How Joey got his bounce back
Linda Jensen knew it was bad news when her veterinarian called her on a Sunday night.
Dr. Bernard Chapuis, a practitioner in Jensen’s home town of Prince Albert, Sask., had recently removed a lump behind the left front leg of Jensen’s Airedale terrier Joey.
“The pathologist at the university [Western College of Veterinary Medicine] had sent back the results and it was cancer,” recalls Jensen, who describes Joey as a gentle, affectionate dog who likes to play with Jensen’s other pet, a wire hair fox terrier named Pixie.
“I asked Dr. Chapuis to arrange an appointment for us in Saskatoon.”
At her initial meeting with veterinary oncology specialists at the WCVM Veterinary Medical Centre (VMC), Jensen learned that radiation therapy was recommended since additional surgery would be too invasive for Joey.
“I decided to try it,” says Jensen. “I knew it was expensive, but I couldn’t bear the thought of not having him. We had that first appointment, and then a few days later we started treatments.”
During their initial consult, clients to the VMC’s radiation oncology service meet with clinical associate Dr. Vivian Fan. After reviewing their pet’s medical history, assessing the current condition and responding to any questions or concerns, she ensures that the tumour has been fully described using a process called staging.
The tumour is staged using diagnostic tests such as thoracic radiographs, ultrasound exams or CT scans. If the patient hasn’t been fully staged by the referring veterinarian before the initial consult, all of the remaining tests are carried out at the VMC. Once all the staging results are available, Fan discusses potential treatment options with the clients.
“Every client is different, so it’s important to know what kind of expectations they have,” says Fan. “If it’s the type of tumour where they can use different treatment options, we’ll arrange for joint consults so they learn about the different options during one-on-one meetings with someone from surgery or from medical oncology or from radiation oncology.”
While some clients decide right away that they want to proceed with treatment, others take a few days to make their final decision. Fan emphasizes that the VMC clinical team respects whatever their clients decide.
“There have been a lot of advancements made in the veterinary field with regards to cancer therapy. It’s important for them to know the treatment options that are suitable for their pet’s cancer so they can make an informed decision. The treatments are costly, so it all depends on what the client is comfortable with.”
The CT scan can be an important tool for staging since it’s more sensitive at detecting certain types of cancer such as lung metastasis. The CT’s medical images also provide vital information that the clinical team uses to develop the individualized treatment plan for radiation therapy.
Before the CT scan, the animal is anesthetized, and radiation therapy technologist Rachel Bloomfield prepares a customized immobilization device that’s used for the scan as well as for all radiation treatments.
Bloomfield then imports all the images from the CT scan to a special software program that’s used to create an individualized treatment plan.
Although Joey had already undergone surgery to remove his tumour – a soft tissue sarcoma – tests revealed that there were still some cancer cells present. Conventional radiation therapy was recommended as a way to clean up all the microscopic disease that had been left behind.
The WCVM’s radiation oncology service offers a foster care program for its out-of-town patients — but Jensen decided to make the 90-minute trek from Prince Albert to Saskatoon. She and Joey came for a total of 19 treatments that were scheduled for every week day with weekends off.
“We drove through some horrible storms in April,” Jensen recalls. “I’d drive down early, and then they’d have him ready to go home around noon.”
In addition to the conventional therapy that Joey received, the VMC also offers stereotactic radiation treatments (SRT) that deliver a higher, more precise dose of radiation and require only three treatments.
Both therapies require that the animals be anesthetized before being placed in their immobilization devices to receive treatment, so Fan is on hand to check their vital signs and do a physical exam beforehand to ensure they are healthy enough for the anesthesia and radiation therapy.
With the conventional therapy, she checks their bloodwork before, half way through and after they’ve completed their treatment protocol. Fan also monitors the common side effects, which she describes as “like a bad sunburn.”
These side effects vary depending on the area that’s being treated and on the purpose of the treatments. For patients like Joey, where the intent is to eliminate the cancer cells and extend survival time, the side effects are greater than they would be for a patient that’s receiving palliative treatments designed to make them more comfortable.
After the initial consult and throughout the treatments, Fan contacts the patient’s regular veterinarian and gives updates on the treatment plan and the side effects.
Once the treatment regimen is over, Fan recommends a two-week follow up appointment at the VMC or with the patient’s regular veterinarian (for out-of-town clients). Since side effects are the major concern, veterinarians often send her pictures of their patients’ affected areas for assessment.
As Jensen looks back on her experience at the VMC, she’s very grateful for all the support that she and Joey received from the staff and especially from Fan, who even took Joey home with her one night when Jensen needed to be away.
She’s also greatly relieved to see Joey back to his old self.
“He moved slowly at first because of the side effects, but it didn’t take long before he was his happy, bouncing self. Right now he’s a pretty happy dog!”
For more information, visit usask.ca/vmc and search “Radiation Oncology.”