November 15, 2023 • 26 mins
In this episode of ER VET, Dr. Justine Lee, DACVECC, DABT, board-certified emergency critical care veterinary specialist and toxicologist interviews Dr. Andi Flory, DACVIM (Oncology) on cancer in dogs and cats. How do we diagnose cancer earlier in dogs, and can it affect how we treat patients with cancer?
SHOW NOTES: Diagnosing Cancer Earlier in Your Dog with Dr. Andi Flory
Become a supporter of this podcast: https://www.spreaker.com/podcast/er-vet-stories-from-the-animal-er-pet-life-radio-original-petliferadio-com--6667836/support.
SHOW NOTES: Diagnosing Cancer Earlier in Your Dog with Dr. Andi Flory
Become a supporter of this podcast: https://www.spreaker.com/podcast/er-vet-stories-from-the-animal-er-pet-life-radio-original-petliferadio-com--6667836/support.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:02):
Is pet Life Radio, Let's Talk Pets.
Speaker 2 (00:26):
Welcome to er Venom pet Life Radio. I'm your host, Sacker.
Speaker 3 (00:29):
Jess Canley, and I'm an emergency critical care vetory specialist
and toxicologist.
Speaker 2 (00:33):
Thanks for joining us today.
Speaker 3 (00:35):
We're going to be talking about cancer and dogs and cats,
a really important topic, especially as our pets age.
Speaker 2 (00:42):
We'll be right back after these messages.
Speaker 4 (00:48):
Take a bite out of your competition. Advertise your business
with an ad in pet Life Radio podcast and radio shows.
There is no other pet related media that is as
large and reaches more pet parents and pet lovers then
pet Life Radio with over seven million monthly listeners. Pet
Life Radio podcasts are available on all major podcast platforms,
(01:09):
and our live radio stream goes out to over two
hundred and fifty million subscribers on iHeartRadio, Odyssey, tune In,
and other streaming apps. For more information on how you
can advertise on the number one pet podcast and radio network,
visit Petlife Radio dot com slash advertised today.
Speaker 5 (01:29):
Let's Talk Pets on Petlife Radio dot com.
Speaker 3 (01:48):
Welcome back to Ervet on pet Life Radio today. I'm
really excited to speak with doctor Andy Florey, who's the
chief medical officer and the co founder of pet t
X and a board certified veterinarycologist, Doctor Florie.
Speaker 2 (02:01):
Thank you so much for joining us today.
Speaker 6 (02:03):
Thanks Justine, it's really great to be here.
Speaker 1 (02:05):
Awesome.
Speaker 3 (02:06):
Just so our audience knows who you are, do you
mind giving us a little bit of background about who
you are, where you train, what you do, and how
you're different from a traditional veterinarian.
Speaker 6 (02:15):
Sure. So, as you mentioned, I'm a medical oncologist, which
means I did extra training to treat cancer in dogs
and cats. My background is that I grew up in
Ohio and I did training at the Ohio State University
and also at Cornell and after that I worked in
various places. I worked at the Animal Medical Center in
New York City, I worked in Australia, and then in
(02:38):
San Diego, which is where I was working when I
met an adorable little patient named Poppy that really just
changed everything for me. Unfortunately, Poppy had a cancer diagnosis
that was just too late, and because of that, her
owner and I co founded a company called pet DX
to develop a test called a liquid biopsy test. And
(03:00):
this test is called Uncle Cainine and it detects cancer
with just a blood draw.
Speaker 3 (03:04):
All right, You know, I have so many questions on that,
of which I'm going to ask you later, because oftentimes
in the er, you know, I'm going to oftentimes do
like complete blood work, X rays, things like that, and
so many times when I do that blood work, what
are the first questions owners will ask me is but
I thought the blood work tested for that. So you know, great,
great technology that you're talking about, and we'll bring that
(03:26):
up in just a minute. But I wanted to ask
some important questions. What are some important things for pet
owners to know about canine cancer and how it affects
dogs and cats.
Speaker 6 (03:37):
So the biggest thing to know is that cancer is
a huge problem in dogs and cats. It's actually the
number one cause of death in dogs, and dogs have
about a one in three risk in their lifetime of
developing cancer, and cats it's about one in five. And
there are a couple of things that really increase the
risk of cancer. The biggest one is age. So for example,
(03:59):
and dogs know that the risk of cancer increases after
the age of seven in most dogs, but there are
some breeds that are at higher risk even by the
age of four. That includes some of the giant breed dogs.
We did a study recently that showed that boxers and
bulldogs are at risk earlier and are at risk even
from the age of four. So it's important to kind
(04:21):
of just understand that dogs are at risk of cancer
cats as well, and it's important to kind of know
about this, have it on your radar, and talk with
your veterinarian about it.
Speaker 3 (04:30):
Unfortunately, when I work in the er, it's really really
frustrating because a lot of owners have never met me before.
You know, they usually have a long term relationship with
their family practitioner, and now they come into the er
for something as vague as like vomiting or even you know,
not feeling well or not wanting to eat for a
couple of days, and I'm making the diagnosis of cancer,
and it can be really hard for pet owner to
(04:52):
hear that news. I wanted to step back and say,
first of all, what are some of the most common
clinical signs of cancer that we should be looking out
for or especially as our pets age when it comes
to dogs and cats, Like, what are some of the
most common signs?
Speaker 6 (05:05):
Yeah, I mean, I would say sometimes it can be
really vague, right, like they're sleeping more or they're a
little lethargic. Appetite changes are a big thing, stool and
urine changes, even water intake changes, all of these things
that you notice at home. If you're noticing a change,
you should definitely bring this up with your veterinarian. Sometimes
it's a little more focused in terms of what you
(05:27):
might notice at home, like you might notice a swelling
or pain in one leg which you see as limping.
You might notice that your dog or cat is losing weight,
so any of these kind of signs. These are unfortunately
common signs that can be any number of things, but
would be really important to talk with your veterinarian about
because especially as our pets are aging, they are at
(05:48):
higher risk of cancer and they could indicate cancer.
Speaker 3 (05:51):
All right, thank you. You know it's so hard because
the signs are vague, but I always tell people if
you notice anything especially chronic, like your dog is vomiting
once or twice a week for several weeks, or your
cats just getting a little bit thinner.
Speaker 2 (06:05):
Sometimes it's that lump or that mass that slowly getting
bigger and bigger.
Speaker 3 (06:09):
To weird things again, like you had mentioned, like the limping,
to difficulty breathing, you know. Unfortunately, there's a whole gamut
of clinical signs that I can be representative of cancer.
So I would say, one in doubt, we always want
to be able to catch it earlier than later. Now,
I had mentioned before, oftentimes in the ER, I'm discovering
cancer or even advance cancer where it's already metastasized on
(06:32):
X rays or ultrasound, and a lot of times the
traditional blood work that I do, such as a complete
blood count and a chemistry panel or even a urine test,
are completely normal. And for those of you guys who
have listened to pet Life Radio er VET for long time,
you probably remember an old episode with doctor Garrett Pactinger
when we talked about some of the tests that we
(06:53):
do in the ER. And this is a really important
one to go back to listen to because a lot
of times people will pay for the blood test, but
they don't don't actually know what they're testing for. And
that's where it's so important that your veterinarian or your
er veterinarian.
Speaker 2 (07:06):
Communicate that to you.
Speaker 3 (07:08):
Now, again, oftentimes, when I'm seeing it, I'm breaking terrible
news to my pet owners. Could early detection help prevent
this scenario? And what can we do. Is it a
matter of getting into our vet earlier, Is it a
matter of doing X rays or ultrasound once a year?
Speaker 2 (07:21):
What do you recommend?
Speaker 6 (07:22):
Yeah, so, early detection can certainly make a huge difference.
When we talk about early detection of cancer, we really
mean two things. Early detection can mean early stage detection,
when we find cancer before it's spread. But early detection
can also mean finding it early before your pet is sick,
and both of those have a lot of advantages. For example,
(07:42):
it often makes cancer easier to treat. Sometimes we have
a better chance at long term control or even cure
if we find it earlier as opposed to later. And
it's often going to mean a better outcome for your
pet in terms of when we treat that cancer, they
tend to do better. So early detection is always important.
And when we think about cancer detection, we really mostly
(08:05):
find cancer, like you mentioned, when they're coming into the
er or they're coming in sick, they're coming in with
something noticeable that's happening at home. And so when it
comes to that, in terms of diagnosis, we have a
lot of the same tools to diagnose cancer in dogs
and cats as we do in people. However, most of
the time when we're finding cancer because pets are already sick,
(08:26):
often cancer can be quite advanced, and that means that
we can't provide that long term control or even cure.
So if we can shift that conversation to finding cancer
earlier and doing screening, which has made a huge impact
in cancer survival in people, then this could really give
us a leg up in terms of being able to
control cancer for longer and screening. What that really means
(08:50):
is looking for cancer when patients are asymptomatic. So for example,
in people, we have mammograms, we have colonoscopies, we have
PSA tests, and these are tests that go for once
we reach a certain age typically meaning we're starting to
become at higher risk for cancer, we go for to
try to find those cancers earlier so that if we
(09:10):
are going to develop that disease, we have a better
chance at controlling it in the long term.
Speaker 3 (09:15):
All right, So we already talked about like doing that
complete blood count, doing that chemistry panel, doing chest X rays,
doing abdominal ultrasound. In terms of technology, do I just
talking and describing what is liquid biopsy, what it tests for,
and what breeds, you might want to consider running that
test or talking to rivet nerin about it.
Speaker 6 (09:35):
So, yeah, So liquid biopsy what this really is. It
is a blood based test. It's looking for circulating tumor DNA.
What this means is that this is little bits of
DNA that are being released from cancer cells. So it's
really looking for the current presence of cancer in the body.
One thing that's important to understand is that it's not
a risk prediction test. It's really looking for evidence of
(09:58):
cancer in the body. So the way this works is
that adding this to a wellness visit, for example, can
increase your veterinarian's ability to catch cancer early because if
we have an indication on this blood test that there's
cancer DNA present in the blood, then we know to
go and look for it and find it and then
we can talk about treatment and hopefully the outcomes can
(10:19):
be better.
Speaker 3 (10:20):
So how often do you recommend doing liquid biopsy and
how it's a test done, Is it painful, how long
does the result take? Do you recommend doing it every
single year or every six months in high risk breeds
like golden retrievers?
Speaker 6 (10:34):
Absolutely? Yeah, So you're thinking of exactly the right line
so really this is a test that's meant to be
kind of paired with your wellness visit. So if your
dog is having once a year wellness visit or twice
a year wellness visit, this is something that can be
paired right in with that wellness visit so that if
there is going to be cancer that develops, that we
have the best chance of catching it. Just like with
(10:56):
any cancer screening test that we go through, we go
through those on a hadens or in a serial test,
so that if we are going to develop we have
a chance to catch it earlier. In terms of how
it's performed, this is a simple blood draw, so your
veterinarian has access to requesting the special tubes that are
needed to run the test through the common diagnostic labs
(11:17):
that they work with, and so they have access to
that more directly through our company pet dx. If you're
interested in finding out more, you can jump on to
petdx dot com and add your name to the interest
list and we can reach out and share information as well.
Speaker 3 (11:31):
Wonderful thank you now, I will say even though I
do er practice with my own pets as a age,
so for me, this is greater than a ten year
old cat. For a dog, usually this is seven to
eight years of age. I usually do routine blood work,
screening and a physical exam, and I even have this
on my calendar for me to do at home for
(11:53):
my own pets because as we age, and of course
we can see cancers in all ages of pets, but
as we age, we do know that we can see
more cancer. So I always do routine blood work just
to screen my pet. Now, quick question for the cat
owners out there is liquid biopsy available or potentially available
in the future for cats.
Speaker 6 (12:12):
It's not yet, but stay tuned is definitely coming. We
know that that cats are really important as well in
this cancer conversation, so stay tuned. It is on the way.
Speaker 3 (12:22):
Right now, we've talked about this before, but what specific
cancers does it test for?
Speaker 6 (12:28):
So yeah, this is a multi cancer detection test, which
means it detects actually thirty different types of cancer that
it was shown in the clinical validation study to detect.
This includes the most common cancers that happen in dogs.
So for example, the detection rate in the eight most
common cancers that we see in veterinary medicine sixty two
percent and in the top three, so these really common
(12:52):
but very aggressive cancers, which are lymphoma, command uce arcoma,
and ostuse arcoma. The test can detect eighty five percent
of these with a very false positive rate of only
one point five percent. This really means that this is
a broad screening test that can detect a wide variety
of cancer, including the most common cancers that happen in dogs.
Speaker 3 (13:12):
All right, and you know, for dog owners out there,
I've mentioned it before in a previous episode, just talking
about some of these three cancers interest. Our coma is
often a really aggressive sort of like a blood or
tissue loving type of cancer, and unfortunately, when I typically
see it in the er vet, it results in severe
internal bleeding. And it's often my favorite breeds that get it,
(13:35):
so German Shepherds, Labrador retrievers, Golden retrievers. And I'm so
paranoid about this cancer because it grows really aggressively on
the spleen and liver, and by the time that I
see it, unfortunately er again, it's often too late because
by the time that tumor, that cancer is ruptured on
the spleen, it really spreads cancer cells and unfortunately a
(13:57):
lot of times it's you know, life saving sturge blood transfusions,
which can be tens of thousands of dollars and it's
really expensive. So again, the fact that there's a blood
test for it is amazing. With lymphoma, lymphoma is a
type of cancer that can really really affect.
Speaker 2 (14:14):
Even younger dogs.
Speaker 3 (14:15):
So I've seen unfortunately, dogs as young as two or
three years of age where all of a sudden, their
lymph nodes are really really prominent. So if you're petting
your dog, you all of a sudden notice lumps underneath
their neck area or in their shoulder area. That's the
kind of stuff you always want to get to a
veterinarian right away because with treatment, the prognosis is actually
fair with chemotherapy. So again, the sooner we can diagnose
(14:39):
a problem, the sooner we can treat it. And then
the last one, Doctor Fleury already mentioned OSU starcoma. Something
as simple as limping or you know, a dog's walking
and all of a sudden, fractures are legs. They're super painful.
I see this unfortunately a lot in greyhounds, and it's
something that can be quite severe. It's a type of
bone cancer. So the fact that we can potentially diagnose
(15:01):
cancer earlier. Is so so helpful because I always feel
like cancer is one of the top three diagnoses that
I unfortunately make in the er. So again, a really
really important that you talked to your veterinarian about this. Now,
how can pet owners broach the cancer conversation with their veterinarians.
What can this conversation deliver?
Speaker 6 (15:20):
So I think the important thing is really to talk
to your veterinarian about your dog's risk for cancer. And
one thing that can be helpful in that conversation is
a tool that we developed based on a study that
we performed, and the tool is called the Cancer Safe
Tool SAFE, which stands for Screening Age for early Detection.
(15:41):
This is a tool that was put together based on
a large study we did in over three thousand dogs
to understand the best age to start cancer screening for
your dog based on your pet's age, breed, and weait.
So you can use this tool. It's at cancersafe dot
petdx dot com and you can use this to understand
when should we start looking for cancer in your dog
(16:04):
and you can bring that up with your veterinarian to
talk about what tests they recommend for screening for cancer.
This might include, like you mentioned, you physical exam, routine
lab work. Sometimes your veterinarian might recommend imaging. And now
we have this new blood test called liquid biopsy that
can help us to detect more cancer earlier as well.
Speaker 2 (16:25):
We'll be right back with doctor Flory right after these messages. Mollie,
here's your dinner. Since that's not your food, don't.
Speaker 7 (16:37):
Let that happen to your precious cat. Elevate your cat's
eating experience with the cat tree tray. The cat tree
tray keeps your cat's food off the floor and conveniently
located on the cat tree. It's the perfect way to eat.
It's a beautiful hot iron tray that easily attaches to
your cat tree and keeps dogs and other critters out
(16:58):
of your cat's dish. As from Multi Pet Households, there's
a six inch trade for large bowls and a four
inch trade for smaller bulls. Er just your cat tree
trade today. Go right now to cattreetrade dot com. That's
cattreetrade dot com. C A T t R E E
t R A Y dot com.
Speaker 8 (17:21):
Let's talk past, Let's done.
Speaker 6 (17:23):
Pet Headline Radio.
Speaker 8 (17:26):
Cat light Radio dot com.
Speaker 2 (17:44):
Welcome back to EREB on pet Life Radio.
Speaker 3 (17:46):
We've been speaking with doctor Andy Florey, a board certified
veterinary oncologist, about what we can do to help detect
cancer earlier in our furry family members. And the main
reason why is the sooner we diagnose.
Speaker 2 (17:58):
Something, the sooner we can treat.
Speaker 3 (18:00):
We've talked about the clinical sides and some of the
top cancers that we see in dogs.
Speaker 2 (18:05):
We've also talked about some of the tests that can
be done.
Speaker 3 (18:08):
The benefits of diagnosing cancer early on our dogs or
our cats.
Speaker 6 (18:13):
Yeah, great question. So early detection really meaning either before
a cancer has spread or before a pet is really sick,
has a lot of benefits for the family. That often
means that they have time to kind of think about
what they want to do. When we're able to detect cancer,
for example, when our patients are stable, when they're not sick,
(18:33):
and before it's spread, we have time to do things
like schedule the treatment. We can do it when it
makes sense for the clinic and for the family. The
family has time to kind of consider their options, and
for the pet. There's definitely going to be benefits of
not having to kind of go through those Unfortunately, trips
to the er right, which can be scary. They might
happen in the middle of the night, as you mentioned,
(18:55):
sometimes those come with a hefty price tag or a
need for things like blood transfus or things like this.
So when we can do this in a more relaxed manner,
it's going to be better for the pet, it's going
to be better for the family, and it's going to
be better for that veterinary care team because an early
diagnosis conversation is always going to be easier than that
too late one.
Speaker 3 (19:14):
When it comes to diagnosing it early and it comes
to treating, Do you mind just talking a little bit
about what does treatment entail? I think a lot of
pet owners often think of a two legged beloved family
member who went through cancer treatment, went through radiation therapy,
went to chemotherapy, all their hair fell out, they were
super nauseous, they were really affected by it. Do you
(19:36):
mind just talking about the difference between human medicine versus
veterinary medicine when it comes to treating pets with cancer,
and are the protocols the same or are the same
drugs used?
Speaker 2 (19:47):
Do we do radiation therapy and venory medicine?
Speaker 6 (19:50):
That's a great question. So we've got a few basic
tools that we use to treat cancering dogs and cats,
and they're really the same tools that are used in people,
but we kind of apply them a little bit differently.
Some of the tools that we have that are very
similar are things like surgery. We have things like medical therapy,
so these would be things that make your pet feel better,
and then we have chemotherapy and radiation. Now, when we
(20:13):
approach treating cancer in our pets, the approach is a
little bit different than it is in people because our
goal is really quality of life at all times. So
our goal as oncologists as veterinarians is to provide your
pet the best quality of life that we can for
the longest period of time, which means we want them
to feel good, we want them to be happy, we
want them to kind of go for walks and do
(20:34):
all of the things that your pet normally does. And
so what that means is that we design cancer treatments
for dogs and cats to maximize quality of life while
we're controlling the cancer, which is a little bit of
a different approach than is taken to treat cancer in people,
where the goal is usually cure which means that higher
doses are used and side effects are very common, whereas
(20:56):
in dogs and cats side effects are less common. Because
we're really maximizing quality of life, and we're prioritizing that
over anything else, and we really want to design the
doses around keeping them feeling.
Speaker 3 (21:08):
Good much we're saying that, you know, I oftentimes have
owners really really worried about the hair loss, really worrying
about quality of life when it comes to chemotherapy or
some of this treatment. I will disclose that when my
own beloved pitbull was diagnosed with a brain tumor, I
instantly got in a car, drove him to Colorado State University,
which is one of the leaders for oncology, and ended
(21:31):
up spending a lot of money to do something called
stereotactic radiation therapy, and I was able to get thirteen
months with my dog, and it was thirteen months of
relatively good quality of life. That's when I made that
decision to humanely euthanize him. But I know for me
that SRT or that stereotactic radiation therapy was really for
(21:54):
treatments in one week, and so yes, my dog had
to be under anesthesia briefly during that time period. But sometimes,
depending on the type of cancer, you might not be
reaching for radiation therapy, you may be reaching for chemotherapy instead,
and some of this can be done at your VET.
So the question is when do you refer like, when
(22:15):
should a pet owner go to the veterinarian or when
should they make an appointment with an oncologist. And do
you mind just talking to me about the differences of
whether or not that chemotherapy should be done at your
VET or with a oncologist.
Speaker 6 (22:29):
A great question. So I would say that in general,
there are medical oncologists, radiation oncologists, and surgical oncologists, and
these are veterinarians that have special training in treating cancer
with those various types of treatment. And sometimes these are
treatments that cannot be performed at your primary care veterinarian.
(22:50):
So if it's a type of cancer that your veterinarian
has treatment options for, then absolutely you can continue that
care with your primary care veterinarian. But in some cancers
there are benefits to going to see a cancer specialist
to just one find out your options and to see
if there are additional treatments that maybe there is access
(23:12):
at the specialty hospital or like you went to a
university setting or something like this, where they may have
access to novel therapies or additional therapies, and so depending
on kind of what fits for you and what decision
you make for your pet, then you may want access
to those alternative treatments.
Speaker 3 (23:30):
I know, I'm super grateful for a board certified veterinary
on collegists out there. You know, most of the time
pet owners oftentimes don't know what the difference is between
a board certified specialist and a general practitioner. And I
always say your family practitioner is the way to go.
You want to go with them, you want to check
with them because you have a long term relationship with them.
But if it's something more complex, something that requires advanced diagnostics,
(23:54):
you definitely want to consult with a veterinary specialist. And
it doesn't necessarily mean your vet has to necessarily refer you.
You can even self refer. I personally will say my
little word of advice is if your pet was just
diagnosed with cancer, or you suspect your pet was diagnosed
with cancer, I always recommend calling to make an appointment
immediately with a board certified oncologist because oftentimes it takes
(24:17):
like four to eight weeks to even get an appointment,
and that way, depending on what you do, you can
always cancel that appointment close to date. But he always
say it's worth talking to an oncologist because they are
the experts in diagnosis and treatment, and just because you
make that appointment doesn't commit you to having to do
chemotherapy or radiation therapy. But again, you're talking to the
(24:40):
expert who can give you the best information on how
you can treat your pet and what your options are.
Doctor Florey, any last tips you want to leave with us.
Speaker 6 (24:49):
Yeah, I mean I would just say in response to that,
I definitely agree. I think just going for the consultation,
it's not a commitment to proceeding with any therapy, but
you can at least find out what your treatment options are,
and all oncologists will really provide you with an array
of options that include everything from kind of more minimal
approach to kind of, you know, a more advanced approach
(25:11):
and help you really make the decision that's right for
you and your family.
Speaker 3 (25:15):
Wonderful, Thank you so much, really appreciate all that you
do and really appreciate you taking time to be with
us today.
Speaker 6 (25:21):
Thank you so much for having me. This has been great.
Speaker 2 (25:23):
Well that brings us to the end of today's show.
Speaker 3 (25:25):
Find me at doctor Justinelee dot com, on Facebook or
Instagram at doctor Justine Lee, or email me your pet
questions at doctor Justine at petlife radio dot com. With that,
we're at a time and we want to thank our guests,
doctor Andy Glory and Mark Winter, our producer, for making
the show possible.
Speaker 2 (25:41):
See you with the next episode.
Speaker 5 (25:43):
Let's Talk Pets every week on demand only on Petlife
Radio dot com
Speaker 8 (26:01):
As
Is pet Life Radio, Let's Talk Pets.
Speaker 2 (00:26):
Welcome to er Venom pet Life Radio. I'm your host, Sacker.
Speaker 3 (00:29):
Jess Canley, and I'm an emergency critical care vetory specialist
and toxicologist.
Speaker 2 (00:33):
Thanks for joining us today.
Speaker 3 (00:35):
We're going to be talking about cancer and dogs and cats,
a really important topic, especially as our pets age.
Speaker 2 (00:42):
We'll be right back after these messages.
Speaker 4 (00:48):
Take a bite out of your competition. Advertise your business
with an ad in pet Life Radio podcast and radio shows.
There is no other pet related media that is as
large and reaches more pet parents and pet lovers then
pet Life Radio with over seven million monthly listeners. Pet
Life Radio podcasts are available on all major podcast platforms,
(01:09):
and our live radio stream goes out to over two
hundred and fifty million subscribers on iHeartRadio, Odyssey, tune In,
and other streaming apps. For more information on how you
can advertise on the number one pet podcast and radio network,
visit Petlife Radio dot com slash advertised today.
Speaker 5 (01:29):
Let's Talk Pets on Petlife Radio dot com.
Speaker 3 (01:48):
Welcome back to Ervet on pet Life Radio today. I'm
really excited to speak with doctor Andy Florey, who's the
chief medical officer and the co founder of pet t
X and a board certified veterinarycologist, Doctor Florie.
Speaker 2 (02:01):
Thank you so much for joining us today.
Speaker 6 (02:03):
Thanks Justine, it's really great to be here.
Speaker 1 (02:05):
Awesome.
Speaker 3 (02:06):
Just so our audience knows who you are, do you
mind giving us a little bit of background about who
you are, where you train, what you do, and how
you're different from a traditional veterinarian.
Speaker 6 (02:15):
Sure. So, as you mentioned, I'm a medical oncologist, which
means I did extra training to treat cancer in dogs
and cats. My background is that I grew up in
Ohio and I did training at the Ohio State University
and also at Cornell and after that I worked in
various places. I worked at the Animal Medical Center in
New York City, I worked in Australia, and then in
(02:38):
San Diego, which is where I was working when I
met an adorable little patient named Poppy that really just
changed everything for me. Unfortunately, Poppy had a cancer diagnosis
that was just too late, and because of that, her
owner and I co founded a company called pet DX
to develop a test called a liquid biopsy test. And
(03:00):
this test is called Uncle Cainine and it detects cancer
with just a blood draw.
Speaker 3 (03:04):
All right, You know, I have so many questions on that,
of which I'm going to ask you later, because oftentimes
in the er, you know, I'm going to oftentimes do
like complete blood work, X rays, things like that, and
so many times when I do that blood work, what
are the first questions owners will ask me is but
I thought the blood work tested for that. So you know, great,
great technology that you're talking about, and we'll bring that
(03:26):
up in just a minute. But I wanted to ask
some important questions. What are some important things for pet
owners to know about canine cancer and how it affects
dogs and cats.
Speaker 6 (03:37):
So the biggest thing to know is that cancer is
a huge problem in dogs and cats. It's actually the
number one cause of death in dogs, and dogs have
about a one in three risk in their lifetime of
developing cancer, and cats it's about one in five. And
there are a couple of things that really increase the
risk of cancer. The biggest one is age. So for example,
(03:59):
and dogs know that the risk of cancer increases after
the age of seven in most dogs, but there are
some breeds that are at higher risk even by the
age of four. That includes some of the giant breed dogs.
We did a study recently that showed that boxers and
bulldogs are at risk earlier and are at risk even
from the age of four. So it's important to kind
(04:21):
of just understand that dogs are at risk of cancer
cats as well, and it's important to kind of know
about this, have it on your radar, and talk with
your veterinarian about it.
Speaker 3 (04:30):
Unfortunately, when I work in the er, it's really really
frustrating because a lot of owners have never met me before.
You know, they usually have a long term relationship with
their family practitioner, and now they come into the er
for something as vague as like vomiting or even you know,
not feeling well or not wanting to eat for a
couple of days, and I'm making the diagnosis of cancer,
and it can be really hard for pet owner to
(04:52):
hear that news. I wanted to step back and say,
first of all, what are some of the most common
clinical signs of cancer that we should be looking out
for or especially as our pets age when it comes
to dogs and cats, Like, what are some of the
most common signs?
Speaker 6 (05:05):
Yeah, I mean, I would say sometimes it can be
really vague, right, like they're sleeping more or they're a
little lethargic. Appetite changes are a big thing, stool and
urine changes, even water intake changes, all of these things
that you notice at home. If you're noticing a change,
you should definitely bring this up with your veterinarian. Sometimes
it's a little more focused in terms of what you
(05:27):
might notice at home, like you might notice a swelling
or pain in one leg which you see as limping.
You might notice that your dog or cat is losing weight,
so any of these kind of signs. These are unfortunately
common signs that can be any number of things, but
would be really important to talk with your veterinarian about
because especially as our pets are aging, they are at
(05:48):
higher risk of cancer and they could indicate cancer.
Speaker 3 (05:51):
All right, thank you. You know it's so hard because
the signs are vague, but I always tell people if
you notice anything especially chronic, like your dog is vomiting
once or twice a week for several weeks, or your
cats just getting a little bit thinner.
Speaker 2 (06:05):
Sometimes it's that lump or that mass that slowly getting
bigger and bigger.
Speaker 3 (06:09):
To weird things again, like you had mentioned, like the limping,
to difficulty breathing, you know. Unfortunately, there's a whole gamut
of clinical signs that I can be representative of cancer.
So I would say, one in doubt, we always want
to be able to catch it earlier than later. Now,
I had mentioned before, oftentimes in the ER, I'm discovering
cancer or even advance cancer where it's already metastasized on
(06:32):
X rays or ultrasound, and a lot of times the
traditional blood work that I do, such as a complete
blood count and a chemistry panel or even a urine test,
are completely normal. And for those of you guys who
have listened to pet Life Radio er VET for long time,
you probably remember an old episode with doctor Garrett Pactinger
when we talked about some of the tests that we
(06:53):
do in the ER. And this is a really important
one to go back to listen to because a lot
of times people will pay for the blood test, but
they don't don't actually know what they're testing for. And
that's where it's so important that your veterinarian or your
er veterinarian.
Speaker 2 (07:06):
Communicate that to you.
Speaker 3 (07:08):
Now, again, oftentimes, when I'm seeing it, I'm breaking terrible
news to my pet owners. Could early detection help prevent
this scenario? And what can we do. Is it a
matter of getting into our vet earlier, Is it a
matter of doing X rays or ultrasound once a year?
Speaker 2 (07:21):
What do you recommend?
Speaker 6 (07:22):
Yeah, so, early detection can certainly make a huge difference.
When we talk about early detection of cancer, we really
mean two things. Early detection can mean early stage detection,
when we find cancer before it's spread. But early detection
can also mean finding it early before your pet is sick,
and both of those have a lot of advantages. For example,
(07:42):
it often makes cancer easier to treat. Sometimes we have
a better chance at long term control or even cure
if we find it earlier as opposed to later. And
it's often going to mean a better outcome for your
pet in terms of when we treat that cancer, they
tend to do better. So early detection is always important.
And when we think about cancer detection, we really mostly
(08:05):
find cancer, like you mentioned, when they're coming into the
er or they're coming in sick, they're coming in with
something noticeable that's happening at home. And so when it
comes to that, in terms of diagnosis, we have a
lot of the same tools to diagnose cancer in dogs
and cats as we do in people. However, most of
the time when we're finding cancer because pets are already sick,
(08:26):
often cancer can be quite advanced, and that means that
we can't provide that long term control or even cure.
So if we can shift that conversation to finding cancer
earlier and doing screening, which has made a huge impact
in cancer survival in people, then this could really give
us a leg up in terms of being able to
control cancer for longer and screening. What that really means
(08:50):
is looking for cancer when patients are asymptomatic. So for example,
in people, we have mammograms, we have colonoscopies, we have
PSA tests, and these are tests that go for once
we reach a certain age typically meaning we're starting to
become at higher risk for cancer, we go for to
try to find those cancers earlier so that if we
(09:10):
are going to develop that disease, we have a better
chance at controlling it in the long term.
Speaker 3 (09:15):
All right, So we already talked about like doing that
complete blood count, doing that chemistry panel, doing chest X rays,
doing abdominal ultrasound. In terms of technology, do I just
talking and describing what is liquid biopsy, what it tests for,
and what breeds, you might want to consider running that
test or talking to rivet nerin about it.
Speaker 6 (09:35):
So, yeah, So liquid biopsy what this really is. It
is a blood based test. It's looking for circulating tumor DNA.
What this means is that this is little bits of
DNA that are being released from cancer cells. So it's
really looking for the current presence of cancer in the body.
One thing that's important to understand is that it's not
a risk prediction test. It's really looking for evidence of
(09:58):
cancer in the body. So the way this works is
that adding this to a wellness visit, for example, can
increase your veterinarian's ability to catch cancer early because if
we have an indication on this blood test that there's
cancer DNA present in the blood, then we know to
go and look for it and find it and then
we can talk about treatment and hopefully the outcomes can
(10:19):
be better.
Speaker 3 (10:20):
So how often do you recommend doing liquid biopsy and
how it's a test done, Is it painful, how long
does the result take? Do you recommend doing it every
single year or every six months in high risk breeds
like golden retrievers?
Speaker 6 (10:34):
Absolutely? Yeah, So you're thinking of exactly the right line
so really this is a test that's meant to be
kind of paired with your wellness visit. So if your
dog is having once a year wellness visit or twice
a year wellness visit, this is something that can be
paired right in with that wellness visit so that if
there is going to be cancer that develops, that we
have the best chance of catching it. Just like with
(10:56):
any cancer screening test that we go through, we go
through those on a hadens or in a serial test,
so that if we are going to develop we have
a chance to catch it earlier. In terms of how
it's performed, this is a simple blood draw, so your
veterinarian has access to requesting the special tubes that are
needed to run the test through the common diagnostic labs
(11:17):
that they work with, and so they have access to
that more directly through our company pet dx. If you're
interested in finding out more, you can jump on to
petdx dot com and add your name to the interest
list and we can reach out and share information as well.
Speaker 3 (11:31):
Wonderful thank you now, I will say even though I
do er practice with my own pets as a age,
so for me, this is greater than a ten year
old cat. For a dog, usually this is seven to
eight years of age. I usually do routine blood work,
screening and a physical exam, and I even have this
on my calendar for me to do at home for
(11:53):
my own pets because as we age, and of course
we can see cancers in all ages of pets, but
as we age, we do know that we can see
more cancer. So I always do routine blood work just
to screen my pet. Now, quick question for the cat
owners out there is liquid biopsy available or potentially available
in the future for cats.
Speaker 6 (12:12):
It's not yet, but stay tuned is definitely coming. We
know that that cats are really important as well in
this cancer conversation, so stay tuned. It is on the way.
Speaker 3 (12:22):
Right now, we've talked about this before, but what specific
cancers does it test for?
Speaker 6 (12:28):
So yeah, this is a multi cancer detection test, which
means it detects actually thirty different types of cancer that
it was shown in the clinical validation study to detect.
This includes the most common cancers that happen in dogs.
So for example, the detection rate in the eight most
common cancers that we see in veterinary medicine sixty two
percent and in the top three, so these really common
(12:52):
but very aggressive cancers, which are lymphoma, command uce arcoma,
and ostuse arcoma. The test can detect eighty five percent
of these with a very false positive rate of only
one point five percent. This really means that this is
a broad screening test that can detect a wide variety
of cancer, including the most common cancers that happen in dogs.
Speaker 3 (13:12):
All right, and you know, for dog owners out there,
I've mentioned it before in a previous episode, just talking
about some of these three cancers interest. Our coma is
often a really aggressive sort of like a blood or
tissue loving type of cancer, and unfortunately, when I typically
see it in the er vet, it results in severe
internal bleeding. And it's often my favorite breeds that get it,
(13:35):
so German Shepherds, Labrador retrievers, Golden retrievers. And I'm so
paranoid about this cancer because it grows really aggressively on
the spleen and liver, and by the time that I
see it, unfortunately er again, it's often too late because
by the time that tumor, that cancer is ruptured on
the spleen, it really spreads cancer cells and unfortunately a
(13:57):
lot of times it's you know, life saving sturge blood transfusions,
which can be tens of thousands of dollars and it's
really expensive. So again, the fact that there's a blood
test for it is amazing. With lymphoma, lymphoma is a
type of cancer that can really really affect.
Speaker 2 (14:14):
Even younger dogs.
Speaker 3 (14:15):
So I've seen unfortunately, dogs as young as two or
three years of age where all of a sudden, their
lymph nodes are really really prominent. So if you're petting
your dog, you all of a sudden notice lumps underneath
their neck area or in their shoulder area. That's the
kind of stuff you always want to get to a
veterinarian right away because with treatment, the prognosis is actually
fair with chemotherapy. So again, the sooner we can diagnose
(14:39):
a problem, the sooner we can treat it. And then
the last one, Doctor Fleury already mentioned OSU starcoma. Something
as simple as limping or you know, a dog's walking
and all of a sudden, fractures are legs. They're super painful.
I see this unfortunately a lot in greyhounds, and it's
something that can be quite severe. It's a type of
bone cancer. So the fact that we can potentially diagnose
(15:01):
cancer earlier. Is so so helpful because I always feel
like cancer is one of the top three diagnoses that
I unfortunately make in the er. So again, a really
really important that you talked to your veterinarian about this. Now,
how can pet owners broach the cancer conversation with their veterinarians.
What can this conversation deliver?
Speaker 6 (15:20):
So I think the important thing is really to talk
to your veterinarian about your dog's risk for cancer. And
one thing that can be helpful in that conversation is
a tool that we developed based on a study that
we performed, and the tool is called the Cancer Safe
Tool SAFE, which stands for Screening Age for early Detection.
(15:41):
This is a tool that was put together based on
a large study we did in over three thousand dogs
to understand the best age to start cancer screening for
your dog based on your pet's age, breed, and weait.
So you can use this tool. It's at cancersafe dot
petdx dot com and you can use this to understand
when should we start looking for cancer in your dog
(16:04):
and you can bring that up with your veterinarian to
talk about what tests they recommend for screening for cancer.
This might include, like you mentioned, you physical exam, routine
lab work. Sometimes your veterinarian might recommend imaging. And now
we have this new blood test called liquid biopsy that
can help us to detect more cancer earlier as well.
Speaker 2 (16:25):
We'll be right back with doctor Flory right after these messages. Mollie,
here's your dinner. Since that's not your food, don't.
Speaker 7 (16:37):
Let that happen to your precious cat. Elevate your cat's
eating experience with the cat tree tray. The cat tree
tray keeps your cat's food off the floor and conveniently
located on the cat tree. It's the perfect way to eat.
It's a beautiful hot iron tray that easily attaches to
your cat tree and keeps dogs and other critters out
(16:58):
of your cat's dish. As from Multi Pet Households, there's
a six inch trade for large bowls and a four
inch trade for smaller bulls. Er just your cat tree
trade today. Go right now to cattreetrade dot com. That's
cattreetrade dot com. C A T t R E E
t R A Y dot com.
Speaker 8 (17:21):
Let's talk past, Let's done.
Speaker 6 (17:23):
Pet Headline Radio.
Speaker 8 (17:26):
Cat light Radio dot com.
Speaker 2 (17:44):
Welcome back to EREB on pet Life Radio.
Speaker 3 (17:46):
We've been speaking with doctor Andy Florey, a board certified
veterinary oncologist, about what we can do to help detect
cancer earlier in our furry family members. And the main
reason why is the sooner we diagnose.
Speaker 2 (17:58):
Something, the sooner we can treat.
Speaker 3 (18:00):
We've talked about the clinical sides and some of the
top cancers that we see in dogs.
Speaker 2 (18:05):
We've also talked about some of the tests that can
be done.
Speaker 3 (18:08):
The benefits of diagnosing cancer early on our dogs or
our cats.
Speaker 6 (18:13):
Yeah, great question. So early detection really meaning either before
a cancer has spread or before a pet is really sick,
has a lot of benefits for the family. That often
means that they have time to kind of think about
what they want to do. When we're able to detect cancer,
for example, when our patients are stable, when they're not sick,
(18:33):
and before it's spread, we have time to do things
like schedule the treatment. We can do it when it
makes sense for the clinic and for the family. The
family has time to kind of consider their options, and
for the pet. There's definitely going to be benefits of
not having to kind of go through those Unfortunately, trips
to the er right, which can be scary. They might
happen in the middle of the night, as you mentioned,
(18:55):
sometimes those come with a hefty price tag or a
need for things like blood transfus or things like this.
So when we can do this in a more relaxed manner,
it's going to be better for the pet, it's going
to be better for the family, and it's going to
be better for that veterinary care team because an early
diagnosis conversation is always going to be easier than that
too late one.
Speaker 3 (19:14):
When it comes to diagnosing it early and it comes
to treating, Do you mind just talking a little bit
about what does treatment entail? I think a lot of
pet owners often think of a two legged beloved family
member who went through cancer treatment, went through radiation therapy,
went to chemotherapy, all their hair fell out, they were
super nauseous, they were really affected by it. Do you
(19:36):
mind just talking about the difference between human medicine versus
veterinary medicine when it comes to treating pets with cancer,
and are the protocols the same or are the same
drugs used?
Speaker 2 (19:47):
Do we do radiation therapy and venory medicine?
Speaker 6 (19:50):
That's a great question. So we've got a few basic
tools that we use to treat cancering dogs and cats,
and they're really the same tools that are used in people,
but we kind of apply them a little bit differently.
Some of the tools that we have that are very
similar are things like surgery. We have things like medical therapy,
so these would be things that make your pet feel better,
and then we have chemotherapy and radiation. Now, when we
(20:13):
approach treating cancer in our pets, the approach is a
little bit different than it is in people because our
goal is really quality of life at all times. So
our goal as oncologists as veterinarians is to provide your
pet the best quality of life that we can for
the longest period of time, which means we want them
to feel good, we want them to be happy, we
want them to kind of go for walks and do
(20:34):
all of the things that your pet normally does. And
so what that means is that we design cancer treatments
for dogs and cats to maximize quality of life while
we're controlling the cancer, which is a little bit of
a different approach than is taken to treat cancer in people,
where the goal is usually cure which means that higher
doses are used and side effects are very common, whereas
(20:56):
in dogs and cats side effects are less common. Because
we're really maximizing quality of life, and we're prioritizing that
over anything else, and we really want to design the
doses around keeping them feeling.
Speaker 3 (21:08):
Good much we're saying that, you know, I oftentimes have
owners really really worried about the hair loss, really worrying
about quality of life when it comes to chemotherapy or
some of this treatment. I will disclose that when my
own beloved pitbull was diagnosed with a brain tumor, I
instantly got in a car, drove him to Colorado State University,
which is one of the leaders for oncology, and ended
(21:31):
up spending a lot of money to do something called
stereotactic radiation therapy, and I was able to get thirteen
months with my dog, and it was thirteen months of
relatively good quality of life. That's when I made that
decision to humanely euthanize him. But I know for me
that SRT or that stereotactic radiation therapy was really for
(21:54):
treatments in one week, and so yes, my dog had
to be under anesthesia briefly during that time period. But sometimes,
depending on the type of cancer, you might not be
reaching for radiation therapy, you may be reaching for chemotherapy instead,
and some of this can be done at your VET.
So the question is when do you refer like, when
(22:15):
should a pet owner go to the veterinarian or when
should they make an appointment with an oncologist. And do
you mind just talking to me about the differences of
whether or not that chemotherapy should be done at your
VET or with a oncologist.
Speaker 6 (22:29):
A great question. So I would say that in general,
there are medical oncologists, radiation oncologists, and surgical oncologists, and
these are veterinarians that have special training in treating cancer
with those various types of treatment. And sometimes these are
treatments that cannot be performed at your primary care veterinarian.
(22:50):
So if it's a type of cancer that your veterinarian
has treatment options for, then absolutely you can continue that
care with your primary care veterinarian. But in some cancers
there are benefits to going to see a cancer specialist
to just one find out your options and to see
if there are additional treatments that maybe there is access
(23:12):
at the specialty hospital or like you went to a
university setting or something like this, where they may have
access to novel therapies or additional therapies, and so depending
on kind of what fits for you and what decision
you make for your pet, then you may want access
to those alternative treatments.
Speaker 3 (23:30):
I know, I'm super grateful for a board certified veterinary
on collegists out there. You know, most of the time
pet owners oftentimes don't know what the difference is between
a board certified specialist and a general practitioner. And I
always say your family practitioner is the way to go.
You want to go with them, you want to check
with them because you have a long term relationship with them.
But if it's something more complex, something that requires advanced diagnostics,
(23:54):
you definitely want to consult with a veterinary specialist. And
it doesn't necessarily mean your vet has to necessarily refer you.
You can even self refer. I personally will say my
little word of advice is if your pet was just
diagnosed with cancer, or you suspect your pet was diagnosed
with cancer, I always recommend calling to make an appointment
immediately with a board certified oncologist because oftentimes it takes
(24:17):
like four to eight weeks to even get an appointment,
and that way, depending on what you do, you can
always cancel that appointment close to date. But he always
say it's worth talking to an oncologist because they are
the experts in diagnosis and treatment, and just because you
make that appointment doesn't commit you to having to do
chemotherapy or radiation therapy. But again, you're talking to the
(24:40):
expert who can give you the best information on how
you can treat your pet and what your options are.
Doctor Florey, any last tips you want to leave with us.
Speaker 6 (24:49):
Yeah, I mean I would just say in response to that,
I definitely agree. I think just going for the consultation,
it's not a commitment to proceeding with any therapy, but
you can at least find out what your treatment options are,
and all oncologists will really provide you with an array
of options that include everything from kind of more minimal
approach to kind of, you know, a more advanced approach
(25:11):
and help you really make the decision that's right for
you and your family.
Speaker 3 (25:15):
Wonderful, Thank you so much, really appreciate all that you
do and really appreciate you taking time to be with
us today.
Speaker 6 (25:21):
Thank you so much for having me. This has been great.
Speaker 2 (25:23):
Well that brings us to the end of today's show.
Speaker 3 (25:25):
Find me at doctor Justinelee dot com, on Facebook or
Instagram at doctor Justine Lee, or email me your pet
questions at doctor Justine at petlife radio dot com. With that,
we're at a time and we want to thank our guests,
doctor Andy Glory and Mark Winter, our producer, for making
the show possible.
Speaker 2 (25:41):
See you with the next episode.
Speaker 5 (25:43):
Let's Talk Pets every week on demand only on Petlife
Radio dot com
Speaker 8 (26:01):
As
Popular Podcasts
New Heights with Jason & Travis Kelce
Football’s funniest family duo — Jason Kelce of the Philadelphia Eagles and Travis Kelce of the Kansas City Chiefs — team up to provide next-level access to life in the league as it unfolds. The two brothers and Super Bowl champions drop weekly insights about the weekly slate of games and share their INSIDE perspectives on trending NFL news and sports headlines. They also endlessly rag on each other as brothers do, chat the latest in pop culture and welcome some very popular and well-known friends to chat with them. Check out new episodes every Wednesday. Follow New Heights on the Wondery App, YouTube or wherever you get your podcasts. You can listen to new episodes early and ad-free, and get exclusive content on Wondery+. Join Wondery+ in the Wondery App, Apple Podcasts or Spotify. And join our new membership for a unique fan experience by going to the New Heights YouTube channel now!
The Breakfast Club
The World's Most Dangerous Morning Show, The Breakfast Club, With DJ Envy, Jess Hilarious, And Charlamagne Tha God!
Fudd Around And Find Out
UConn basketball star Azzi Fudd brings her championship swag to iHeart Women’s Sports with Fudd Around and Find Out, a weekly podcast that takes fans along for the ride as Azzi spends her final year of college trying to reclaim the National Championship and prepare to be a first round WNBA draft pick. Ever wonder what it’s like to be a world-class athlete in the public spotlight while still managing schoolwork, friendships and family time? It’s time to Fudd Around and Find Out!