2016 AAHA Oncology Guidelines for Dogs and Cats
Every primary-care companion animal practice will encounter canine and feline oncology cases. A successful, full-service practice should be prepared to diagnose, stage, and treat cancer in dogs and cats, and should have a relationship with veterinary oncology specialists for purposes of selective case referrals. Cancer cases are often among the most sensitive and challenging that a practitioner will encounter. Few areas of expertise can do more to strengthen a practice’s relationship with its clients than having an effective protocol and approach to managing cancer in canine and feline patients.
Cancer treatment is case specific and multifactorial. Treatment modalities are based on the tumor type and its stage. Staging is a critical factor in deciding which treatment modalities to use, or whether to treat the disease at all or to instead rely on palliative measures. Chemotherapy, immunotherapy, adjunctive therapies, radiotherapy, and surgery can be used individually or in tandem depending on the type of cancer involved and the owner’s preferences. Chemotherapy is now commonly used in veterinary oncology. However, the inherent toxicity of chemotherapy agents requires strict safety precautions to avoid inadvertent exposure of the patient, clinical personnel, the pet owner, and the environment.
Quality of life, for the patient and, indirectly, for the pet owner, is central to cancer case management. Managing the patient’s quality of life includes maintaining a reasonable level of pain-free, functional activity during treatment and minimizing treatment side effects. At times, and particularly in advanced cancer cases, maintaining the patient’s quality of life and extending its lifespan are mutually exclusive. The decision on how to achieve a balance between quality and quantity of life is complicated by the fact that cancer is often a disease of older pets, the time of life when the pet–owner relationship is usually strongest. Because oncology cases may conclude with the death or euthanasia of the patient, a satisfying outcome for all is highly dependent on good communication between the practitioner and the client. This dialogue should include all members of a healthcare team that is collectively equipped to manage the pet owner’s expectations, guide treatment decisions, and provide empathetic client support.
The AAHA Oncology Task Force gratefully acknowledges the contribution of Mark Dana of the Kanara Consulting Group, LLC, in the preparation of these guidelines.