Advanced Treatments

The three treatments on this page come into the conversation when standard treatment has not been enough, or when the disease is advanced. What they share is that what they cannot do needs discussing as openly as what they can.

The decision is always made on quality of life. That a treatment is possible does not mean it is right for every animal.

Chemotherapy

In cats and dogs, chemotherapy is used most often for lymphoma, mast cell tumours and some tumours of the internal organs.

The aim is usually not to cure but to hold the disease back, and to do so while the animal feels well. That is where the approach parts from human medicine: doses are chosen so the animal can carry on with its ordinary life. Side effects are therefore usually mild and most animals live normally through treatment.

How it runs: the diagnosis is confirmed by biopsy or needle sample, the spread of the disease is assessed by imaging, and the protocol follows from that. A blood count is taken before each treatment; if the white cell count is low, that session is postponed.

What to watch for at home, and when to call, is given to you in writing at discharge.

Peritoneal dialysis

When the kidneys can no longer filter the blood, toxins build up. Peritoneal dialysis uses the lining of the abdomen as a natural filter: a fluid is run in through a catheter placed in the abdomen, left for a time, and drawn back out with the toxins. The cycle is repeated.

When it comes up: in acute kidney injury, where medication and intravenous fluids have not been enough. The commonest causes are poisoning, particularly antifreeze, leptospirosis, and a urinary obstruction that went unrelieved too long.

What it does: it buys the kidneys time to recover. It does not repair them; it keeps the animal’s toxin load bearable in the meantime.

What it does not do: it is not a long-term answer in chronic kidney disease.

It is labour-intensive, requires admission, and has complications: the catheter blocking, inflammation of the abdominal lining, protein loss. We go through these at the start.

Stem cell treatment

Stem cell treatment aims to support tissue repair and to modulate the inflammatory response. At this clinic it comes into consideration in chronic kidney disease, polycystic kidney disease, and chronic wounds that will not heal.

This needs to be said plainly. Stem cell treatment in veterinary medicine is a developing field. The evidence is still accumulating, and this treatment does not replace established standard care; it is used alongside it. Results vary between animals and cannot be guaranteed in advance.

With kidneys in particular the expectation has to be set correctly: chronic kidney disease cannot be reversed. The goal is not to remove the disease but to support the animal’s quality of life. It does not take the place of standard kidney care, meaning diet, fluid support, and control of blood pressure and phosphate.

In chronic wounds the aim is to support healing, and there too nothing is achieved without addressing the underlying cause, whether that is circulation, infection or pressure.

Whether the treatment is appropriate is decided together, on the animal’s stage, age and general condition.

Deciding

None of these three is a case of “if it can be done, it should be”. The same things need discussing each time: how the animal will feel during it, how often it will have to come in, and at what point stopping is the right answer.

We prefer to have that conversation at the start. Spending an older animal’s remaining time travelling to and from a clinic is not always the right choice, and saying so is part of our job.