Jack the Rabbit: A Family’s Story

Jack was a handsome bunny who presented to the Western Veterinary Cancer Centre for evaluation of a very large tumor in his chest. This tumor type, called a thymoma, was so large that it was compressing his lungs fairly significantly.  Rabbits can be challenging patients to anesthetize, especially so when they have a large tumor in their chest interfering with normal breathing efforts.  Jack was treated for his thymoma using radiation therapy, and initially had a dramatic response to treatment.  Unfortunately, his remission was of short duration, and he re-presented 3 months after therapy with massive tumor regrowth.  We received the following letter shortly after Jack’s death.  It is reproduced with permission.  It is important to realize that, when treating a patient for cancer, things may not always go the way we hope.  I think the letter also shows that we need to focus on the good things we were able to achieve, rather than lamenting the things that proved unattainable.


Jack resting in the back yard.

Jack resting in the back yard.

Thank you doesn’t even begin to say what I feel. Right from the first time we saw him “Jack” was an individual in his own right and we loved him very dearly every day we had him. Not to say that he was perfect (he did what he wanted no matter what) but he knew no matter what he did we loved him anyway.


Before we adopted him from the Calgary Humane Society he had been adopted twice before and returned for various reasons. Totally their loss. Alex has a video of him when he first came to live with us and there he is running in and out of the bedroom, kicking up his heels and shaking those beautiful long ears. Pure joy to watch in his new freedom. He did go back to his cage at night to sleep but for the whole day he ran amuck, just as we feel all pets should do.


His favourite places were under the bed in the master bedroom, under the love seat in the family room downstairs and under the hearth (right next to the love seat). He would sit down there with us when we watched movies and when I turned on the Weather Network in the morning to see what the day would be like he always joined me. He loved the weather Network and was very up on the latest reports.


When Alex moved into her own place next to the University he discovered windows and would sit and watch the birds in the tree just off the balcony or the clouds rolling by in the sky (more weather only close up and personal now). He loved this and Alex loved having him there. He always had a sympathetic ear when she got home and told him about the trials of the day at work. And he always reminded her that stroking a rabbit’s silky fur lowers blood  pressure and puts you in a much better state of mind. He was better than any shrink could ever be.


The next part was written by Alex and says it so much better because of how close she was to him for the last few months of his life.




I want to thank all the staff at Western Veterinary for all their kindness and compassion dealing with Jack’s thymoma. Even knowing what I know now, I have no regrets for the choices I made seeking treatment. It may not have given us as much time as we had hoped it would, but the time we had was so much better because of the treatment and care he received from Dr. Mauldin and the team. I can’t express how much I appreciate being able to take that time to come to terms with things and, in the end, know he was as comfortable and happy as he could be.


I realize the expense gets more of the “he’s just a rabbit, go buy a new one” attitude than most treatable illnesses would, but they don’t know Jack. For me, he was someone to come home to, someone to hang out with and take care of, to remind me however bad things get there’s more to life than what happens at work or in school or with friends. Taking care of him has been therapeutic for me, putting life into perspective and emphasizing that need for someone who will never judge or grade me, just let me do my best for his sake. Being able to give him the chance to recover was worth it, and I know I’ll never regret having tried. He was always a fighter and lived every day to the fullest which was all I ever wanted for him. I know he’s in a better place now, where he can run in the grass and nap in the sun, but I still miss him every day and know part of me always will. We came through so much together, it would never be easy to say goodbye which is why I’m so thankful for all the support and assistance we found with you. When I first brought him home I promised I’d always take care of him, and when I realized there was an option to treat his tumor (however temporarily) I knew I would because as hard as it was to consider him passing under anesthetic or having complications come up in recovery, I would rather risk him dying there surrounded by those best suited to save him and who genuinely care, than to suffer every day at home and die in agony without having tried.


Jack had a happy life with us, hiding under furniture inside the house and under bushes outside in the yard, cuddling for pets and treats, destroying the odd sweater or sofa cover, having breakfast together, fighting my sister’s chinchilla, napping in the sunny spot in the living room and generally running wild all day. For a former shelter pet he did alright, and I’m glad I saved a life worth saving. Everyone who knew him is sad to see him go, but I’m glad he’s not suffering anymore and that I had that last week to say goodbye. I’m glad he had fresh greens every morning and a treat every night, I’m glad he got to run around the back yard on warm summer days and watch TV with us at night and bum around the house the rest of the time. I’m glad he was mine for 5 years, we had each other’s friendship. I’m glad I had the courage to stay with him and hold him at the end so he wouldn’t fell abandoned again, and that when the time came you were there to help me do this last thing for him.


Jack, checking up on his people


Thank you also for the beautiful flowers. It was such a nice surprise to come home to and find them sitting in front of my door. Bitter-sweet but nice to know that we were all in this together.


We are so thankful that Western Veterinary is in Calgary and that Dr. Mauldin, Catherine, Cindy, Julie and the whole WONDERFUL TEAM work there. You guys are totally awesome and we love you all very very much.


Barb and Alex


& “Jack” (who will always be in ALL our hearts)

Jack, being camera shy

Jack, being camera shy

Posted in Family Stories, Rabbits, Radiation Therapy, Thymoma | Leave a comment

What is a Board Certified Oncologist?

Confused about what is required to be board certified in a veterinary specialty?  This video looks at what is required to become certified in either radiation or medical oncology.  These are 2 completely different specialties, and require different post-doctoral training to achieve.


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Radiation Therapy for Lymphoma

There has been a lot of confusion concerning the utility of radiation therapy, a localized treatment, to treat canine multicentric lymphoma, a systemic disease.  While the mantra is typically “use localized therapies to treat localized diseases, and systemic therapies to treat systemic diseases”, this may be an instance where we need to break away from dogma.

There’s no doubt that early efforts to incorporate radiation therapy into the treatment of canine lymphoma were unimpressive.  However, these protocols were usually used as rescue attempts – treating patients who had failed chemotherapy, and come out of remission.  In this setting, it’s not surprising that radiation therapy had a less than stellar showing.

However, the oncologists at the Western Veterinary Cancer Centre have become convinced that radiation therapy can have an important role to play in treating canine lymphoma patients, as long as 3 basic rules are followed:

  1. The radiation is delivered in a low-dose rate manner.  Radiation delivered in this fashion is very damaging to the cancer cells (lymphocytes), but allows normal tissues to repair the damage and escape a lot of the radiation toxicity seen with older protocols.  Practically speaking, this means that both the bone marrow and GI tract escape a lot of the toxic effects seen with older radiation therapy protocols.
  2. The radiation is used in conjunction with the induction phase of chemotherapy.  Induction is the phase of chemotherapy where we are pushing our hardest, trying to get a patient into remission.
  3. The patient is in clinical remission when the radiation is delivered.

The general idea behind combining chemotherapy and radiation as part of the induction process is based on the fact that these 2 forms of cancer therapy have very different mechanisms of action.  So, in theory, a cancer cell that has become resistant to chemotherapy will not be resistant to the effects of radiation.

Typical induction for canine lymphoma involves a cycle of several drugs.  Drug A is administered and kills all of the cancer cells sensitive to it, but leaves behind a population of Drug A resistant cancer cells.  So we follow up with Drug B, which kills all of the Drug B sensitive cells, but leaves behind a population of Drug AB resistant cells.  Finally, Drug C is given, with similar results and now we have a surviving population of cancer cells that is resistant to Drug ABC – all of the drugs in our protocol.  Therefore, even though our patient appears to be in remission, we know that somewhere in their body there is a population of cancer cells that is resistant to all of the drugs we are using.  It’s a small population at first – but over months-years it will become the dominant cancer population in the body, and consist of cells refractory to many chemotherapy agents.  That’s where radiation comes into play.  We use radiation, which is not affected by the drug resistant nature of the remaining cancer cells, to try and cure our patient.  We know, of course, that cure is a pretty high bar for this disease – that there will probably be a few surviving Drug ABC+Radiation resistant cells.  However, anything we can do to safely decrease the amount of cancer cells in our patient should directly translate into improved tumor control and, hopefully, survival.

Our protocol is derived from the work described in this abstract.  We have treated 15 dogs with chemo+LDRI over the past 16 months.  To date, none of these dogs have failed remission.

From the abstract:


The median 1st remission was 410 days (95% confidence interval [CI] 241-803 days). The 1-, 2-, and 3-year 1st remission rates were 54, 42, and 31%. The median overall survival was 684 days (95% CI 334-1,223 days). The 1-, 2-, and 3-year survival rates were 66, 47, and 44%.


Results of this study suggest that treatment intensification by a 2-week interradiation treatment interval coupled with interradiation chemotherapy is an effective treatment for dogs with lymphoma.


These are amazing numbers.  The median survival time for dogs treated only with the chemotherapy protocol used in this study is about 360 days, with a 3 year surviving population of 10%.  Compare that to the chemo+LDRI group where the median survival is 684 days, and the chance of 3 year survival is 44% – over 4 times what we achieve with chemotherapy alone.  From our perspective, this is ample reason to offer a Chemo+LDRI treatment option to families caring for dogs with lymphoma.

Combining chemotherapy and radiation can be dangerous, and the protocol requires a lot of logistical manipulation to be sure that both the radiation and the chemotherapy are administered in a safe and effective way.  Ideally, this therapy should be under the direct supervision of an oncologic specialist – preferably both a medical and radiation oncologist.  There are many decisions that have to be made regarding the safety of drug administration, timing of the radiation therapy, and blood test parameters that are safe for therapy.   There is a fairly steep learning curve with this kind of combination approach – we still feel as if we are learning new things about this protocol after 16 months of using it.

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What is Radiation Therapy?

A brief introduction to some of the basics concepts pertaining to radiation therapy.  If you are looking for more detailed information on stereotactic radiation therapy (SRT), then look here.

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What is Chemotherapy?

A brief introduction to the concept of treating veterinary patients with chemotherapy.


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Stereotactic Radiation Therapy

Stereotactic radiation therapy (SRT) is a newer form of cancer therapy for veterinary cancer patients. This video discusses some of the logistical and theoretical aspects of this form of radiation therapy.

Warning: This video contains actual patient photos. If you will find this upsetting, it would be best not to watch.

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How Common is Cancer in Animals?

This is a fairly common question that we get asked.  Below is a little video discussing the incidence of cancer in pet animals.  The short answer is: “unfortunately, fairly common”.

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What is Cancer?

A brief introduction into the concepts of benign and malignant cancers.

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Demystifying Basic Cancer Terminology

A lot of the terminology surrounding cancer diagnosis and treatment can be confusing and a bit frightening.  This video is intended to address some of the basic concepts you will encounter when you have a pet diagnosed with cancer.  This is the long version (about 25 minutes).  I will post shorter clips dealing with each of the concepts covered separately.

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Western Veterinary Cancer Centre on Shaw TV

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