Chemotherapy safety: A key element of the upcoming 2026 AAHA Oncology Guidelines for Dogs and Cats

When Jaci Christensen, BAS, LVT, VTS (Oncology), joined the oncology department at Texas A&M’s Veterinary Medical Teaching Hospital 15 years ago, she was not yet well-versed chemotherapy safety. She simply stepped in and administered chemotherapy the way everyone else on the team did, with “very little PPE, very little anything,” she recalled.

It wasn’t until 2017, when she was asked to give a lecture at a conference about USP <800> (a new edition of chemotherapy safety guidelines), that she began researching these safety protocols in earnest. At first, her main goal was to simply gather enough information to make her presentation on a fairly dry topic more interesting.

“My thought was, let me try to figure out why these guidelines are shifting,” she said. However, she didn’t find much that was specific to veterinary medicine. “So, I started diving into all of the research out there in human medicine, where they’re looking at the exposure risk and the increased chances of cancer in the nurses who are exposed to these drugs.”

“Very nonchalant”

The findings were startling. “Traces of these drugs are being found in the urine of nurses and staff who’ve never even received chemotherapy. And then, there are the reproductive risks,” Christensen said. “As I was reading this, I was becoming more and more concerned about my own safety, because for years prior I was not taking steps to protect myself.”

Beyond her personal wellbeing, she thought of colleagues who’d lost pregnancies. “These were all individuals who were handling chemotherapy, and everyone was very nonchalant,” she said. “It was just a wow moment. Like, what have we been doing? It really changed everything for me.”

Since she couldn’t find much research on the impacts of administering chemotherapy in veterinary medicine, Christensen took matters into her own hands. She created an informal online survey, which was shared widely.

“I got quite a few responses on what PPE veterinary technicians were using, the rates of miscarriages and cancer diagnoses, and all those kinds of things,” she said. “It was eye-opening to realize that it was very uncommon for veterinary technicians to be wearing the right PPE, or to be taking the best steps to follow USP <800>.”

From there, Christensen began writing about this topic and lecturing on it as frequently as she could. “I’ve tried to do as much as I can to make sure that my team is trained and takes it very seriously, and that it gets echoed to our veterinary students as they go out into the world, carrying that with them. Hopefully, things can start to shift,” she said.

Because, while she believes that USP <800> has been “hugely impactful in changing the mindset,” the fact that it’s not currently enforced by any agency in veterinary medicine means those standards are not always followed.

That’s not coming from a place of veterinarians or technicians not wanting to follow those guidelines, she said. “It’s truly just that the information hasn’t been presented.”

Common chemotherapy safety mistakes

Unlike previous USP guidelines, which tended to have some gray areas that were open to interpretation, Christensen said that USP <800> is specific regarding important details, like what PPE is appropriate with injectable chemotherapy, and how that might differ from the PPE one should wear with oral chemotherapy.

Some of the biggest mistakes Christensen said she still sees tend to be around proper use of PPE as outlined in USP <800>. “Some of the big ones are wearing chemotherapy-approved gloves and chemotherapy-approved gowns, and double-gloving, which previously wasn’t the standard,” she said. Reusing items like gowns is another frequent issue, and she also noted that, too often, individuals fail to use closed system transfer devices and needleless devices.

“A lot of people make the mistake of drawing up these drugs with a syringe and needle, because that’s what’s done for every other drug,” she said. “But, you know, following [the USP <800>] guidelines, what you should be doing is using needleless devices and spikes and using closed system devices so there’s no chance for that drug to leak out of your needle or spill onto the counter.”

For the most part, Christensen said, the confusion she sees from veterinary professionals is related to keeping up with the latest advancements in an evolving field. “There are a lot of questions like, ‘What’s your standard treatment for lymphoma’ or, ‘What’s your go-to for this disease,’” she said. “A lot of the consults we receive are related to, ‘Hey, what’s new in veterinary oncology?’”

The 2026 AAHA Oncology Guidelines for Dogs and Cats

Christensen, cochair of the 2026 AAHA Oncology Guidelines for Dogs and Cats task force, became a licensed technician in 2008 before earning her bachelor’s degree in veterinary technology in 2012 and her VTS five years ago.

She said the topic of chemotherapy safety is important to her—and an important part of the guidelines—because, “historically, veterinary medicine has kind of been the Wild, Wild West when it comes to safety,” she said.

“It’s not like radiation safety, where everyone knows what we should be doing to protect ourselves, and everybody does it and follows the guidelines,” she continued. “I feel like [when it comes to chemotherapy], we’re in the early era of radiation safety.”

Since the hazards involved in administrating chemotherapy often are not emphasized in technician education, employers tend to be responsible for providing the necessary equipment and information to keep the technicians safe, she said.

That’s just one reason why the comprehensive AAHA Oncology Guidelines will be so beneficial for veterinary professionals. Aside from staff and patient safety recommendations, the guidelines include sections on:

• diagnosis and staging,
• principles of surgical biopsies,
• the latest on new drugs and treatments,
• key insights on drug approval processes,
• and early interventions for supportive care.

Additionally, the guidelines provide useful suggestions for client communication (including discussion treatment expectations) and technician utilization, both topics Christensen is passionate about.

The tech’s role in oncology care

Christensen remembers that, when she first joined the team at her hospital, her duties were fairly minimal—and because, like many technicians, she wanted to be utilized, feel valued, and feel like her work was impactful, she looked at ways to get more involved.

In particular, as she became more aware of the importance of chemotherapy safety, she began asking to talk to clients about it.

She was given the green light, and her responsibilities grew. “Now I’m within a department where the technicians are heavily utilized, and I’m now able to have these hard conversations with clients about what to expect post-chemotherapy,” she said. “I mean, cancer is very scary for pet owners—and everyone, really. It’s been hugely impactful to me to be able to play a role in easing that stress and fear that our clients come in with.”

But it’s not only the clients this work benefits. It’s also good for the entire veterinary team; veterinarians, especially, may see the benefits as it frees them up to focus on their responsibilities, knowing these important tasks are being handled appropriately.

“Yeah, these are hard client discussions, but we can help with that. Double checking math so less mistakes happen—we can help with that,” Christensen said. “Understanding the drugs that we’re giving so that we recognize when something’s going wrong—there are just so many parts of a technician’s role that are often left out in this field, but those are things that are really helpful for technician satisfaction.”

“I’m biased, I’m sure,” she continued, “but I think the technicians that work in the oncology department are probably the happiest technicians because of the extent to which we’re utilized and the impact that we make to pet owners and pets alike,” she said.

 

Photo credit: fstop123/E+ via Getty Images 

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