It seems that periodically we endure a particular difficult period at the Brockton Animal Hospital. It may be because of the demise of several older pets that we have cared for many years. Or it can occur upon the passing of a long term client. But the most common cause of “clinic sadness” is when an overwhelming stream of similar difficult diagnoses emerge, such as cancer. With that in mind, and recently witnessing just such a stream in our hospital, I thought it appropriate to repeat a post from two years ago. For those who may be facing some difficult decisions, I hope you will find it of some value. For others it may shed some light on just how difficult pet ownership can become.
In the unfortunate circumstance that a lump that has been removed from your pet is diagnosed as cancerous, what next? That is dependent on several facts. First, and probably most important, were the margins on the biopsy clean? In other words does it look like your vet “got it all”. Of course, we can never be sure if there are small or even microscopic tumors lurking in the body. For many malignant growths, if the margins are clean and the grade of the growth is not particularly aggressive this may constitute a cure. If this is the case in your dog or cat it is important to remain vigilant in constantly checking for other lumps and bumps on your pet at the site of previous surgery as well as all over the body.
If, however, it appears that there were cancerous cells at the margin of the surgery then the situation is more complicated. Sometimes a repeat surgery will be recommended in an attempt to remove remaining cancerous cells. If the growth is considerably invasive additional therapy may be needed in order to treat the illness. Surgery alone often is not enough to effect a cure or even a remission. In this case it is a good idea to seek out the opinion of a veterinary oncologist. There are many options available ranging from radiation therapy, chemotherapy as well as alternative and nutritional treatments. In some instances therapy is directed toward cure but in others the intent is to allow your pet to maintain a comfortable and meaningful life for as long as possible. This is referred to as palliative care. In this circumstance, there may be difficult decisions to be made and it is imperative that the family considers many factors.
While some pet owners desire to do “whatever it takes” to maximize the time left with a pet, others will take a more pragmatic approach and weigh in more heavily on the specific aspect of what they define as quality of life. These decisions are personal ones and it is incumbent to consider the emotions of all the family members. In addition to recommendations of the oncologist take some time to have an honest discussion with your local vet. If the relationship with your vet is a close one he or she may be able to add perspective with the additional knowledge of your family and/or your pet’s history. These decisions can be the most difficult ones to make in the life of a beloved pet. Try to approach these issues early in the course of the disease to prevent making irrational or emotional decisions under extreme duress.
For many of us our pets are a huge part of our lives. Having lost a canine friend to cancer almost two years ago I marvel at how much I enjoyed his last three months. I often refer to them as some of the sweetest days of his life. The approach after diagnosis was to gather as much information as possible, consult with oncologists, surgeons and veterinary friends and to engage in open and frank discussions with all family members. We chose palliative chemotherapy, Low Level Laser Therapy and nutritional support. I still smile when I think of him and especially when I consider that from the day of his surgery until the very last day of his life he never missed a meal or a walk that we all so cherished.