News & Events


News and Events

Chemotherapy Versus Radiation—What’s the Difference?

A pet’s cancer diagnosis can be overwhelming, and explanations about cancer types, prognosis, and treatment options may be difficult to comprehend when you are blindsided by your beloved companion’s illness. If your family veterinarian has diagnosed cancer in your pet, the Veterinary Referral Center’s (VRC) oncology department will consult with them to design a treatment plan that best addresses your pet’s cancer, and ensure you understand every step of the diagnosis, treatment, and prognosis. Your pet’s treatment likely will include chemotherapy and/or radiation, two common cancer treatments that our oncologists use, independently or combined with other modalities, such as surgery, to target cancer cells. 

What is chemotherapy?

Chemotherapy is the administration of medication that can kill or slow the growth of cancer cells. The medications are often the same as those used for human cancer patients, and your pet’s exact medications will depend on their cancer type. Your pet may receive one chemotherapy medication at a time, or a combination of medications to target the cancer. 

How is chemotherapy administered to pets?

Chemotherapy medications may be administered by various routes; however,

many are given intravenously (IV) to reach immediate high blood levels. If your pet is prescribed IV chemotherapy administration, our hospital has a dedicated chemotherapy suite to ensure their comfort and safety during treatments. Some chemotherapy medications are available in pill form, which may be administered to your pet in the hospital or in the comfort of your home.

Chemotherapy vs. Radiation

What cancer types are treated with chemotherapy?

Chemotherapy is part of almost every cancer patient’s treatment plan. The medications spread through your pet’s body via the bloodstream, treating the whole system instead of targeting only a specific area. Chemotherapy is useful for cancer treatment in the following situations:

  • When we know your pet’s cancer has metastasized (i.e., spread) from the primary site to another place in the body
  • If your pet’s cancer type has a high likelihood of metastasis
  • If your pet has other health problems that make him a poor surgery or radiation candidate  
  • If your pet’s cancer is disseminated throughout his body instead of growing as a single mass 

 

What are chemotherapy’s side effects in a pet?

Many pet owners are pleasantly surprised, because veterinary chemotherapy does not cause as many side effects as human chemotherapy. The most common side effect in pets receiving chemotherapy is mild nausea, which can be medicated. We believe the treatment for cancer should never be worse than the disease itself, and we strive to keep your pet’s life as normal as possible during treatments.

What is radiation therapy?

Chemo and radiation for dogs

Radiation therapy is the use of a focused radiation beam to kill cancer cells possibly left behind following surgery or with newer techniques growing within a mass itself when surgery is not an option. Radiation breaks the DNA inside cancer cells so the cells can no longer replicate. Treated cells die when they try to divide, and are cleared away by the body. Radiation can be used to:

  • Slowly shrink a mass when surgery is not possible
  • Shrink a tumor before surgical excision
  • Kill microscopic cancer cells following an incomplete surgery
  • Relieve pain in patients who cannot undergo surgery or if surgery is not elected

 

How is radiation therapy administered to pets?

Radiation treatments used to treat residual disease when surgery is not complete are administered daily, Monday through Friday, for 16 to 20 treatments. This is a form of definitive radiation. Palliative therapy, on the other hand, is used for pets to help alleviate pain when surgery is not elected or is not possible. Palliative radiation is typically administered weekly for four weeks, or daily over the course of a week, to alleviate pain and hopefully  improve quality of life. 

Pets are sedated or anesthetized during treatments so they remain completely still, and the radiation beam can be precisely focused on the tissue to be treated, sparing nearby healthy tissue from possible side effects.

In addition to providing the conventional radiation therapy techniques discussed above, VRC is one of only a few U.S. veterinary hospitals that has a Halcyon system, which is capable not only of intensity modulated radiation therapy (IMRT) but can also perform a treatment called stereotactic radiation therapy (SRT). SRT is similar to Cyberknife, which is used in human hospitals. It allows our veterinary radiation oncologists to deliver radiation treatments with extreme precision in fewer doses, making treatment possible for previously untreatable cancers. 

What side effects are expected after a pet has radiation therapy?

Most pets experience few, if any, side effects from radiation therapy. The most common side effect is called moist desquamation, which is similar to a sunburn, is often seen as treatment ends, and may cause redness of the skin followed by a moist appearance before a scab begins to form on the skin. The scab should heal and fall off shortly after treatments end. Also, since your pet must be sedated or anesthetized for treatments, they may seem tired and want to rest when they return home. This is a side effect of the anesthesia, not the radiation treatments. 

Our veterinary team will work with your family veterinarian to decide the best treatment options for your pet’s cancer. Please do not hesitate to contact us with any questions, or to consult with our oncology department. 

The Advantage of a Board-Certified Veterinary Anesthesiologist Caring for Your Pet

Few things cause pet owners more anxiety and fear than their beloved companion undergoing anesthesia. We understand how frightening this experience can be—we’re pet owners, too. So, we work hard to alleviate those fears with expert anesthetic administration and monitoring, and protocols tailored to your pet. Recently, we welcomed Dr. Raphael Vezina, a board-certified veterinary anesthesiologist who will help us provide your pet with the highest possible standard of care.

What does board certified in veterinary anesthesiology mean?

Some veterinarians, like doctors in human medicine, dedicate their professional lives to a specialty, such as anesthesia, and its applications. An anesthesiologist undergoes three years of rigorous extra training to become board-eligible. The designation means he is specially trained to administer anesthesia and to anticipate, recognize, and care for any anesthetic issues.

This is followed by a rigorous examination to achieve board-certification status from the American College of Veterinary Anesthesia and Analgesia (ACVAA). Passing this examination grants the status of Diplomate of the American College of Veterinary Anesthesia and Analgesia (DACVAA).

What does anesthesia involve for my pet and why is it necessary?

Anesthesia is controlled unconsciousness, where your pet is unaware, unable to move, and doesn’t feel pain, usually during surgery. These three points are key to ensuring the highest quality surgical care. Anesthesia may also be required for imaging cases, such as performing MRIs in animals.

The risks associated with anesthesia depend on the procedure being performed and your pet’s health status. Many pets do not need surgery—other than a spay or neuter procedure—until they are older and acquire dental disease or lumps and bumps. These older pets may suffer from concurrent diseases, such as kidney or heart failure, and a board-eligible anesthesiologist can help prepare patients best prior to anesthesia and tailor anesthetic protocols to each individual patient’s needs.

Many veterinarians refer their older patients to our hospital for surgical procedures because we have a board-certified anesthesiologist on staff. Your family veterinarian may do the same if your dog with heart issues, or your cat with chronic renal failure, needs to undergo anesthesia, or your pet needs in-depth diagnostic testing that is not available at her clinic. We will form a team to diagnose and treat your pet. As a specialty center, we are a full-service veterinary hospital that provides advanced care in neurology, emergency and critical care, internal medicine, oncology, and many other areas, and we are especially proud to offer the services of our board-certified anesthesiologist.

Before your pet’s anesthesia

After your family veterinarian refers your pet to us for a procedure requiring specialized anesthesia, we will first study her medical records to decide on her best anesthetic protocol. We may recommend additional testing, such as blood work, X-rays, an electrocardiogram, or an ultrasound, to determine the extent of your pet’s condition and the effect of anesthesia. We will perform a thorough physical examination to evaluate your pet’s health status, consult with your family veterinarian about the results, and formulate the best anesthetic plan to ensure your pet is pain-free, unaware, and safe during her surgery.

While your pet is anesthetized

When your pet is sufficiently sedated by the pre-medication, we will induce anesthesia, which generally involves an injectable medication to fully sedate her, and then an inhalant form to maintain her level of unconsciousness. With any anesthesia, we always place an endotracheal (breathing) tube down the pet’s throat to maintain the airway, provide oxygen and anesthetic gas, and prevent fluid from getting into the lungs.

anesthesia

Patients undergoing sedation and anesthesia are rigorously monitored so that any changes in their vital signs that could cause a danger to your pet is identified and treated according to current best practices.

Your pet will receive the same level of attention and care during anesthesia that you would. We use the same monitoring equipment used in human hospitals to check her vital signs, including:

  • Heart rate
  • Respiratory rate
  • Heart rhythm
  • Oxygenation level
  • Blood pressure
  • Temperature
  • Depth of anesthesia
  • Pain response

While machines are excellent at providing information regarding your pet’s status under anesthesia, there is no better monitor than our anesthesiologist, who will continuously check your pet’s signs and correct any problems.

After your pet’s anesthesia

The period after anesthesia is critical, and we will closely monitor your pet to ensure she is recovering well from anesthesia and all her vital signs are returning to an awake animal’s normal levels. To help your pet wake up smoothly and comfortably from anesthesia, we follow these rules:

  • Keep the room semi-dark and quiet.
  • Monitor pain and administer more pain control as needed.
  • Maintain ideal body temperature with warming units and blankets.
  • Ensure your pet is breathing well, alert, and swallowing normally before removing the endotracheal tube.
  • Keep your pet calm; some pets become dysphoric during recovery and may need additional sedation.

To mitigate stress and its consequences during your pet’s hospital stay, anti-anxiety medications may also be given as needed.

Your pet may be able to go home or may need continued hospitalization, depending on the procedure, how quickly she makes a full recovery from the anesthesia and her medical condition.

Has your family veterinarian referred your pet to our hospital for a procedure? Are you concerned about anesthesia? Give us a call to discuss the safety measures we take with every pet under the supervision of our board-certified anesthesiologist.

Meet Our Newest Criticalist!

We are thrilled to announce that Dr. Jennifer Savini is the newest criticalist at VRC. She joins John Anastasio, DVM, DACVECC, Karen D’Lauro, DVM, Sara Fatula, VMD, Paul McGough, DVM, Elaine Perez, DVM, Christina Rotoloni, DVM, and Jennifer West, VMD as a member of our Emergency & Critical Care Department.

Her services include:
• Blood transfusion therapy
• Central line placement
• Monitoring of blood gases
• Targeted fluid therapy & balanced electrolyte management
• Cardiac resuscitation, defibrillation, post-resuscitation care
• Continuous cardiac monitoring
• Respiratory case management
• Drainage of chest fluids
• Nutrition via feeding tube
• Management of critical post-op patients

More about Dr. Savini:

Dr. Jennifer Savini, DVM, Practice Limited to Critical Care grew up in Malvern. She received her Bachelor of Arts in Biology from NYU in 2006. She then went on to veterinary school at the University of Missouri where she earned her Doctorate of Veterinary Medicine. She completed a rotating internship, emergency and critical care internship, and emergency and critical care residency at the University of Pennsylvania, finishing in 2015. Since 2015, she worked in a private practice specialty hospital in Mount Laurel, NJ.

Dr. Savini’s clinical interests include trauma, respiratory disorders, and toxicities. She enjoys traveling, and plays videogames and reads in her spare time.

Common Exotic Pet Emergencies

Pets don’t fall ill on a nine-to-five schedule, and they often require after-hours care. Emergency treatment can be easily found at night or on weekends for dogs and cats, but what about exotic pets? Reptiles, birds, and small mammals are excellent at hiding signs of illness and may not show any visible symptoms until they require urgent care. We are excited to announce that we now offer night and weekend emergency care for scaled, furry, and feathery pets. If your family exotic pet veterinarian is not open, we are here.

How to tell if your exotic pet requires emergency care

Exotic pets require routine veterinary care just like dogs and cats, and often need an emergency veterinarian’s services as well. A pet may appear healthy when you leave in the morning but show signs of illness by the time you return home. It’s difficult to know whether your exotic pet requires immediate treatment or can wait until your family exotic veterinarian is open, so we’ve put together a list of signs that your exotic pet needs emergency veterinary care.

  • Birds require emergency care if you see:
    • Weakness
    • Bleeding
    • Straining to defecate
    • Struggling to lay an egg
    • Refusing to eat or drink
    • Staying in the bottom of the cage
    • Fluffed or ruffled feathers
    • Pronounced keel bone
    • Loose stool
    • Labored breathing
    • Discharge from the eyes, ears, or beak
    • Continuous squinting or closing of eyes

 

  • Ferrets require emergency care if they exhibit:
    • Diarrhea
    • Vomiting
    • Tense abdomen
    • Decreased urination
    • Pawing at the mouth, which may indicate nausea due to low blood sugar
    • Depression
    • Lack of appetite

 

  • Guinea pigs and rabbits who show these signs require emergency care:
    • Diarrhea
    • Decreased stool production
    • Lack of appetite
    • Head tilt
    • Pain
    • Rolling or flipping
    • Depression or lethargy

 

Guinea pigs and rabbits may have serious gastrointestinal issues if they are not eating. The gastrointestinal tract can go into stasis, which may require hospitalization and treatment, or even surgery, to correct. We recommend syringe-feeding ground pellets or Oxbow Critical Care mixed with water to provide enough fiber to stimulate the gastrointestinal system until you can get your pet to a veterinary hospital.

  • Reptiles require emergency care in these situations:
    • Cold body temperature
    • Weakness
    • Prolapse of body tissue through the vent or rear
    • Paralysis

chameleon

In general, if your exotic pet appears weak or lethargic, is not eating or drinking, or has a decreased stool or urine output, she likely requires emergency care. Don’t hesitate—if your exotic pet is not eating, even for less than a day, that is an emergency.

Exotic pets, especially reptiles, are adept at appearing healthy, and it may be late at night or during the weekend when you realize she has a problem. Exotic pets often require specialized care, so be sure to have emergency exotic pet care in place in addition to your regular veterinarian. We strive to be there for your pet when your family veterinarian is unavailable, and we will stabilize her and transfer her back to their care. Together, we provide round-the-clock care for your pet in all situations.

Is your family exotic veterinarian closed and you think your pet may need urgent care? Don’t worry about the late hour or holiday season—give us a call to see if your feathered, scaled, or furry friend requires immediate treatment.