Integrative medicine involves the use of evidence-based, complementary practices for the treatment of veterinary cancer patients. These are treatments given in addition to standard-of-care treatments and therapies. Integrative medicine takes a whole body approach to treatment. It considers environment, diet, exercise, supplements, and non-traditional treatments that can improve a patient’s quality of life.
We still lack good evidence for most complementary practices. Nonetheless, we know pet owners will seek such therapies for their beloved pets. In this article, we hope to provide recommendations that may help owners make the best decisions for their pets.
Environmental factors play a large role in the development of human cancer and likely are significant in the development of veterinary cancers as well.
In human medicine, cigarette smoking alone accounts for up to 1/3 of all cancers. Environmental tobacco smoke is also known to promote cancer development in humans, and studies show increased risk of feline intestinal lymphoma for cats in smoking households and increased nasal and oral tumors in long-nosed dogs and cats. Therefore, we recommend no smoke around pets. Otherwise, herbicides, paint solvents, coal and kerosene heaters, radon, and asbestos have all been linked to cancer development.
Cancer patients require daily maintenance just as any other pet. Flea, tick and heartworm medications are imperative, and recommendations can be made by your veterinarian. Vaccinations should be maintained, though scheduling may need adjustment to allow vaccines to be given when the immune system is good to receive them. Grooming should be continued; however, for pets that visit the groomers, owners should ask about timing to reduce risk of infections that may cause harm. Adding a new puppy or kitten to the family can be problematic, as some puppies or kittens may not be appropriately vaccinated nor protected from severe and potentially lethal diseases. The addition of a new pet should be discussed with the oncologist. Coughing or sick pets should be avoided.
Clients often choose to switch pet food to one that is recommended or claims to have the best ingredients. The truth is that non-prescription diets are held to the same, limited standard, and so it’s impossible to reliably know if one diet is any better than the other, as long as they all have the same AAFCO feeding trial evidence of safety (there’s a label on the bag of food that certifies testing). The rest is just marketing.
Commercial foods are balanced, and it’s safe to continue feeding. However, to optimize nutrition, it may be recommended that a patient switch to a prescription diet, as these diets are held to higher nutritional standards. Another consideration is a homemade diet.
The advantage of a homemade diet is that you choose the ingredients and know their quality. However, homemade diets take time to prepare, and most online recipes are not nutritionally balanced for our pets. There are two websites that can help: https://www.mypetgrocer.com/ and https://secure.balanceit.com/. However, we recommend that a board-certified veterinary nutritionist be consulted for home feeding recipes. We are fortunate at CARES to have a nutritionist, Dr. Lindsey Bullen, who is available for phone consultation at a cost. She can be reached through the nutrition coordinator, Brandi Griffin, at (919) 600-6609 or firstname.lastname@example.org. If you choose a diet change for a cancer patient, make sure that change occurs over 1-2 weeks to avoid diarrhea. Small amounts of the new diet should be added to the existing diet so that the ratios of each food change daily until the new food is exclusively fed.
Exercise has some of the strongest evidence in humans to support its use to improve quality of life and prolong overall survival in certain tumor types. It’s reasonable to assume the same for our pets and patients. General recommendations are at least 150 minutes of exercise per week.
There is evidence in human medicine that mindfulness practices (yoga, meditation, massage, etc.) improve quality of life. We truly don’t know how to translate this to veterinary medicine other than to recommend belly rubs and petting in a way that your pet enjoys on a regular and daily basis. Pets are highly attuned to our stresses, and so mindfulness as a pet owner may have an impact on your pet’s quality of life. Please see the following article:
For patients with pain, acupuncture may help to play a role. It will not cure a tumor, but there are patients who are responsive to this modality. Discuss with your oncologist, as this therapy may play a role in pain management for certain patients.
There is no evidence-based research to prove that supplements extend survival in cancer patients. Anecdotal successes, small case studies, and in vitro (laboratory) studies indicate exciting possibilities, but clinical trials have not shown clear support. It’s important to remember that some supplements can cause harm. If you read about a supplement you wish to try, discuss it with your pet’s oncologist first. Also, please consult https://nasc.cc/members/. Always use supplements sensibly and as directed. Some supplements that may be considered:
- Probiotics – It’s still too early to know true benefits of probiotics for veterinary cancer patients, but it’s reasonable to recommend them. One recommended humanproduct that has been evaluated in the veterinary literature is https://www.visbiome.com/. There is a veterinary formulation as well. Other veterinary probiotic formulations include Fortiflora and Proviable. For more information about the gut microbiome and its role in health, here is a lay article of interest: https://www.nytimes.com/2017/11/06/well/live/unlocking-the-secrets-of-the-microbiome.html?&moduleDetail=section-news-5&action=click&contentCollection=Health®ion=Footer&module=MoreInSection&version=WhatsNext&contentID=WhatsNext&pgtype=Blogs
- Omega-3 fatty acids – These are anti-inflammatory molecules that can be found in flaxseed, walnuts, and fish-based diets. They can also be found in appropriately balanced ratios in many prescription veterinary diets. Some owners choose to use fish oils. These should be mercury free and sprinkled on food at recommended doses. Doses that are higher than this can be dangerous.
- I’m-Yunity (Turkey tail mushroom) – There was one study of dogs diagnosed with hemangiosarcoma that showed better than expected results. There were few dogs tested, and more research is needed to prove the benefit of this supplement. Additional clinical trials are ongoing, and so far, there is no evidence of harm. There are many formulations, but this is the website for the product involved in veterinary clinical trials: http://www.imyunity.com/
- Vitamins – There is little evidence to support their use and some evidence to support that they may do harm. It is best to receive nutrients through diet. For patients who are not eating a formulated diet, a daily multi-vitamin (Centrum or children’s vitamin depending on patient weight) may be considered. However, it is optimal to seek consultation with a board-certified veterinary nutritionist first.
For more complete recommendations and consultation on cancer treatments for your pet, feel free to call us anytime at CARES, 215-750-2774.