This is an overview of working with canine cancer, and the first in a much more comprehensive series.

Intro

Any herbalist who decides to make working with animals their primary focus, will encounter many of the same conditions over and over – none more serious, daunting and unpredictable than cancer. In the fifteen years I’ve been in formal practise, I have dealt with over a thousand cancer cases – about a third of my total, and interacted with thousands more dog- owners who were facing this challenge. During those years I have lost two of my own to cancer, one in advanced old age and the other, unexpectedly in midlife. In my work and private life I’ve watched the numbers rise, and rise, with many small animal veterinarians now calling canine cancer an epidemic. On Internet groups I’ve watched countless animal lovers express fear, anger, confusion and a deep need for answers – “But she didn’t look sick” and “We did everything right” – such common refrains.
It was, in fact, a cancer case I worked on casually, for a family member, that persuaded me finally to make the transition to professional, herbalist and nutritionist. And it is cancer cases today that regularly bring tears to my eyes, and sometimes make me wonder if I can continue such heartbreaking, and often exhausting work.
But, the successes – which might not always mean remissions – keep me going. I know – it’s best not to think of therapy as “fighting” the disease – as herbalists, we prefer to support, adjust, offer balance – and in the process, we learn whatever it is we’re in need of learning. With most of the health conditions I handle regularly, that’s not so hard to do. With cancer, it’s different. The sheer scope of it, the toll it takes on dog, human family, the environment and the fact it keeps steadily rising – the fact a dog only has a few years in the first place – shifts my spiritual, holistic outlook to something else. I admit it; I hate this disease. I want to vanquish it, and that’s pretty much what every dog owner who hires me wants as well. Remission. Long survival times. CURE.
Of course, there are no guarantees in life, and never less so than with cancer. For all the challenge it can be to work with these dogs, week in and week out, there have been some amazing stories, some beacons of hope and many, many places of joy. As I have grown in knowledge as a herbalist, I’ve found that yes, cancer is in many ways just a disease like lupus or cardiomyopathy or any number of others; while we can’t “cure” it, we can offer so much to support the body, ease symptoms and side effects. Through that process, we can enter into a sacred circle of healing that transforms and heals, even as we say goodbye to our friend and companion. I have, in my cancer files, a whole folder of clients who sent me pictures from their dogs deathbed, just prior to euthanasia, so I could “be there as well”. They wanted me included, they felt I should be there. I cannot look, often, at those pictures, but when I do, I feel graced by their presence. I’ve never asked for one, but so many clients have sent them. Some of the images are among the most powerful expressions of pure love and grief I have ever seen. They fill me with such gratitude to have been some part of this journey, this relationship, this innocence. I hope, through articles such as this one, my blog and my thesis, and of course continued consultation work, to give something of back of value, too. This article will discuss a few of the popular herbal treatments for cancer, where they may be applicable, and where other, less commercially wellknown herbs can be more useful, and hence the importance of individualized herbal assessment and recommendation in dogs with various forms of cancer.

The beautiful, friendly and intelligent Golden Retriever  is one of the breeds most devastated by a high incidence of cancer.
To start with; we all know what cancer is. “On a physical level, cancer is a wild, uncontrolled growth of abnormal cells that can arise anywhere in the body”. 1 In dogs, cancer affects 50% of all dogs over 10 years old and is considered by some to be the Number One killer (after euthanasia). Lymphoma, Osteosarcoma, Mast Cell Tumour, Hemangiosarcoma, Bladder Tumours, Melanoma and Mammary Tumours are the most common types, with some less common types showing up in disproportionately high levels in specific breeds (Histiosarcoma in Bernese Mountain Dogs, for example). Some breeds are affected to an alarming degree; it’s estimated that 75% of Golden Retrievers will develop cancer in their lifetime, for example. Boxers, Rottweilers, Scottish, Boston and West Highland White terriers, Great Danes, Flat-coated Retrievers, Bernese Mountain Dogs, English Bulldogs and American Cocker Spaniels among the highest risk (for a variety of cancers). While many aspects of causation are debated, there is little doubt that genetics plays a role in the high indigence of specific cancers in certain breeds (and within each breed, certain lines as well). Ethical breeders, that is to say not-for-profit breeders, will never breed from a dog who has had cancer; sadly, profit-driven breeding is by far the larger operation in North America and dogs with any and all kinds of heritable health conditions are bred to be sold to pet stores or cheaply online. There is little doubt that inappropriate diet (cereal based kibbles, additives) overuse of vaccination, and constant, immediate exposure to lawn and household chemicals and other toxins are all playing a role in the canine cancer epidemic. 2

Standard and Holistic veterinary approaches

Conventional care focuses much the same as in humans – chemo, surgery, radiation. With some cancers, depending on stage and grade, overall health of dog; these methods buy much time or are even curative. As with humans, treatments for dogs have advanced and are often able to offer longterm support, we might think of the Wisconsin protocol for dogs with lymphoma, which assures us that “80-90% of dogs receiving this treatment will go into remission” and that “in the vast majority of cases, dogs will suffer only very minor side effects as a result of this care.”.3 The average lymphoma case I take on goes through at least one, and often two rounds of chemo, usually exhibiting few side effects and enjoying greatly extended, good- quality time. Prognosis for other cancers is similar again to human: what stage, grade and type of cell are we dealing with? How old is the dog? And of course, does the owner opt to work with dietary adjustments and herbs, or do they use the conventional approach alone?

Nutritional management is generally limited to recommendations of a prescription diet such as Hill’s N/A or Royal Canin. Many veterinary oncologists simply recommend feeding the dog “whatever she likes” or emphasizing a good quality commercial diet. Herbal recommendations are non-existent, outside of holistic practise; the conventional vet/oncologist may refer the client to a holistic vet, if the client appears interested. This interest is common; many who pursue aggressive forms of treatment also enlist the support of a holistic vet, with the idea that an “integrative approach” offers the dog the best chance of survival. Under the umbrella of that term, advice ranges from quite sophisticated to very generic. In the majority of cases I have personally dealt with, holistic vets recommend a home cooked or raw diet, and a number of supplements such as Apocaps, turmeric, Denamarin or other Milk thistle extract, Yunnan Baiao and fish body oils. While these recommendations can be very helpful, there are many areas wherein they can be less than desirable, too – either inadequate, in my experience, or else constitutionally wrong and/or unbalanced. Many of my own clients are those who are not following any veterinary advice at all, but seek out knowledge on their own, usually via the Internet, various cancer groups (yahoo, Facebook) and forums, and who also work from popular books on cancer support for dogs. In contrast to the minimalist/formulaic approach I see from most holistic vets, this group will often present me with an Intake form of 30 pages or more, half of which is the supplement list! I have seen cases wherein the massive supplementation was also driving up nutrient levels to an unsafe level, with one memorable case wherein the total iron was 6 times the RA – and in many cancers, iron restriction is indicated. This is one place where a strong grounding in canine nutrition is necessary.

Nutritional Strategy
While diet is absolutely foundational to managing the canine cancer patient, it is beyond the scope of this article to go into in detail here. We might take note, that there are, as with herbs, general guidelines we need to work with and consider, and much individuality to take into account in dietary formulation. A cancer diagnosis may be the owner’s first awakening to the idea that those bags of dehydrated, “complete and balanced” nuggets they feed day in, day out may not actually, be the ultimate diet for dogs. While a link between high starch intake and cancer is not firmly established, it is an accepted viewpoint amongst holistic vets, animal herbalists and savvy dog owners that a diet more in keeping with the needs of a carnivore, is superior to commercial dry foods, cancer or no cancer. Beyond the consensual idea here – lower carb, higher fats and protein – there is much disagreement and debate. Approaches range from almost zero carbohydrate and raw foods, to lowered carb with carefully selected sources of fiber and plant material, moderate protein and high fat(this latter reflects my own generic approach, with the qualifier that not every dog can tolerate these levels ; the practitioner needs to be flexible). There are many veterinarians who maintain that not enough formal research has been carried out to justify any specific formulaic change to nutrients at all. I have worked with many vets who feel a vegetarian diet is optimal. The fact I have seen long remissions on basically vegan diets, as well as the standard low carb, approach raises some interesting questions.
My bottom line: the role of nutrition is key on several levels and must both meet all nutrient requirements for dogs, and focus/gear towards the individual history and the type of cancer. I develop the diet before I start the herbal protocol, but if this is not an option, a premium food with lower carbohydrate, no history of recalls and with fresh foods/fatty acids supplemented as indicated is the next best thing.

Contrary to what you might have heard, many veggies and some fiber is an important part of a canine cancer diet.

Herbal Approach (mine)
After  optimizing the diet, the way I approach canine cancer is methodical and specific.
– Considerations start with the type, stage and aggression of the cancer; systems affected, other conditions, overall health and vigour of the dog, constitutional type, side effects from veterinary therapies
– Part of my selection process relies on John Boik’s strategical approach to plant compounds and their potential impact on various neoplasias
– Addresses the whole dog – emotional/spiritual aspects, /quality of life

It might be useful here to take a look at a few common forms of canine cancer and how they typically manifest, why we need an individualized approach and not a
“One Size Fits All” approach to cancer.

Lymphoma – an aggressive, but very treatable cancer of the lymphatic cells. Untreated, most dogs die within a month from the time symptoms appear; average length of remission with chemo is 14 months for the first remission and 9 for the second. One of the best understood cancer, studies also show that a combination of chemo and high fat, high Omega3 fatty acid diet with supplemental L-arginine further extended survival time. 4 I have had dogs live 5 years from diagnosis, when this protocol was followed. It’s primary drawback is expense. Chemotherapy averages 1000$ a month and can last 9 months or more, in total. Fortunately there are agencies all over North America that assist people facing extraordinary vet bills. Lymphoma accounts for about 25% of all cancers in the dog. Studies have linked it to herbicide exposure, which may account for its prevalence.
Mast Cell Tumour – this cancer is exactly what it sounds like, a malignancy involving mast cells, which are immune system cells that, unlike other types, do not circulate through the body but accumulate in tissue, and are  “heavily involved with inflammation and allergic reactions”5  Longterm survival is common with low to intermediate grade MCT; other dogs will develop multiple tumours all at once, while still develop skin tumours over time with internal metastasis. Some MCT is very aggressive and others, technically indolent. Understanding this cancer is crucial to developing a protocol, including diet; we have special considerations here that include avoidance of foods that contain high levels of histamine; avoidance of anyfood that seems to provoke a reaction(loose stool, recurrent ear infections etc) and an emphasis on herbs that cool rather than heat – that don’t stimulate the immune system at all(and I avoid modulators/amphoterics here as well). Of course there are many factors to consider, but dietary restrictions and an avoidance of immune stimulation are essentials here. Standard treatment is surgery, sometimes chemo, and longterm Benedryl.

Hemangiosarcoma – HSA is a cancer of the lining of the blood vessels, with the spleen, heart, liver and under the skin as primary locations for tumour development. HS is very aggressive and metastatic; standard approach is splenectomy and/or chemotherapy. Many people opt out of aggressive treatment; the sad truth with HSA is that surgery and chemo extend life by an average of 3 month only. Of all the canine cancers, HSA is the most dreaded, and with good reason.
There is always an ethical dilemma when facing a client request for help with this cancer; one the one hand, the longest survival time I have seen – with chemo and comprehensive dietary and herbal support – was one year. That was an exception; most of the time we’re looking at 6 months. No one wants to mislead a client –on the other hand, if they understand the nature of the situation and wish to proceed anyway – this is a case whereby the preparation of food and administering of herbs can be a final gift, an important part of the last journey together. I accept these cases after some discussion with the owner. It’s important with HSA not to thin the blood too much; so many of the generic “cancer supplements” do exactly that, and we need to be careful in case the dog has a bleed, very thin blood will hasten the demise. I include internal support for the blood vessels as well as anti-hemorrhagics and am very prudent with anti-coagulants. Special considerations here also focus on managing the dog without a spleen.

When I began working with dogs, there was very little material to utilize, specific to the species. The veterinarian who mentored me used a classic “kitchen sink” approach – if a supplement or herb was vaguely thought to be “anti-cancer,” we used it. Protocols were often pages long and involved 30 or more herbs and supplements. It was a passionate, if not exactly skillfull methodology. And, sometimes it appeared to work! As time passed, much more has been published with regard to canine cancer and natural compounds, and I’ve worked out a more calculated approach. John Boik’s work has been very influential for me, so I will mention it here: in “ Natural Compounds in Cancer Therapy” he states that we are specifically seeking constituents that offer the following:

1) Reduction of genetic instability (reduction of oxidative stress)
2) Inhibition of abnormal gene expression
3) Inhibition of abnormal signal transduction
4) Encouragement of normal cell – to – cell communication
5) Inhibition of tumour angiogenesis
6) Inhibition of metastasis
7) Increase immune responses 6

Now, this represents a bit of a shift in thinking, not so much away from the standard herbal approach but expanding into an allopathic inclusiveness that recognizes cancer as the formidable challenge it is; in working with this constituent-based approach I soon learned that it does not exclude work with energetics, Vitalist actions and traditional herbal approaches. It simply helps us to finetune our choices and offers a deeper understanding of what we are looking for in a herbal protocol for cancer. Boik discusses constituents found in a range of plants and how/where to utilize them, making this approach and his textbook indispensable.
The Herbs

These represent some of what I feel are the most important herbs to work with , although by no means exhaustive, these are important and foundational. My practise is primarily Western, although many of the herbs below are not native to North America they are so commonly used in Western veterinary medicine as to be impossible to leave out..not to mention, useful!

Group One – Popular Choices

Sweet Annie (Artemisia Annua) Another herb that has become extremely popular in the veterinary world, extracted Artemisinin is used extensively in holistic practise, usually as part of the generic grouping (turmeric, fish oil, mushroom complex). Artemisinin (or the whole herb) is not one of my first choices, although many clients are already using it; there is much disagreement with regard to protocol and several contraindications/side effects in dogs, who – in my opinion – are already dealing with illness and toxicity. That said there is a place for Sweet Annie, particularly with bone cancer and in advanced illness generally. Extracted artemisinin needs to be administered along with iron, in order to form the cell-killing free radicals that we use it for. In particular, the iron needs to be unbound ferrous ion form, which can be provided via red meats such as beef and venison; dose must be monitored .
One thing is certain, Artemesia must not be given within two months of radiation therapy. Sweet Annie’s interaction potential with chemotherapy agents is largely unknown. I think of this one as a herb to consider, but not a frontline defense. Too many variables, too many side effects (nausea, neurotoxicity in sensitive dogs, possible elevated renal values.)

Astragalus (Astragalus membranaceus)
With a range of actions both cancer-specific (stimulates T-cells, raises white blood cell count) and related (cardioprotective, hepatotonic) there is good reason that Astragalus is so greatly utilized with canine cancer. I almost always include astragalus in my own formulations for most types of cancer, as well as the side effects of cancer therapy; preferred method of preparation is a decoction of the dried root, in which case the usual dose range applies( 5- 30 grams per 8 ounces water, decocted 20 minutes and given according to soze(I use higher end of the gram weight and give in food, 1 cup for small dogs (under 30 pounds) one cup BID for medium and one cup TID for large and giant breeds.

Boswellia (Boswellia serrata) Boswellia first came to my attention for use with osteo-arthritis, although my own arthritic dog had a severe gastric reaction which meant it wasn’t on the table for us, my research uncovered a lot of interesting applications. Fifteen years later I am seeing Boswellia recommended by at least half the holistic oncologists I work with. Usually given at fairly high doses and in capsule form, my chief issue with boswellia is reckless dosing which results in GI upset. I start dogs off with low doses and work up (and never with a history of gastric ulcer). Goal-dose (of the dried concetrated resin) is 10 mgs per pound, TID. I start with about 1/3 of that.

Turmeric (Curcuma longa) Turmeric’s popularity – like its usefulness – cannot be understated. Antioxidant, hepatoprotective, cholagogue and anti-inflammatory, turmeric is useful both preventively and in active disease. Contraindications for dogs focus on gall bladder disease, but there is much controversy over optimal method of administration. I use either a paste of the powdered root with 3% black pepper, and isolated curcumin in gel capsules if the paste is not tolerated (indigestion, refusal to eat it) and generally will balance the drying tendencies here with Marshmallow root (Althea officinalis or related species) , chickweed (Stellaria media) and Self heal (Prunella vulgaris). Dose range is usually 5 mgs/lb of the standardized extract(95% curcumin) or 1/8 to ¼ tsp per 10 lbs bodyweight, of a paste made from organic powdered turmeric, 3 % black pepper and mixed with water and a little fat (fish oil, coconut, chicken fat, olive oil).

Yunnan Baiyao – proprietary blend of “Chinese herbs”, YB is a standard formula used by holistic vets with cases of bleeding cancers, notably hemangiosarcoma. Demian Dressler, author of the Dog cancer Survival guide, writes that YB may help stop some bleeding but should be given “five days on and five days off to avoid elevated liver enzymes” 7 – a significant concern for me . He writes that “ the ingredients include various yam roots, ox gall bladder, pseudoginseng, sweet geranium, and more. The precise recipe is a guarded secret in China.”8 I have personally seen much gastric upset with Yunnan Baiyao and prefer to use a formulation with yarrow (Achillea millefolium) and Sherpherd’s purse (Capsella bursa)especially with chemo or a history of gastric sensitivity. My own protocol for HSA focuses on building capillary integrity and cardiovascular strength, maintaining normal platelet levels, prevention of metastases and then the usual system-by-system analysis and recommendations.

Milk Thistle (Silybum marianum) classic liver support, many holistic vets recommend milk thistle all through cancer therapy while others avoid it during chemo(due to antioxidant actions). In holistic veterinary medicine an extract of silymarin is usually given at relatively high doses. Much of the time this is done to protect the liver and without consideration of other herbs, or the individual. I use milk thistle alone or in formula depending on the case, and almost always the whole ground seed, not in extract (although I will utilize both in cases of acute toxicity). Dose is 10 – 15 mgs/kg, of the standardized silymarin extract, 2 – 3 times daily as indicated.

Marine Lipids (Fish body oil, krill) fish body oil and krill are exceedingly popular and should usually be given with cancer, in higher dose than we normally utilize. Fish oils and krill provide the essential fatty acids DHA and EPA (docosahexaenoic and eicosapentaenoic acids) which are conditionally essential, anti-inflammatory, cardioprotective fatty acids . Ideally, products for human or canine use should contain a ratio of 1:5 – 1 EPA to DHA. It’s also important to distinguish fish body oil from liver oils, which are very high in Vitamin A and also contain some D. Two problems I see with supplemental marine lipids; one, is the failure to also supplement Vitamin E, which is sometimes avoided due to antioxidant action during chemo, and sometimes neglected simply out of failure to recognize the importance…and two, using high dose fish oil (with or without Vitamin E) in bleeding cancers can be a factor in fatal bleeding, so I am very conservative in these cases (hemangiosarcoma). Standard dose is 1-2 grams for small dogs, 3-4 grams for 10-35 lb dogs, 6-9 grams for 35-60 lbs and up to 12 grams daily for dogs over 60 lbs. These values assume that each gram (1000 mg capsule) will provide 180 EPA and 120 DHA. If your capsules contain more or less, adjustment is important.
I may use more, less or none at all, depending on the case and the diet.

Essiac – the famous blend contains four principle herbs: Burdock, Sheep sorrel, Turkey Rhubarb and Slippery Elm. I rarely see holistic vets recommending Essiac these days; both Turkey Rhubarb and Sheep Sorrel are too high in oxalates, and since one study showed stimulation of breast cancer cells in vitro with Essiac, it has fallen from favour. Not recommended.

Fungi
Several veterinary products are now available, featuring (usually) Reishi, maitake, coriolus and shiitake mushrooms, with many practitioners also using higher doses of individual mushrooms. A study last year sowing improved survival times for HAS patients who received Coriolus took the animal world by storm. I often use Cordyceps and Chaga as well as blends, there are few contraindications; with Mast Cell tumour it’s best to avoid immune stimulation.
“Dogs with hemangiosarcoma that were treated with a compound derived from the Coriolus versicolor mushroom had the longest survival times ever reported for dogs with the disease. These promising findings offer hope that the compound may one day offer cancer patients — human and canine alike — a viable alternative or complementary treatment to traditional chemotherapies.”9

Ashwagandha (Withania somnifera) is incredibly helpful with many cancers, but underutilized in my experience, by the holistic veterinary community

Additional Choices

Burdock (Arctium lappa, spp) Some clients are surprised at my inclusion of this humble and invasive wild plant in their dog`s protocol. Burdock is a classic alterative, hepatic, mild diuretic and cooling herb with broad applications in cancer therapy. It’s usually well accepted in decoction too, which is nice!
Dandelion (Taraxacum officinalis) Another one of those herbs that clients often raise an eyebrow when I mention it- I use the root most frequently in cancer cases, to support the liver without as much diuretic effect as the leaf, and act as a gentle laxative for dogs who are experiencing constipation. Ground flax and dandelion usually do the trick and the root offers more than just aperient action, of course. In cases of edema I generally include the leaf.
Siberian Ginseng ( Eleuthero senticosus) my go-to herb for stressed out cancer patients, El;euthero offers much to dogs facing multiple vet visits, possibly pain and ongoing owner upset. David Hoffman calls it “antihepatotoxic” 10 Often thought of chiefly as an adaptogen, Eleuthero offers much to the canine cancer patient. In addition to helping the body adapt to stress, it stimulates NK (Natural killer) and T-cells and helps offset side effects of chemo and radiation. One of the first herbs I consider.
Self Heal (Prunella vulgaris) Here’s a herb that is very underused in cancer – in veterinary herbalism in general. Michael Tierra writes “ This is an important herb in Chinese medicine and has been all but overlooked in Western herbal medicine. Perhaps because the latter does not distinguish the anti-tumour properties of the whole herb. It is used for all solid masses and tumours and may be combined with other herbs in formula”. 11 Self Heal is safe, promising and has a venerable history of use in China; I use it in most cancer formulas but may avoid if there is gastric upset, as I have seen some sensitivity at doses high enough to be worthwhile.

Ashwagandha ( Withania somnifera) I use ashwagandha extensively – for support with cachexia, with debilitated and/or nervous, stressed dogs with arthritis – essential with low WBC levels. I’ve found some challenges with administering withania and often simply have clients use capsules. My initial concerns about using a Solanaceae family herb were unfounded, as I have not seen the kinds of problems with Withania one might expect to see with tomatoes or white potato in solanine-sensitive animals. I now make good use of ashwagandha with cancer.
Violet (Viola odorata) Another classic “cancer herb” that seems to have dropped off the radar of holistic vets. My own dog who has a lowgrade Mast Cell Tumour gets violet as part of his daily blend – Violet is a classic alterative, is cooling and moistening (hence of much value to balance many of the warmer herbs we use with cancer) contains rutin and salicylic acids – a first choice for me with Mast Cell and any solid mammary tumour.
Calendula (Calendula officinalis) calendula is pretty wellknown in the animal word as a topical vulnerary for hot spots and other skin irritations, less understood as a lymphatic and rarely referred to as a potential immune modulator. I make use of it with cancer for all three. I use a water infusion of the dried herb in chronic cases and an alcohol extract in acute, usually with red root and other appropriate additions. Complements turmeric in cases of excess GI heat.
In various cases I might use Aloe vera, Codonopsis, Echinacea, Stillingia, Andrographis, American ginseng, Coleus forskohlii, St. John’s wort, Yarrow, Cat’s claw, – too many to list here. The herbs above reflect very common choices that I feel contribute greatly to a comprehensive protocol and with few contraindications.
Secondary

This important group of herbs represent those we use not so much for cancer-targeting actions (although many do possess anti-inflammatory, antioxidant and other helpful properties) as for general support. These are s small sample of standard, safe and useful herbs for issues associated with chemotherapy, steroids, and radiation.

Analgesics and anti-spasmodics – this group would include Corydalis, Jamaican Dogwood, Crampbark, Black Cohosh

Nervines – my favorites for dogs experiencing anxiety or restlessness include California Poppy, Passionflower, Linden and Monarda.

Digestive – Slippery elm is popular among dog lovers, but I have found Marshmallow root (Althea officinalis) far more helpful with stomach problems in dogs undergoing chemo. Plantain (Plantago spp can be added as a fresh, lightly steamed or well diced vegetable, mixed into food; fennel, ginger and chamomile may all be tried to settle nausea and help stimulate appetite.

Cardiovascular – Hawthorn (Crataegus spp) for me, an essential herb for the dog undergoing chemo. I use a solid extract a great deal of the time but also decoction of the berry, infusion of leaf and flower, and occasionally, glycerite. Other choices might include Arjuna, Ginkgo, Coleus and Motherwort.
Supplements
The following list is by no means exhaustive, but covers the most supplements I, and many holistic vets, use most often with dogs. As with herbs these need to be selected and dosed according to the individual case. I cover one in some detail  each Newsletter (which has been interrupted this year but will commence again in July)

CoEnzymeQ10
Bioflavonoids
Melatonin
Lipoic acid
IP6
Resveratrol
SAMe Modified Citrus Pectin
Pre and probiotics
Proteolytic enzymes
Ellagic acid

A word on antioxidants and chemo

One of my own challenges with cancer cases is working with a veterinary team who often don’t agree with one another, nor with me (or some combination thereof). The oncologist will bow out of the food discussion, claiming it doesn’t matter what we feed; the holistic vet will often be respectful of my experience and input but throw in scattered bits of TCM that contradict what we need to do if working in a Western Integrative approach; it is my top goal to keep this from becoming too confusing to the client. One area of almost constant disagreement is the use of antioxidants during chemotherapy. The holistic vet will say yes, the oncologist no – my own approach is to abide by what the client decides based on veterinary discussion. I will offer links that show the pros and cons of both but not influence them. With much at stake, and good arguments to be made on both sides, this has to be a personal decision. In many cases, we agree to use some, but not all, the antioxidant support we might consider once the chemo is done.

Case studies

It`s been hard to wade through the case folders and pick a few examples of dogs to share here, but rewarding. Many, if not most of the dogs I work with will die and sometimes, as in the case of most hemangiosarcomas, within a few months even with aggressive veterinary intervention and comprehensive nutrition and herbal support.

Connor – Bile duct carcinoma
Connor was my sister-in-law`s dog, a tall, gangly Pointer mix with seemingly one purpose in life; to fetch and retrieve. He had given his Mom a fair bit of grief as a young rescue dog, with some behavioural issues and that boundless Pointer energy. In later life he had settled considerably and was the dog they always knew he could be, when at 9 years old, a bout of severe diarrhea did not clear up with bland diet and antibiotics. Veterinary evaluation revealed cancer in the bile duct of the liver, a grave situation and one the oncologist felt left Connor with at best 3 months.
I was called in to help. Without anything near the experience and education I have under my belt now, I did my best. First, I put together the most comprehensive supplement list I knew how, which was pretty much the kitchen-sink, and then we took Con to the local holistic vet (only one in those days). The vet wanted to use a completely vegan diet, and added, oh – a dozen more supplements? It`s difficult to remember them all and I mention Connor here partly because the result of our approach was astonishing; not only did he NOT die in 3 months, he lived a full 3 years more – good quality time, with deterioration(cachexia, nausea) only at the very end…and no veterinary medications at all.
In retrospect it was a terribly unbalanced diet, I would do things differently today, to say the least! We used a range of liver support, including milk thistle, lipoic acid, SAMe and chlorella, this latter suggested by the vet as he feels it aids in heavy metal detoxification. My suggestions included grapeseed extract, Vitamin C, flax, selenium, and reishi (Ganoderma lucidum) while the vet recommended a range of homeopathics. We fed Connor mostly home made meals, a lot of tofu, soy cheese, mushed cooked vegetables with a range of culinary herbs, and as he became bored with all of that, I developed a lasagna recipe, made vegan shepherd`s pie, and ultimately resorted to a vegetarian kibble. After much cajoling the vet permitted some fish based canned food. While I cringe in dismay at some of this, the results were absolutely startling to everyone. Connor was happy till the end, and my professional focus was confirmed.
Janie – Mast Cell Tumour – Janie was an early cancer client of mine, her human came to me shortly after I started practising and was one of my first Mast cell cases. Mast cell needs to be handled differently from other cancers. Diet needs to be very restricted and yet fully balanced; here is a case where the history is so critical in order to know which foods, if any, the dog has reacted to in past. I look at the list of supplements we used (2005) and can’t help but think I was still in the “kitchen sink” phase – still, much like Connor, we enjoyed a very long survival time. Janie had had an aggressive mast cell tumour removed from her leg and followed up by radiation, with all the complications that can ensue. Today, I would structure her diet somewhat differently, but working with my knowledge at that time, we did several recipes geared to whole foods and higher fat, and of course, covering all nutrient requirements. In addition, we used fish oils, high dose Vitamins A and C, quercetin, enzymes, CoQ10, milk thistle, borage oil, lipoic acid, turmeric, astragalus and Devil’s claw (Harpagophytum procumbens). When the cancer returned four years later there was liver involvement, and we used a vegetarian diet with increased liver support; Janie died 5 years after the initial surgery, a survival time that stunned her veterinary team.
Astor – lymphoma – Astor is an 16 year old American Cocker spaniel who is, gratefully, still with us 18 months after I began work with him. His Intake form presented me with the following: “Lymphoma, Hypothyroid, Heart Murmur/ Enlarged Heart, Dry Eye, Luxating Patella, Arthritis, Allergies, Digestive sensitivities”. After the dietary formulation (which was quite the juggling act) and with consideration to his many issues and veterinary meds, I started Astor on fish oils with Vitamin E, CoQ10, ashwagandha, calendula, burdock, chaga, an additional multi-mushroom formula, grapeseed extract, 1P6, stillingia, red root, turmeric, assorted enzymes and a green food supplement( high in anthocyanins and multiple other flavonoids) with a glucosamine supplement and Devil’s Claw added later to help with increasing arthritic pain. I was initially contacted by Astor’s human in December of 2013 and he has enjoyed good quality time, without chemo, since then. While he may be preparing to make his transition soon, the extra time was of great value to his owner, who has since expressed an interest in studying canine nutrition more deeply.

Molly – hemangio – one of the most difficult things to deal with, for me, is the client who has been made aware of the dog’s likely death, and wants to “fight this thing anyway”. I know this cancer intimately; not only have I studied it, worked with it, corresponded with Dr. Jaime Modiano, a leading hemangiosarcoma researcher, and watched countless cases on my yahoo groups lose their fight – I’ve lived with it. My own dog Luke, an 8 year old Rhodesian, died without warning about two hours after his evening walk, from a catastrophic internal hemorrhage. Hemangio is not a diagnosis we want to hear. In fifty percent of cases, as Dr. Modiano puts it, “the first symptom is death”.

Molly was a service dog, an eight year old Golden retriever with a heart as big as the outdoors. Her diagnosis shattered the world for her person, a middle aged man with PTSD following military service – and one leg. When Rob contacted me I knew it was important to do everything we could, and that he understand it still wasn’t likely to give more than a few months. “I’m a fighter” was his response” and I need to give something back to her”.
Over the next 7 months, Rob cooked the meals I developed for Molly and she devoured them with gusto. In addition, I used probiotics, 1P6, a blend of 14 mushrooms featuring turkey tail (Coriolus versicolor) yarrow, a flavonoid blend including rutin, apigenin, luteolin and foods rich in flavonoids, crataegus, schisandra, taraxacum root, ,eleuthero, prunella and violet ( most herbs given via infusion or glycerite). We also used quercetin and bilberry extracts with moderate Ester-C (excess C can overacidify a dog’s urine and contribute to the development of crystals or bladder stones). Despite two serious bleeds that resulted in hospitalization, Molly had 7 months of quality time (her prognosis initially was 6 weeks). While some owners might want to let a dog go quickly, Rob wanted to fight, and fight we did. Molly suffered a catastrophic bleed 7 months to the day after diagnosis. I have a picture of Rob holding her as she passed. And no regrets about the hard work we did; cure was never the goal, but sending a cherished friend off with love, buying a little extra time, was.
In conclusion, I have a specific methodology with regard to cancer cases, and it always starts with diet. In contrast to the notion of a single “cancer diet” I work with the individual and use nutrient levels and food choices I feel will specifically support their type of illness and constitution. In most of my work I select herbs according to the ideal of using whole plants and supporting the system and individuality of the animal, but with cancer I feel a strong case can be made for a partially allopathic approach to plant extracts. I will use standardized silymarin as well as whole milk thistle, for example. With so many factors to consider – type of cancer and how it tends to behave effects of veterinary treatments and the philosophy of both owner and vet, cancer is an extraordinarily challenging condition to work with in dogs. That said, the rewards of doing so are many, ranging from extended survival times, to making the dog more comfortable as they transition…to a contribution towards the emotional journey of human and dog, at the end of what is always a very special relationship. More than once I have recommended herbs for the human, to help with relaxation, stress and emotional suffering! Despite the challenges, working with cancer in dogs is a part of my job I feel gratified to be able to do, with sensitivity and with love.
Sources

John Boik, Natural Compounds in Cancer Therapy
Donald Yance, Herbal Medicine, Healing and Cancer
Micheal Tierra, Treating Cancer with Herbs
Susan Wynn/Barbara Fougeres, Veterinary Herbal Medicine
Susan Wynn/Steve Marsden, Manual of Natural Veterinary Medicine
Shawn Messonnier, Preventing and Treating Cancer in Dogs
Demian Dressler, The Dog Cancer Survival Guide
David Hoffman, Medical Herbalism
David Winston and Merrily A. Kuhn, Herbal Therapy and Supplements

Footnotes
1) Donald Yance: Herbal Medicine, Healing and Cancer
2) Whole Dog Journal 2012: http://www.whole-dog-journal.com/issues/15_4/features/Canine-Malignant-Lymphoma-and-Lawn-Pesticides_20494-1.html
3) http://www.caninelymphoma.com/canine-lymphoma-chemotherapy-madison-wisconsin-protocol/
4) http://www.lef.org/Magazine/2002/7/report_arginine/Page-01?p=1&checked=1
(Important to note here that Supplemental L-arginine can be contraindicated in many cases, too – use is very specific)

5) The Dog Cancer Guide, Demian Dressler DVM
6) Natural Compounds in Cancer Therapy, John Boik
7) The Dog Cancer guide, Demian Dressler
8) Ibid
9) http://www.upenn.edu/pennnews/news/compound-derived-mushroom-lengthens-survival-time-dogs-cancer-penn-vet-study-finds
10) Medical Herbalism, David Hoffman

11) Treating Cancer with Herbs: an Integrative Approach, Michael Tierra