The Dog Cancer Survival Guide (81 page)

Depending upon your vet, you may need to communicate about this role. Researchers conducted an interesting study in which oncologists and their (human) patients were surveyed about decision-making roles. The results showed that a significant majority of the oncologists thought patients wanted them (the doctors) to make all of the decisions regarding treatment plans. Meanwhile, a majority of the patients wanted the exact opposite: to be in charge or to share decision-making power. As you can imagine, this difference causes needless friction and upset. The study authors recommended oncologists get on the same page with their clients by asking, “Do you want me to make all the decisions, do you want to make all the decisions or do you want to share decision-making?”

Your vet might assume you want him to be in charge of deciding how to treat your dog’s cancer, which is why I recommend initiating this conversation, if the topic doesn’t come up naturally.

“Don’t listen to the oncologist when they say, “He only has __ to live.” I had to go on anti-anxiety medication, because I was so afraid of my dog dying! Then I got Dr. Dressler’s book. It totally empowered me. I felt like I actually could make a difference in the outcome. Traditional vets only know radiation, chemo, and surgery. If you talk about supplements, etc., they just stare at you like you have two heads. Thank goodness, I found a terrific oncologist who is open to everything, and actually carries on a conversation about all the alternative things that I am doing for my dog. I know Dr. Dressler strongly recommends talking to your vet before administering any of the supplements. So now, I bring in a whole list of things my dog is eating and taking, and he gives me the thumbs up. I also, because of the book, knew about what to do before surgery, and what questions to ask the vet. Don’t ever give up hope.”

– Vicki Hagopian, Hudson, Massachusetts

If you don’t have one already, get a copy of your dog’s complete medical records, or, at least, whatever your vet has on file. I recommend doing so as soon as possible, so you can read through it in preparation for your next consult. Having your own copy of the file will also help if you consult with another vet, oncologist or other specialist. The information in the files is yours by law, so your vet will have no objection to copying them for you (there may be a small fee to cover costs). The records will include a copy of the biopsy and any other tests that verified your dog’s diagnosis. If recent X-rays were taken, your vet will let you borrow the original X-rays to bring to a specialist for review. If the X-rays are digital, they can be emailed or burned to a CD for you.

Keep the file up to date, in future, by getting notes and reports from every vet, oncologist or any other health care professional involved in helping your dog. Ask them to fax their notes and reports to your general practice vet, so that his medical file remains complete.

In order to lead your team, you should have a full understanding of your dog’s illness. Hopefully, reading this book has helped you, and discussing the specifics of your dog’s cancer with your vet and/or oncologist is still very important. Your treatment plan analysis has probably generated several questions already, and there are many more (listed below), which may also be helpful.

Vets typically have very busy schedules and a great deal on their minds, so the best way to get your questions answered is to make a scheduled appointment, to have her undivided attention. Most vets are happy to schedule courtesy phone consults, and some also give short courtesy in-person appointments.

If you have a good relationship with your vet, you might be worried that you are hurting her by asking for a second opinion. Even so, if your vet or oncologist does not have much experience treating your dog’s specific cancer, ask for a second opinion. It may help you (and your vet) to think of this second opinion as an appointment to gather more information.

As in any field, different vets are good at different things, and it is very hard to find a vet who does everything well. Most vets know this is true, and they will not be insulted when you want to consult with someone else to round out your team.

Because I’m an oncologist, clients are usually coming to me for a second opinion. However, if they want a third opinion from another specialist or another practitioner, I’m not offended, I’m not insulted and I’m not hurt. I fully support their decision.

To make the best use of your time, be prepared with written questions. This may be an emotional meeting, and having a list will help you stay organized. Give yourself permission to ask whatever you need answered. Even if you have dealt with cancer before, there may be gaps in your knowledge. There really is no such thing as a stupid question (and if your vet seems to think there is, or if you get the feeling that you are being treated unfairly or unkindly, it may be time to find a new vet for your team).

If you don’t understand something, make sure you ask for clarification. We vets can get preoccupied with the medical details of a “case,” and may even forget that you do not understand medical jargon.

It’s also a good idea to use a recording device or take notes on paper to make sure you don’t have to rely on your own memory later. Bringing a friend or family member with you, preferably someone who is less emotionally involved than you are can help you to stay focused and provide emotional support.

Ideally, guardians would get a second opinion for most cancer diagnoses, mainly because it’s always good to get another perspective. If you can do this, I recommend it.

If your vet is a conventional practitioner, I recommend seeing a holistic or alternative vet for your second opinion, even if you are sure that you want to follow what your current vet recommends. You may get something out of that visit that you would never have learned any other way. You can find holistic vets in your area by visiting the American Holistic Veterinarians Medical Association’s website
www.AHVMA.org
and using the “Find a Holistic Veterinarian” feature. You can also look at the Veterinary Institute of Integrative Medicine’s website
www.VIIM.org
.

I have the same advice for guardians who use holistic or alternative vets. Getting the perspective of a conventional vet or oncologist may offer you new insights, or serve as confirmation for your plan.

If you are even considering using chemotherapy or radiation (and some of the more complicated cancer surgeries), I recommend bringing an oncologist onto your team. Oncologists spend all day, every day, treating cancer with conventional tools. There is no doubt that they have more experience than any general practice vet, and there is no substitute for their expertise in conventional cancer care.

Unfortunately, there are only about two hundred small animal veterinary oncologists practicing in the United States as of this writing, and most of them practice near large cities, so finding an oncologist in your area may be difficult. Some offer phone consults to guardians, and others can consult with your general practice vet. You can find an oncologist by going to the American College of Veterinary Internal Medicine’s website
www.ACVIM.org
and using the Search for a Specialist feature. There is also a company called Oncura Partners which can be contracted to review your dog’s case and help your veterinarian manage his cancer. You can find out more at
www.OncuraPartners.com
.