A cancer diagnosis for a beloved pet can be an overwhelming experience for pet owners. As general practitioners, you are often the first point of contact, the ones delivering the news and helping families navigate their options. Although all cancer cases may benefit from referral to a specialist, some are more critically time sensitive than others. Additionally, referring the client to the right specialist can significantly affect the pet’s outcome.
The veterinary profession is already stretched thin, with demand for services far outweighing supply. General practitioners (GPs), you should be empowered to feel confident in your role as a patient’s primary veterinarian while acknowledging what you know, recognizing where additional expertise is needed, and understanding that guiding pet owners through this journey is as much about communication as it is about medicine.
Challenges facing the GP
The reality is that GPs manage diverse cases, from dermatology to cardiology, orthopedics, and behavior. Expecting any GP to be fully up to date on every cancer treatment is unrealistic.
Some pet owners may have researched their pet’s specific cancer more thoroughly than their primary care veterinarian has had time to, and that is not a failure; it is simply the nature of modern veterinary medicine and the information age in which we live.
One of the biggest challenges facing GPs is knowing when and where to refer. Sending a case to the wrong specialist or delaying a necessary referral can negatively affect the patient’s outcome. For example, suppose a patient with a soft tissue sarcoma is sent to a medical oncologist instead of a surgical or radiation oncologist. In that case, 2 months might be lost waiting for an appointment, time that could have been used for definitive treatment.
Additionally, access to specialists is a growing concern. Medical oncologists often have long appointment wait times. With fewer than 150 active diplomats certified in veterinary radiation oncology by the American College of Veterinary Radiology,1 pet owners may need to travel significant distances for treatment, making early decision-making even more critical.
Top hurdles pet owners face after a cancer diagnosis
Reasons to Prep Your Patients Prior to a Cancer Referral
- Every day counts and the sooner the patient can be prepped, the quicker they can make treatment decisions.
- In addition to getting more information faster, your patient will appreciate spending less time and money on consults that they may need from other local specialists.
- Your office benefits from providing care in-house, you stay involved in your patient's treatment journey and it helps strengthen the relationship you have with your client and patient.
- The specialty clinic can work faster at providing treatment options when they receive a pet who has already been diagnosed and worked up.
For pet owners, the cancer journey is not just a medical one; it is emotional, financial, and logistical. Some of the biggest challenges pet owners face include the following:
Access to specialty care: Finding an oncologist, especially for radiation therapy,
can be challenging. Treatments such as stereotactic radiation therapy have gained popularity because of their shorter treatment timelines (3-5 days vs weeks of daily conventionally fractionated radiotherapy).
• Understanding treatment options: Many pet owners struggle with risk vs benefit decisions. They need clear, unbiased information from specialists who handle these cases daily.
• Fear of anesthesia: Owners often worry about anesthetic risks, but it is crucial to help them understand that without treatment, their pet will die from the disease. The risk of a negative outcome from anesthesia is less than 1%.2 We must reframe the conversation to address the real risk: doing nothing.
• Social and emotional pressures: Pet owners often hear conflicting opinions from friends, family, and coworkers: “Why would you spend $10,000 treating a dog?”, “Isn’t it cruel to put them through this?”, and “Are you doing this for them or for you?” It is important to convey to pet owners that it does not matter what
others believe but what the owner believes. Ultimately, the pet owner must be comfortable with the risk-benefit analysis and prognosis for the pet.
• Financial strain: Veterinary oncology treatment can be costly. A 3-day radiation treatment might cost $12,000 and be due in a single payment 3 days after treatment was started. Although chemotherapy, a longer treatment process, can be even more costly, the payments are spread out over months rather than days. Pet insurance can be a game changer for those who have it, but less than 4% of the dogs and cats in the US are insured.3 Therefore, pet owners should consider how paying for treatment will affect their lives before agreeing to treat.
• Existential struggle: Many owners ask, “Am I crazy for treating my pet?” Some need reassurance that their decision is valid, whether they choose aggressive treatment or palliative care. Our job is to guide, not judge.
• Information overload: Cancer treatments are evolving rapidly, and many GPs are unaware of the latest treatment options. Rather than feeling overwhelmed, the key is knowing when and whom to ask for help.
• Time commitment and logistics: Chemotherapy and radiation may require frequent visits, long-distance travel, or weeks of commitment, making treatment unfeasible for some families.
Setting expectations: What pet owners want from their primary veterinarian
GPs are in a challenging but powerful position. Clients expect you to:
• Be honest about what you know (and do not know): You do not have to know everything, but you should know where to find the right answers. It is OK to say, “I don’t know, but I know who will have clear answers.”
• Provide a clear path forward: Cancer is overwhelming. Pet owners look to you for the next steps, not just a diagnosis. Knowing when to refer and which specialist is the right one is critical.
• Present options nonjudgmentally: Your clients want to know that you will support their decisions, whether they choose aggressive treatment, palliative care, or no treatment at all. They fear being judged for whatever decision they make.
• Communicate urgency where it matters: Some cancers, such as lymphoma, progress rapidly. If treatment is delayed, a pet who could live 12 to 18 months with treatment may only have weeks left.4 This again underscores the importance of referring to the right type of specialist.
• Offer emotional support: The way you present the diagnosis sets the tone. Clients need to feel that they have a trusted guide through the journey.
• Help them understand why: Most owners do not just want to know what to do next—they want to understand why a treatment is or is not recommended. If your client has information that is new to you, let them know that you will research it or put them in touch with someone with more expertise in that area.
Takeaway
Veterinary GPs play a critical role in a pet’s cancer journey—not just in initial diagnosis and referral but also in guiding families through an emotional and sometimes overwhelming process. You do not need to be an oncology expert to effectively advocate for your patients. What matters most is ensuring they reach the right specialist at the right time, presenting options without judgment, and helping them make informed, compassionate choices.
Whenever possible, initiating a basic diagnostic workup, such as cytology, baseline laboratory work, or imaging, can help expedite the referral process and improve patient outcomes. Even small steps taken in advance can significantly affect how quickly a specialist can act on the case. That said, not every situation allows for it, and that is OK—the most important step is getting the patient to the right specialist without delay.
Cancer does not wait. Neither should we.
REFERENCES
- History of ACVR. American College of Veterinary Radiology. Accessed May 5, 2025. https://acvr.org/who-we-are/history-acvr/
- Brodbelt DC, Blissitt KJ, Hammond RA, et al. The risk of death: the confidential enquiry into perioperative small animal fatalities. Vet Anaesth Analg. 2008;35(5):365-373. doi:10.1111/j.1467-2995.2008.00397.x
- North American Pet Health Insurance Association State of the Industry Report 2024. North American Pet Health Insurance Association. April 9, 2024. Accessed May 5, 2025. https://naphia.org/wp-content/uploads/2024/04/NAPHIA-SOI2024-Report-Highlights_Public-May16.pdf
- Vail DM, Pinkerton ME, Young KM. Canine lymphoma and lymphoid leukemias. In: Vail DM, Thamm DH, Liptak JM, eds. Withrow and MacEwen’s Small Animal Clinical Oncology. 6th ed. Elsevier; 2019:688-715.
