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September 05, 2007

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Patrice Cahalan

Hi Vet Doctor,
I came upon your blog after googling "dog with cancer, treatment." My Great Pyrenees was rescued by sheriff and Humane Society from a Douglas County puppy mill; she had spent her life as a caged breeder; she is an older dog. Her name is Angel and I've had her for only three years. The vet says she has breast cancer and her tumors are palpable. We took her to the vet oncologist and he quoted a BOATLOAD of money for treatment. Do you know anyone at all who will be able to treat my Darling Angel on some kind of income-based sliding scale? I don't want to put her through misery just because she's had such a hard life already, but I sure don't want to lose her. Please can you kindly advise me?
Sincerely,
Patrice
Des Peres, MO

Doc

Dear Patrice,

Well done on the rescue operation. Chemotherapy in dogs is somewhat different than in people, as we generally use lower doses of drug. This results in much less difficulty for the patient than we typically think of. With people receiving chemo, they usually feel terrible, and this is often NOT the case with dogs. Here is a link to a previous post on the subject: http://www.yourpetsbestfriend.com/your_pets_best_friend/2006/09/chemotherapy_is.html

With mammary tumors, surgical removal is usually the first step, and this can be complicated. With modern anesthesia (read MUCH safer when I say modern) and good support during surgery, such as being maintained on I.V. fluids, you simply cannot do this cheaply. Even if the doctor were willing to work for nothing (which doesn't seem fair), the expenses and support staff must be paid.

Chemotherapy has several different possible expensive components. Some (though by no means all) of the drugs are very expensive, and the bigger the dog, the more you spend. It is not uncommon for the wholesale cost of the drug (i.e. NO markup to you, the client) to be fifty to one hundred dollars per dose.

Some of these drugs must be administered in a free-running I.V. drip at a measured rate over a period of no less than thirty minutes. This requires an I.V. pump (not a cheap device) placing an I.V. catheter, the fluids, tubing, tape, and a staff person supervising for that thirty minutes.

Chemotherapy drugs are hazardous materials and require special handling and disposal.

Prior to each chemotherapy session, blood must be drawn for a complete blood count to be sure that the previous treatment has not damaged the bone marrow. If that had occurred, another treatment might permanently destroy the patient's ability to produce blood cells.

Some years ago, under VERY special circumstances, I treated a 60-pound dog for lymphosarcoma, charging only my own out-of-pocket costs. [This is NOT something I can afford to do regularly.] The patient achieved only a two-month remission, and the cost to the client was about $900. It was a very discouraging situation all around. They don't all turn out like Checkers: http://www.yourpetsbestfriend.com/your_pets_best_friend/2006/10/in_memoriam_che.html

The only way that I know to mitigate the cost of these complex and expensive treatments would be to contact the University Veterinary Teaching Hospital to see if there are any research trials going on. Sometimes a research project is looking for a particular type of cancer to try out a new treatment and grant money helps to pay for it. These trials tend to be few and far between, however.

Thanks for reading.

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