https://www.vetsurgeon.org/f/clinical-questions/30507/new-clinical-article-club-what-diet-should-we-feed-a-cat-or-dog-with-cancer-with-owen-davies Hi everyone, I&#39;m really excited to launch our new forum discussion series, the VetSurgeon.org Clinical Article Club. It&#39;s a bit like a book club, where you discuss articles and their implications for your work with each other, and, as a result ofen-USTelligent Community 10https://www.vetsurgeon.org/thread/240231?ContentTypeID=1Wed, 14 Dec 2022 12:36:26 GMT146601cc-3922-4be7-9974-7e1d4e45a66b:7b020c9d-8e93-4650-a322-571b5b2cf20eArlo Guthrie<p>That rounds up our first Clinical Article Club discussion. Great to have some interesting questions there, and I&#39;d like to thank&nbsp;<a href="/members/owen-davies" class="internal-link view-user-profile">Owen Davies</a>&nbsp;for being our first author to take part. Great job.</p> <p>I think we have something to build on here, and I like the way the&nbsp;<a href="https://www.veterinary-practice.com/article/what-diet-should-we-feed-a-cat-or-dog-with-cancer" rel="noopener noreferrer" target="_blank">original article now has a link at the foot</a> which leads to this discussion with the added questions and points raised. That way, people who read the article in the future will now benefit from this extra info.</p> <p>We&#39;re now putting together a schedule for regular discussions every two weeks, so hopefully there&#39;s be something for everyone!</p><div style="clear:both;"></div>https://www.vetsurgeon.org/thread/240221?ContentTypeID=1Mon, 12 Dec 2022 17:28:00 GMT146601cc-3922-4be7-9974-7e1d4e45a66b:1a341f96-afa5-4fe1-9173-02ae2605cbe2Andreas Ege<p><span>Actually, intestinal cancer was (indirectly) the main reason I ended up with raw feeding.</span><br /><span>My own cat had chronic diarrhoea. Diagnostics (pretty much all besides ct/mri and gut biopsies) didn&#39;t give anything, campylobacter cleared but diarrhoea stayed. Not responsive to steroids, metronidazole or tylosin. Did start her on a self-made raw diet after spending a few months researching (hardly any information both for risk or benefit available at the time, and no commercial cat diets), kind of as a last ditch approach. The diarrhoea improved to reasonably formed faeces again and, more importantly, the cat got control back and was using the litter tray again. Huge increase in QoL both for the cat and us.</span><br /><span>About a year later I put her to sleep and the post-mortem revealed a diffuse intestinal sarkoma.</span><br /><span>I suspect the higher digestibility might have been the main reason for the faecal improvement. I know, it&#39;s just a single case and the improvement might just have been coincidence (though, obviously, I doubt it&nbsp;</span> <span>).</span></p><div style="clear:both;"></div>https://www.vetsurgeon.org/thread/240220?ContentTypeID=1Mon, 12 Dec 2022 10:51:36 GMT146601cc-3922-4be7-9974-7e1d4e45a66b:142a19bc-be54-4b50-9d6c-576998b45467Owen Davies<p>[quote userid="2300" url="~/001/veterinary-clinical/small-animal/f/misc-case-discussions/30507/new-clinical-article-club-what-diet-should-we-feed-a-cat-or-dog-with-cancer-with-owen-davies/240195#240195"]I remember a student was stating it was time for jelly and ice cream-it has stuck with me for years. Why make a dogs life any more miserable when we are in palliative care mode.[/quote] <p>I agree David. &nbsp;If an animal genuinely has very limited time left I am more than happy to spoil them!</p></p><div style="clear:both;"></div>https://www.vetsurgeon.org/thread/240219?ContentTypeID=1Mon, 12 Dec 2022 10:50:19 GMT146601cc-3922-4be7-9974-7e1d4e45a66b:f1d48361-6de8-4109-9252-b7f72e106157Owen Davies<p>[quote userid="10320" url="~/001/veterinary-clinical/small-animal/f/misc-case-discussions/30507/new-clinical-article-club-what-diet-should-we-feed-a-cat-or-dog-with-cancer-with-owen-davies/240196#240196"]Thinking of patients with gastro-intestinal cancer, such as alimentary lymphoma in cats, where the disease is likely to be directly affecting digestions/ absorption - is there a role for hydrolysed diets here, or is something low-residue/ digestible likely to be just as useful (and more tempting)?[/quote] <p>Hi Lucy - great point! &nbsp;The GI cases can be a real challenge. &nbsp;If cases have gastrointestinal signs through malabsorption then the dysbiosis this creates will be similar regardless of what caused the malabsorption (e.g. lymphoma / IBD / primary lymphangiectasia). &nbsp;And in feline lymphoma (in particular) the cats will often have had chronic IBD extending back years in the first place (some people postulate that the chronic inflammation predisposes to lymphoma).</p> <p>So, I try&nbsp;to treat all the malabsorption cases the same, with the addition of chemo in the GI lymphoma cases. &nbsp;Hydrolysed / novel protein diet, thorough endoparasite control, and judicious use of antacids, antibiotics and probiotics. &nbsp;I will choose chemo drugs that are minimally upsetting to the GI tract (lomustine, cyclophosphamide etc. are good choices to start with), and if the cancer responds you can often see an improvement relatively quickly (within a few weeks). &nbsp;The mistake people sometimes make is thinking that chemo is the only treatment for these guys.</p> <p>Of course if the patient is very sick and resolutely inappetent, then something is always better than nothing, so if the animal will eat an &quot;ok but suboptimal diet&quot; instead of an &quot;ideal&quot; diet then I will go with the former! &nbsp;Quantity can be just as important as quality!</p></p><div style="clear:both;"></div>https://www.vetsurgeon.org/thread/240196?ContentTypeID=1Fri, 09 Dec 2022 14:24:41 GMT146601cc-3922-4be7-9974-7e1d4e45a66b:58b1d967-8caf-450d-b6be-f71f65abec26Lucy Fleming<p>Interesting discussion - almost one where the &quot;right&quot; diet is going to be different based on not only the type of disease, but also the treatment plan (such as the concerns over raw feeding pets with immunosuppression throughs chemotherapy, vs &quot;treating&quot; those on palliative care). Thinking of patients with gastro-intestinal cancer, such as alimentary lymphoma in cats, where the disease is likely to be directly affecting digestions/ absorption - is there a role for hydrolysed diets here, or is something low-residue/ digestible likely to be just as useful (and more tempting)?</p><div style="clear:both;"></div>https://www.vetsurgeon.org/thread/240195?ContentTypeID=1Fri, 09 Dec 2022 13:15:07 GMT146601cc-3922-4be7-9974-7e1d4e45a66b:9933b6e9-4be7-454c-9253-d5bbc2e49bd7david kemp<p>I remember a student was stating it was time for jelly and ice cream-it has stuck with me for years. Why make a dogs life any more miserable when we are in palliative care mode.</p><div style="clear:both;"></div>https://www.vetsurgeon.org/thread/240194?ContentTypeID=1Fri, 09 Dec 2022 09:07:59 GMT146601cc-3922-4be7-9974-7e1d4e45a66b:b44d17fb-a066-40a7-ac45-b5860090f058Arlo Guthrie<p>Bumping this up the list - any more questions for Owen?</p> <p>He won&#39;t be around to answer forever, and it would be nice to make sure this thread has all the additional questions one might have about feeding cancer patients, as it will remain as a reference for others in the future.&nbsp;</p><div style="clear:both;"></div>https://www.vetsurgeon.org/thread/240182?ContentTypeID=1Wed, 07 Dec 2022 22:11:03 GMT146601cc-3922-4be7-9974-7e1d4e45a66b:b1626e2c-58ec-4095-9a80-63155322af09Owen Davies<p>[quote userid="4080" url="~/001/veterinary-clinical/small-animal/f/misc-case-discussions/30507/new-clinical-article-club-what-diet-should-we-feed-a-cat-or-dog-with-cancer-with-owen-davies/240159#240159"]Could Owen expand on dietary supplements/adjustments for particular tumours that might cause specific issues such as anaemia/hypercalcaemia etc?[/quote] <p>Hi Joanne - the management of anaemia is something that I often wonder about in many cases. &nbsp;Particularly cases that are on chemo / TKI treatment that develop an insidious and progressive anaemia as the weeks and months go on. &nbsp;It&#39;s a tricky one and I haven&#39;t got a magic answer! &nbsp;In many cases we conclude the cause of the anaemia is&nbsp;multifactorial - for example there may be a component of chronic disease, a component of myelosuppression from drugs, a component of GI loss (low-grade ulceration due to some chemo medications etc.) or sometimes a component of anaemia due to the cancer itself (e.g. auto-immune or related to low-grade bleeding from a tumour). &nbsp;So, first thing is to think what factors are involved in the anaemia in your particular case. &nbsp; With a non-regenerative / poorly regenerative anaemia then&nbsp;checking iron and vitamin B12 are prudent&nbsp;things to do, and supplementing these can be very beneficial. &nbsp;If you have a regenerative anaemia you could consider a trial of gastroprotectants if you consider low-grade GI bleeds likely , as well as ceasing / adjusting drugs which may be ulcerogenic. if you feel&nbsp;the tumour itself is playing a role in the anaemia, then perhaps treatment needs changing to get better control of it. &nbsp;And of course it is always sensible to make sure the animal is on an appropriate diet AND is actually eating an appropriate amount of this (some animals will be offered an appropriate food but eat insufficient due to being full of treats! - this is not uncommon when the pet has been diagnosed with cancer).</p> <p>With regard to hypercalcaemia - I wouldn&#39;t try to feed / supplement any different. &nbsp;Most hypercalcaemias of malignancy have onset acutely - and so the body&#39;s homeostatic mechanisms should not have become lazy! &nbsp;Getting the cancer burden into remission will be most effective treatment of restoring calcium homeostasis, and it is very rare to need any more than this. &nbsp;Supplementation &nbsp;of calcium and / or vitamin D can also be very dangerous if there is no good need to do it...</p> <p>If the dog / cat has cancer cachexia (loss of muscle mass due to disease) then there is no magic treatment (other than getting the disease into remission - not always possible) however the supplementation of omega 3 fatty acids may be helpful, and if you use a veterinary product (without vitamin A or vitamin D which can be toxic in high levels) then this is a relatively benign thing to implement. &nbsp;</p></p><div style="clear:both;"></div>https://www.vetsurgeon.org/thread/240179?ContentTypeID=1Wed, 07 Dec 2022 21:43:17 GMT146601cc-3922-4be7-9974-7e1d4e45a66b:161270cc-ad81-46b2-9e10-ec64080f1c7eOwen Davies<p>[quote userid="3685" url="~/001/veterinary-clinical/small-animal/f/misc-case-discussions/30507/new-clinical-article-club-what-diet-should-we-feed-a-cat-or-dog-with-cancer-with-owen-davies/240157#240157"]Is there some grounds for suggesting that raw food shouldn’t be fed to animals receiving chemotherapy from an immunosuppressive point of view (the chemotherapy, not the raw food!)?[/quote] <p>Hi Nicola - good question. &nbsp;Yes - just as per Allison said. &nbsp;The prevalence of pathogens in raw food is uncomfortably high, and where a dog/cat may exist in equilibrium with these&nbsp;when immunocompetent, if immunosuppressed they may be unable to do so. &nbsp;I will never forget a dog who my colleague treated a few years ago - he was receiving a multiagency chemotherapy treatment for lymphoma and his owner refused to stop feeding the raw diet that he had read about on the internet. &nbsp;The dog developed septic endocarditis and his heart cultured positive for Salmonella spp. at post mortem....</p></p><div style="clear:both;"></div>https://www.vetsurgeon.org/thread/240165?ContentTypeID=1Wed, 07 Dec 2022 11:56:11 GMT146601cc-3922-4be7-9974-7e1d4e45a66b:bd327bdc-a860-4223-b5fb-e6796f35411cArlo Guthrie<p>[quote userid="3169" url="~/001/veterinary-clinical/small-animal/f/misc-case-discussions/30507/new-clinical-article-club-what-diet-should-we-feed-a-cat-or-dog-with-cancer-with-owen-davies/240156#240156"]Well done, <a href="/members/boblehner" class="internal-link view-user-profile">bob lehner</a>, kill the conversation with such a succinct summary.[/quote] <p>Laughed out loud, I was thinking the same, that perhaps <a href="/members/boblehner" class="internal-link view-user-profile">bob lehner</a> you should have prefaced your comment with: *** SPOILER ALERT ***&nbsp; </p> <p>But no matter.&nbsp;</p> [quote userid="3169" url="~/001/veterinary-clinical/small-animal/f/misc-case-discussions/30507/new-clinical-article-club-what-diet-should-we-feed-a-cat-or-dog-with-cancer-with-owen-davies/240156#240156"]I will make one additional comment - I pretty much disregard any article where the author comes out with a closed-minded view on raw feeding. [/quote] <p><a href="/members/apache" class="internal-link view-user-profile">Michael Woodhouse</a> Now you can shoot me down for operating well above my pay grade here, but I read Owen&#39;s article and didn&#39;t think it read as a closed mind to raw - he just pointed out that whilst there is possibly some merit in argument that raw is more natural for a cat, the claims that they improve immune function are unproven and there are some risks. That&#39;s not being closed, just stating facts, surely.&nbsp;</p></p><div style="clear:both;"></div>https://www.vetsurgeon.org/thread/240159?ContentTypeID=1Wed, 07 Dec 2022 08:33:37 GMT146601cc-3922-4be7-9974-7e1d4e45a66b:9eb843f3-5c2b-4153-b3f4-f630312cc480joanne mcallister<p>I really enjoyed this article, thank you. Could Owen expand on dietary supplements/adjustments for particular tumours that might cause specific issues such as anaemia/hypercalcaemia etc?</p><div style="clear:both;"></div>https://www.vetsurgeon.org/thread/240158?ContentTypeID=1Tue, 06 Dec 2022 22:16:01 GMT146601cc-3922-4be7-9974-7e1d4e45a66b:62821acd-da25-4d91-ae80-fad30f6091b1Allison Gleadhill<p>Yes there is a good argument for avoiding raw if a dogs on chemo as that&rsquo;s definitely out for a person on chemo - Stilton sushi shellfish &amp; salads are off for people until 4 weeks after your last dose</p><div style="clear:both;"></div>https://www.vetsurgeon.org/thread/240157?ContentTypeID=1Tue, 06 Dec 2022 22:00:45 GMT146601cc-3922-4be7-9974-7e1d4e45a66b:65697812-1dec-4b27-b0de-1cb56c9e70d7Nicola Cole<p>Is there some grounds for suggesting that raw food shouldn&rsquo;t be fed to animals receiving chemotherapy from an immunosuppressive point of view (the chemotherapy, not the raw food!)?</p><div style="clear:both;"></div>https://www.vetsurgeon.org/thread/240156?ContentTypeID=1Tue, 06 Dec 2022 21:33:47 GMT146601cc-3922-4be7-9974-7e1d4e45a66b:113528ed-4c6b-4fdc-9f6b-db51c96bd51dMichael Woodhouse<p>Well done, <a href="/members/boblehner" class="internal-link view-user-profile">bob lehner</a>, kill the conversation with such a succinct summary. I came to a similar conclusion as a straight talking Yorkshireman.....</p> <p>I will make one additional comment - I pretty much disregard any article where the author comes out with a closed-minded view on raw feeding. I cook my own meals and have managed to survive ok. Lets not imply causation from correlations (just because there may be pathogens in raw food does not = infections in owners). Whilst it&#39;s not my choice for my dog, some of the healthiest animals we see in the practice are fed raw food. My dog gets decent quality food, but will happily chew on a dead rabbit or anything she can catch.......</p><div style="clear:both;"></div>https://www.vetsurgeon.org/thread/240147?ContentTypeID=1Tue, 06 Dec 2022 11:14:50 GMT146601cc-3922-4be7-9974-7e1d4e45a66b:d3e61a71-5b25-43d2-a4d5-9bb512af0bd0bob lehner<p>Interesting article.</p> <p>&#39;&#39;&#39;The best diet to feed a pet with cancer is one they like! Feeding palatable foods will increase intake, not only minimising the risk of cachexia but improving quality of life&#39;&#39;.</p> <p>To me this says it all.&nbsp; Surely far better to let the animal enjoy its remaining days, rather&nbsp; than trying to feed it something it doesn&#39;t like, because it might be &#39;better for it&#39;.</p><div style="clear:both;"></div>