Chemotherapy

Chemotherapy offered at Animal Specialty & Emergency Hospital:

Here at Animal Specialty & Emergency Hospital, Dr.’s Thomas Smith and Chris Ludlow are highly educated in Chemotherapy and their foremost concern is your pet’s well being. Our Internal Medicine technicians are experienced in caring for cancer patients and administering chemotherapy. They will make your pet’s chemotherapy experience as comfortable and as calm as possible.

Benefits of chemotherapy

Chemotherapy is a very successful treatment for certain types of cancer. Transmisable venereal tumors are curable with chemotherapy. Animals with lymphoma can be expected to go into remission for several months or longer. In conjunction with limb amputation, chemotherapy can extend the life expectancy with osteosarcoma. Other cancers such as mast cell tumors, and various types of leukemia may benefit from chemotherapy as well. Your pet’s type of cancer may not respond to chemotherapy. Dr.’s Smith and Ludlow will determine if your pet is a good candidate at your consultation appointment.

Our goal with chemotherapy is offering the best opportunity for remission, and improved survival, while at the same time preserving a good quality of life.

Risks and side effects

There are risks involved with any type of treatment for cancer. Symptoms are usually mild including; nausea, vomiting or diarrhea and can be treated with supportive care. Since we are a 24 hour facility, doctors and technicians are always available to treat these possible side effects. During your consultation appointment you will receive a handout on all the chemotherapy medications used and their possible side effects.

Usually these side effects are outweighed by the benefits of killing cancer cells.

The expense

Chemotherapy can be costly. The medications are the same used to treat human cancer patients, and most of the drugs are expensive. Another expense is the additional precautions and special equipment used in administering chemotherapy to prevent harm to the technician’s involved.

A detailed protocol sheet with the estimated weekly expense will be given to you at the time of your consultation.

 

Potential chemotherapy side effects

 

The following is a list and explanation of potential chemotherapy side effects.

             Vomiting, nausea, and diarrhea –

Gastrointestinal upset is a common side effect of most chemotherapy drugs, usually noticed 24–48 hours and/or 3–5 days post-treatment.

Vomiting: Remove food and only allow small amounts of water for 12 hours. Then, introduce a bland diet slowly over the next 12 hours. Please call the hospital if vomit contains blood, is severe (3 times or more per hour) or does not resolve within 24 hours. Prescription anti-nausea medication may be required.

Diarrhea: Diarrhea often resolves without treatment. If diarrhea is mild to moderate, feed your pet his/her normal diet and observe closely for other symptoms (vomiting, fever, lethargy, etc.). Please call the hospital if diarrhea is severe, contains blood, is accompanied by other symptoms, or lasts longer than 24 hours.

Injection site irritation – Most chemotherapy drugs are administered intravenously, and we take every precaution to prevent extravasation (injection of the drug outside of the vein). Some chemotherapy drugs can cause severe skin irritation, necrosis, and sloughing if extravasation occurs. Most injection site irritation will begin to show within 24-48 hours. Please call the hospital if you notice any irritation or discomfort at the site of an injection.

Things to look for: Licking or chewing at injection site Redness or rash that resembles a burn Pain or sensitivity in the area that the injection was given

Fever – A fever can be caused by stress, or infection due to a compromised immune system. You should designate a digital rectal thermometer for your pet. If your pet feels warm to the touch or does not seem to feel well you should take his/her temperature. Your pet’s temperature should be somewhere between 100.0 and 102.0. Anytime your pet’s temperature is 103.0 or higher you should contact the hospital immediately, as this could indicate life threatening infection in a chemotherapy patient.

Things to look for: Common symptoms in a pet with a fever are lethargy, depression and inappetance.

Allergic reaction – Some chemotherapy drugs can cause an allergic reaction. These allergic reactions can vary from mild to life threatening. Prior to giving these drugs we will administer an antihistamine and will check your pet for signs of allergic reaction before you take him/her home. Most allergic reactions will occur within 20 minutes of receiving chemotherapy, but you should observe your pet closely for 24 hours.

Things to look for: Hives or rash on your pet’s abdomen, ears, feet or gums. Difficulty breathing, facial swelling, vomiting, excessive salivation Petechia – Petechia or bruising is usually caused by a low platelet count and could indicate bone marrow suppression.

Petechia will usually appear as reddish or purple spots varying in size and are usually most visible on the abdomen. If you notice petechia or any abnormal bleeding please contact the hospital immediately.

Things to look for: Bleeding from your pet’s mouth or nose Blood in you pet’s urine or feces. Please note that hemorrhagic cystitis can occur from certain chemotherapy drugs without an underlying platelet problem. Petechia anywhere on your pet’s body

Alopecia and hyperpigmentation – Alopecia and hyperpigmentation are not harmful to your pet. Alopecia (hair loss) is most common in breeds whose hair grows continuously (Poodles, Terriers, Old English Sheepdogs, etc.). Alopecia may involve the entire body, or only focal areas such as the abdomen or whiskers. Hyperpigmentation (darkened skin color) can occur in any breed. Alopecia often resolves, but hyperpigmentation is usually permanent.

Hemorrhagic cystitis – The chemotherapy drug cyclophosphamide can irritate the inner lining of the urinary bladder, causing it to bleed. This condition is known as hemorrhagic cystitis. It is important that your pet have free access to fresh water and be taken outside to urinate frequently. This can be a serious condition, so contact the hospital if you notice blood in your pet’s urine.

Please feel free to contact us if you have any questions or concerns. Any changes in your pet’s attitude or activity level should be noted and observed. If you pet does not feel well or is just ‘not acting right’ please let us know as this could be an early indication of a more serious problem.

 

Chemotherapy drugs

The following is a list of commonly used chemotherapy drugs and the potential side effects of each one.

Vincristine

Potential adverse effects include GI upset (anorexia, vomiting), irritation or necrosis at injection site, neurotoxicity, alopecia, stomatitis, inappropriate ADH secretion, jaw pain, and bone marrow suppression (anemia, thrombocytopenia, and leukopenia).

L-asparaginase (Elspar)

Potential adverse effects include GI upset (anorexia, vomiting), hemorrhagic pancreatitis, hepatotoxicity, hypersensitivity (allergic reaction), and coagulation disorders. Bone marrow suppression (anemia, thrombocytopenia, and leukopenia) is rare.

Cyclophosphamide (Neosar, Cytoxan)

Potential adverse effects include GI upset (anorexia, vomiting), alopecia, hemorrhagic cystitis, and bone marrow suppression (anemia, thrombocytopenia, and leukopenia).

Doxorubicin (Adriamycin)

Potential adverse effects include GI upset (anorexia, vomiting), alopecia, stomatitis, irritation or necrosis at injection site, cardiac toxicity, nephrotoxicity, hypersensitivity, hyperpigmentation, and bone marrow suppression (anemia, thrombocytopenia, and leukopenia).

Chlorambucil (Leukeran)

Potential adverse effects include GI upset (anorexia, vomiting), alopecia, delayed growth of shaven fur, and bone marrow suppression (anemia, thrombocytopenia, and leukopenia).

Methotrexate

Potential adverse effects include GI upset (anorexia, vomiting), stomatitis, gastric ulcers, alopecia, depigmentation, pulmonary infiltrates and fibrosis, irritation or necrosis at injection site, and bone marrow suppression (anemia, thrombocytopenia, and leukopenia).

Cisplatin

Potential adverse effects include GI upset (anorexia, vomiting), nephrotoxicity, and bone marrow suppression (anemia, thrombocytopenia, and leukopenia).

Cytarabine (Cytosar)

Potential adverse effects include GI upset (anorexia, vomiting), conjunctivitis, stomatitis, hepatotoxicity and bone marrow suppression (anemia, thrombocytopenia, and leukopenia).

Lomustine (CCNU)

Potential adverse effects include GI upset (anorexia, vomiting), alopecia, stomatitis, corneal de-epithelization, nephrotoxicity, hepatotoxicity, pulmonary infiltrates and fibrosis, and bone marrow suppression (anemia, thrombocytopenia, and leukopenia).

Vinblastine

Potential adverse effects include GI upset (anorexia, vomiting), alopecia, stomatitis, constipation, irritation or necrosis at injection site, inappropriate ADH secretion, jaw and muscle pain, loss of deep tendon reflexes, and bone marrow suppression (anemia, thrombocytopenia, and leukopenia).