Factors Which Influence Owners When Deciding to Use Chemotherapy in Terminally Ill Pets

Abstract

Simple SummaryCancer is as common amongst pets as it in humans. Chemotherapy can be integrated into treatment regimes for terminally ill pets to attempt to shrink tumours to extend life expectancy, but it does not cure cancer and it can have negative side effects including vomiting, depression and behavioral changes. To date, little research has been undertaken to explore owners’ decisions whether or not to treat their animals with chemotherapy. Seventy-eight dog and cat owners completed an online questionnaire to determine if they would opt for chemotherapy if their pet was diagnosed with cancer, and asked how they thought their pet’s quality of life would be affected. Fifty-eight percent of respondents would not use chemotherapy largely due to their previous experience of it. Seventy-two percent over estimated pet survival time post chemotherapy, with most people believing it would lead to remission or a cure. Owners expected their pets to be less active, sleep more and play less, reducing their quality of life. Common side effects associated with chemotherapy were not rated as acceptable. The results suggest pet owners would benefit from an increased understanding of the positive and negative impacts of chemotherapy when initially discussing treatment options with the veterinary team.AbstractChemotherapy is a commonly integrated treatment option within human and animal oncology regimes. Limited research has investigated pet owners’ treatment decision-making in animals diagnosed with malignant neoplasia. Dog and cat owners were asked to complete an online questionnaire to elucidate factors which are key to the decision making process. Seventy-eight respondents completed the questionnaire in full. Fifty-eight percent of pet owners would not elect to treat pets with chemotherapy due to the negative impact of the associated side effects. Seventy-two percent of respondents over estimated pet survival time post chemotherapy, indicating a general perception that it would lead to remission or a cure. Vomiting was considered an acceptable side effect but inappetence, weight loss and depression were considered unacceptable. Owners did expect animals’ to be less active, sleep more and play less, but common side effects were not rated as acceptable despite the potential benefits of chemotherapy. Based on the results, veterinary teams involved with oncology consultations should establish if clients have prior experience of cancer treatments and their expectations of survival time. Quality of life assessments should also be implemented during initial oncology consultations and conducted regularly during chemotherapy courses to inform client decision making and to safe guard animal welfare.

“What Would You Do?”: How Cat Owners Make End-of-Life Decisions and Implications for Veterinary-Client Interactions

“…For example, factors identified from previous research include the animal’s quality of life (QoL), the owner’s finances, time and other resources, and their attachment to their cat [ 32 , 33 , 34 , 35 ]. Many of the factors in other previous studies were identified via ‘expert’ consensus [ 36 ], or used in surveys [ 29 , 37 ], and therefore the information collected may not reflect owner perceptions but expert consensus, or has been limited to quantitative data via surveys or structured interviews. For example, Slater at al.…”

The Use of Chemotherapy to Prolong the Life of Dogs Suffering from Cancer: The Ethical Dilemma

“…Concerns that the animal is being kept alive for the owner are not unique to chemotherapy and consideration should be a given to whether veterinarians should initiate a treatment just because they can [5]. However, in balancing the interests of the owner, animal and veterinarian there is the added dimension that chemotherapy involves the use of drugs that are mutagenic, carcinogenic, teratogenic and may be irritant [32], and there has been limited research on treatment decision-making by owners with animals diagnosed with malignancies [31].…”

“…There are other significant concerns with the use of chemotherapy in dogs. Owners of animals undergoing chemotherapy may be poorly informed and despite the fact that chemotherapy is becoming a more common therapy there have been no large scale studies on the prevalence and incidence of side-effects associated with this treatment [32]. Of additional concern is that the public health risks associated with the use of chemotherapeutic agents may not be given adequate attention in veterinary practice [43].…”

“…Palliative care without chemotherapy does not extend the life of the dog but is a common choice given the costs, commitment and uncertain prognosis with chemotherapy. Although veterinarians, particularly veterinary oncologists, may view cancer as just another disease of animals that can be “treated”, animal owners are likely to view cancer from a different perspective and may view chemotherapy in the light of their own experiences or that of their relatives [32]. In addition, chemotherapy, because it is generally mutagenic and carcinogenic, is a public health risk and owners, veterinarians and veterinary nurses may be rightly concerned about its use in animals [32].…”

“…Although veterinarians, particularly veterinary oncologists, may view cancer as just another disease of animals that can be “treated”, animal owners are likely to view cancer from a different perspective and may view chemotherapy in the light of their own experiences or that of their relatives [32]. In addition, chemotherapy, because it is generally mutagenic and carcinogenic, is a public health risk and owners, veterinarians and veterinary nurses may be rightly concerned about its use in animals [32]. Aftercare of a dog undergoing chemotherapy may place an added burden that an owner should take into consideration [30].…”