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However, it’s not always an immediate death sentence. There are treatment options you can offer owners, which can help improve their quality of life and prolong their survival during this terrible time. However, it is important for pet owners to be aware that there is no cure.
Carcinomatosis refers to the widespread dissemination of malignant epithelial cancer, with metastasis to the visceral and/or parietal pleura.
Carcinomatosis is rare in dogs and can occur anywhere. The most common sites are the abdominal and/or chest cavity. Carcinomatosis may present with or without malignant effusions.
Older dogs are most commonly affected by both mesothelioma and carcinomatosis. However, carcinomatosis can occur in young dogs. There is no breed or gender predilection.
The most common presenting sign is dyspnoea from pleural effusion and/or abdominal distension from peritoneal effusion, although most dogs will present with chronic, nonspecific signs of illness.
Carcinomatosis may occur through the dissemination of malignant epithelial cells through direct seeding of body cavity surfaces, lymphatic spread and haematogenous route.
The prognosis for carcinomatosis (regardless of the origin of the primary tumour) is grave, with most dogs humanely euthanised shortly after diagnosis.
The median (average) survival time in untreated dogs is about one month.
Unfortunately, this cancer is incurable and challenging to treat. However, treatment can significantly palliate clinical signs and quality of life and, in some cases, prolong survival. Moreover, the presence of an effusion is not necessarily associated with a worse prognosis.
If the main concern is marked pleural and/or peritoneal effusion, then intracavitary chemotherapy is recommended to try to stop or slow down the rate of effusion.
Conversely, if the main concern is not malignant effusion, then I recommend injectable chemotherapy.
Intracavitary chemotherapy has a limited local penetration depth of 2 to 3 mm. Therefore, it is unlikely to work in larger or thicker lesions or nodules.
Chemotherapy drugs that could be considered include cisplatin, doxorubicin, mitoxantrone and carboplatin.
Palladia® (toceranib phosphate) is an oral anticancer drug (multiple receptor tyrosine kinase inhibitor) that is administered at home on Monday, Wednesday & Friday with food.
In a recent retrospective study evaluating 23 dogs with carcinomatosis (60.8%, n =14) or mesothelioma (34.8%, n = 8) treated with Palladia®, one in three dogs responded to therapy. While most of the remaining dogs did not respond to therapy, they experienced stable disease, meaning the cancer did not progress.
The median survival time for all dogs treated with Palladia® was about ten months. However, dogs with effusion had a lower median survival time of approximately 5.5 months. Most dogs (73.9%) experienced mild gastrointestinal side effects, with diarrhoea and hyporexia being the most common side effects. However, most gastrointestinal side effects resolved with a short break from Palladia®, dosage reductions, and supportive care medications. Rarely do Palladia® side effects lead to discontinuation of therapy. (Hicks et al. VCO 2024)
Anti-nausea, appetite stimulants, gastroprotectants, pain relief and anti-inflammatories are some supportive care medications that can be used in dogs with carcinomatosis.
Sick dogs may benefit from steroid anti-inflammatories (e.g. prednisolone), which can make dogs feel better within one to two days.
Vets, I hope this information helps you understand more about the prognosis and treatment options for dogs with carcinomatosis.
If you have a question about canine carcinomatosis or have a case that you would like evaluated, please do not hesitate to get in touch by clicking here.
This post was first published on The Pet Oncologist Blog: Carcinomatosis in Dogs: Exploring Treatment Options During Tough Times
Dr. Catherine Chan BVSc (Hons I) FANZCVS (Veterinary Oncology) Diplomate ACVIM (Oncology). Board-Certified & Registered Specialist in Veterinary Oncology I graduated in 2009 from The University of Queensland with a Bachelor of Veterinary Science. I began my veterinary career by completing a small animal rotating internship at Veterinary Specialist Services in Brisbane, followed shortly by work in small animal emergency and general practice. In 2012, I moved to Sydney to complete a three-year veterinary oncology residency program at the Animal Referral Hospital in Homebush. Since then, I have worked at several specialist referral hospitals in Brisbane. I have also spent time in the USA at the University of Missouri and Colorado State University. I am a board-certified specialist in veterinary oncology with both the Australian and New Zealand College of Veterinary Scientists (ANZCVS) and the American College of Veterinary Internal Medicine (ACVIM).
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