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Hospice and End of Life Care

Hospice and End of Life Care

One of the hardest decisions you will likely have to make is deciding when it is time to let your beloved pet go. Sometimes the choice is an easy one; your pet’s disease has progressed and they are obviously distressed. Other times it can be difficult because your pet’s symptoms wax and wane or because in some areas they are worse but others the same or even better.

Our biggest concern here at the Cancer Center is quality of life (QOL) and maintaining it as long as possible. While there are some minimums to QOL, exactly where the line is drawn is a deeply personal choice. You, as the caregiver for your pet, are the best person to evaluate how they are doing in their daily life. Keeping a record of how your pet is doing daily, will help you evaluate how they are doing in the long run. We can give recommendations based on what we see in the clinic, but ultimately it is a decision that you and your family must make. Remember, too, that your pet has been diagnosed with a terminal disease, and there is no wrong decision to make in regards to your pet so long as they are happy and comfortable.

As difficult as the thought of euthanasia and end of life care is, it is important to talk with the members of the immediate family ahead of time. Knowing what actions will be taken, when they will be taken, and who is ‘in charge’ of making those decisions, will help make that time, when it comes, go much more smoothly. Consideration should also be given to aftercare and what ways, if any, you’d like to memorialize your pet.

This section contains some information about assessing quality of life, euthanasia (what it is and options for it), and options for aftercare of your pet. Also included are some pet grief and counseling resources for those who are interested or in need of them.

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Paint Your Pet

Paint Your Pet

  • September 22, 2019
  • 12 p.m. — 5 p.m.
  • $60 per person
  • 25% of the proceeds go to Paws Against Cancer
  • At OVS, The Cancer Center

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Quality of Life

Quality of Life

Quality of Life (QOL) is how happy and ‘good’ your pet is doing on a day-to-day basis. For us at the Cancer Center, QOL is the main driving force behind what we do. From the first time we see your pet to the last, QOL is our top priority. QOL, though, is more than just the clinical side of how your pet is doing. There are several different factors that play into QOL and most of them involve how your pet is at home. The importance of each area and how it affects QOL is different for each family, and can even differ from one pet to another.

QOL should be assessed often after your pet is diagnosed with any disease. The exact frequency will vary based on your pet’s specific disease and how affected they are by it. At a minimum, QOL assessments should be made monthly or after any significant change in the status of your pet’s health. Weekly, or even daily, assessments may even be appropriate to best monitor your pet. You should do what feels most comfortable for you. If daily assessments help you feel in control of your pet’s QOL, then by all means do them, even when they are doing great. It is also important to review your pet’s previous assessments from time to time. This helps you see both their response and their progression. Some changes take time to notice and ‘normal’ for your pet can change without you realizing it.

The following is a list of questions you can ask yourself about your pet to help determine what QOL means for the both of you, what you are willing and/or able to do, what is acceptable for your pet to experience, and what is not. There will also be a list of explanations of some of the more common areas that help determine QOL. It is also important to discuss your goals and limitations with your doctor, as well as bring up any questions or concerns that you have with them. They can help guide you down this often difficult path and aid you in making educated decisions about, and for, your pet. We have created a QOL assessment table that you can use to monitor your pet. You can also take the information you get from the following pages and create your own that is tailored specifically to your pet and family.

Questions to consider

  • Is my pet experiencing pain? If so, how severe is it?
  • Can they eat, drink, urinate, and defecate normally/on their own? Am I willing or able to help them if they can’t?
  • Is my pet nauseous, vomiting, or having diarrhea/soft stools? If so, how often and how severely does it affect them?
  • Are they able to keep themselves clean and sanitary? Am I willing or able to do this for them if they can’t?
  • How is my pet doing mentally? Are they bright and alert? Are they mentally aware of their surroundings? Do they seem quieter than normal, or mentally altered? Are there any new behaviors that are concerning or hazardous to my pet or others in the household?
  • How much time can I realistically set aside to provide more intensive medical care for my pet? What am I able to provide financially for the care of my pet?
  • Do the good days outweigh the bad days? Are there more good days than bad days?
  • Is my pet able to experience or do the things they enjoy most?
  • Are there any side effects, symptoms, or medical conditions that I will not tolerate my pet experiencing?
  • Is euthanasia something I will consider for my pet? How much value is placed on the opinion of the veterinary team when it comes to recommendations about treatment versus euthanasia?

Areas to consider

  • Mobility is how well your pet can get around and how they feel when they get around.
    • Good: gets around without assistance; enjoys walks/playing; doesn’t hesitate to move around or jump up/down
    • Limited/poor: needs some help getting up, down, and/or around; can only walk or play for short periods of time; hesitates or isn’t able to jump or walk up/down stairs; has difficulties posturing to eliminate; pain can be controlled all or mostly with medications
    • None/minimum: requires assistance to get around or isn’t able to move at all; pain cannot be adequately controlled with medications
  • Nutrition includes what your pet is eating, how well they are eating, and how much of the nutrients your pet is absorbing.
    • Good: will readily eat their regular diet and eat an appropriate amount of food for their size; maintains their weight and appropriate muscle condition; missed meals, vomiting, and diarrhea are a rare occurrence (not more than a couple times a month or for more than a day or two in duration).
    • Limited/poor: will eat only some of their meal and/or needs some encouragement (verbal coaxing, hand feeding, etc.)  to eat; body and muscle condition decreases but is still acceptable; will only eat ‘special’ foods and treats; appetite waxes and wanes; missed meals, vomiting, and diarrhea occur often (only a couple times a month and lasts for only a few days at a time or sporadically for only a day or two but for at least 3 weeks out of a month).
    • None/minimum: will not eat at all; will not eat regular food but can be encouraged or coaxed to treats and ‘special’ food; body and muscle condition has decreased dramatically; missed meals, vomiting, and diarrhea occur several times a week to daily.
  • Hydration is how well your pet is able to maintain appropriate fluid levels in the body. This includes both increases and decreased in fluid intake. It is important to distinguish changes in hydration that are causes by the disease from those caused by medications.
    • Good/normal: stays adequately hydrated on their own without assistance or coaxing; urinates normally and of an appropriate volume
    • Poor/inappropriate: drinks more or less than normal; may need SQ fluids to maintain hydration or medications to remove excess fluid from the body; urination is altered based on the fluid intake
    • None/extreme: is not drinking at all or cannot stop drinking; need IV fluids or water rationing; urination is absent or very frequent
  • Attitude/Mentation is how your pet is acting and interacting with you and other members of the family. This can also include how many normal activities your pet voluntarily does.
    • Good/normal: is interactive, bright, and responsive to you and other members of the family; readily participates or wants to participate in normal family activities; seems happy and appears to be enjoying life.
    • Limited/poor: will interact some with family; might not interact as often or be as enthusiastic; may seem to ‘dragging’ or quieter than normal; will do some normal activities but not others; is responsive but might take more effort to get a reaction
    • None/minimum: will not interact at all or very little, even after a lot of effort; hides or runs away from interactions; will not participate or must be forced to do normal activities; is very quiet, minimally responsive, or not conscious at all.
  • Unique traits and favorite things can help you to monitor just how ‘happy’ your pet is. What falls into this category is different for each pet but include any activity, habit, or hobbies that your pet does.
    • Good/normal: participates in activities and acts normally
    • Limited/poor: desire to participate can vary or be limited; traits or habits may be decreased; may want to do it but can’t or won’t actually participate.
    • None/minimum: will not participate in most or any activities/hobbies; show no interest in activities/hobbies; traits are decreased or absent

Quality of Life Assessment Tool

This table can be used to track your pet’s quality of life.

Answer the questions as best you can by choosing the answer that fits best since the last assessment was taken. If this is the first assessment or an assessment after a significant change in health, choose the answers that best fit the symptoms your pet is currently having. 

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Euthanasia and Aftercare

Euthanasia and Aftercare

Euthanasia is the intentional ending of a life to stop overwhelming pain and suffering. Understandably, the decision on whether or not to euthanize is a deeply personal one. While we would all hope that our pets would pass quickly and quietly in their sleep, sometimes steps must be taken to end it sooner in order to spare them unnecessary pain and suffering.

In veterinary medicine, euthanasia is accomplished by the administration of an anesthetic overdose. By using anesthetics, we can ensure that your pet passes with a minimal amount of distress. The nature of anesthetics means that long before the body systems stop functioning, your pet has reached a state of unconsciousness. While the body may still react to outside stimulus or perform involuntary actions, your pet will not be mentally aware, in pain, or distressed by these actions.

Once the decision to euthanize has been made, the next decision is whether you would like to be present with your pet for the procedure or not. There is no wrong choice when it comes to this since it a very personal decision. You may also need to decide if there are other people or pets that you would like present for the procedure. Most veterinary clinics are able to perform euthanasias. If you would like your regular vet to perform this service for you and family, please contact them with any questions you have about how they perform the procedure and to get you scheduled. You may also want to have this done at either your own home or at our office. On the next page, you will find a list of a few mobile veterinarians. Below is some general information about euthanasia at the Cancer Center.

Here at the Cancer Center, if you decide to be present, an IV catheter will be placed to help ensure that procedure happens quickly and smoothly. The doctor will go over the procedure prior to beginning and will wait until you are ready before proceeding. Once the procedure is complete, the doctor will verify that your pet’s heart has stopped beating. You can spend as much time as you need with your pet, both before and after. There is no rush.

If you decide not to be present, your pet will still be surrounded by love. An IV catheter will be placed and one or more staff members will sit with your pet as the doctor performs the procedure. Your pet will be offered words of love and signs of affection, as if they were our own, to ensure that their last moments are as happy as we can make them.

Aftercare is what is done with your pet’s body after death or euthanasia. The options are the same as they are for people: cremation or burial. With cremation, you have the option of an individual cremation in which your pet’s ashes are returned to you, or a communal cremation in which your pet’s ashes are not returned to you but instead scattered after cremation. Burial can either be accomplished at home (depending on the laws where you live) or at a pet cemetery. Depending on your wishes, we are more than willing to help facilitate the aftercare that you would like for your pet.

In-home Hospice Care and Euthanasia

The following is a list of veterinarians that perform house calls. In the event that your regular vet is unable to make house calls, the following providers can perform a variety of services, from general wellness care to hospice and euthanasia. Each provider is different in what they offer and the area that they are able to cover. Please contact them or refer to their websites for the specifics of what they are able to provide to you and your pet.

Olympia and South Puget Sound Area

Peaceful Transitions Veterinary Services, Dr Blair Burggren

(360) 791-5500


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Pet Loss, Grief, and Support

Pet Loss, Grief, and Support

The grief associated with the loss of a pet is a very real and powerful thing. Just as with the loss of a person, everyone will handle and move through the stage of grief after the loss of a pet at a different rate. There is nothing ‘wrong’ about being sad, angry, or distraught after losing a pet. There is also nothing ‘wrong’ if you are able to ‘move on’ quickly after. The experience of grief is unique to each individual and each death that an individual experiences.

Hopefully, you will have a network of love and support to aid you through the loss of your pet. These people can be family, friends, and sometimes even strangers who have been through a similar experience. Regardless of your support network, you may also want or need additional support. This can be in the form of Pet Loss Groups or in ways to memorialize the life of your pet. Below we have compiled some resources that may be of use to you. This is by no means an inclusive list, but can serve as a starting point for your journey towards healing.

Also important to note is that if you need additional professional assistance to help you through the loss of a pet, please seek out appropriate medical or mental health services. There is nothing wrong about what you are feeling and experiencing, or in seeking out the help you need to be safe and healthy.

Argus Institute Counseling and Support Services

Located at Colorado State University in Fort Collins, CO, Argus provides free grief counseling and tools to help you make end-of-life decisions for your pet.

The can be reached by phone or through their website which is full of free tools, information, and webinars to help you through end of life care and pet loss.

(970) 297-1242


Dove Lewis Pet Loss Support Program

Dove Lewis is a non-profit emergency hospital in Portland, Oregon, that also provides various services to the greater animal community. This includes weekly Grief Support Groups and tools online that you can use to memorialize your pet. They can be reached by phone, email, or online.

Phone: (503) 234-2061

Email: petloss@dovelewis.org

Website: https://www.dovelewis.org/community-services/pet-loss-support

Ideas for coping with the loss of a pet

Some people gain comfort from memorializing the life of their pet. Below are some of the ways we’ve seen people process through the loss of their pet. You certainly aren’t limited to the ideas listed below. Use the ideas below or come up with your own.

  • Hold a small memorial service or light candles in honor of your pet’s spirit.
  • Create a memory box or photo collage with pictures and objects that were part of the pet’s life.
  • Contribute to a charity in your pet’s name or volunteer at an animal shelter or rescue group.
  • Plant a tree in honor of your pet’s memory.
dog bowl of treats



Nutrition is an important part of life, from the very beginning to the very end. When a pet is sick, though, nutrition suddenly becomes all the more important. We know that people have very personal views on their pet and what they are fed. The following pages contain some general information on pet nutrition. The most important thing, though, is that your pet is eating, whether it’s grocery store pet food, premium pet food, or a homemade diet. Food provides your pet with nutrients, and if they are not eating, no matter how good or healthy it is for them, they will not get the nutrients they need. To help navigate the complex world that is pet nutrition, we have summarized some of the basics for you. Please use this information to make choices about what your pet eats, and feel free to talk to the staff or doctors if you have questions or would like more information. This is by no means an inclusive list and there is always new information coming out in regards to pets and their nutritional health.


What makes up food and in what proportions is important. Too much or not enough of something can have detrimental effects to your pet’s health. All commercial pet foods have to follow certain regulations on what is put into their food. When feeding an appropriate commercial diet, deficiencies are rare. The two most common concerns when feeding a commercial diet are allergies/intolerance to specific ingredients and too much of an ingredient (usually fats or protein). If your pet has a food allergy, or you suspect one, you can work with your regular veterinarian or a dermatologist to determine which food is best for your pet.

The following list is some guidelines you can use when evaluating your pet’s food. Remember, the most important thing is that your pet eats. So even if you have to offer food you wouldn’t normally feed them, if they will eat it, consider it a win.

Things to consider when evaluating commercial diets:

  • Keep protein to healthy levels (no more than 30% for dogs and 40% for cats).
  • Choose diets with whole foods used as ingredients: e.g. lamb, duck, chicken meal (whole muscle), peas, rice, barley, etc.
  • No raw meats, bones, or other uncooked animal products. Freeze-dried meat usually isn’t cooked prior. Use caution when feeding these items.
  • If your pet is severely underweight, puppy/kitten food or food for active adults is an option. Also, you can feed an “all life stage” food at the puppy/kitten recommendation
  • If your pet is overweight, talk to your doctor to see if a weight loss plan would be beneficial. Recent studies for cancer patients show that some extra weight can give a pet a positive prognostic factor, however, if your pet has any concurrent issues (like arthritis or diabetes) weight loss with body conditioning may still be recommended.

Home-cooked and safe ‘people food’ options

  • Protein options
    • Cooked chicken breast or lean deli meats
    • Extra lean ground beef or turkey with fat rinsed off after cooking
    • Low-fat cottage cheese
    • Stage 1 meat baby food
    • Egg whites (an occasional yolk is ok, but most should be removed)
  • Carbohydrate options
    • Cooked white rice, brown rice, or rolled oats
    • Mashed regular or sweet potatoes (no butter or cream!)
  • Vegetables and fruits that are safe for animals. Some options include:
    • Carrots, green beans, zucchini, peas, cucumber, broccoli, cauliflower, or tomatoes
    • Apples, watermelon, cantaloupe, strawberries, blueberries, raspberries, or bananas
  • Any of the above options can be combined to create a home-cooked diet.
    • Chicken and rice is a great easy-to-digest diet for sensitive or upset tummies. The end product should be around 30% protein and 70% carbohydrates.
    • Home-cooked diets can be combined with commercial diets to make a more balanced meal for your pet or to encourage them to eat their regular food.
    • If you are planning to feed a home-cooked diet long term, we recommend consulting a veterinary nutritionist so that a complete and balanced diet can be formulated specifically for your pet. This will avoid long term issues with deficiencies or toxicities.

Food and medications

For most pets, food and treats are the easiest way to get them to take necessary medications. While this is a great option, some care must also be taken. Many pets are ‘too smart for their own good’ and learn that medication is hidden inside food items. This not only makes medicating your pet difficult, but some pets will even go off their food entirely for fear of there being medications inside.

To try to avoid food aversion due to medications, we suggest the following:

  • Select a few items that are only used to give medications and avoid using any of the foods your pet eats normally.
  • Give multiple treats at a time. Start with small empty treats and once your pet is eating them readily, slip in the treats with medications followed by more empty treats.
  • Use treats that have strong flavors and smells (this helps to hide the bitter or odd smell/taste of medications).
  • The following items are good to use in small amounts. Use with caution as many of these are high in fat that can upset some pet’s tummies if they are given too much.
    • Pill pockets (there are many flavors available)
    • Cheese, cream cheese, or cheese products like cheese-wiz
    • Lunch meat roll-ups (only if you don’t use as a regular food item)
    • Bread squished around a pill
    • Peanut butter or pill-sized PB sandwiches
    • Vienna sausages or hot dogs pieces (if not used as regular food)
    • Liverwurst
    • Butter- this works well when you need to pill your pet but find that it sticks in their throat and they spit it out
    • Powders can be mixed with a spoonful or two of either baby food or canned food. Just make sure that it is a small enough quantity that they eat it all in one sitting.

Raw Meat Diets

Raw meat diets have been surrounded by an intense and emotional controversy. Most of the evidence in favor of raw meat diets is based on personal anecdotes from those that have fed their pets this diet. Unfortunately, there are no peer-reviewed studies that show there is a nutritional benefit to feeding raw meat diets to animals.

While there have been no peer-reviewed studies specifically done on the feeding of raw meat diets, there are substantial studies showing bacterial contamination in all commercial raw meat diets and most home-prepared raw meat diets. There have also been studies showing that pets fed raw meat diets are not only more likely to get sick from pathogenic bacteria, such salmonella and E. coli, but the humans that interact with these pets get sick as well, even if their pet isn’t showing any symptoms. This risk is increased when combined with immunosuppression on both the human and animal side. The young, elderly, and those with compromised immune systems are at highest risks for these infections. Even if caught early and treated, infections from these bacteria can be deadly.

Our recommendation is that pets not be fed a raw meat diet. If your pet is currently eating a raw meat diet, please make sure to inform our staff so appropriate precautions can be taken to ensure all the pets and staff here remain safe. If your pet is going to be receiving therapy that will further compromise their immune system, we ask that you either switch to a commercial diet or cook your pet’s food thoroughly for the duration of their treatment. It is also advisable to do the same for any other pets in the household as they can act as carriers for the bacteria.

If you have any questions about raw meat diets, or want more in depth information about the risks, please feel free to talk to our oncologists.

Nutritional Resources

Below are a few recommended starting points if you are looking for information on the web about nutrition. These sites include additional resources for formulating a diet for your pet. If you have any questions, please talk to your doctor or a staff member.

American College of Veterinary Nutrition

This group is part of the society that certifies veterinarians and technicians in animal nutrition. Their website has information for both veterinary staff and pet owners.

American Academy of Veterinary Nutrition

This is a professional group for veterinary staff and other animal care professionals that work with the common goal of improving animal nutrition. They have several links to others websites and groups that can help with dietary information for your pet.

Association of American Feed Control Officials

This a professional group that provides information to local, state, and federal agencies that are in charge of the regulation, sale, and distribution of all animal foods. They created recommended guidelines and regulations to ensure the quality and safety of all animal diets. 

photo of pills forming a question marke, sun, fork, knife, and plate to represent chemo drugs

In-patient Chemotherapy

The following information covers some of the more common drugs used at home to treat cancer. Which drugs are used will depend both on which disease your pet has and what other therapies are being pursued. If you have any questions about the medications here, please talk to your doctor or a staff member.

In-patient Chemotherapy

Most people have had experience with cancer and cancer therapy, whether it is personal experience, with a family member, or through a close friend. Often, these experiences are not pleasant, despite having positive rewards at the end. Cancer in veterinary medicine, though, is treated differently than in human medicine. Our goal in veterinary medicine is not to achieve a “cure” but to achieve the best quality of life for our patients. We may be able to achieve a remission (different than a cure) with some diseases, but for others we aim to stop or slow down growth.

When a pet experiences a side effect from chemotherapy, it typically starts the second or third day after treatment. This period, from three to five days after treatment, is when symptoms occur with the GI tract.  The bone marrow can have problems as early as day three but it is typically six to eight days after when cell counts are at the lowest. If white blood cells get too low, opportunistic microbes can get a hold and make pets feeling sick. Symptoms can include problems with the GI tract as well as decreased energy and generally “not feeling well”.

Most of our patients (greater than 90%) will have absolutely no side effects from chemotherapy. That is unless you want to include feeling better and happier with the side effects. For the majority of our patients that receive therapy and have a response, this will be the only “side effect” they experience.

Of the remaining 5-10% than develop side effects, most will be mild in nature and easily controlled from home. The most common side effects reported include loss of appetite, low energy, nausea, diarrhea, soft stool, and vomiting. To help treat these, we send home medications for you to have on hand in case side effects occur. Typically, cats will get upper GI side effects (nausea, vomiting, and loss of appetite), while dogs can experience the whole range of symptoms. The medications can be used prophylactically (starting the night of therapy) or held in reserve and used only if symptoms occur. It is important to use these medications at the first sign of symptoms. If started early, side effects can be stopped before they become more serious. The medications we send home are safe to use and will not cause your pet any issues if they are given them but did not actually need them.

A small number (1-2%) of pets will require more intensive care to control their symptoms. This includes outpatient injectable medications or inpatient hospitalization with IV fluids and injectable medications. This typically occurs when the symptoms come on suddenly and at home medications are not adequate to control them, or due to an overwhelming response of the cancer to therapy that “floods” the body with dead cancer cells. This can cause your pet to feel sick while the body plays catch –up in filtering out the dead cells. If symptoms are not addressed quickly, your pet’s condition can deteriorate rapidly. In extreme situations, a pet can have a fatal event after receiving therapy, usually from suppression of the bone marrow (low cell count), compromised body systems (like kidney or liver), or untreated symptoms (vomiting, diarrhea, etc). If your pet is not responding to medications at home or has severe symptoms that come one suddenly, please seek immediate care here, your regular vet, or your local emergency center.

Ultimately, the primary goal of veterinary chemotherapy protocols is to provide good quality of life for our patients while managing the cancer for as long as possible. Thus, if a pet has a side effect we switch drugs, adjust doses, or stop treatment entirely. We do not want our patients getting sick any more than you want your pet to be sick. If you have any questions or concerns about sick effects and your pet, please feel free to discuss these with your doctor.

Marijuana and THC/CBD

The following information covers some of the more common drugs used at home to treat cancer. Which drugs are used will depend both on which disease your pet has and what other therapies are being pursued. If you have any questions about the medications here, please talk to your doctor or a staff member.

Marijuana and THC/CBD

With the legalization of marijuana in Washington, there have been a plethora of companies that have started to target pets and their owners with the benefits of its use. Please use caution before giving your pet anything that has marijuana or any of its chemical compounds mixed in with it. Pets are more sensitive to some of the compounds (like THC) and can become severely ill if too much is ingested.

While we have no doubt that there are viable uses for this drug and some of its compounds, there are no peer-reviewed scientific papers that address which compounds are needed, in what combination, and how to properly dose it for various conditions. Until the time that we can safely dose and prescribe the appropriate compounds, we cannot make any recommendations about the use of this product besides not to use it.

If you are compelled to add any marijuana products to your pets treatment regime, please talk to your doctor before starting them so they can give you more detailed warning about what compounds need to be avoided and what side effects to watch for. Your doctor is also happy to talk with you if you would like more information in general about marijuana compounds.

photo of pills forming a question marke, sun, fork, knife, and plate to represent chemo drugs

Low-dose Chemotherapy

The following information covers some of the more common drugs used at home to treat cancer. Which drugs are used will depend both on which disease your pet has and what other therapies are being pursued. If you have any questions about the medications here, please talk to your doctor or a staff member.

Low-dose Chemotherapy

A handful of oral chemotherapies can be given at home, either as a low-dose long-term medication, or at a higher dose for a short, specific amount of time. These drugs are prescribed for at home use because the risk of side effects (to both pet and human) at the prescribed dose are low and they must be given over a long enough period of time that administration in the clinic would be unrealistic.

Side effects of the drugs to your pet are similar to other therapies: low white blood cell count, changes to the liver or kidneys, vomiting, nausea, diarrhea, and/or soft stool. The first two will be monitored by blood work performed at specific intervals. The latter are watched for at home. In either case, if side effects are noted, the medications are either stopped or the dose is adjusted to avoid side effects. If there are any concerns specific to a medication, your doctor will let you know before prescribing it.

Below are a few precautions and recommendations in regards to your pet and their medications. These guidelines help to avoid chronic health affects to you as their caregiver and anyone else in the family.

  • Most important: It is perfectly safe for people and other pets to be around the pet receiving medications, even while they are being treated.
  • Direct handling of medications should be avoided.
    • Certain individuals should avoid contact if possible. This includes children, other pets, and persons who are pregnant, may become pregnant, or are nursing.
    • A single exposure is unlikely to cause an issue, especially if cleaned up quickly by washing the affected areas with soap and water. The concern is with chronic exposure and the changes it can cause over time.
    • Wear non-powered latex or nitrile gloves (available as most pharmacies) when handling medication or anything that might be contaminated with the medication.
    • Wash your hands thoroughly after administering the medication, even if you wore gloves.
  • Do not open the capsule or crush the tablet.
    • Chemotherapy should be given whole, unless you are specifically instructed to break or open the capsule/tablet.
    • Unfortunately, due to the great chance of contamination, liquid formulations are discouraged. Medications come as either tablets or capsules.
    • If your pet chews the medication while taking it, that is fine. If they spit it out chewed up, make sure to thoroughly clean the area with soap and water or a detergent cleaning spray.
  • Less than 1% of the medication will be excreted by your pet as the active drugs, typically through the kidneys (urine).
    • Most drugs are broken down by the liver and these breakdown products are excreted in the feces.
    • Most drugs are also sensitive to light and temperature, breaking down very quickly when exposed to the natural environment.
    • Frequent cleaning of the yard or litterbox is all that is needed.
    • At our dosing levels, there is no drug found in the saliva of pets.

Targeted Therapy

The following information covers some of the more common drugs used at home to treat cancer. Which drugs are used will depend both on which disease your pet has and what other therapies are being pursued. If you have any questions about the medications here, please talk to your doctor or a staff member.

Targeted Therapy

There are many new drugs available to treat cancer (and various other diseases as well) that are not actual chemotherapy, but instead work by targeting the suspected genetic mutations involved in cancer cell growth. While there are new targeted therapies coming out all the time, the main three used here are masitinib, dasatinib, and toceranib. These medications can be used alone, but they work best when combined with other oral and/or injectable therapies.

Side effects to these medications are very rare and can often times be stopped with minor dose adjustments. We’ve also learned a lot about dosing over the years. We habitually dose below the ‘recommended’ amount without seeing a loss of efficacy, while also avoiding most/all of the side effects from the medication. Possible side effects to all targeted therapies include bone marrow suppression and GI upset, such as vomiting or diarrhea.

Some rare side effects that we monitor for that are specific to commonly used targeted therapies:

  • Masitinib can also cause a protein losing nephropathy (protein loss through the kidneys), so watch for a change in drinking and urination habits at home. We will monitor for any changes in blood work here at the clinic.
  • Toceranib can cause ulcers and bleeding of the GI tract that you would see at home as frank (red) blood in the vomit or stools, ‘coffee ground’ appearance to vomit, or stools/diarrhea that are tarry and/or dark. If you notice any of these side effects, please let you doctor know right away.
  • Dasatinib is especially prone to causing diarrhea, nausea, and vomiting so we typically prescribe an ‘antidote’ that is given one hour prior to the dasatinib to help prevent these side effects. However, if your pet still has trouble tolerating the medication, a dose adjustment often takes care of the issue.