Urinary Tract Infections

Bacterial infections are common with pets diagnosed with TCC. In this study from 2015. fifty-five percent of dogs with TCC had at least 1 positive culture result during the course of treatment. In addition, 25% of dogs that had a urine culture obtained before starting chemotherapy had positive results. These findings suggest that all dogs diagnosed with TCC undergoing chemotherapy should have a culture performed before starting treatment and cultures should be repeated regularly throughout treatment. Undiagnosed and untreated UTI can lead to renal failure, pyelonephritis, lower urinary tract dysfunction, septiciemia, prostatitis, discospondylitis, or anemia and can, themselves, be life-limiting (2).

Any sudden changes in urinary frequency, blood in the urine, straining, and/or incontinence should be checked by a veterinarian to check for infection and the urine should be cultured. The culture is used to determine the specific bacteria causing the infection to make sure an appropriate antibiotic is prescribed.

NSAID Side Effects

NSAIDs, such as Piroxicam, can cause GI ulceration or bleeding as a potential side-effect. Animals taking Piroxicam should be monitored for symptoms such as vomiting, diarrhea, bloody vomit or stools, and poor appetite. If these symptoms present, a veterinarian should be contacted immediately (3). Often times, the NSAID can be changed to a safer option such as a COX-2 selective or preferential agent or the drug administration schedule can be adjusted to less frequent dosing (4).

Pain Management

Consult with your veterinarian whenever your pet is in pain. Here is a good article on managing pain in dogs and cats with cancer.

• CBD was discussed on the Holistic/Supplements page on this site for it’s potential anti-tumor effects but it also has potential to reduce pain.

• Acupuncture is another option to treat chemotherapy side effects (nausea, diarrhea, neutropenia, vomiting, constipation) as well as cancer pain. This article discusses the use of acupuncture in veterinary cancer patients (5). Refer to the page “Finding a Specialist” to find a certified Veterinary Acupuncturist in your area.

• Analgesic agents and steroids - note: Firocoxib (Previcox) provided better pain control in two studies of arthritic dogs when compared to Deracoxib (Deramaxx) (9) and Carprofen (Rimadyl) (10).

Below is a table listing common analgesic agents in treating cancer pain in dogs and cats (6).

Myelosuppression and Neutropenia

Myelosuppression (bone marrow suppression) and neutropenia (low neutrophils - a type of white blood cells) can occur about 7 days after treatment in dogs and 7 to 28 days in cats. Dr. Sue Ettinger recommends using antibiotics as a preventative measure for those chemo drugs that have a higher risk of myelosuppression (7). Chemo dosages can be adjusted or treatments can be delayed to manage myelosuppression in the future.