Cancer is correctly termed a malignant neoplasm. A neoplasm is an abnormal proliferation of cells. A malignant neoplasm is a group of cells that undergo uncontrolled growth, invade and destroy the surrounding tissues and metastasize (spread to distant sites in the body). In all animals, new cells are constantly being made to replace old and injured cells. This keeps the body fit and healthy. This process of cell replacement and repair is highly regulated and controlled by the body. The name given to the highly regulated sequence of events that a cell goes through when it grows and divides in two is the cell cycle. The regulation of the cell cycle ensures that only perfect copies of the original cell is produced. Cancer starts when a healthy cell is damaged and starts to grow out of control. Perfect replicas of the original cell are not produced and the normal regulation of the cell cycle is lost. The abnormal cells start to grow in an uncontrolled way. What causes this process to go wrong is complex and not fully understood. Some possible causes of cancer are:
- Breed. We know some breeds are more prone to developing cancer than others eg boxers and flat coat retrievers. These breeds are likely to have more genes in them that may cause cancer
- Age. Generally older dogs are more prone to cancer. This is because damage to cells accumulates over time increasing the chances of a faulty cell replication occurring resulting in cancer
- Environmental effects. Carcinogens are chemicals that can cause problems in cell replication leading to cancer. Smoking is the most obvious one of these and exposure to passive smoking is a potential problem in pets. There are also likely to be many other environmental chemicals that could increase cancer risks
- Obesity increases cancer risks
The clinical signs of cancer can vary tremendously depending on the organ of the body that is first affected (the primary site), invasion of surrounding tissues and whether the cancer has metastasized (most commonly to lungs or liver). The treatment of cancer in dogs and cats has progressed dramatically over the last few years. Surgery still forms the cornerstone of treating many cancers and can be supported by follow up chemotherapy and radiotherapy. Other forms of cancer, such as blood and bone marrow cancers, are entirely treated with chemotherapy. Early detection and diagnosis followed by the appropriate treatment gives the best chance of treating cancer in dogs and cats. It is heart breaking to inform an owner that their pet is suffering from cancer. The owner is faced with so many difficult decisions:
- The possibility of radical surgery to treat the cancer
- The possible need for follow up chemotherapy/radiation therapy and side effects associated with this
- The possibility that despite all this, their pet may still die
- How much do they put their pet though, especially as affected patients are often elderly
- The costs of treatment
- The risks of treatment
The treatment plan that is ultimately undertaken will depend upon the veterinary surgeons in charge of the case and the owner’s decisions and beliefs. We hope that this support group can help you through the process.
There are numerous reasons why owners may be presented with the difficult decision of having to amputate their dog’s or cat’s leg. Such cases may include:
- Bone cancer particularly osteosarcoma
- Other types of cancer affecting the bones/joints/soft tissues of the leg that can not be managed in any other
- Trauma of the limb that makes repair impossible. This may include severe bone fractures (although with advances in orthopaedic surgery these are fairly rare now), severe soft tissue injuries resulting in irreversible damage to muscles and/or blood supply and nerve damage resulting in the limb becoming totally non functional
- Intractably painful limbs due to other conditions such as infections and severe arthritis
In dogs, the commonest reason amputation is carried out is for treatment of osteosarcoma. In cats, it is due to severe limb trauma usually following a road traffic accident. In this article, I will concentrate on dogs. Osteosarcoma is a very aggressive form of bone cancer that presents with severe progressive lameness. Sometimes, affected dogs present with a fractured leg that occurs because the bone has been weakened by the cancer and just doing something normal like getting up can result in the bone breaking. This is called a pathological fracture. Larger breeds of dog are most commonly affected with osteosarcoma with Greyhounds, Rottweilers, Great Danes and Irish Wolfhounds particularly commonly affected. The average survival time for a dog with osteosarcoma is 6 months with surgery alone and 12 months with amputation and follow up chemotherapy. You do not cure dogs with osteosarcoma by amputation because by the time the cancer becomes apparent in the bone, it has already spread elsewhere in the body. The big advantage of amputation is that it is the most effective way of eliminating the pain associated with osteosarcoma. Amputation and follow up chemotherapy is still the most common treatment option that is undertaken. More advanced limb salvage procedures are carried out in some specialist centres and now there are pioneering procedures using prosthetic limbs in dogs. It is unclear whether these offer any real advantages over amputation and each case needs to be considered on an individual basis. The decision to amputate a dog’s leg who is suffering from bone cancer poses an owner a whole host of dilemmas:
- Do I put my dog through such a big operation? Will they cope on three legs?
- Is it reasonable to put my dog through such a big operation when survival time can be relatively very short?
- What are the risks of the operation?
- How long will it take my dog to be back to normal after surgery?
Most of these questions are difficult to answer and the decisions made by owners depend on the advice offered by their veterinary team and their personal beliefs. However there are some generalities that we can consider:
- Although a major operation, amputation of limbs in dogs is a relatively simple surgical procedure. There are risks of serious haemorrhage but a suitably experienced surgeon should be able to avoid this. The general anaesthetic risks depend on each individual case but provided there is no pre-existing diseases such as heart and lung disease, these risks are usually fairly low
- I have never seen a dog not cope on three legs that I have operated on. An eminent orthopaedic surgeon once said that dogs are born with 3 legs and a spare! Each case must be judged on an individual basis and if there are serious pre-existing diseases affected the other legs then amputation may not be suitable. But provided the other 3 legs are sound, dogs will cope. I have even amputated a limb from significantly obese dogs. They have required intensive post op care, rehabilitation and dietary control but have all done well.
- Dogs do not have the emotional issues that human amputees endure. I can only imagine how incredibly hard it must be for people to deal with loosing a limb but for dogs this does not exist.
Despite all the above, it is a difficult and emotional decision for owners to make. We hope therefore that this support group can help.
If you’ve seen our logo, it reads “Cherrydown Vets Ltd – to us they’re one of the family.” That’s not just a nice tag, but how we see your pets and the way we think they should be cared for by us. We believe support and care beyond just the clinical needs of your pet are extremely important. Just as with people, serious illness in pets can cause great distress and worry in a family. Not only is it important to get the right treatment physically it can be an enormous benefit emotionally to be able to talk to others who have been, or are going through the same experiences. So that’s why we put our heads together and have come up with two new Facebook pages to start to bring together people whose pets are going through the same difficult times. Animal CanCare is our support group for people whose pets are suffering from cancer and Tri Paw Pals is our animal amputee support group. In the coming weeks and months we will start to populate the pages with useful advice, interesting articles and stories of animals we see and treat. But that’s only part of what these Facebook Pages are for. The main reason to have them is to allow you, the owners to tell us and others, about your experiences and the things that you found helped, or made coping and making decisions that bit easier. We will answer your questions where we can, or put you in contact with people we think might help. While these pages have been set up by Cherrydown Vets we have not set this up just for our clients. We want to invite people from all over the country to join in, to help fellow pet owners and form a community that helps one another with guidance and input from us and other experts we think can help you. For those of you that are joining us here at the beginning of this journey, things aren’t going to be immediate as it will take time to build and gather momentum. But bear with us, join in and tell your friends about these pages so that word spreads and soon a few will become many and the help, support & ideas will grow.
So there you have it, now it’s partly up to you to help make these pages what you want them to be. So go on, write a comment, tell us if you like us, post photos of your pets and tell us about your experiences and how we can make your journey, and that of your pet, just a little bit easier. We look forward to hearing from you. If you want to contact us or know more about Cherrydown Vets then visit our social media sites: Our web page – http://www.cherrydownvets.co.uk where, amongst other things, you can see videos of us going about our business and realise why we love what we do. Our Facebook Page – www.facebook.com/CherrydownVets where we interact with our friends on a daily basis offering a mix of informative blogs, topical information, details of local events and a few things to bring a smile to your day. Our Twitter Page (@CherrydownVets) – http://twitter.com/CherrydownVets where we keep you up to date with what we’re up to and who we’re following.