Radiation Treatments Keep Mouth Cancer at Bay for Cocker Spaniel with Heart Disease

“Many people think that working in oncology is a sad job, but the reality is that we work in a very positive environment, celebrating every little step of our patients’ journey with us. We love working with pets and their families. We get to see them often for their treatments and rechecks, so we get very close to them. There are also bad days, but the fact that we are able to celebrate the good days and support the families and their pets during the bad days is what makes working in oncology such a rewarding job.” 

—Dr. Celina Morimoto, radiation oncologist at Foster Hospital for Small Animals

Patients who complete cancer treatment at the Henry and Lois Foster Hospital for Small Animals (FHSA) at Cummings School of Veterinary Medicine at Tufts University are honored with a graduation ceremony—a tradition started by the Harrington Oncology service’s veterinary technicians. Recently, 12-year-old Cocker Spaniel Angie was among those celebrated, marking a milestone for her and her family.

“Angie is a very independent, very stoic, very proud dog. She can do tricks like lie down, but if she doesn’t feel like it, she just looks at you like, ‘I don’t think so,’” says her owner, Diane Bosco, with a laugh. “She’s been such a loyal friend to me in many ways. She’s an amazing dog. She makes us laugh and smile all the time.”

Bosco describes Angie as the alpha dog with her brother Brady, who is about twice her size. When she’s ready to head in from the yard, she barks, and he obediently follows her into the house.

Last summer, Angie was diagnosed with aggressive mouth cancer. A growth had formed on her gums over a few months and started bleeding. She could not chew food and would not let anyone touch the side of her face. A biopsy revealed the growth to be an anaplastic carcinoma, a type of cancer that tends to grow on the skin or mucous membranes. Bosco reached out to FHSA and scheduled a consultation with the Harrington Oncology service two weeks later.

“It was an amazingly fast time. I thought we’d be waiting a month or two, and maybe she wouldn’t be alive. We started treatments a week or two after that. They were very good about getting it done quickly,” says Bosco.

Bosco met with Dr. Celina Morimoto, radiation oncologist at FHSA and assistant clinical professor in the Department of Small Animal Clinical Sciences at Cummings School, to discuss treatment options.

“Angie's tumor has invaded her gums and caused some upper jaw bone destruction. Surgery would require removal of part of the upper jaw and possibly the nostril to control the tumor,” says Morimoto. “Diane was worried the surgery would be too extensive. That concern led her to choose radiation.”

Angie also suffers from advanced heart disease, and combined with being an older dog, anesthesia would be an additional risk.

“Many owners get discouraged with the idea that radiation requires at least a few repeated anesthesia events, but even a pet with advanced-stage heart disease is okay to undergo repeated anesthesia, as long as they get the okay from their cardiologist,” says Morimoto. 

When determining a cancer treatment plan, Morimoto first explains the two main goals of radiation therapy to pet owners: definitive intent, which maximizes the dose to control the tumor for as long as possible, and palliative intent, which focuses on reducing pain, side effects, and the number of treatments. Bosco chose the palliative-intent protocol for fewer treatments and less risk of side effects.

“Dr. Morimoto has been the most compassionate vet I’ve ever had; she really took our needs, and Angie’s needs, into consideration,” says Bosco. “Dr. Morimoto said that it would hopefully improve the quality and length of her life, and that’s exactly what happened.”

Angie had four radiation treatments spaced one week apart in September. Before starting, Bosco took Angie to her cardiologist. The cardiologist offered guidance to the Oncology team in case Angie had heart issues during or after radiation. Fortunately, Angie had no complications from the therapy.

Bosco anticipated some trepidation from Angie at the hospital, as she typically runs and hides when they go to the vet.

“Never once in all the times we went to Tufts [Cummings School] did she do that—she went out of the car gladly,” says Bosco. “She was not afraid; she felt comfortable and loved. That to me is one of the best signs when your dog is not afraid to go in and see the people who will be treating her.”

The staff also put Bosco at ease. “Everyone I come into contact with, from the front desk to students, is always so caring. You’re so nervous when you’re there, you don’t want to be waiting around. They were always so prompt. I never had to wait more than five minutes.”

Morimoto emailed Bosco after each treatment to see how Angie was feeling back at home. Angie was more tired than usual but tolerated the treatments well overall.

At her re-check in early November, Angie’s CT scan showed the tumor had partially shrunk. There were no signs of spread to her lungs.

“Angie is considered to have a partial response, which means radiation therapy was successful. The tumor may regrow in the future. Achieving a cure would require more aggressive treatments and increased risk of radiation side effects (poor quality of life), which is not desired for pets with cancer,” says Morimoto.

Bosco reports that Angie’s energy returned fully within a few weeks of finishing radiation therapy. She does not chew on the left side of her mouth, but otherwise shows no signs of discomfort anymore. Bosco recently dressed Angie in a sweater that she somehow managed to pull over her head and front paws to take off.

“She has her old personality back,” Bosco laughs about the sweater. “We’re so excited. She’s running around, happy, bossing her brother around, being her usual independent self. You wouldn’t know she has cancer.”

At her last treatment, the Oncology staff celebrated Angie with a traditional graduation ceremony.

“They brought her out, rang the bells, and took her picture,” says Bosco. “All the staff and students were there. Angie was still a little groggy, but loves attention, so she was proud and happy. Special touches like that really make a big difference in how you feel about a hospital, the doctors, and the students.”

Next up for the Boscos is planning a big Christmas.

“It almost seems miraculous to me that this is happening. I didn’t know if she’d still be alive, and she’s going to be here for Christmas,” says Bosco. “My dogs love Christmas. They get toys and gifts and jump up to try to get their stockings down. Dr. Morimoto gave us another Christmas with Angie.”