BODY AND SOUL

The dreaded word that you hope never comes out of your vet’s mouth: cancer. With lo­cal lead­ing vets, we break down this dev­as­tat­ing dis­ease and weigh its causes, symp­toms and treat­ments.

Pets (Singapore) - - Contents - BY GIL­LIAN LIM

Break­ing down ca­nine cancer and what you and Fido can do to fight it.

just like hu­mans, our ca­nine friends can con­tract cancer too. Statis­tics show that this dan­ger­ous dis­ease is on the rise: in a 2017 mor­tal­ity study done by the Bri­tish Small An­i­mal Vet­eri­nary As­so­ci­a­tion, cancer ac­counted for 27 per­cent of all deaths in pure­bred dogs, and an ear­lier study in 1982 showed that al­most one in ev­ery two se­nior dogs over the age of 10 will die from cancer.

Sure, it might seem cat­a­clysmic, but is it the end of your pooch’s life? “It’s im­por­tant to un­der­stand that many can­cers to­day can be treated and more suc­cess­fully man­aged than in the past with ad­vances in med­i­cal tech­nol­ogy and re­search, while most im­por­tantly main­tain­ing a good qual­ity of life,” shares Dr Brian Loon, prin­ci­pal vet­eri­nary sur­geon of Am­ber Vet.

To help you and Fido un­der­stand this mam­moth-like dis­ease, we speak to sev­eral vets in or­der to lay down its causes, symp­toms and treat­ment op­tions.

WHAT IS CANCER?

Cell di­vi­sion oc­curs all the time within our bod­ies to re­place age­ing and dy­ing cells. How­ever, cancer hap­pens when the reg­u­la­tion of cell di­vi­sion is lost and cells con­tinue to di­vide in an un­con­trol­lable man­ner. They grow into ad­ja­cent or dis­tant body or­gans and form tu­mours, which may manifest ex­ter­nally (i.e. a lump’s on a dog’s skin), or in­ter­nally (i.e. within a dog’s liver or spleen).

Each type of cancer is clas­si­fied by the type of cell that’s ini­tially af­fected.

For ex­am­ple, lym­phoma orig­i­nates in the lym­pho­cyte cells of the im­mune sys­tem, of­ten af­fect­ing tis­sues such as the lymph nodes, spleen and bone mar­row. Tu­mours that are lo­calised and demon­strate lim­ited growth are termed be­nign, while those that spread are termed ma­lig­nant and are more ag­gres­sive.

Though tragic, it is in­deed true that there are more cases of ca­nine cancer now. “In the past, I used to have ap­prox­i­mately four to six cases a year,” says Dr June Tan, prin­ci­pal vet­eri­nary sur­geon of Frankel Vet­eri­nary Cen­tre. “At present, the num­ber has risen on aver­age to about two to three cancer pa­tients per months. It’s not a good up­ward trend, I must say.” Dr Eu­gene Lin, se­nior vet­eri­nary sur­geon of The An­i­mal Ark Vet­eri­nary Group agrees

with Dr Tan—he sees about 15 to 20 cases of cancer a month. “It’s be­come eas­ier to di­ag­nose cancer with the ad­vance­ment of vet­eri­nary di­ag­nos­tic modal­i­ties and pro­ce­dures,” Dr Lin adds.

When we asked our ex­perts which can­cers they’ve come across most of­ten, com­mon ones in­clude lym­phoma, mam­mary tu­mours, mast cell tu­mors, me­lanoma, hae­man­giosar­coma and lipoma.

SYMP­TOMS AND CAUSES

If you’re look­ing for cer­tain tell-tale signs that are sure in­di­ca­tors that your pup has cancer, just like how a fever, cough and sore throat might in­di­cate you have the flu, you might be dis­ap­pointed to know that there aren’t any.

The symp­toms for cancer vary de­pend­ing on which or­gan the cancer is re­sid­ing in. “A cancer in the blad­der may re­sult in bloody urine or dif­fi­culty in uri­na­tion, while a cancer in the lungs may re­sult in in­creased breath­ing rate,” shares Dr Ong Wei Jin, a vet­eri­nar­ian from Ohana VetCare. “Mean­while, a tu­mour in the brain can re­sult in seizures and a cancer of the spleen can re­sult in col­lapse from sud­den mas­sive bleed­ing into the ab­dom­i­nal cav­ity.”

Plus, th­ese symp­toms are non-spe­cific and might ap­pear in non-can­cer­ous con­di­tions, and not all can­cers dis­play warn­ing signs too. “That makes early de­tec­tion dif­fi­cult for the paw-rent,” ad­mits Dr Tan. “Cancer can­not be de­tected through blood works too.”

So what can a cau­tious paw-rent look out for? Early symp­toms of cancer in­clude (though are not lim­ited to) the pres­ence of a steadily grow­ing mass, non-heal­ing sores, ex­er­cise in­tol­er­ance, lethargy, loss of ap­petite or sud­den weight loss, un­usual poo like per­sis­tent di­ar­rhoea or strain­ing to defe­cate or pee, stiff­ness in gait, un­ex­plained vom­it­ing or di­ar­rhoea, or be­ing non-re­spon­sive to med­i­ca­tion.

How­ever, it is pos­si­ble to keep a look­out for spe­cific can­cers sim­ply be­cause pure­breds have a pre­dis­po­si­tion to par­tic­u­lar can­cers. For ex­am­ple, Golden Retriev­ers, Box­ers, Ber­nese Moun­tain Dogs and Labradors are prone to mast cell tu­mors, while Rot­tweil­ers, Great Danes and Ger­man Shep­herds are prone to os­teosar­coma. “Al­though all dogs are equally sus­cep­ti­ble to cancer, hered­i­tary as­pects such as the pass­ing down of genes of cer­tain breeds and lin­eages can play a part,” ex­plains Dr Tan. Dr Lin adds: “Scot­tish Ter­ri­ers are 18 times more at risk of get­ting cancer of the blad­der than other breeds of dogs.”

Other than genes, fac­tors such as en­vi­ron­men­tal el­e­ments and weak im­mune sys­tems have been sin­gled out as causes of cancer. “For ex­am­ple, ul­tra­vi­o­let ra­di­a­tion from the sun as in the case of skin can­cers, or free rad­i­cals in pro­cessed food, ra­di­a­tion, or even viruses,” says Dr Ong. “A healthy im­mune sys­tem is also im­por­tant in the pre­ven­tion of cancer.

Cats af­fected by retro­vi­ral in­fec­tions, such as fe­line im­mun­od­e­fi­ciency virus and fe­line leukaemia virus, are more prone to some forms of cancer. This is anal­o­gous to HIV-af­fected hu­mans be­ing more prone to some forms of cancer.”

PRE­DIC­TION AND TREAT­MENTS

Can you an­tic­i­pate that your furkid will de­velop cancer? The up­shot: No. “Cancer can­not be pre­dicted with cer­tainty,” shares Dr Loon. “The ex­act causes are not well­known in gen­eral till to­day.”

While it is true that cancer tends to strike se­nior pooches be­cause old age weak­ens their im­mune sys­tem, that doesn’t mean that young pups are can­cer­free ei­ther. “I have re­moved a can­cer­ous tes­ti­cle from a three-month-old dog be­fore,” shares Dr Lin.

So what can paw-rents do when they feel sus­pi­cious masses or spot odd symp­toms such as sud­den weight loss in their ca­nine com­pan­ions? “The best thing any paw-rent can do is to seek the opin­ion of a vet­eri­nar­ian when some­thing is amiss,” ad­vises Dr Ong. Dr Tan agrees: “Be­ing able to recog­nise the symp­toms and treat­ing them quickly will im­prove the prog­no­sis of the treat­ment.”

It is crit­i­cal that paw-rents have a firm di­ag­no­sis be­fore think­ing of treat­ment

op­tions. This in­cludes be­ing cer­tain whether the lump is firstly can­cer­ous or not, what type of cancer it is, and what stage or grade is it at. “Stag­ing refers to the ex­tent of the growth of the tu­mor while the grade refers to how fast it might spread,” shares Dr Tan. “An early grade tu­mour, such as grade one, is small and non-spread­ing com­pared to a stage four cancer, which is big and in­va­sive to other body parts.”

To iden­tify the type of cancer your pooch might have—whether it is be­nign or ma­lig­nant—it’s best to un­dergo a biopsy or cy­tol­ogy of the growth. Biopsy pro­ce­dures could be as sim­ple as per­form­ing a fine nee­dle as­pi­ra­tion and look­ing at the cell un­der the mi­cro­scope in the clinic, or it could be as com­plex as per­form­ing an open surgery or a min­i­mally in­va­sive en­do­scopic surgery to ob­tain biop­sies, which will be sent to the pathol­ogy lab­o­ra­tory. Af­ter the type of cancer has been iden­ti­fied, it’s cru­cial to see how much it has grown through pro­ce­dures like chest x-rays and ul­tra­sounds.

Tra­di­tional treat­ment for ca­nine cancer in­cludes surgery to re­move the tu­mor, chemo­ther­apy, and ra­di­a­tion, the lat­ter of which is not avail­able in Sin­ga­pore. In the last 10 years, im­munother­apy—which al­ters the im­mune sys­tem to fight cancer cells—has also been de­vel­oped in the form of vac­cines as well. How­ever, the type of treat­ment de­pends en­tirely on the lo­ca­tion, stage, grade and type of cancer— the ear­lier the mass is re­moved when it’s smaller, the higher the chance for a full cure.

Other al­ter­na­tive treat­ments in­clude but are not lim­ited to tra­di­tional Chi­nese medicine and acupunc­ture, gene ther­apy and molec­u­lar tar­get in­hibitors.

PRE­VEN­TION

“Un­for­tu­nately, there is no sure way to avoid cancer,” ad­mits Dr Lin. “But we can help to re­duce the chances of our beloved pets con­tract­ing cancer by en­sur­ing they’re not ex­posed to car­cino­gens, like chem­i­cals, molds and toxic plants, and to ap­ply sun­block or limit their ex­po­sure to so­lar ra­di­a­tion if they like be­ing in the sun.”

Vets such as Dr Ong sug­gest boost­ing your pup’s im­mune sys­tem. “It’s the first line of de­fence in de­tect­ing and de­stroy­ing cancer cells, so it’s best if your furkid is in gen­eral good health,” says Dr Ong.

“This in­cludes a good body con­di­tion score by reg­u­lar ex­er­cise, a well-bal­anced diet sup­ple­mented with an­tiox­i­dants, early ster­il­i­sa­tion of fe­male dogs, and the re­moval of any re­tained tes­ti­cles in male dogs.”

Reg­u­lar health checks are a def­i­nite must, es­pe­cially for age­ing pooches, as th­ese as­sess­ments might in­clude imag­ing stud­ies de­pend­ing on the vet clinic, which can help de­tect masses at their ear­lier stages. “We can de­tect liver and spleen can­cers via ul­tra­sound ex­ams be­fore they are pal­pa­bly phys­i­cal or show any signs of ill­ness,” says Dr Loon.

Even still, health checks oc­cur once or twice a year at most. To fill in the gaps, Dr Ong sug­gests keep­ing a close eye on your pooch at home. “We can­not stress the im­por­tance of early de­tec­tion enough,” he says. “That would mean spend­ing time with your pets to pick up on any un­usual lumps and learn­ing how to do ba­sic phys­i­cal ex­am­i­na­tions on your pet as well.”

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