Surgical Debulking in Dogs

Debulking surgery in dogs is a surgical procedure that is used to combat tumors. As the name suggests, it is concerned with removing the bulk of the tumor. It is not a curative procedure; its aim is to remove the vast majority of the tumor to allow secondary treatment such as radiation to be more effective in removing the microscopic remains. It is also known as cytoreduction or cytoreductive surgery. It is a relatively common procedure used at a later stage of the tumor when it is large, or in a location where it is difficult for the whole tumor to be removed. 

Firstly, your vet will refer you to the surgical department to see an oncologist who will diagnose the type of tumor and decide if a debulking procedure is appropriate. If it is deemed the correct course of action, they will then set a timeline to undertake the operation depending on the severity and availability of the theatre and staff. This process could take anywhere from a week to a few months. 

If debulking treatment is recommended, the procedure itself will be as follows:

• An intravenous catheter inserted. 
• Anaesthetic will be administered. 
• An ovoid incision will be made around the mass and sharp dissection will be used to remove the tumour from the surrounding tissue. (hemorrhage will be controlled with ligation if necessary).
• Any residual abnormal tissue in the surrounding area will likely also be removed. 
• The subcuticular tissue will then be reconnected and the skin stitched back together.
• The wound will be bandaged.  

The success of this procedure is difficult to quantify, as it is not curative alone. It is usually used in tangent with another secondary procedure. Having said that, it is an effective procedure that has regular success. It is effective in preparing the dog for final treatment of radiation to remove the last remaining cancerous cells. Which, if successful, can permanently cure the dog. 

There are alternatives to this treatment such as curative-intent surgery. This aims to remove the tumor in its entirety in one procedure. However, this is not always practical as the tumour may be in such a position where the whole tumour cannot be accessed. In this case, debulking surgery is the solution. There is also the alternative of chemotherapy and radiotherapy. However, both of these may not be effective against large tumours. Plus, both run the risk of actually causing cancer. Whilst they are an alternative they are much more effective when used in conjunction with debulking surgery. 

If the operation is successful, the dog could be discharged the same day with painkillers. If in severe pain they may be kept overnight. A combination of anti-inflammatory and narcotics are usually used to combat the pain. The wound will need to be checked regularly to ensure there isn’t infection. To this end, the dog should also be prevented from licking the incision. An Elizabethan collar may be required to prevent this. The dog should also not be doing any exercise for three to four weeks. 

Postoperatively, the dog will likely be rechecked at the vet’s after 48 hours, one week, and two weeks. However, these are guidelines and there are a lot of variable factors, from the size and location of the tumor, to the age and health of the dog.  

For the dog to be fully healed will depend on the whether there was any treatment such as chemotherapy needed afterward and the success of that secondary treatment. It is difficult due to the varying nature of different dogs’ tumors and the success in fighting those off to give an accurate timescale, but it is likely to be in the months' category. 

The cost of treatment varies largely depending on the age and health of the dog, the size and stage of the cancer, plus the number of visits needed.

Here is a breakdown of estimated costs:

• Initial visit and diagnosis will cost approximately $200.
• Surgery usually starts from $1,500.
• If chemotherapy is then needed it could be $200-$2,000 for three to six months of treatment.
• Painkillers could cost between $25 and $50 dollars a month.
• Antibiotics and other medication usually cost between $30 and $50.

So, whilst chemotherapy is an alternative it may cost up to $2,000 and the dog may still need surgery if the chemotherapy fails. Radiotherapy is also an alternative but that ranges from $2,000 to $6,000. The alternatives are not necessarily cheaper and success is more likely to be achieved with the surgery. 

As with any surgery, there is a certain level or risk. However, if debulking surgery is recommended and the owner opts to avoid this route, they may lose the opportunity to prevent the tumour spreading to a terminal stage. Plus, the long-term implications are the risk of spending a considerable amount of money on the non-surgical alternatives only to then need the surgery and the chemotherapy and radiotherapy postoperatively. Many tumors are dangerous and inclined to spread; tackling them surgically offers the best chances at safe removal. Whilst it is always worth considering the possibility of the cancer returning, the implications of not acting may be fatal. 

The best cure for cancer is prevention. Following these steps could limit the chances of your dog contracting cancer in the first place. Dogs are built with the capabilities to fight off cancer. However, exposure to certain products can increase the chance of cancer cells growing. It would be prudent to:

• Decrease the use of certain flea and tick products. Fipronil is found in many popular tick and flea products and may encourage thyroid cancer.
• Reduce the use of toxic lawn products. Research has found a direct correlation between lawns maintained with lots of toxic products and the dogs at those properties developing cancers in their life. 
• Check the labels of your detergents. Many household products contain carcinogens that have cancer-causing properties. 
• Minimize vaccinations. Increasing evidence is emerging showing aggressive malignant cancer growth in areas where dogs have been injected with some vaccine products. Discuss the most appropriate and necessary vaccinations with your vet.
• Discuss with your vet the best age to neuter your dog. Research is increasingly pointing to a correlation between young neutering and spaying and bone cancer later in life. 
• Manage your dog’s diet. Ensuring a dog does not get overweight significantly reduces the chance of it getting cancer. Aiming for an anti-inflammatory diet as much as possible will also reduce cancer risk. Glucose in carbohydrates gives the cancer cells the energy they need to grow. Cutting down on foods like potatoes will help to reduce their risk. Discuss with your vet whether a diet of raw, lean meats, with moderate fat and minimal grains and starchy foods may be an effective preventative measure for your dog.