Bone Cancer in Dogs
Oncology
Bone Cancer in Dogs
Oncology
Tips and Questions for the Oncologist
Professional Background & Experience
Is the doctor a diplomate of the American College of Veterinary Internal Medicine?
If so, the initials DACVIM will be associated with the doctor’s name.
Does the doctor belong to a professional veterinary association such as the American Veterinary Medical Association or a state or local veterinary association?
How does the practice structure continuing medical education for the doctors and technicians?
How long has the doctor been practicing oncology?
How many cases of osteosarcoma does the doctor treat during a given year?
How is chemotherapy administration structured in the practice?
Office Hours
What are the regular hours?
Are they compatible with your schedule?
Will they accept emails or appointments electronically?
Who covers the practice when the doctor is unavailable?
What is the average wait time for making a non-emergency appointment?
Emergency Care
How are emergency calls handled during regular office hours and after office hours?
Is there an emergency facility in your area, should you need it?
Fees and Payment
What methods of payment are accepted?
What is the policy regarding pet insurance ?
Staging the Disease
- Review the primary site – take the x-rays to the consultation.
- Chest x-ray – to determine if it has spread to the lungs (most common place of metastasis).
- Blood work (complete panel) – obtain copy for your records.
- Bone biopsy – is it mandatory? What are the risks and potential complications? What if the biopsy is “non-specific”? How will it change the treatment?
- Diagnosing osteosarcoma
- If a biopsy has already been done, bring a copy of the report. Does it state the type of bone cancer, the mitotic index and if the cells are well-differentiated or not? Did the pathologist make any recommendations?
- If your dog has already had amputation surgery or other removal of the primary tumor, bring a copy of that report.
- What other tests are needed before deciding on a treatment plan? Blood tests? Scans? How will those tests affect treatment choice?
Understanding the Terminology in the Histopathology Report
- Mitotic index – The higher the number of mitoses (cell reproduction), the faster the tumor is growing at the cellular level (a low index is better than a high one).
- Well differentiated malignant cells – A lot of “parts.” The cells are more complicated. The more differentiated the cell, the longer it takes to reproduce, so tumors with well differentiated cells don’t grow as fast.
- Poorly differentiated malignant cells – Not a lot of “parts.” The cells are less complicated so they can reproduce faster, which makes the tumor grow faster.
Treatment Options
Amputation alone
Amputation plus Chemotherapy
Are there any ongoing clinical research trials in the area?
Hospice Care
Bisphosphonates
- Zoledronic acid
- Pamidronate
- Alendronate
Diet Supplements
- Discuss how they feel and their approach.
Questions for Each Option
Are we a good candidate for this option? Why or why not?
What does it consist of?
Will my dog be in pain? How do you normally treat the pain?
What is the recovery time?
What is the survival time?
What kind of quality of life will my dog have?
What are the costs?
What would you do if it was your dog?
Basically, ask any and all questions until you feel comfortable with each option and know that you have enough information.
Making the Decision
- Write down all your questions.
- Write down all the answers – even give the paper to the doctor to spell out the options.
- Ask for supporting documentation or studies if they have them.
- Do not be afraid to walk away.
- Tell them you need time, that you will call.
- Ask them if they can go see the next client and come back to you.
You have to be comfortable with the option you choose and only you know what that will be. So, because we make our decisions with the best information we have at that time, GET ALL THE INFORMATION you can. Ask a lot of “whys,” then ask a lot of “why nots.”
Listen to what they say, but do what you feel is right. It is your money, your dog, your decisions.
Then go forward with strength and confidence and never look back. There are no wrong decisions, ever.
