- Today, we're talking
about lung tumors in dogs.
I'm gonna give you five things
that I want you to know
about lung tumors in dogs.
(upbeat music)
What's today's tumor topic?
Well, today, topic is
a little bit personal.
We're talking about lung tumors.
It's not my dog who was diagnosed,
but it is one of my very
good friend's and colleague
and her own personal dog, Mabel was
just diagnosed with a primary lung tumor.
And she said to me,
"You don't have a video
about lung tumors."
And you know, at the end
of each video where I say,
"Hey, if you have a topic
that you'd like me to cover, let me know."
Well, this one is for Mabel
and let's break it down.
Number one, lung cancer
is the leading cause
of cancer related deaths in people.
But it's actually very uncommon for dogs
and cats to have primary lung cancer.
And estimated to be the
cause about less than 1%
of the reason that dogs and cats die.
So primary lung cancer in dogs
and cats is very uncommon.
And what's actually way more
common in dogs and cats,
but we're gonna focus
on dogs in this video
is metastatic cancer, cancer
that spreads to the lungs.
But we're gonna be focusing
on primary lung cancer in this video.
I will be doing another follow
up video on metastatic cancer
because we approach that very differently.
We approach that with chemotherapy.
The treatment of choice,
spoiler alert for this
is going to be surgery if
there's been no spread.
So again, pretty uncommon for dogs
and cats to have primary lung cancer.
Who do we tend to see it in?
Tends to be a cancer of middle age
and older dogs, usually
dogs about 11 years of age.
The over representative
breeds include Boxers,
Doberman Pinschers, Irish Setters
and Bernese Mountain Dogs.
So how do we find lung cancer?
So in some cases, your
dog may be symptomatic,
so showing us symptoms.
But it's not uncommon for us
to find this as part of your
pet routine geriatric screen.
So when your veterinarian says,
"I'd like to do routine chest X-rays."
This is exactly the reason
that we recommend those chest X-rays.
Me personally, my recommendation
is that your dog and cat get chest X-rays
and an ultrasound, but for lung cancer
for lung nodules, get
chest X-rays twice a year.
And people say, "That
sounds really frequently."
Remember our pets age more quickly.
So that'd be like me or you getting,
you know, chest X-rays
every couple of years.
And the reason it's so important
for things like lung cancer
is we often find these before
our pets are symptomatic.
And as I'll tell you at
the end of this video,
dogs have a better prognosis
if they're not symptomatic,
they're not showing clinical signs.
So again, it's really a good
idea to do those chest X-rays
in my humble opinion, twice a year.
And I usually start them at middle age.
Middle age changes depending
on the size of your dog.
So if you have a Great Dane,
middle age is gonna be a lot earlier
than if you have a Chihuahua,
or a Maltese or something
like that, or a Labrador.
So talk to your vet and
say, "When is middle age?
When should we start doing
these routine imaging,
chest X-rays and ultrasound?"
But what are the clinical signs?
That's what veterinarians call it.
What are the symptoms that you may see?
The most common one that
we see in about 50 to 90%
of dogs is going to be cough,
labored breathing, we
see in about depending
on the study about five to 25% of cases,
your dog may be tired in
about 10 to 15% of cases,
their appetite can be off.
And so again, it could just
be changes in appetite.
I have a whole other video about that.
And I think often it's really confusing
because they may not eat the regular food
but they'll eat other food for you
and we get confused as to whether
or not that's normal or
not and whether or not
they should go into the veterinarian.
So changes in appetite and
about 10 to 15% of cases,
weight loss in about 10% of cases,
coughing blood and that's usually one
that you know, gets us worried
or gets a pet owner worried
in reported about three to 9% of cases.
And then rarely we'll see
lameness, and that's because
this cancer can cause something
called hypertrophic osteopathy,
and so we can see lameness as well.
So again, the most common thing
that we're gonna see is
coughing, and labored breathing.
And those would definitely be reasons
to go to your veterinarian
and get an X-ray.
But my take home message for you guys,
is that we don't always see clinical signs
and routine physical exams.
We're going in giving
those chest X-rays couple times a year,
getting your pets weight monitored
are gonna be really good ways
to hopefully detect these earlier.
So number three is blood test.
And your veterinarian is gonna recommend
blood work and your analysis.
That's always an important test just
for overall health screening,
see what else is going on,
make sure they're not anemic.
Sometimes they have secondary
high white blood cells from infections,
but chest X-rays are gonna
be really important to
make the diagnosis.
And that's usually the first test
that your primary care
veterinarian will do.
In one study, it's been
shown that symptoms
are often not seen until the nodule
is about three centimeters.
So that's really important.
Again, one of the reasons
why doing those routine
chest X-rays we're gonna
help detect these earlier.
So let me show you what
three centimeters is.
Alright, so I have you
know, a couple of calipers
that we always, that you
may have seen in some
of our other videos where we're talking
about skin lumps and bumps
'cause I always recommend doing
your monthly lump and bump exam.
So this is three centimeters which
is usually about the frames on my,
like the height of my glasses,
that's a good estimate.
So, you know, that's usually the size
of the lung nodule before a dog will start
to show clinical signs or
symptoms that we talked about.
So that is important, why?
Again, we wanna take those X-rays early.
Some other tests that your
veterinarian or cancer specialist
meant talk to you about are
ultrasound-guided, aspirates
of the mouth to collect
some cells, or a biopsy,
I don't think they're always
necessary in every case
so I'm gonna leave those details
to be discussed with your
veterinarian oncologist.
And we'll have links below
on where you can find that
or this discussion may be something
that you're talking about
with a surgeon if you're,
meeting them before surgery.
One test that I do wanna
definitely bring up
is a thoracic CT scan,
because those are gonna be more accurate
for a couple of really important things,
and usually means that you're gonna have
to go to a specialty
center to get that CT scan.
And so that's a three dimensional picture.
And why that's really helpful is
it's gonna be better to detect spread
to the lymph nodes
within the chest cavity,
and also whether or not
that first lung mass
has spread to other nodules in the lungs.
And why that's really important because
if that first lung cancer has
spread throughout the lungs,
you're not gonna wanna go to surgery.
So it really changes what we're gonna do.
So I definitely recommend that a dog
that has a solitary lung
nodule detected on chest X-rays
have a CT scan before going to surgery.
I think that's a really important test
definitely worth the investment,
you know, before you go to surgery,
it has been shown that on a CT scan,
a nodule has to be just under a centimeter
about seven to nine millimeters.
So a little smaller than an
Eminem or a pea or a Skittle
to be detected on X-rays,
but only a millimeter
really, really small to
be detected on a CT scan.
So the sensitivity of a
CT scan is much better.
And again, you talk about
it with your surgeon
or your oncologist 'cause I definitely
recommend a CT scan
before going to surgery
'cause again, if the cancer
is spread to the other nodules
in the lungs, we're not gonna recommend
taking out that first lung nodule
'cause it's already spread.
We're gonna talk about something systemic,
like chemotherapy.
Alright, now let's talk about treatment.
Alright, how do we treat
lung tumors in dogs?
So the treatment of choice
as I've talked about,
keep kind of giving everything away
is definitely surgery.
If you have a solitary single lung nodule,
that hopefully you've
confirmed with a CT scan,
the next step is going to be surgery.
And this is a thoracotomy.
So this is a big deal surgery.
Usually this is going to require
referral to a boarded surgeon.
So you're gonna want
to check their website
for board certified surgeon.
Usually these dogs are in the hospital
for a night or two with a
chest tube in overnight.
They do well, they're on pain medications
and things like that.
Sometimes the surgeon
can do it with a scope,
thoracoscopy, the surgeon I worked
with previously did that.
So it just meant a smaller
incision and a quicker recovery.
Typically they're gonna
biopsy the lymph nodes
at surgery as well depending
on where the lung tumor was,
but hopefully with that, so hopefully,
if you had a solitary primary lung cancer,
it's gonna to be really important
'cause we're gonna get the type
of tumor and the grade of
tumor which we'll talk about
in the final section,
which is very prognostic
gonna help us predict the overall outcome.
Whether or not the dog needs
chemotherapy after surgery.
A lot of that will depend on the biopsy,
but in general, we wanna remove
the primary lung tumor first,
and then decide whether
they need chemo based
on the biopsy including the
type of tumor that it is
and the grade of tumor.
Some of the other prognostic factors
may play a role like how big the tumor was
and things like that.
So if they are gonna need chemo
often we'll use drugs like Carboplatin,
Navelbine which is also called Vinorelbine
and sometimes some non-steroidal
anti-inflammatories as well.
For the most common types of lung tumors,
which tend to be carcinomas,
bronchioloalveolar carcinomas.
There are some less common lung tumors
like histiocytic sarcomas,
squamous cell carcinomas
and things like that.
So again, can't make
specific recommendations
about what, you know, your dog may need
but that's why hopefully after surgery
and you get your biopsy back,
you can consult directly
with an oncologist.
Please don't ask me what I would,
specifically recommend 'cause I can't make
recommendations over YouTube.
These videos are just
to give you some general recommendations,
some general information,
hopefully demystify the process.
Remember, I have a whole
playlist on chemotherapy,
check out vlog number 93, about
chemotherapy side effects,
home safety with chemotherapy,
what to do if your pet is
going through chemotherapy
in terms of managing side effects,
how to give your pet pills
and things like that.
So please check out all
those videos as well.
And finally, what is the prognosis
for a dog with a lung tumor?
And so, overall, when
they look at all the dogs
with lung tumors, it's
actually not bad, it's a year.
And I know if you're listening
to this, you're like,
"Dr. Sue, you're crazy. A
year is never long enough."
When I say a year we have
to remember that the lifespan
of dogs is much shorter than people.
And so a year is not
an insignificant period
of time in a dog's life.
But when it's your own
dog, I get it, I get it.
It's never enough time.
But it's a respectable amount
of time when we're talking
about cancer overall.
There are some cancers, you know,
lymphoma without
treatment is only a month,
but there's a huge wide
range within that guys
and there's gonna be a lot
of variables that will contribute to that.
And so some of it is the tumor type.
So the main predictive factors
are the type of tumors so
that we need, the biopsy,
the grade, so low grade,
intermediate grade,
or high grade, and that's
a big prognostic factor
we'll talk about how that can change it.
Did your dog have clinical signs?
Coughing, weight loss.
Some studies also show if they
had fluid around the lungs,
that can be a negative
prognostic factor as well.
So some some of those
symptoms that we talked about,
which are also called clinical signs.
So again, another reason why doing those
X-rays to try to catch
these tumors before your dog
is showing symptoms can be so important.
And then the stage,
how far advanced it is.
And the stage also takes into
account the size of the tumor.
Again, you know, going back to why finding
these tumors when they're
smaller can be so important.
So a dog with a solitary,
small, low grade tumor
can do really well with just surgery.
And in some studies like 800 days,
which is over two years so
they can do really well.
In contrast, an intermediate grade tumor
or grade two tumor in some
studies lives about 250 days,
so about eight months,
so depend on some of the characteristics
on the biopsy, I may recommend chemo.
How big was the tumor?
Was the dog showing symptoms?
And things like that.
And then the high grade
tumors in some studies,
about a week or two.
So very, very different
and the hard part is guys,
we usually don't have
this biopsy information
back until after surgery.
So again, it could be very
challenging 'cause we have
to make these decisions
before we go to surgery.
Alright guys, that was my attempt
at quick tip information on lung tumors.
There's gonna,
I know I can't answer every question,
there are gonna be some dogs where
it may be deemed impossible to remove,
the primary lung tumor, and you may talk
to your oncologist about
just doing chemotherapy.
There are some cases where we might use
a different chemotherapy
than I recommended.
So in some of the cases,
we're using Palladia,
which is an anti-angiogenic therapy.
It's a drug that was originally
labeled for mast cell tumors.
So again, talking to
oncologist is gonna to be
a great way to get an
individualized plan for your pet.
Links below.
Again, tell me the videos
that you wanna see.
Thank you so much for watching.
I hope you found this video helpful.
Mabel, I'm thinking about you.
I hope that you kick this cancer's butt.
And again, thanks for watching, everyone.
I look forward to seeing
you at the next video.
(upbeat music)
