Dr Karen explains Integrative Cancer Care

When a family pet is diagnosed with cancer, owners feel overwhelmed. The internet is a minefield of information and misinformation, adding to stress. Our goal at All Natural Vet Care is to offer integrative and alternative cancer care for pets. 

We can offer integrative cancer care for pets undergoing conventional treatments, as well as complimentary care for those for whom regular treatments are either declined, or not suitable. We offer strategies which focus on individual pet care, and current best evidence or case based therapies.

Dr Karen has recently recorded this information for a podcast by PAW Pure Animal (Blackmores) which you can listen to here

Integrative Cancer Care can be thought of as the combination of complimentary and alternative treatments, with conventional cancer care. The goal of integrative veterinary care is support for our patients as they undergo stressful treatments such as surgery, chemotherapy, radiation therapy or other treatments. This supporting care is aimed at reducing side effects, improving outcomes, and improving overall quality of life and survival.

The types of treatments we may offer include: nutritional guidance, nutritional supplements, herbal remedies, energetic remedies such as Flower essences or Homeopathy, acupuncture, advice for preventative health care ( vaccines etc) to reduce chemical load, and alternative treatments such as Intravenous Vitamin C.

We understand that every pet, every family and every situation is different, so this becomes a program of individualised patient care. We usually recommend a number of treatments that can work in well together. We want to be realistic about what we can achieve. My experience treating pets with cancer has taught me that there is no one miraculous natural substance that will cure cancer, but that we can make a real difference with a combination of carefully chosen treatments.

As part of goal setting, we obtain what is called “informed consent” from our pet carers. This means we discuss the benefits, as well as any potential side effects, of  treatments we may prescribe. Some of the treatments we discuss are not readily accepted in mainstream veterinary medicine.

Nutritional advice is the foundation of any integrative cancer care plan. Nutritional support for cancer care has been a part of mainstream veterinary practice for many years. In 2006, Gregory K Olgivie demonstrated improved outcomes in dogs undergoing treatment for advanced lymphoma, if they were fed low carbohydrate diets supplemented with omega 3 essential fatty acids and L-arginine. The Prescription Diet Hills n/d has been formulated along these lines.

I prefer to recommend a “clean” home prepared diet, using good quality ingredients, suited to my patient and attainable by their owner. The gold standard might be organic human grade meat and organ meat, (often white meat) with a variety of vegetables, omega-three essential fatty acids, and balanced up with a good quality whole food supplement.

Individual pets may require a different approach. I prefer to avoid raw meat and bones for dogs and cats undergoing chemotherapy. Pets with liver disease, kidney disease, gut disorders or food sensitivity may need an individually prescribed diet.

The Ketopet Sanctuary has helped shed light on the potential benefits of a ketogenic diet for pets with cancer. This diet shifts the body's metabolism from sugar-using to fat-using. It is not a diet suited to every patient. It involves strict calorie restriction, and is a raw, high fat, low carb, moderate protein diet.

One theory is that cancer cells require carbohydrates for metabolism and will be less able to thrive on a diet higher in fat. The diet results in weight loss, reduced insulin resistance, and therefore reduced inflammation which is the driver for many cancers.

For me the most important diet goal is that my patient enjoys the food. They want to eat it, and it helps maintain healthy body condition, and a healthy gut.

There are many natural and plant based compounds, that have multiple effects, that may benefit dogs and cats with cancer. One aim is to try to use lower doses of multiple supplements, thereby reducing potential side effects, and increasing effectiveness as they work in together. (Steve Marsden.)

Examples some of the nutritional supplements we may choose from include: high quality fish oil certified free of heavy metals, good quality veterinary probiotics, combinations of antioxidant vitamins and herbs, Co Enzyme Q 10, melatonin, L arginine, taurine, and L-glutamine.

The use of antioxidants as part of complimentary cancer care in both people and pets is something that has been widely debated for many years, and the implications are still not fully understood. On the one hand, antioxidants may offer numerous benefits in cancer co-care including: protecting healthy cells from damage, increasing apoptosis in cancer cells and reversing chemotherapy drug resistance in cancer cells. Eg: Coenzyme Q 10 is an antioxidant that can protect cardiac cells from oxidative damage due to Doxorubicin treatment. The opposite argument is that many conventional treatments rely on oxidative effects for some of their anticancer activity, and theoretically antioxidants will interfere with this.

There are two specific antioxidant treatments we may discuss. Low Vitamin D levels in dogs have been associated with increased risk for cancer in dogs, as well as immune mediated disease, atopic skin disease, poor immune function and hormone imbalances. Low blood Vitamin D levels in people have been associated with bone cancer (osteosarcoma) and a similar association may be present in dogs.

Other cancers that may be linked to low vitamin D include mast cell tumours, lymphoma and leukaemia. Supplementing Vitamin D may improve response to treatment, and foods high in Vitamin D (eg sardines, beef liver) may be added to the diet. But these may not be enough. Long term dosing with very high levels of Vitamin D may be toxic, so ideally blood levels are checked beforehand, and monitored every 2-3 months to ensure the dose is both adequate and non-toxic.

High blood levels of Vitamin C, only achievable with intravenous dosing, have been shown in numerous studies (using in vitro, and animal models, as well as clinical reviews) to have cancer cell killing effects, and to improve survival both with and without chemotherapy, in many types of cancer. In our experience dogs undergoing this treatment seem brighter, with improved appetite, enhanced energy levels, and better quality of life. Anecdotally we have seen improved survival in many dogs. We can discuss with pet owners the suitability of this type of treatment for individual dogs, and any potential cautions (based on cancer diagnosed, type of conventional treatment used, and any additional concerns eg renal disease or bladder stones).

Overall, the experience of integrative human practitioners, and of most vets working in integrative practice, is that we see better outcomes, improved quality of life, and even survival, in dogs or cats receiving antioxidants as part of an integrative approach to cancer care. However we may time these to avoid chemotherapy (ie: no antioxidants 24 hours before and 48 hours after treatments), and may not use them during radiation treatment.

There are numerous herbs used in cancer care. These include milk thistle (used as liver support during chemotherapy, but also has antioxidant and cancer protective effects); Tumeric, Green tea, Bilberry, and Boswellia. 

Coriolus versicolar (Turkey-tail mushroom) is one example of an herb that has been researched for its benefits in dog cancer care. A study at Pennsylvania  University in 2012 showed increased survival in dogs who had undergone splenectomy for treatment of a malignant splenic tumour (heamangiosarcoma) if they were prescribed Coriolus. Since current chemotherapy protocols do not offer significant improved survival for this type of cancer, this is a viable and now evidence informed option. Further studies are underway. 

Yunnan bayou, or “White Medicine from Yunnan Province” is a traditional Chinese herbal formulae, containing Panax notoginseng and other herbs. It is used traditionally to help stop bleeding via effects on platelet function. Panax notoginseng may also have cancer protective effects including inhibition of angiogenesis-(i.e inhibition of the formation of blood vessels required for cancer progression).(E Banninck). It may therefore be used to help improve survival in dogs diagnosed with splenic cancers which have the potential to bleed.

Acupuncture is used in our practice to manage the effects of cancer, or cancer treatment such as reduced appetite, lethargy, or pain. We will also use acupuncture as a non-chemical treatment for other health conditions that may significantly affect quality of life eg: degenerative joint disease or back pain.

We all know that sticking to regular routines and exercise will help reduce stress in dogs and cats. This supports good immunity as well as quality of life. More recently human studies have shown improved response to treatment in patients who exercise in the thirty minutes prior to chemotherapy treatments. 

As part of lifestyle counselling we can also discuss strategies to reduce the chemical load our pets are exposed to. We review the best options for flea and tick and heartworm prevention,  avoiding or reducing  vaccines, and reducing exposure to chemicals around the house.

Quality of life is the primary goal of integrative and complimentary cancer care. With this in mind, we will need to discuss end of life care, and the timing of the very difficult decision to allow our pets to be let go. We can support pet owners, and find resources to empower them during this difficult time.

Taking into consideration all these strategies, we aim to help every pet owner make informed decisions they are comfortable with, and enhance the quality of life and health of pets diagnosed with cancer.

References:

Olgivie G (2006) Nutrition and cancer: Frontiers for Cure 2006 World Small Animal veterinary Association Conference.

Banninck E:  College of Integrative Veterinary Therapy

Steve Marsden: College of Integrative Veterinary Therapies

To book an initial consultation with Dr Karen or Dr Matthew for a pet has been diagnosed with cancer please book here (call if wait times appear to be over one week and we can try to triage your visit)