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Chemotherapy FAQs

Posted On Apr 20, 2024
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Here are some of the most common questions asked by clients whose pets get referred to a veterinary cancer specialist.

 

My Pet is On Chemo:

  • Should I limit my pet's activity after chemotherapy?
Let your pet decide their activity level. Every pet is going to be different, but the majority of patients have no appreciable change in activity level the day of chemotherapy.
  • Can my dog go to the groomers while receiving chemo?
Depending on the pet, the type of cancer and the chemo, there are safer times than others.  Check with the doctor treating your pet.
  • Can my other pets in the house be around the chemo patient after receiving chemo?

Other pets can be around the chemo patient with no risk, but obviously should not be allowed to lick urine or ingest stool of the patient, though they would need to ingest a lot of it for it to be a problem. Most metabolized chemotherapy is out of the patient's system in 72 hours. If you have concerns about this, speak to your pet's oncologist.

  • Is it ok to delay chemotherapy treatment for 3 or 4 days due to schedule conflicts?

Treatments should be as close to schedule as possible. A one or two day schedule variation is usually okay, but oncologists usually prefer to stay on schedule. Depending on the protocol your pet is receiving and where in the protocol your pet currently is, timing of treatments can be extremely important.

  • Why is this important?
The timing of chemotherapy administration is designed to maximize treatment effectiveness and minimize the toxicity. By giving chemotherapy too early, you can increase the likelihood and / or severity of toxicity; by giving chemotherapy too late, you can decrease the effectiveness.
  • How is the schedule/timing of treatments determined?
Most protocols are based on years of study and altered based upon our years of experience with the specific drugs in the protocol.
  • How long will chemotherapy stay in my pet's body?

The metabolites (by-products) of chemotherapy will stay in the system for different lengths of time depending on the drug given. Most chemotherapy drugs are cleared from the body in 48 to 72 hours. This, however, does not mean that the effects of that chemo go away in that time period.

  • Why is this important?
Knowing when your pet’s urine or stool is free of chemotherapy metabolites is important for your safety. We always try to keep you and your pets safety forefront in our recommendations.
  • How is it still effective after 48 to 72 hours?
Chemotherapy kills cancer by targeting rapidly dividing cells – and the cancer cells are usually among the fastest growing in the body. The cancer cells may take more than 48-72 hours for them to die.
  • What precautions do I need to take while chemotherapy is still in my pet's system?
You should limit your exposure to your pet's urine, fecal matter and vomitus (if your pet vomits). If you must handle these waste products, either use gloves or wash your hands thoroughly.
  • When is it safe to allow my dog or cat to lick me?
The amount of chemotherapy in animal saliva is extremely low, so it is usually safe if they lick you. If you have a medical condition, are immunosuppressed, very old or have very young children, contact your physician for the best medical advice for your particular situation. 
  • Where is chemotherapy excreted?
Most chemotherapy is excreted either in the urine or in the stool and sometimes both. It depends upon the type of chemotherapy drug as well as the method of administration— orally versus intravenously.
  • There is a lot of medication my pet is taking.  Is it okay to give all of these together?

Some medications need to be given before or after others. In addition, some drugs are never given with other drugs. In most cases, it is fine to give all the prescribed medications together. If certain medications need to be given at certain times, your veterinarian should alert you and write it on the label of the prescribed medication.

  • Why is this important?
Some medications can interact with each other making them either more or less effective.
  • How do I remember when to give what drug?
It is best to write down what drug you are giving and what time you are giving it—a calendar can serve this purpose well. Weekly pill containers sold at most drug stores can also help.
  • What should I do if I give the wrong drug at the wrong time?

Call the veterinary oncologist or your local veterinarian for advice. In most cases, they will have you re-start the correct medication at the correct time the following day.

  • When will my pet begin to show signs from a drug interaction?

Hopefully, this will never happen, but drug interactions can begin within hours. Again, if your pet is given medications together that were not meant to be given at the same time, please call your pet's veterinary caretaker immediately.

  • What should I do if my pet does show signs of a drug interaction?

Take your pet in to be seen by veterinarian right away.

  • What if my pet vomits after getting their medication? 

If your pet vomits after receiving medication, check to see if the medication is in the vomitus and note how long after the medication was given that the vomiting occurred. Call your veterinarian or pet's oncologist to inform them and ask for recommendations. Do not just assume that you should administer another dose.

  • What should I do if this happens?
If your pet happens to vomit after getting an oral medication we have no way of determining how much of that drug was absorbed during that period of time. If you are unable to find the pill or capsule within the vomitus, it would probably be safe to assume that the pill remained within the pet, but you should call your veterinarian or pet's oncologist for their advice.
  • Why do I have to wear gloves when giving a chemotherapy pill?

Some chemotherapy protocols will ask that the owner administer oral chemotherapy at home. It is important to wear gloves when handling these medications, as these medications are prescribed for your pet, not you—so you want to minimize your exposure.

  • Why is this important?
It is best to act conservatively when handling chemotherapeutic medications. Although the possibility of having a serious reaction is rare, these drugs are known to be carcinogenic and mutagenic in humans. Using gloves and disposing of them properly minimizes any unnecessary exposure. Pregnant women and immunosuppressed people should not handle chemotherapy drugs.
  • How do I administer the chemo pill?
With the exception of wearing the gloves, the administration of the chemotherapy pill is the same as any other oral medication. If you have never given your pet oral medication, ask your veterinarian to show you how to administer a pill to your pet.
  • What happens if I touch the pill without gloves?
Most (if not all) of these types of medications are safety coated. Wearing gloves is a precaution to help minimize any possible contamination. Wash your hands if you accidentally touch the pills. 
  • When should I put the gloves on and take them off?
The exterior of the container of the medication is contamination-free. When it's time to medicate your pet, put the gloves on, open the container, remove the pill and give it to your pet. Once you have completed pilling your pet, take the gloves off by pulling them inside out, and then put the cap back on the container. 
  • Where should I dispose of the gloves?
These pills are safety-coated and the chance of contamination is very low. The gloves can be disposed of in your every-day garbage.

  • Why do you measure my pet's weight in kg's not lbs?
Most non-chemo medications are dosed based on weight in kilograms; also it’s an easier conversion to metered square, which is the unit how most chemotherapy medications are dosed.
  • My pet has had accidents in the house recently, which is unusual for him. Could this be from chemo? Why is my pet drinking so much?
If your dog is on prednisone, as many cancer patients are at some point during treatment, this could be causing urinary accidents in the house. This medication generally makes them thirstier, which causes them to drink more water than usual. If your pet is not on prednisone, check with your veterinarian or pet's oncologist, as there are several medical causes for an increase in urination.
  • Do I have to worry about them going to the bathroom inside (or outside)?

Depending on the type of chemotherapy given, it is possible that in the first 48 to 72 hours after treatment, your pet might excrete some of the metabolized drug in their waste (urine, feces, vomit).

  • Why is this important?
Knowing when your pet’s urine, stool or vomitus is free of chemotherapy metabolites is important for your safety.
  • How should I clean up after my pet?
It is a good idea to use gloves whenever cleaning up after your pet. You should limit your exposure to your pet's urine, fecal matter and vomitus (if your pet vomits). If you must handle these waste products, use gloves, pet waste bags, or wash your hands thoroughly after cleaning up. 
  • What should I use if I need to disinfect?
To disinfect in the house, use 1 part bleach to 10 parts water with a disposable cloth or towel. 
  • When is it ok to let my pet go to the bathroom outside?
For the first 72 hours after your pet receives chemotherapy, it may be good idea to try to have your pet urinate and defecate away from areas where children may play.
  • Where can I get gloves?
Gloves can be purchased at any local drug store, pharmacy or surgical / hospital supply store.
  • My pet won't eat his regular food, but does want to eat people food. He seems more finicky lately. Should I worry?

Dogs will quickly learn that if they decline their regular food, that you may give them some people food – cold cuts, chicken and rice, etc. If they get used to this, it may be difficult to get them back to a dog food-exclusive diet.

 

Cats can get very finicky with what they will and will not eat, and can develop aversions if, for example, they are given medications with a particular food.

 

The goal needs to be to keep your pet eating as close to a normal, balanced diet as possible. A veterinary nutritionist can be consulted if there are questions.

  • Why can't I crack open or split a chemo pill?

When handling chemotherapy drugs, it is best to be careful and not expose yourself or others to these drugs. Splitting a pill or opening a capsule could potentially aerosolize the drug and increase your and your household’s exposure to these medications. Another reason why chemotherapy tablets should not be split is that the active drug is not always evenly distributed throughout the tablet.

  • I am a cancer patient. Why do I not need to wear gloves when I am taking oral chemotherapy?
    If you are prescribed chemotherapy then you and your physician have discussed the risks and benefits of taking and handling these medications. If you are ingesting / swallowing the drug, handling them will not increase your overall exposure.
     
  • What should I do if I have already split a pill or opened a capsule?
    Chemotherapy medications require special disposal. Place them in a container and bring them to your local veterinary oncologist or veterinarian for the proper disposal. In addition, the area where the pill or capsule was opened should be cleaned and washed thoroughly to minimize household exposure.
     
  • If my pet bites into the chemotherapy pill or capsule are we both at risk of exposure?
    Yes, you both are at risk, but because the medication was prescribed for your pet, we are not worried about your pets exposure—only about yours and other in your household.
     
  • What should I do if I am exposed?
    You should call your personal physician. Thoroughly washing the exposed area with water is one of the quickest ways to decrease your exposure.
     
  • My pet seems to be more tired and isn't acting himself lately, but is eating and drinking normally. Should I worry?
You should consider checking your pet's rectal temperature to rule out a fever, which could indicate that medical attention is needed. You can purchase a rectal thermometer at your local drug store and take your pet's temperature. Designate this thermometer for your pets use only – use a small amount of Vaseline on the end of the probe and insert about an inch into the rectum.
A normal temperature for dogs and cats is 100-102.5°F. If your pet's temperature is elevated, you should contact your pet's oncologist or local veterinarian, as they might want to examine your pet. You can also look at the color of your pet's gums, which should be pink – if the gums appear pale or white it suggests an immediate evaluation should take place. Some pets simply need a few days to get back to normal after treatments so this may be normal for them. Call your veterinarian if you are concerned.
  • When will I start to see side effects from chemotherapy in my pet?
Side effects of chemo can be seen (depending on chemo) anytime from immediately after treatment to more than 1 week after the treatment. Most commonly we see nausea, diarrhea, loss of appetite and loss of energy. Every animal reacts differently to the chemotherapy they are receiving. Be observant of your pet starting immediately. If side effects do occur, let your veterinarian or pet's oncologist know so that they can offer supportive care or recommendations and hopefully prevent future occurrences.
  • I am pregnant; What precautions should I take with my pet on chemo?
You should alert your personal physician that your pet is currently on chemotherapy. If possible, have another member of your household clean up any pet related waste products—urine, stool or vomit. If you must handle these waste products, use gloves, pet waste bags, or wash your hands thoroughly.
  • Why is this important?
It is possible that toxins the mother is exposed to during pregnancy can adversely affect the developing baby. By knowing what precautions to take, you and your child’s safety are protected.
  • How can exposure affect my unborn child?
New research has found that children born to mothers treated with chemotherapy during the last two trimesters of pregnancy appear to be normal and completely unaffected by the experience. It is always better to be safe and minimize any exposure to chemotherapy, especially during the first trimester of pregnancy. 
  • What are the risks if I have to clean up after my pet if I am alone?
With the appropriate precautions—gloves, pet waste bags, thorough hand washing, and the proper disposal of contaminated materials—the risks are minimal. 
  • When is it okay for me to clean up after my pet?
If it is possible to have someone else clean up the waste for the first 48 to 72 hours after each chemotherapy treatment, you can minimize your exposure. In addition, if you do not directly handle the medications, you will minimize the exposure to yourself and your child.
  • Where should I dispose of my pet's waste?
Feces or flushable litter can be flushed down the toilet or put in a plastic bag and disposed of in the garbage. If your pet urinates or defecates in your yard, hosing the area down on a regular basis is advisable. If your pet’s bedding becomes contaminated with waste—feces, urine or vomit—it should be washed separately  in the laundry.
  • What if I notice blood in my pet's stool?
Red blood (called frank blood) on stool is not necessarily alarming – this can be caused by stress or straining. Black, tarry stool (called melena) indicates bleeding from the stomach or high up in intestines. If you are concerned about the amount of red blood in the stool, you should call your veterinarian or pet's oncologist. If you are noticing black, tarry stool you should see your veterinarian for an immediate evaluation to identify the cause. If your pet is actively bleeding from the rectum, contact your veterinarian or an emergency center if they are unreachable.
  • What if I notice blood in the urine?
There are several causes for blood in the urine. If you notice this, contact your veterinarian or pet's oncologist.
  • How do I know if my dog or cat is in pain?

Your pet speaks to you in nonverbal ways every day. You know your pet better than anyone else.  If there is any reason for you to think that they are acting differently, let your veterinarian know.

 

Some signs of pain are panting, not eating, seeming uncomfortable when they walk or move, not wanting to move, crying, whining, and restlessness.

 

Contributed by:  The Veterinary Cancer Center