{"id":22538,"date":"2020-12-15T15:39:31","date_gmt":"2020-12-15T15:39:31","guid":{"rendered":"https:\/\/todaysveterinarypractice.com\/?p=22538"},"modified":"2022-03-31T14:27:51","modified_gmt":"2022-03-31T14:27:51","slug":"nutrition-for-small-animal-cancer-patients","status":"publish","type":"post","link":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/nutrition\/nutrition-for-small-animal-cancer-patients\/","title":{"rendered":"Nutrition for Small Animal Cancer Patients"},"content":{"rendered":"

In the United Kingdom and the United States, the most commonly reported cause of death in dogs is cancer.1,2<\/sup> When a patient is diagnosed with cancer, veterinarians may be faced with many challenging questions. Clients may ask about prior diets they have fed the dog and about feeding \u201ccancer\u201d diets and\/or supplements in the future. One study reported that 51% of owners whose pet had cancer expressed distrust in their pet\u2019s diet and 90% reported having changed the diet when they learned of the pet\u2019s cancer diagnosis.3<\/sup> Without proper guidance, clients may shift their feeding practices toward home-prepared or other diet types, which can be problematic. Reviews of publicly available pet recipes for raw or cooked home-prepared diets have shown these diets to be unbalanced, to present the risk of introducing foodborne illness, and\/or to have insufficient instructions to ensure proper nutrition.4-11<\/sup><\/span><\/p>\n

To advise clients, veterinarians need to rely on scientific evidence while respecting clients\u2019 needs and perspectives. Human oncology patients may use nutrition, supplements, and natural products to empower themselves, attempt to take control of their health, and increase their quality of life. Acknowledging the concept of humanization (i.e., considering pets as family members), it is logical to expect and respect these same emotional needs when clients are facing cancer in their pet. Clients are highly motivated to be a part of the healthcare of their pet with cancer and seek nutrition recommendations. Thus, the veterinarian and healthcare team need to educate clients about their pet\u2019s nutrition at the time of cancer diagnosis and throughout treatment. <\/span><\/p>\n

Cancer Diets<\/h2>\n

Although research on cancer in dogs and cats continues to advance while availability of treatments (e.g., new drugs, immunotherapy, radiation protocols) and palliative care increases, research on nutrition for veterinary cancer patients remains scarce. Most reviews focus on management of anorexia or cachexia<\/a>.12,13<\/sup> Other than a study of lymphoma in dogs, no published feeding trials have examined the effects of different diet nutrient profiles on dogs that have cancer of various stages or are undergoing treatment.14<\/sup> Regardless of this lack of research, clients want information about popular cancer diets, such as low-carbohydrate and\/or ketogenic diets. Because cancer cell metabolism is often the rationale for advocating these types of cancer diets for pets, veterinarians should understand some of the underlying research. <\/span><\/p>\n

Low-\/No-Carbohydrate Diets<\/h3>\n

The best-known cancer cell metabolic abnormality was first described by Otto Warburg in the 1920s.15<\/sup> Warburg reported that compared with normal tissue, tumors showed unusually high rates of glucose uptake and lactate production even in the presence of oxygen. This aerobic glycolysis, now called the Warburg effect (<\/span>BOX 1<\/b><\/span>),15,16<\/sup> has given rise to the concept of low- or no-carbohydrate diets to \u201cstarve\u201d cancer cells. However, subsequent cancer cell metabolism studies have determined that not all cancer cells survive by using aerobic glycolysis only; they also have metabolic flexibility.17-22<\/sup> This flexibility involves adaptively upregulating and downregulating carbohydrate, fat, and protein metabolism as needed in response to nutrient availability, tumor microenvironment, and even cancer treatments. Some studies found cancer cell lines that use fat metabolism; others found different levels of carbohydrate, fat, and protein metabolism within the same cancer cells in solid tumors. These studies demonstrate that the nutrition recommendation to limit carbohydrates for patients with cancer is an oversimplification.<\/span><\/p>\n

BOX 1 The Warburg Effect16<\/sup><\/div>
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