Examining an innovative treatment option for chemotherapy-induced canine diarrhea


Boarded oncologist Dr Sue Ettinger discusses her in-clinic experience with the new drug

Content sponsored by Jaguar Health

Oncology is a rapidly evolving field in veterinary medicine, and recent studies have demonstrated the demand for improved cancer drugs and related therapies. In the US alone, 30 million pet owners had a dog diagnosed with cancer in the last 10 years,1 and approximately 1 of every 3 dog owners said having a pet with cancer had a heavily negative impact on their quality of life.1 What’s more, the results of another study showed that 68% of pet owners decided not to treat their pet with cancer because of factors such as age, treatment cost, and adverse effects of treatment.2 Sue Ettinger, DVM, DACVIM (Oncology), joined a recent episode ofdvm360 Live!™ to address the state of veterinary oncology, discuss a drug for treating chemotherapy-induced diarrhea in dogs, and explore what’s on the horizon for oncology research.

What is Canalevia-CA1®?

Crofelemer delayed-release tablets (Canalevia- CA1) are conditionally approved by the FDA for chemotherapy-induced diarrhea in dogs and can be prescribed by general practitioners. Ettinger explained to host, and dvm360® chief veterinary officer, Adam Christman, DVM, MBA, “It’s locally acting and it’s an antisecretory drug, so it works on the chloride channels to restore water balance, so they don’t have that watery diarrhea.”

Ettinger also commented that she appreciates that it is a natural and organic product. The drug is made from sap harvested from the Croton lechleri tree, which grows in rainforests in South America. Ettinger said, “Jaguar…Health is working to sustainably grow this and working with the indigenous people there to plant new trees. I think 2 new trees are planted for every tree that’s harvested for the sap, so it [is] really, really cool.”

Putting it into practice

In the following segment of dvm360 Live!™, Ettinger and Christman were joined by pet parent Christian Nahas and his dog Sambuca. Ettinger explained that Sambuca had been diagnosed with an intrapelvic sarcoma. She called it a “high-grade tumor” that was “pretty aggressive.” After determining that the tumor was nonsurgical, Sambuca received stereotactic radiation therapy, followed by chemotherapy to prevent metastasis. The tumor has since decreased by 55%, Ettinger said.

Nahas explained how the chemotherapy caused bouts of diarrhea for Sambuca. Ettinger then prescribed Canalevia-CA1, which was given to Sambuca over the course of 3 days. Nahas said, “Every time we gave it to her…her stool improved. Whatever that does, it works.” He added that he noticed results the day following the first dose.

Take C.H.A.R.G.E. Registry and Canine Cancer Care Index

In addition to new drugs in the oncology domain, Ettinger spoke passionately about recent and upcoming research she hopes will give the veterinary profession a broader perspective on canine cancer in the future. She began with the Take C.H.A.R.G.E. (Canine Health and ReGistry Exchange) initiative. “What we’ve been missing in veterinary oncology and veterinary medicine is a registry to be able to know how many cancer cases are out there in dogs,” said Ettinger. “[This initiative is] starting to compile medical records state by state, so we can look at age, breed, gender, and the different cancers and really start to know how many cancers there are in our pets.” The index started with a retrospective review of 35,900 anonymous canine patient records and 830 confirmed cancer cases. The database continues to grow as clinics and pet parents upload new cases, according to the official website. Ettinger said that the patient data is anonymized for privacy and that clinics can easily sign up to contribute online.

Explaining 1 of the interesting initial takeaways from the index, Ettinger said, “They looked at the incidence, the newly diagnosed cancer cases in dogs vs. people, and this going to kind of blow your mind: It was 2.8% in dogs and 0.57% in [humans].” She continued, “People do feel like, is there more cancer being diagnosed in pets? And that’s exactly why we need this registry, so we can break that down and unpack it much more.”

As to the importance of compiling such data, Ettinger summed it up, saying, “I know cancer is scary, but information is power.”


  1. Clouet B, Maese E. Taking charge of canine cancer. Gallup. August 10, 2022. Accessed August 18, 2022. https://www.gallup.com/analytics/395981/taking-charge-canine-cancer.aspx
  2. Gallup survey of dog owners. Jaguar Health Canine Cancer: Take C.H.A.R.G.E. Accessed May 24, 2022. https://takechargeregistry.com/about
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