Monday 14 October 2019

Insurance helps pay for pet cancer treatment

When treatment costs are high, pet insurance is invaluable
When treatment costs are high, pet insurance is invaluable

Pete Wedderburn - Animal Doctor

Last week I told the story of Ryan, an eight year old Collie cross. He'd been brought to see me because he'd stopped eating and lost his usual energy. All of his lymph nodes were enlarged, with lumps as big as golf balls all over. A simple biopsy had confirmed that Ryan was suffering from lymphoma, a malignant cancer of his lymph nodes.

Lymphoma is the third most common cancer to affect dogs: our practice sees several cases of this every year. It can affects dogs of any age, which makes it particularly shocking for owners. While it may be somehow acceptable when an elderly dog develops a terminal disease, it's very hard to cope when a dog in his prime is affected. It just seems so unfair.

The good news about lymphoma is that there are treatment options. The "right" answer varies, depending on a range of factors including owners' finances. I outlined the three broad options which were available to Ryan.

First, some owners choose not to give any treatment, preferring just to let the illness run its natural course. This is a tough choice to make, as inevitably affected dogs get worse over just a few days, forcing an owner to carry out euthanasia to prevent any suffering.

The second option is to use a simple, cheap treatment: a type of steroid called prednisolone. Prednisolone tablets will often quickly return a dog to apparent full health. If Ryan was given these, there would be a good chance that he would rapidly start eating again, and the cancerous lumps would shrink down to normal. The bad news is that this improvement normally only lasts for weeks, or at best, several months. In most cases, the cancer then returns, with more severe signs than before. At this point nothing more can be done to help, and again, euthanasia is then carried out.

The third option for Ryan was full chemotherapy, using the same type of highly toxic but powerful drugs that are used to treat human cancer. This can be expensive, with intravenous infusions of high potency anti-cancer drugs and repeated blood tests to monitor his reaction to the treatment. This is often very effective in the short to medium term, with minimal side effects, despite people's fears. Chemotherapy is used cautiously in pets, using lower doses than in humans. It's recognised that it would be unfair to give doses of drugs that would cause serious side effects such as complete baldness or severe nausea. While humans can understand that the short term suffering may be worth it for the longer term remission, dogs live in the moment, and it is not considered fair to allow them to suffer, even if it might mean that they would live for longer.

Chemotherapy is the most effective treatment for lymphoma, with the latest regimes returning dogs to a completely normal life for many months. However it does not fully cure the patient, and eventually, the disease does return.

The decision for Ryan was influenced by one important factor: he was covered by pet insurance. His owners had taken out the policy when he was a puppy. They had often questioned whether or not to carry on with this, as he was such a healthy dog, but now they were deeply relieved to have done so. Thanks to the insurance, they would have to pay just €80 for the entire duration of his illness, while the insurance company would cover all of the rest of the veterinary bills. This meant that the entire focus could be to do the absolute best for Ryan, regardless of the cost. Ryan was booked in for comprehensive cancer treatment. A year later, over €5000 had been spent on keeping him healthy and happy. His owners would not have been able to afford this level of expense if it had not been covered by his insurance policy.

Once we had decided that chemotherapy was Ryan's best option, we did a few other tests. We took xray pictures, and carried out ultrasound: these confirmed that Ryan was suffering from the earliest stages of cancer. If we had discovered that the cancer had already spread (e.g. to his liver and lungs), his prognosis would have been far worse.

Ryan started his chemotherapy five days after he had first been brought in to the vet. It was a weekly routine that would soon become familiar. He was left in at our vet clinic at 8.30am, a blood sample was taken for analysis, and he was then given a slow intravenous infusion of potent cancer killing drugs. He was sent home on three different medications, in a multi-compartment dosing tray to make sure that each tablet was given at the right time.

Ryan responded well to his treatment regime. He started to eat hungrily again, the cancerous lumps disappeared, and he had a wonderful year of life. Sadly, malignant cancer is still difficult to cure permanently: eventually, Ryan fell ill again: the lumps reappeared, and his owners made the tough decision to let him go. This time, however, they had prepared themselves, and so it was less of a shock than it would have been at the start. And as they said goodbye, they realised that there was much to celebrate: Ryan had enjoyed a contented, active life, and he'd had over a year of extra life, thanks to their help. Ryan will be sadly missed, but he had as good, and as long, a life as he could possibly have had in the circumstances.

Wexford People

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