single day like it is your last. Many dogs don’t need the level of treatment that Pebbles had, so my advice would be to give it a try. You can stop at any point, but just give it a shot as you never know what may happen. Pebbles was given a year max to live IF she responded well to treatment – she surpassed all our wildest dreams and gave us far longer.


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