After working with hundreds of pets with cancer, and their owners, Dr. Kathy Mitchener, a veterinary oncologist, has identified three commandments of Cancer Care that are essential in maintaining the quality of life and human-animal bond. Dr. Mitchener has found these commandments will help build an atmosphere of hope for both the pet and pet owner.
Do Not Let Them Hurt: Comprehensive pain management is critical to the quality and longevity of life for cancer patients. Research has shown that once an animal is in pain, there is magnification of the pain response. The goal then is to prevent pain, not try to alleviate it once it occurs. Local anesthesia may be helpful in those animals that have localized pain. Pain-relieving medications can be used, including fentanyl patches, which are applied to the skin and slowly release the active ingredient. Oral pain relievers can be of benefit, especially if the pain is mild. If an animal is undergoing surgery, the pain medication should start while the animal is still anesthetized, so as the animal wakes up, the pain reliever is already working.
Proper care of the animal also helps in pain management. The animal should be handled gently. Use orthopedic beds and other devices to make the animal more comfortable and decrease the risk of painful secondary problems such as "bed sores."
Do Not Let Them Vomit: Nausea and vomiting are actually uncommon problems for animals undergoing chemotherapy. If either one becomes a problem, however, it needs to be managed swiftly. Vomiting animals can quickly become dehydrated and develop electrolyte imbalances. Nauseated and vomiting animals will generally not eat, which brings us to the Third Commandment.
Do Not Let Them Starve: This is perhaps the most vital of the three. If an animal will not eat, but has a functioning digestive tract, enteral dietary therapy should be used. The first step is to increase the appetite. This may be accomplished by warming the food: serving palatable, aromatic foods; and feeding in a stress-free environment. Medications that stimulate the appetite, such as diazepam (Valium) and cyproheptadine may be used.
If the animal will not eat on his own, a "stomach tube" may be used. Depending upon the animal, the tube may be inserted through the nose and then into the stomach or intestine; or the tube may be placed through an incision in the skin into the esophagus or stomach.
The diet of the animal will need to be tailored individually. The correct diet may not only limit weight loss, but also improve the response to chemotherapy, and decrease the adverse effects of radiation therapy. In general, the diet should:
- Limit the amount of simple carbohydrates
- Contain moderate amounts of highly digestible protein, with possible supplementation of certain amino acids including glutamine, cystine, and arginine
- Include moderate to relatively high amounts of omega-3 fatty acids
In providing care for pets with cancer, the medical management of the cancer is only one part of the goal. Other needs of the pet and owner need to be met to achieve the quality of life they want and deserve.