Cancer in Dogs

Hey, guys, this is Dr. Lehrer. Today we're going to be doing a video on something that's kind of sensitive. So I just want you guys to be aware of it. If you've had a pet that's had cancer or is currently going through cancer or you're concerned about that, that's what today's video is going to be about. It's going to be what exactly is cancer? It's going to be about what are some different clinical signs or things that you might see in your pet that might make you take him to the vet so we can find out they have cancer. How it is that we as veterinarians go and diagnose if your pet has cancer and what kind of cancer they have, the different life expectancies for pets who have cancer, figuring out when the time is to go ahead and do what we usually don't want to do, which is put them to sleep at the time that they are suffering too much, and then what are some of the more common cancers that we see? Stay tuned and we'll get into that shortly. All right, so what is cancer? Cancer is essentially cells that are growing out of control. And the fancy word for cancer in scientific or medical terminology is neoplasia. We break down that word into neoplasia. Neo just means new growth and plasia, or new and plasia means growth. And when you have this growth, typically what will happen is you're going to have one of two things. You're either going to have one cell that's going to split, split into two, that's going to split into four, that's going to split into 8, 16, 32, and 64, and so on and so forth. Or you're going to have one cell that may just get bigger, bigger, bigger, or a set of cells that get bigger, bigger, bigger, bigger. So those are the two different kinds of neoplasia that we can have. Now, cancers or neoplasia can either be a small growth right here. Again, not all. Neoplasia has to be the kind that spreads to your lungs and spreads to your brain and all that kind of stuff. It can just be a benign little growth. Benign means that it's not going to spread everywhere. As long as you go ahead, just leave it alone, it's not going to cause any issues. Or if you cut it out, then it won't be an issue. Or you could have what we call metastatic cancer or neoplasia, and that is something that will start off here and then spread to the rest of your body. And that's usually the. The stuff that we get really concerned about in regards to what are some different signs that you might see with your pet? So you might see that they become lethargic. So they are very sleepy, not as energetic, not as engaging with you. The appetite may change or decrease. You may notice soft poop. You may notice that they're extra gassy. You may notice vomiting. You may notice a decrease in appetite. You can notice changes in the color of the white of their eye, where it could become yellow, or you can notice that their gums are becoming very pale. These are just some things that will clue you in that you need to get your pet checked out. Now, obviously, not every single time that you see these things, is that going to be an indication for cancer. These are just general things. There is no specific clinical sign that is going to tell us that, oh, my pet has cancer. So we have to go in there, go through our list of possibilities. Cancer is always on the list of possibilities for a veterinarian, and most likely I would anticipate for an MD but depending on what the pet's age is, what. What their breed is, the signs that they're showing, and what we see on physical exam, those would then tell us cancer is still at the bottom of the list or cancer's moving up on that list. Okay, now, how do we, as veterinarians diagnose cancer? So we'll first get the history from you guys. So it's very important that you let us know what's going on at home. Then we will go ahead and do our physical exam and our vitals based on those things. We will then typically end up doing blood work, which will look at white blood cells, red blood cells, liver values, kidney markers, pancreas markers, to say a few. We will typically want to do X rays of the chest and the abdomen and a urinalysis. This is what we call a minimum database. And so that is going to tell us, hey, this is what we've seen on the blood work. It's pointing us in this direction. We went ahead and did the X rays, which is the initial SCRE screening imaging that we do for pets now. And then that would lead us into further tests, whether it's an ultrasound or a CT or some sort of scoping or something like that. Now, just to be quick, you might say, well, what's the difference between the X ray versus an ultrasound versus a CT scan? An X ray is essentially, we get to see inside the abdomen. So the abdomen is this part of the body right here. Please pay attention to please, please do not pay any attention to the dad bod that's going on here. I'm trying to work on it. You know, I'm skinny, fat. I know. Just. Just work with me. So we have all the majority of the major organs in this area. So you're going to have, typically, you're going to have the stomach, which is right here. You're going to have a pancreas lobe here and another pancreas lobe here. Then you're going to have the liver that's going to be tucked up under your rib cage, which is one of the reasons why you have your rib cage to help protect your liver as well as your. Your lungs and heart. We're also going to have the gallbladder, the kidneys, we'll have the intestines, we'll have the lymph nodes. So usually we're going to say, hey, let's do the blood work. We see something weird here that's going to point us to this particular organ system is being affected. Let's look at it with imaging. First step in imaging is the X rays. If we see something off on the X rays, we're going to say, hey, the liver looks enlarged or it looks abnormally shaped. And when we looked at the X rays of the chest, there was no evidence of metastasis. So we don't see any little dots throughout there or tumors throughout there on the lungs. Great. Now what we need to do is we would go ahead and do an ultrasound of the abdomen, and that's going to help us take a look at the organs on the inside. So you're saying, what's the difference between an X ray and an ultrasound? Short version is you take an apple, which is my fist, and in theory, what you would do with the ultrasound is you have this probe and. And wherever you put the probe on the belly, it's going to send out a beam, and that beam is going to ricochet waves of energy back and it's going to interpret that and create an image. So it'll slice my hand in half, and then you'll be able to look at it almost like when you cut an apple. And so that's typically the difference between an X ray and an ultrasound. Now, next form of imaging that we might do in terms of, you know, trying to look at the insides, it would be a CT scan. CT scan is like an ultrasound, but on steroids. And so the reason, the difference between the extra, the ultrasound and the CT scan is we're actually able to see a lot More different. A lot other parts of the body that we're not able to visualize that well or image that well within ultrasound. So like the skull, the face, the nose, the bones, those aren't. You're not going to be able to image that well with an ultrasound. The CT scan, you can image a lot of those things much, much better. And you'll be able to pick things up or the radiologist will be able to pick things up a lot better on the ultra, on the CT scan than they would an ultrasound. The reason we don't jump straight to a CT scan is because the patients, A, have to be put under general anesthesia and B, because it is more expensive to go ahead and do a CT scan. So we, in terms of imaging, we'll do X rays, we'll do an ultrasound, and maybe we'll do a CT scan. Okay, now let's say we find something in there, we find a tumor in the abdomen, or we find the tumor in the liver or some sort of organ. Then what we do is we decide, okay, if I'm trying to find out what this is, we go ahead and we collect a sample of that. Now you can do one of a few things. You can do a full thickness biopsy, which means we go in there, we open up the abdomen, we, we take a cake slice of the tumor and we send that off to the lab and they go ahead and interpret that based on how those cells line up, if they're in certain patterns and also the kinds of cells that they are, that will give us the indication of what it is we think or what kind of tumor we think it is. You could also potentially do, if we're looking at the intestines, if we, God forbid, we think your pet has intestinal cancer. So we would typically do a scope. So that's sticking a camera down the throat and into the intestines. And so we can go ahead and do endoscopic samples. And so what they do is they have like a little grabber and it goes in there and it grabs tissue and we send that off to the lab. So that's a less invasive way of doing that. And then there is a laparoscopic. So laparoscopic means that we make a few holes in the abdomen. So one here for an instrument, one over here for a camera, one over here sometimes to help go ahead and fill the abdomen with gas. I'm not an expert on the holes, but I know that there are a few different holes that are made so that we can use the camera, the instruments and sometimes either some suction or gas or fluid that we would have through a different port or a different hole. The laparoscopic is nice because a lot of times we're able to get the sample that we want without making a big hole. That is not something that is commonly available because you're not going to have a lot of people who know how to do that. That's typically going to be the surgeons. And not all surgeons know how to do that. And the equipment is very expensive for that. So it is ideal to go ahead and do laparoscopic sampling if and when possible, but recognize that not everyone's going to have the capability to do that. So just be aware. Now, if you were paying attention, you might have heard me say, I think, or what tumor we think it is. And you mean. What do you mean, you think? I thought you were collecting a sample so that, you know, I work with a integrated veterinary oncologist who I was talking to about, you know, getting official diagnosis. And one thing that she said was, she said, in one study in human medicine, they said that. And if my memory serves me correctly, if you get a diagnosis from a pathologist, from a biopsy in human medicine, and you go to a second pathologist and you give them the same exact sample, there is a 40% chance, not 14, but a 40% chance that that second pathologist will give you a different diagnosis in veterinary medicine. Again, if my memory serves me correctly, the statistic was 30%. So it's an improvement. But nonetheless, it is still a 30% chance. So what she told me was, she said sometimes she'll go to a third pathologist to be the tiebreaker. But even then, what she told me was that the way that we will get as close to a certain diagnosis of a particular tumor as possible is we will get the results from the histopathology. We will put the treatment plan together for said disease. And if the tumor responds the way that we anticipate and the studies show that other tumors, that same, similar tumors have responded to that same treatment, at that point, that is when we get the official diagnosis of, yes, this is exactly what we thought it was, because it responded the way that we want it to. Now, that was a lot. So now we're gonna move on to the next part of the video. Life expectancy when your pet is diagnosed with cancer. So if you have one of these little benign growths, remember, benign means that it's not bad. It just could be a pain in the butt sometimes. It might not even do anything. But the Life expectancy can range. If you have a dog that's bleeding in their belly from, let's say most commonly a tumor on their spleen, it could be a matter of hours or sometimes. I've seen, in my experience, where I had a cat that had a primary tongue. Oh, tongue. Not a tongue, a lung tumor. And that cat lived for four years after we diagnosed with no chemotherapy, nothing, just, you know, we, I diagnosed it. So the length of survival varies greatly from patient to patient and from cancer to cancer. So it's something that you just have to be aware of. Now in regards to determining when is the right time to put your pet to sleep, that is something where I've done a video on that before and I'll just do a little 22nd version of it. What we normally will tell people is make a list of about 5 to 10 things or activities that make your. Let you know that your pet is enjoying life. For me, I know that. Or that your pet is experiencing life. So for me, Ruby, you guys might have seen Ruby. Ruby loves to chase lizards. So if I take Ruby outside and she's not chasing a lizard, I know something's up. Ruby is scared of thunderstorms and fireworks. If Ruby, God forbid, knock on wood. Hold on. If Ruby were to get cancer and she didn't, and she wasn't feeling well and she wasn't responding to fireworks or thunderstorms, then I know that, you know, that's something I have to check off the list that she is not feeling well. And so these, you know, the more obvious things are, hey, do they greet me when I come home? Are they in the kitchen when I'm cooking, begging me for food? You know, are they, you know, engaging with me, wanting to be affectionate? If that is what your pet wants to do. Does your pet love to go for walks? Do they love to play with a certain toy? These are different behaviors that you could add on your list to go ahead and try and remove the emotional clouding of your judgment and help you make a decision that is more clear on when is the right time. Once your pet is not doing 50% of that list, then you have to start counting how many days are there bad days and how many days are good days. And when you have more good days or when you have more bad days than good days, then you know, that's the time. Okay, the last part of this is some of the more common cancers that we see in large breed dogs. We will see bone cancer. And so the most common bone cancer we see is something called osteosarcoma. Osteo means bone. Sarcoma is a kind of cancer. And so that is commonly seen in large breed dogs. I'm talking about dogs that are 60, 70 pounds and or more. The breeds that are more common for that are going to be golden retrievers, labradors, bullmastiffs, rottweilers, boxers, just to name a few. Now, the most common skin cancer that we see is not. What do you think? Melanoma, mast cell tumor, hemangioma. What are we thinking? What do you think we got? Anything? Anything? No, it is not melanoma. It is actually mast cell tumors. So mast cell tumors are the most common skin cancer that we will see in dogs. Boxers are the poster child for that particular kind of cancer. And there are three versions of that kind of skin cancer in terms of mast cell tumors. You can have ones that are benign, you can have ones that are mostly benign, but sometimes they're aggressive. And then you can have ones that are really aggressive. Okay. And then the other common cancer which we may start to see more frequently is breast cancer. And that would be a, you know, and it's more commonly seen in intact females. So those, those are female dogs that have not been spayed. Data is going to start to come out because more and more people are not going to be spaying their animals just because there may be not. Maybe there are side effects to going ahead and spaying your dogs and your cats or neutering your dogs and cats. And so it is not going to be black and white. Oh, you're a good person or a bad person if you spay or neuter. It's going to be a pick your poison kind of thing. So those are the three, some of the most common cancers that we see in dogs. 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