Not Treating Dog Cancer

Why You Might Not Want to Treat Dog Cancer

There are many reasons why you may elect not to pursue treatment if your dog is diagnosed with cancer. Not treating dog cancer is often a reasonable choice, and sometimes it’s the best choice you can make for you and your dog.

Choosing to not treat does not mean you do not care about your dog. Instead, you are shifting focus from curative or life prolonging efforts to prioritizing comfort.

There are studies that have found that the quality of life and priorities of pet owners influence the quality of life of their pets. Thus, it is not only okay, but essential, to consider how dealing with the cancer diagnosis will affect the entire family caring for that dog.^1,2

You may be surprised, but treatment is not always recommended by veterinarians or veterinary oncologists. What is important is that you have an open and honest conversation with your veterinarian about treatment options, pros and cons, and expected survival time with and without treatment, so you can make an informed decision that you feel is best for you and your dog.

When There Are No Great Treatment Options

For some cancers, there may not be reasonable treatment options. If your dog has advanced aggressive cancer, a rare cancer, or a cancer with a very poor long-term prognosis, treatment may not be the best option.

In some cases, treatments that do exist may have poor outcomes with a high risk of side effects. In these cases, declining treatment may actually be the best course of action. One needs to weigh the risks and benefits of a particular treatment, and how it will affect the quality of your dog’s life.

When Veterinary Visits Are Stressful

The stress of veterinary visits is also a factor to consider. If you have a dog who is extremely anxious at the vet’s office or in the car, and treatment involves daily visits to the oncologist, you may decide that in the long run you would rather have less time with a happier dog than put your pup through that treatment schedule.

The fear and discomfort at the vet may be unnecessary for your dog to endure during their final days, weeks, or months. Keep in mind, dogs who are stressed at the hospital may have an increase in vital parameters like heart rate and blood pressure,³ and chronic elevated stress hormones can influence overall health.

It’s OK to prioritize bucket list items like trips to the park or the lake over trips to the vet if they are unpleasant for your dog.

When Your Dog Doesn’t Tolerate the Treatment(s)

The goal of cancer treatment in our pets is generally not to cure but to extend life while preserving or increasing the quality of life.

Unfortunately, that does not always happen despite our best efforts.

• Chemotherapy, radiation, surgery, and medications all have potential adverse effects.
• Dogs tend to tolerate chemotherapy very well, however, common adverse effects of chemo include gastrointestinal upset and decreased neutrophils (a vital white blood cell), which can increase the risk of secondary infections.
• Radiation can have acute and chronic side effects including pain.
• Some dogs are extremely difficult to medicate at home and may spit out pills or struggle when you attempt to give a medication. This extra stress and daily drama may not be worth enduring, for you or your dog.

If your dog is not doing well with a certain treatment, simply not treating dog cancer so you can prioritize comfort may be your best decision.

In fact, quality of life evaluation is being integrated as an important monitoring tool for pets receiving chemotherapy. If your pet’s quality of life is decreased that may be an indicator that it is time to stop treatment.⁴

Not Treating Dog Cancer Because of Other Serious Health Problems

Another reason to stop and consider if treatment is right for your dog is if they have other health issues that may put them at increased risk for adverse effects or treatment failure.

If your dog has comorbidities like chronic kidney disease (CKD), chronic liver disease, heart disease, Cushing’s disease, seizures, or severe anxiety, you may have to weigh the risks of certain treatments with a different mindset.

Your veterinary team can help you weigh the risks of mixing other serious disease processes and cancer treatment. Veterinary oncologists are specially trained to manage underlying conditions while maintaining a good quality of life in pets with cancer.

When It’s Difficult to Access Care

Access to care can be another roadblock to treatment. Availability of treatment options may be difficult due to geographic location and/or time constraints.

Ask yourself: what kind of time and energy will getting treatment take for you and your family? It may be that the closest veterinary oncologist is hours away, so weekly or daily treatments are not feasible. Radiation protocols can be particularly demanding in terms of frequency of treatment. It may be that your work schedule does not align with the available treatment hours.

These are daily logistical realities that must be considered and can influence your choice to treat. Talk to your veterinary team about your time and travel limitations and see if there is a treatment plan that fits both your schedule and your dog’s needs.

Choosing the extra hour you have at the end of the day to take a walk or snuggle with your dog may be the best for both of you in the end. If it’s next to impossible for you to get your dog to treatments, not treating dog cancer makes all the sense in the world.

When There Are Financial Limitations

We all understand that advanced veterinary care can be expensive. A personal financial situation may make treatment impossible without threatening you and/or your family’s well-being.

If you are reading this article, it is already clear you love and care about your dog, so making the choice of not treating dog cancer is understandable and you should not further punish yourself for having to make such a decision.

Remember, veterinarians are trained to offer the gold standard as an option to each patient, but that does not mean that they expect you to choose that path.

Unfortunately, it is common for veterinarians to rely on clients to initiate a conversation about finances.⁶ Veterinarians are working to change that, but in the meantime do not hesitate to ask your veterinarian about cost and payment options.⁶

It may be possible to get funds together from donation funds or to reach out to other organizations who have the mission to assist in these types of situations. There are also likely other treatment options available that may have a different success rate but still provide your dog a chance to feel better.

Only you know your financial limits. Your ability to care for yourself and the other beings who depend on you is vitally important. Everyone has financial limitations, and you should never feel pressured to exceed your own limitations.

Is This for My Dog or for Me?

When you are making the decision to treat, always ask: Is this for me or my dog?

Dogs do not experience illness exactly like we do. They are lucky enough to live in the present. They don’t worry about the past, future, or median survival times.

If pursuing aggressive treatment will cause daily pain without a good long-term outcome, all your dog will experience is daily pain.

Consider it from a dog’s perspective: if you didn’t have the foresight to understand potential benefits of a treatment protocol, would you be willing to endure it if it were scary, invasive, or separated you from your favorite people?

The right choice is too often not the easy choice when it comes to our beloved pets.

Focusing on Quality of Life and Hospice Care

Whether or not you choose to treat, taking the time to be thoughtful about your dog’s quality of life toward the end is very beneficial. It can be very helpful to have a more qualitative approach to quality of life, to remove the lens of emotion that can skew objectivity. When you are living with your dog and seeing small changes every day, the definition of “normal” can slide quickly without notice.

Having a chart or log you start at the beginning of the cancer diagnosis can help you track quality of life. Fill this out daily or weekly. You can include quality of lifer parameters such as minutes spent taking a walk, being interactive with family members, appetite, accidents in the house, ease of mobility, and more.

Hospice care doesn’t worry so much about treating the exact disease that your dog has, but instead focuses on relieving symptoms and keeping your dog happy and comfortable. Your regular veterinarian can help guide you through providing hospice care for your dog at home, and there are also veterinarians who focus specifically on hospice and end of life care. These vets can help guide you through this stage of your dog’s journey and make sure your pet is comfortable. It is important to remember the goal is quality of life, not quantity.