Here you will find resources and information for veterinarians.
- Body Surface Area Charts
- Body Surface Area Calculator
- Chemotherapy Flow Chart
- Example Consultation Reports
- Safety Equipment
- Information about complementary and alternative therapies
- Cancer statistics
Body Surface Area Charts
Here to assist you in treating your patients with cancer, are downloadable and printable body surface area (meter-squared) conversion charts that you can place in your treatment area.
Remember that all weights are in kilograms, and to double-check all chemotherapy doses!
Body surface area calculator
Veterinary chemotherapy dose calculation
Chemotherapy Flow Chart
To assist you in tracking chemotherapy treatments your patients have received, cumulative doses of drugs, dose reductions, etc.
Veterinary Oncology Consultants is pleased to offer our Chemotherapy Flow Sheet as a free download.
We have been using and refining this record sheet for many years and we think it allows critical information to be easily accessible in a reasonable space. We keep ours attached to the inside of the front cover of our patients’ records…let us know what you think and how it works for you!
Example of our Consultation Report
Information Coming Soon…
Complementary and Alternative Therapies in Veterinary Oncology
The internet is a boon for salespeople who capitalize on the fears and hopes of owners of pets with cancer.
Typically these claims lack data from controlled clinical trials showing safety and efficacy, and because the substances are not regulated as drugs, they are not required to be produced according to GLC so contamination and inconsistent potency are relatively common problems. Once data showing safety and efficacy is available for any particular substance, it becomes part of “mainstream” medicine.
Common products that pet owners find are Tumexal, Hemp products, Apocaps, K9 Immunity, K9 Transfer factor, and wormwood products (Artemisinin), which all lack data showing they are either bioavailable in dogs and / or safe or effective (other than what is on their websites). We cannot say if they work or not, because it has never been scrutinized in any sort of clinical trials (despite the hundreds to thousands of dogs they claim to have used it on) – it’s all anecdote and testimonials.
There are little published data on most of the “alternative” medicines. It is also very difficult to identify any potential toxicity, as most patients are receiving multiple different types of supplement, which confuses the issues. Other compounds may cause toxicity; for example, although rare, xiao-chai-hu-tang is documented to cause acute hepatic disease. This is a single case report, but so is the “efficacy” on which it is being prescribed for many patients. It also has been associated with interstitial pneumonitis. Some direct experience we have had is that some of our patients also receive Five Mushroom Extract; used in the assistance of treatment for cancer and chemotherapy for “immune support”; consisting of various Chinese Mushrooms, including Cordyceps, Shitake, Reishi, and Tremella.
We had one patient that developed severe and acute liver toxicity and possible gastric ulceration that continued despite stopping chemotherapy but then resolved after ceasing the alternative medications (but there were approximately 20 of them so it’s not possible to identify the actual causative agent), those didn’t recur when chemotherapy was restarted.
In dogs with lymphoma, the only study published so far has been for Maitake mushroom as a treatment. There was no decrease in lymph node size (objective response) seen in any of the dogs. Thirteen dogs developed progressive disease before the 4th week. Another study investigated Coriolus versicolor (Yun-Zhi) for dogs with haemangiosarcoma, and claimed improved survival in the abstract, but in the article, the improvement in survival was not significant statistically, and was based on 5 dogs; there was no discussion about tumour grade (which markedly affects survival).
An interesting statistic to consider when thinking about where the new “cures” for cancer come from is that between 1990 and 2005, there were 920 anticancer compounds that underwent clinical trials (so these are ones that got beyond the initial testing of in vitro and mice testing and into human subjects) in the USA. Of these only 32 were found to be effective. Many got as far as late-stage clinical testing before being found to be ineffective. It is important to remember this when evaluating whether to recommend untested “alternative” drugs, where the likelihood of finding true benefit is probably no greater than for traditional drugs; in other words, it would have only a 3.5% chance of actually benefiting patients, but without the testing and analysis that we require “conventional” drugs to go through, we will never know which of the alternative medications might work.
Separate to that is the question of “supplements” to reduce the toxicity of chemotherapy. In truth we do a good job of this with antiemetics and antibiotics, so unless there is a specific problem with an individual patient’s chemotherapy, we are not sure there is an advantage to adding more chemicals (even if “natural”).
However, we totally understand that owners wish to try anything that may help their pet, and we try to support them in safely and sensibly pursuing whatever other avenues feel right to them. Many of our patients do also receive complementary and alternative treatments in addition to their conventional treatments. The problem is that there are many unscrupulous salespeople out there ready to prey on these people – and a plethora of “offerings” – so they need a lot of help to sort out what is what. This phenomenon isn’t new of course, the internet just makes it easier.
If they really want to pursue complementary and alternative treatments they would be better off going to see a veterinarian specially trained in that area. We do ask people to avoid antioxidant supplements with chemotherapy, as they can interfere with the mode of action of chemotherapeutics and reduce efficacy.
There are different types of statistics used surrounding cancer, but one of the most frequently used is a type of average called the median.
Statistics are important and helpful, but they still don’t allow us to predict how an individual patient will do. Recently a friend and colleague directed us to this beautiful essay by one of the great thinkers of our time, the evolutionary biologist Stephen Jay Gould. It relates to his personal experience with cancer, and different ways of interpreting the survival data that patients and doctors have available to them.
We find it to be very helpful to remember that a specific number does not tell you how an individual patient will do with or without therapy; there are always “outliers”. In addition, there are many treatments that do not change the median survival because the advantage is to fewer than half of the patients. The benefit for those individuals, of course, is great.