I wrote a guest blog for a site last week. I've been taking a bit of a break from writing to focus on some other aspects of life. Hopefully, I can be back for a little while.
"So Fluffy's biopsy report came back..."
As veterinarians we all dread this conversation. Cancer carries with it so many different stigmas and connotations that I've heard no less than a dozen different viewpoints from the same owner during the same conversation. It is an emotionally charged, painful subject not helped at all by the fact that quite frequently we can not win.
From my perspective, it is also not helped at all by the fact that it typically happens to older pets. I hear it all the time, "Well, if he were six or seven we might do the treatment but he's thirteen. He lived a good life." While on the surface I can't disagree with that statement I can't help but have a slightly different perspective. By the time I diagnose most pets with cancer, they haven't felt well for awhile. I know I can't cure them, and in many cases we don't have a lot of time, but I can often give the dog or cat some time where the disease is at least not spreading or may even go into remission. These few weeks or months of comfort, quality of life and increased energy are worth the added expense to me personally and offer a huge psychological benefit to your pet from a professional standpoint. These sort of results need not absolutely deplete the owners checking account, either. I have treated lymphoma for six thousand dollars and we were able to get a good eighteen months of high quality life. I have treated it for a few hundred and we got another four months for owners to say good bye to the pet they knew, and not the sick animal their pet had become.
Chemotherapy in pets can have many different meanings. Typically there are protocols for various types of cancer and these generally involve multiple drugs; this is the best way to ensure the longest remission period. Most dogs and cats handle chemotherapy very well and suffer very few of the side effects their human counterparts do. They may exhibit hair loss and bouts of nausea, but most owners report increased energy levels and increased appetite in most patients. Chemotherapy is technically any drug that specifically targets a disease process. For that reason, chemotherapy can include literally dozens of different types of treatments for the same disease. When it comes to financial aspects, the most effective chemotherapeutic protocols do typically carry the highest price tag. For example, the gold standard treatment plan for lymphosarcoma- a cancer of the lymphatic system- carries a price tag of nearly six thousand dollars. That does not mean that there are no options between spending half of the year’s mortgage and doing nothing. We can typically formulate an effective plan to fit nearly any budget. It is important to remember that treating malignant aggressive cancer with chemotherapy is often only a means to prolong a healthy quality of life and is not curative. While some chemotherapy in some cancers does offer a cure, by and large it only buys us time to enjoy our best friends a little longer and prepare ourselves for goodbye.
The most important aspect of treating cancer is to keep the lines of communication as open as possible. I do not assume that any one person is not going to pay for any diagnostic or service. My job is to tell you what is available for your pet and make recommendations based on what is medically appropriate. You are allowed to say no to anything. I am not allowed to make that choice for you by not offering. I have never had an owner elect to euthanize a pet at this point and thought to myself that it was not the right decision. If you're ready and you feel your pet is ready it is not my place to get in the way.
The most important things to me are comfort and appetite. After a diagnosis, we can often keep your pet comfortable and eating on a very tight budget with very few, if any, side effects. After we understand each other on that issue we are able to move forward with what we want to accomplish and what we can expect.
In summary, my job is to recommend what I feel is medically appropriate for your pet given the condition they are in, the disease they are facing and the outcomes that can be expected. Your job is to work with me to find the best possible treatment that fits your lifestyle and expectations. We owe it to each other to keep those lines of communication as open as possible.
Heath McNutt is a small animal veterinarian practicing in Vermont. He maintains a blog of veterinary related topics at http://rutlandherald.typepad.com/vets_view/