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Nutrition and Supplements for Pets with Cancer
The use of dietary supplements and other forms of self-selected complementary and alternative medicine (CAM) is increasingly common in human cancer patients. The same appears to be true in veterinary health.
Use of these therapies gives owners a sense of control and enables them to feel that they are making a positive difference to their pet’s wellbeing.
The fact that owners have undertaken some form of selection process in choosing their dietary or complementary therapy means that there is some degree of emotional investment in the selected supplement. Failure to understand and to empathise with the decision to use nutritional supplements or CAM risks damaging the trust between owner and veterinary surgeon which can further polarise owners away from scientific or evidence-based approaches.
There is also a risk that if nutrition and CAM treatments are not discussed openly, treatment selection can have a detrimental effect for the patient.
Although there are actually tens of thousands of published studies examining diet and CAM therapies for cancer, frequently studies are subject to certain limitations. Investigators may have a vested interest in the success of a given product. Investigations can be conducted with insufficient control, numbers or follow up for meaningful conclusions to be drawn.
There is often, nowadays, a conflation of evidence-based and non-evidence-based methods, creating a sense of comfort for those scientifically-minded readers but requiring greater concentration to understand the flaws in the methodology. While there are some exceptionally well-planned and well-executed studies, these usually fail to provide evidence in support of the treatment in question.
This short article will summarise the evidence that we have regarding dietary and other complementary cancer therapies.
Low Carbohydrate/Ketogenic Diet
It has been shown beyond doubt that cancer derives a disproportionate amount of its energy from the cytosolic metabolism of glucose to lactate, not from the more efficient mitochondrial oxidative phosphorylation pathway. This observation was first made in the 1920s but still, there is no consensus regarding the explanation for this physiological change. Countless different strategies have been developed to take advantage of this effect. They are variously labelled: low carbohydrate, high-fat/high-protein, ketogenic, grain-free.
In humans with advanced cancers, blood glucose levels are correlated to outcome; those with a lower blood glucose survive longer. There does appear to be a rationale for reducing the intake of simple sugars, especially. There is some very limited evidence to say that this approach may be useful for dogs with lymphoma.
There is a risk with any home-prepared diet that vital elements will be deficient or even missing. The digestibility of these diets can be relatively poor which is of significance in a largely geriatric population. Some commercially available high-fat diets can induce steatorrhoea which is associated with abdominal discomfort and rarely with significant faecal blood loss. There is a stated risk that these diets induce acidification which in turn is reported to promote the development of further cancers; we feel that the strength of this argument is weaker than the argument for use of the diet. Perhaps of greatest importance, patients can suffer low energy levels. This might be acceptable for human patients who make their own lifestyle choices but, in the context of the veterinary cancer goal of optimising quality of life, is arguably an unacceptable outcome.
High Fibre/Vegetable Content Diet
There are many studies in human and a few in veterinary health showing that diets high in coloured vegetables have a preventive effect against the development of cancer. In human patients, reducing the dietary contributions from red and processed meat is also advantageous. However, these changes have not been shown to be associated with an improved outcome following cancer diagnosis.
The practice of adding fruit and vegetables to a dog’s diet appears to be a very low risk activity and, in our view, is likely to add both to the interest and the nutritional value of their diet rather than to detract from it. Of course, dogs cannot tolerate onions and garlic so these must be avoided. Cats, however, are obligate carnivores. They digest and assimilate animal protein. Vegetable proteins are deficient in certain essential (for cats) amino acids and in vitamins A and B12. Cats are also unable to satisfactorily digest the higher carbohydrate content associated with plant-based foods.
Curcumin is found in the spice, turmeric. There are observational and clinical studies that indicate some activity as a chemopreventive (medical agent that reduces the incidence of cancer) and anti-proliferative (medical agent that reduces the progression of cancer) agent.
Administration There are no clear data concerning dose. An average human dose of 5g of turmeric daily is reported in India. This equates to approximately 200mg of curcumin. Absorption is variable but is enhanced when consumed with fatty or oily foods, for example, fish oil.
There is some evidence that curcumin potentiates the anti-coagulant effect of other drugs including aspirin and other NSAIDs. Curcumin may inhibit the effectiveness of cyclophosphamide.
Glutamine is an essential amino acid with a particular role in maintenance of gastrointestinal mucosal health. Oral glutamine has been shown to reduce the risk of gastrointestinal complications in people receiving medical therapy for cancer.
There are no clear data concerning dose. Glutamine should be given orally.
Glutamine may interact with anti-seizure medications.
Mushrooms are believed to exert an anti-cancer effect by inducing non-specific immune stimulation. The proteoglycan molecules of the mushroom resemble bacterial cell wall and their association with macrophages leads to release of cytokines and an anti-tumour immune response. Epidemiological data indicate a reduced cancer mortality among human patients consuming medicinal mushrooms. When human cancer patients received Maitake mushroom D-fraction (a refined component), chemotherapy response rates were seen to more-than-double. It is unclear whether a better response would be achieved from consumption of crude ground up mushroom or from consumption of single refined components.
There are no clear data concerning dose. The mushroom, whether as crude mushroom or refined constituent, is taken orally.
There are no known interactions though Maitake mushroom has been reported to induce a degree of hypoglycaemia.
Fish oil is known to be high in omega 3 fatty acids. Fish oil consumption is perceived to bias fatty acid metabolism towards anti-inflammatory rather than pro-inflammatory pathways. There are no data indicating improved cancer survival for patients receiving fish oil supplementation. Increased neutrophil numbers have been described in patients receiving chemotherapy.
There are no clear data concerning dose for an anti-cancer effect. Administration of doses that are disproportionately greater than might be taken for maintenance of human health may induce steatorrhoea and other gastrointestinal complications.
There is a perceived risk of increased bleeding time. We advise against administering to patients with thrombocytopenia (9/L). Fish oil does synergise with anti-hypertensive medications, eg ACE inhibitors, in people.
Cannabis extract, which may be known to you as CBD oil, has attracted a significant amount of interest as a CAM in the management of cancer patients. There are anecdotal reports of cancer treatment successes in humans and pets. There are stated cancer benefits including increased appetite and reduced nausea among patients. Chemosensitisation and increased apoptosis of cancer cells are reported in vitro.
It is possible for individuals to purchase CBD oil and to choose to give it to their pet. From a legal perspective, CBD oil is classified as marijuana. We would strenuously recommend against making recommendations or being seen to make recommendations concerning the possible use of a class B narcotic in patients under your care.
Current government guidelines for the use of CBD oil in humans state that CBD is classified as a medicine and therefore cannot be sold without a marketing authorisation. It is also accepted by the government that patients will access these products without a marketing authorisation and they urge such patients to discuss the use of the treatment with their doctor. Similarly, we should be ready to discuss treatment with owners, whilst taking care to ensure that we are not seen to be making explicit recommendations
If CBD oil is used, a starting dose of 0.2-0.5mg/kg per os BID is suggested in dogs, the same dose would be given once daily in cats. If the product being used also contains the psychoactive element of marijuana (THCd9), this dose will be too high. Doses can be incrementally increased at one-week intervals. Side effects of CBD oil include sedation and diarrhoea.
CBD oil impedes activity in the cytochrome P450 system which will therefore lead to alterations in the pharmacokinetics of any medications which depend upon this metabolic pathway for their detoxification. Perhaps the most commonly used example is the NSAID drug family.
One resource which is a great source of information is the Memorial Sloan Kettering Cancer Center (MSKCC) website. This is a renowned cancer treatment centre in New York.
A web search of MSKCC and the name of the supplement that an owner asks about will give you information on evidence for use of the therapy, potential drug interactions and any safety concerns which are reported in human oncology.
In the absence of veterinary data, this resource may prove useful.
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Holistic Cancer Prevention for Pets
Pet guardians fear this diagnosis above all others, not only because the conventional treatments are so perilous, but also because, despite treatment, it is most often fatal. More than 50% of dogs over the age of 10 are diagnosed with cancer every year, and the incidence of cancer in cats and younger animals is growing. As responsible guardians, we need to understand the risk factors that contribute to the development of cancer, do all we can to prevent it, and take effective action when a diagnosis of cancer is made.
Cancer in cats and dogs develops due to a variety of factors, many of which we cannot control. These include age, genetics, environmental pollution, and electromagnetic radiation. Other factors include poor nutrition, unhealthy lifestyle, conventional medical treatments (such as vaccination) that can disrupt the immune system, toxic chemicals used in the home, and stress. The stress factor is compounded in many purebred pets by inbreeding, which increases or creates genetic predispositions to poor immune function and disease.
Conventional cancer treatments like radiation, surgery, and chemotherapy may destroy the cancer yet create other problems at the same time. And even the most cutting-edge therapies may only prolong a pet’s life without truly curing the cancer. Quality of life issues also impact the choice of treatments once cancer has invaded.
Recent research suggests that cancer is primarily a chronic inflammatory disease. And indeed, many of the factors involved in the development of cancer in cats and dogs do cause chronic, low-grade inflammation. Such inflammation not only kills cells directly, but also deposits toxic inflammatory by-products and other “sludge” in the extracellular matrix that surrounds the cells. This toxic build-up reduces the flow of oxygen, nutrients, and wastes between cells and blood, and creates a fertile environment for abnormal cells that can thrive in such damaged environments. Preventing and resolving inflammation and clearing the matrix are primary goals of any program to prevent or treat cancer.
Prevention and Treatment of Cancer in Pets: Two Sides of the Same Coin
Both prevention and treatment of cancer in cats and dogs involve the same components:
- Fresh, whole food: Most commercial pet foods (especially dry foods) are made with the leftovers and unwanted parts from livestock slaughter and processing, and loaded with additives and preservatives.
- Clean, purified water: This is essential to the body’s ability to resolve inflammation and clean up its waste products.
- Limit vaccinations: The antibodies produced by vaccines cause inflammation, and every booster can perpetuate it.
- Reduce pollution & toxins: This includes indoors air pollution, yard chemicals, and other sources of toxic exposure. These cause over-reactivity of the immune system and inflammation.
- Minimize electromagnetic radiation: This can be a cause of low-grade, chronic inflammation.
- Use non-toxic flea control: Most flea products are pesticides that can contribute to the toxic overload of the body and inhibit natural cleansing processes.
- Minimize stress: It suppresses the immune system.
- Exercise: Regular physical activity is a natural immune booster and stress reducer.
Let’s look at the factors we can control in more detail.
The Best Diet for Dogs & Cats for Cancer Prevention or Treatment
Any cancer prevention or treatment program begins with diet. Nothing will go farther in promoting health than a balanced, fresh, preferably organic, whole foods diet. When the body is supported with the building blocks needed to maintain healthy cells and repair damaged ones, healing from within can begin.
Many types of cancer cells, particularly lymphoma, utilize glucose from carbohydrates as fuel. Limit the fuel, and the cancer’s growth will also be limited. A low-carbohydrate diet can be very helpful in fighting cancer. Additionally, many cancer cells cannot utilize fat as an energy source; so more and better-quality fats in the diet will help combat the weight loss that commonly occurs in cancer patients. Holistic veterinarians frequently recommend a diet that is low-carbohydrate, moderate protein, and moderate to high fat for cancer patients.
For dogs, a diet of roughly 50% meat, and 40–50% non-starchy vegetables or whole grains is optimal. Fish oils should be added to provide additional fat (Omega 3 fats are best and are abundant in fish oil). For cats, a diet of 80% meat (cats can tolerate fattier meats than dogs) and 20% non-starchy vegetables is recommended, again with fish oil added for additional fat. For both dogs and cats, supplement with vitamins, minerals, and antioxidants should also be part of the daily diet.
When a home-prepared diet is not possible, try ready-made frozen raw food for dogs and cats, freeze-dried food for dogs and cats, dehydrated dog diets, or a very high quality, low-carbohydrate wet food for dogs or cats.
If cooked or processed foods must be used, consider adding fresh, ground, or minced meats, and (for dogs) pureed or steamed non-starchy vegetables. Dark leafy greens, broccoli, and carrots contain antioxidants that are beneficial in fighting cancer.
One other dietary issue needs mentioning, and that is weight management. Overweight pets are at increased risk of many diseases, such as arthritis, diabetes, and heart disease as well as cancer. Food does not equal love, and your pet would rather have quality time with you than a big dinner or a few extra treats. Even more importantly, fat doesn’t just sit there quietly. Instead, it produces inflammatory mediators that can contribute to tumor formation. Keeping your pet at an ideal weight is an essential part of a healthy lifestyle.
Water and Hydration for Dogs & Cats
Depending on where you live, the tap water can range from decent to toxic. Distilled water is not suitable for long-term consumption because it pulls minerals from the body, but it can be useful in a short-term detoxification program. Filtered water is best, followed by spring water. However, bottled water can leach toxic chemicals from the plastic into the water. The animal’s water needs to be kept clean and fresh at all times. If your pet is not a great water drinker, try an automatic flowing waterer. Wet foods, including homemade and raw diets, are also an important source of moisture.
Vaccinations in Dogs & Cats
Many holistic veterinarians agree that over-vaccination is a contributor to chronic disease and cancer in cats and dogs. Some cancers, such as vaccine-associated sarcomas, are directly caused by killed vaccines (like rabies, feline leukemia, and FIV). Most booster vaccines (other than legally mandated rabies vaccines) are unnecessary for adult pets. If your veterinarian recommends multiple or annual vaccinations, consider finding one who is more aware of the risks. Any animal diagnosed with cancer (or any chronic disease) or is exhibiting signs of a weakened immune system should not be vaccinated at all.
Indoor Air & Yard Pollution
Indoor air pollution has gotten a lot of press lately; it can be even worse than general air pollution from cars and factories. For our companions’ sake, it is important to examine our home and yard care practices. Cleaning chemicals are the first place to look; if the floor or carpet cleaner you use contains toxic chemicals (as most do), and your companion’s nose is continually close to that floor (as most are), then the body must continually detoxify itself. Plug-in air fresheners are popular with some pet owners to help cover up that “pet” smell, but they are a constant source of petrochemicals in the air our companions breath. For this reason, they should be avoided. Choosing natural and green cleaning products can go a long way to limiting the toxins your companion takes in.
Yards and other green spaces are another area of toxic exposure to our companions. Chemical fertilizers, pesticides, herbicides, and similar products around the home should be eliminated. There are abundant non-toxic alternatives readily available today.
Recent research suggests a fascinating connection between electromagnetic radiation and cellular changes that can lead to cancer. Sources of electromagnetic radiation include sunlight, cell phone and broadcasting towers, underground and above ground power cables (ambient sources outside our control). But also, home wiring, electrical cords and outlets, microwave ovens, appliances, cordless and cellular phones, computer monitors, and televisions. This is especially relevant for cats, who love to curl up in warm places, like the top of the TV or computer monitor. Keep your companion’s bed as far away from electrical components as possible. At night, make sure all electronics are turned off. This is important not just for the radiation, but also light. Even the tiny glow from power indicators can be disruptive to sleep, and inhibit the body’s healing cycles.
Natural Flea Control
Flea management is an essential part of health, but conventional spot-on flea control products that you find at grocery stores and most pet stores are heavy-duty pesticides. These poisons absorb through the skin and permeate the animal’s system. While a portion of them are eliminated in the urine and the feces, some components may not be cleared and can contribute to the toxic sludge build-up in the extracellular matrix. Tablets given by mouth are no better. A recent report from the U.S. Environmental Protection Agency makes it clear that every conventional pesticide-based flea product can cause illness and even death in pets. In response, the agency is encouraging more truthful labeling, but it is not requiring safer products.
There are many natural flea control products that offer effective non-toxic alternatives to chemical pesticides. They take slightly more effort than occasionally putting a few drops on your companion’s skin, but they are well worth it for the long-term health of your four-legged friend.
Stress and Anxiety for Dogs & Cats
You may look at the cat sprawled in a patch of sunlight on the sofa, or the dog curled up at your feet, and wonder, “What stress?” Yet our furry companions can and do experience stress as much or more than we do. For instance, dogs with separation anxiety live in extreme stress for a good portion of every day their guardian is away at work or school. Cats in multiple-cat households are frequently stressed over too-small territories (adding cat furniture and other vertical space can be very helpful).
Of course, both cats and dogs are acutely aware of the stress levels of their human companions: the more stressed you and other family members are, the more your cat or dog feels, absorbs, and manifests that stress, whether by acting out behaviorally or internalizing it as illness. Managing our own stress may be the most important step we can take to improve our pets’ well-being.
For dogs, one of the best ways to reduce their stress is through proper training. EVERY puppy should go through a “puppy class” at the very least. Even when you adopt an older dog, both you and the dog can benefit from a consultation with a qualified trainer or behaviorist. These professionals help you interpret the dog’s behavior and teach you how to communicate in ways that your dog can understand. A well-trained dog is a secure dog—and a much safer one as well.
Cats are not as easily trained (although it’s not impossible, and it can be very helpful for active breeds like Orientals and Bengals). But you can reduce their stress in other holistic ways, such as energy therapies, Tellington TTouch, massage, and flower essences.
“Indoor enrichment” can be helpful for both dogs and cats to reduce mental and emotional stress. This may include: food-dispensing toys, sensory enrichment (such as a window perch for bird-watching, pet-directed videos, and cat furniture for climbing), and novel objects (like cardboard boxes or paper bags).
Exercise for Dogs & Cats
You need it, and so does your pet. Exercise is one of the best ways to combat stress, and is also crucial for the health of the mind and body, whether human, dog, or cat. In their natural state, canids and felids roam large territories and hunt for a living. The more we can mimic this natural lifestyle, the better.
Play is wonderful, because it provides both exercise and the joy of fun and laughter (on your part!). There is truly nothing more hilarious than the antics of a cat chasing a laser beam or feathers on a pole or string. Cats need exercise as much as dogs do, and regular play sessions are the ideal way to accomplish it. Or, try a kitty harness and go for walks. Introduce this activity gradually to increase the chance of acceptance.
Dogs are a bit easier to exercise, and a brisk walk can do you both good. A play date with another dog or a romp at the dog park can be great exercise as well as mental stimulation and stress relief. If your dog is a firm believer in staying home, then play fetch in the house, or find some other way to provide exercise every day.
Physical activity is vital for pets for weight control, digestive health, detoxification, immune health, muscle tone, respiratory health, and mental and emotional stability.
Treating Cancer in Dogs & Cats
A diagnosis of cancer in your beloved companion requires many difficult choices. You will surely forget to ask many important questions when you first hear the dreaded word, so schedule a follow-up visit with your veterinarian to discuss the issues that are likely to arise. Try not to make any profound decisions until you have a chance to educate yourself about all the options available—both conventional and alternative. Ask for a referral to an oncologist who can answer questions about conventional treatment methods. Find a holistic veterinarian, either in your area or one who will provide virtual consultations, regarding alternative cancer treatments. Cancer is serious business, and an integrative team approach is best.
Offer the chance for a better quality of life, even if it cannot cure the cancer. Holistic care aims to provide the animal with the resources its body needs to heal from within. Every case is different. There is no one way to treat any type of cancer, although the above suggestions can help no matter what type of cancer the animal has. There are also some basic immune-boosting, anti-inflammatory, and cancer-fighting nutritional supplements that can help in many cases.
Diet, of course, is fundamental. You can give supplements all day long, but if the basic diet is “junk food,” you’re just throwing good money after bad, and needlessly stressing your pet.
Holistic Supplements for Dogs & Cats to Support Cancer
Digestive Enzymes: they help fight inflammation, as well as help the digestive system break down and more easily absorb the urgently needed nutrients in food.
Omega-3 Fatty Acids (from marine sources): some of nature’s most potent anti-inflammatories. These healthy fats are crucial for immune and nervous system function, and are necessary for rebuilding cell membranes.
Antioxidants: prevent oxidative damage (which promotes ongoing inflammation) and increase immune function. They help prevent cell and tissue injury by scavenging and destroying free radicals and playing an important role in cancer prevention and control. Vitamins A, C, and E are the best-known antioxidants. Other powerful antioxidants include green tea extract, co-enzyme Q10 (which reduces free radical production at the source), N-acetylcysteine, proanthocyanidins, flavonoids, carotenoids, and quercetin. Curcumin, from the Indian spice turmeric, warrants special mention, as it also inhibits tumor growth and metastasis and tends to reduce the side effects of chemotherapy. However, some oncologists recommend against antioxidants for pets receiving conventional therapies such as radiation or chemotherapy, so check with your veterinarian before supplementing with antioxidants.
Medicinal Mushrooms: an important part of Traditional Chinese Medicine, and contain powerful immune-modulating compounds such as beta-glucans. Many holistic practitioners incorporate them into their cancer protocols.
Medicinal Herbs: many herbs are renowned for their cleansing, tonic, anti-tumor, or anti-cancer effects. Herbs can be extremely powerful, and with power comes potential toxicity, so work with your veterinarian to ensure safe use. There are two herbal formulas widely used in cancer care: Essiac and the Hoxsey Formula. Both are named for the original formulators of the herbal compounds, (although Essiac is the formulator’s last name, Caisse, spelled backwards).
Homeopathy: often very helpful in treating cancer. I use homeopathy for almost all cancer patients. Some homeopaths claim they can cure some cancers with homeopathy alone. Considering there are no side effects and it is very easy to administer, it should be a part of any cancer-fighting regimen. Treatment is very specific to each individual and must be guided by a veterinarian trained in homeopathy. You can locate one through the Academy of Veterinary Homeopathy.
Acupuncture & Traditional Chinese Medicine: acupuncture is very helpful for pain relief in cancer patients. It can stimulate the immune system and assist in promoting detoxification as well. Chinese herbs are also used for cellular health. For a list of practitioners in your area, see the American Holistic Veterinary Medical Association referral directory or the International Veterinary Acupuncture Society.
While cancer is a frightening diagnosis, there is much that can be done to improve the quality of your companion’s life and potentially extend the amount of time you have with him or her. Keep in mind that it is crucial to remain as optimistic as possible. A positive attitude is not Pollyanna, it is completely practical. Remember, your companion senses your stress. All of the therapies discussed will go farther when administered with large doses of love and affection.