Most pets don’t suf­fer side ef­fects from chemo­ther­apy

Bray People - - LIFESTYLE - Pete Wed­der­burn

THE O'REILLY fam­ily trooped in to my con­sult room: two par­ents, three chil­dren and a tail-wag­ging, easy-go­ing Labrador called Bob. Most pets come to the vet with one hu­man: Bob was so im­por­tant to the O'Reillys that it was al­ways a fam­ily af­fair. The chil­dren ranged in age from ten to six­teen, and Bob was nine years old: he was like a brother to them.

Bob had never been se­ri­ously ill. Pre­vi­ous prob­lems had been sim­ple to solve. One time he'd suf­fered an up­set stom­ach af­ter be­ing given the leftovers of a week­end fry up. On an­other oc­ca­sion, he'd cut his foot when pad­dling in a river on a walk with the fam­ily. He'd bounced back rapidly from th­ese mi­nor set­backs, and so his vis­its to the vet had never been any­thing to worry about.

On this oc­ca­sion, I could see that Bob was down­cast. He didn't try to jump up on me as usual, and he stood qui­etly, rather than dash­ing around the con­sult room, sniff­ing ev­ery cor­ner.

Mr O'Reilly ex­plained the back­ground as he lifted his dog onto the ta­ble: “I don't think there's too much wrong with Bob, but he didn't want his din­ner last night, and he isn't hun­gry this morn­ing ei­ther. He usu­ally loves his food, so we thought we should bring him down to have him checked out by you. It's prob­a­bly noth­ing, but bet­ter safe than sorry!”.

As I checked Bob over, I asked a few more ques­tions, but there wasn't much more to say. As far as the O'Reillys were con­cerned, Bob just wasn't quite him­self. It was noth­ing more se­ri­ous than that.

My brief phys­i­cal ex­am­i­na­tion left me with a sick, hol­low feel­ing in­side. Bob had golf­ball sized lumps un­der his chin, in front of his shoul­ders, and at the back of his hind legs. The most likely cause was a se­ri­ous type of can­cer. I glanced around at the fam­ily, still smil­ing and laugh­ing, en­joy­ing their visit to the vet.. How was I sup­posed to break this ter­ri­ble news to them about their beloved dog? This type of con­sul­ta­tion must be one of the most dif­fi­cult tasks that a vet needs to do.

I qui­etly fin­ished my ex­am­i­na­tion, and lifted Bob down from the ta­ble with­out say­ing a word.

“What's the story then?” Mr O'Reilly asked. “Has he man­aged to eat some­thing that's dis­agreed with him? He sticks his nose into ev­ery­thing!” The chil­dren gig­gled in the back­ground.

I de­cided to break the bad news grad­u­ally. “I'm afraid that this time Bob might have some­thing more com­pli­cated wrong with him this time. If you leave him with me to­day, we'll do a few tests, and by this evening, I'll know a bit more.”

The chil­dren were ex­cited for their pet, as if he was hav­ing some sort of ad­ven­ture, and they went back out to the wait­ing room bab­bling with en­thu­si­as­tic chat­ter. As they went, I gen­tly held their fa­ther's el­bow, and asked him to stay with me for a pri­vate chat on his own.

I then told him the full, se­ri­ous story. It was very likely that Bob had a con­di­tion known as Lym­phoma, a can­cer of white blood cells. The bad news is that it's a se­ri­ous type of can­cer; the good news is that it can re­spond well to treat­ment. We'd need to wait for biopsy re­sults to have the di­ag­no­sis con­firmed, but in the mean­time, he should try to grad­u­ally let his fam­ily know that this was more than a mi­nor blip for Bob.

The chil­dren weren't there for our next con­sul­ta­tion: it was just Mr and Mrs O'Reilly, with Bob by their side. I had the full biop- sy re­sults, and they al­ready knew that the can­cer di­ag­no­sis had been con­firmed. There was no ban­ter in the room this time: this was a se­ri­ous no-non­sense dis­cus­sion.

I gave them a sim­ple sum­mary of Bob's prospects. With­out any treat­ment, he would get steadily worse, and he'd prob­a­bly only live for a few weeks. Mrs O'Reilly sobbed qui­etly as I said this, and I moved rapidly on. “The good news is that just with sim­ple treat­ment us­ing steroids, Bob would rapidly re­turn to his nor­mal bouncy self. The lumps would go down in size and his ap­petite would re­turn”. She'd stopped cry­ing now, and was lis­ten­ing care­fully to me. I went on to ex­plain that this im­prove­ment would only last a few weeks or months, and then he'd fall se­ri­ously ill again. But there was one other op­tion: chemo­ther­apy.

Mr O'Reilly shook his head as I said this. “We don't want to put Bob through that” he said. “We don't want him to go bald and we don't want him to stay alive if it means suf­fer­ing the con­stant side ef­fects of drugs”.

I ex­plained the facts: chemo­ther­apy, as used in pets, is not the same ex­pe­ri­ence as the hu­man equiv­a­lent. 95% of dogs have no side ef­fects from chemo­ther­apy, or mild ones that go away by them­selves. Less than 5% of dogs have un­ac­cept­able side ef­fects, most of which can be treated. And for lym­phoma, the re­sults can be im­pres­sive: there is a good chance (90%) of get­ting com­plete re­mis­sion, which lasts a year or more in around 50% of cases. And one in four dogs is still do­ing well af­ter two years.

The O'Reillys lis­tened to me but they couldn't give me an an­swer. They went home to think.

What hap­pened to Bob? Did his own­ers choose chemo­ther­apy or not? I'll fin­ish his story for you in next week's col­umn.

Bob is fac­ing a can­cer di­ag­no­sis. Will his own­ers put him for­ward for chemo­ther­apy? Find out next week.

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