A cancer diagnosis for your dog can be downright scary—especially when you don’t know what to expect. Big Barker’s consulting vet, Dr. Sarah Wooten, recently had the pleasure of interviewing Dr. Sue Ettinger (aka Dr. Sue the Cancer Vet) about osteosarcoma, a particularly serious form of bone cancer. Researchers are hard at work finding new ways to fight this disease, and in this interview, Dr. Sue shares everything dog parents need to know about osteosarcoma and dogs.
Dr. Sue Ettinger is a practicing veterinary cancer specialist, international speaker, book author, and is currently the head of the Oncology Department at the Animal Specialty & Emergency Center in the Hudson Valley, NY. She is one of approximately 400 board-certified specialists in medical oncology in North America. She received her veterinary training at Cornell University College of Veterinary Medicine and completed her residency in medical oncology at the Animal Medical Center in NYC in 2003. She has recently won the Woof Pack Award for Exceptional Doctor Performance in the Northeast specialty region.
Dr. Sue is the co-author of the Second Edition of The Dog Cancer Survival Guide, which is a best-selling book in small animal health for the last several years. She co-hosts the podcast The Pet Cancer Vet on radiopetlady.com.
Dr. Sarah Wooten: How common is osteosarcoma in dogs?
Dr. Sue Ettinger: Osteosarcoma is the most common bone cancer in dogs. Currently, it comprises 85% of all primary bone cancers, and 5% of all tumors; however, there isn’t a good way to track cancer rates in animals like there is in humans.
SW: Which breeds are most at risk?
SE: Large and giant breeds have the highest risk for osteosarcoma. While osteosarcoma is reported in certain breeds such as German Shepherds, Great Danes, Saint Bernards, Golden Retrievers, Greyhounds, Irish Setters, and Rottweilers, researchers are determining that the height of the dog is a higher risk factor than the breed, i.e. the taller the dog is, the higher the risk is for osteosarcoma.
SW: How can a dog owner reduce the risk of osteosarcoma?
SE: It is hard to reduce the risk because genetics and conformation are at play. If you have an at-risk breed or a tall dog, I recommend that you learn how to monitor your dog for any signs of bone cancer, which include lameness/limping, swelling over the bone that is affected, and pain. There is a saying that goes with osteosarcoma: away from the elbow, towards the knee. Osteosarcoma shows up near the knee in the hindlimb, and near the wrist in the front limbs. If you see the signs I mentioned, schedule an appointment with your veterinarian ASAP! If your veterinarian recommends trying some pain medication first, I recommend insisting on getting an X-ray that day, as the earlier cancer is diagnosed, the higher the likelihood you can treat it. Make your vet do X-rays!
There is new research that shows that waiting to spay or neuter large breed dogs may reduce the risk of osteosarcoma. The original study was done in Rottweilers and showed that dogs neutered at younger than 1 year of age were more likely to develop osteosarcoma. I recommend waiting until dogs are one year of age before spaying and neutering.
SW: Is there a vaccine?
SE: Cancer vaccines are not used to prevent cancer. There is a vaccine in development by Aratana, but it is still in studies at UPenn. This vaccine is immunotherapy and is considered treatment to be used in conjunction with chemotherapy and surgery. The hope is that this vaccine will extend survival times in dogs who have already been diagnosed and treated for osteosarcoma.
SW: What is the best treatment for osteosarcoma?
SE: The best treatment is amputation of the affected leg, followed up with chemotherapy. I know that amputation seems extreme, but it takes away the pain and is required to remove the cancer. I do know that some hospitals, such as Colorado State, do limb-salvage surgery; however, the standard recommendation is amputation, even for old and arthritic pets.
I find that sometimes pet owners have a hard time coping psychologically with the idea of amputating a leg. By and large, people struggle with the idea of amputation much more than the dogs struggle—they are just happy their leg doesn’t hurt anymore! If you are facing a diagnosis of osteosarcoma in your dog, I know this is a hard decision, but amputation is the best thing you can do for a dog that has been diagnosed with this terrible disease. There is a wonderful online support community at http://tripawds.com/ that I encourage you to check out. You can also just google “three legged dogs” to see lots of pictures of happy dogs on three legs.
SW: How much does treatment cost?
SE: Costs vary by region, but in general, surgery costs anywhere from $3000 to $4000, and chemotherapy costs $3000 to $5000. Stereotactic radiation is also available; however, it is costly at $8000 to $10,000.
SW: With surgery and chemotherapy, what is the expected survival time?
SE: Median survival time is 1 year, but 25% of dogs live 2 years.
SW: What is the expected survival time with just amputation?
SE: With amputation alone, 4 to 5 months survival is average.
SW: How can a pet owner best manage their dog’s pain?
SE: Dogs can be stoic and not complain, but I can tell you, if a dog is limping, then he is painful. There are several good oral medications available to manage pain. I want to make sure dog owners know that not everybody wants to treat aggressively, and that is OK. Surgery alone is palliative and a reasonable treatment option, and dogs are very happy and pain free after surgery, at least until the cancer comes back. Two to four doses of palliative radiation can increase comfort better than oral pain medication, and is a lot less expensive than traditional chemotherapy, and some dogs are able to reduce or discontinue their pain medication with the treatment.
Dr. Sarah Wooten is Big Barker’s consulting veterinarian. Dr. Wooten is a small animal veterinarian with more than 15 years of clinical experience. She is an expert contributor to sites such as vetstreet.com, DVM360.com, and The Bark Magazine.