Brain Tumors in Dogs

DISCLAIMER: I'm not a vet and I have no veterinary or medical background whatsoever. This information on brain tumors in dogs is not meant as a substitute or replacement for veterinary advice. It's meant for educational and informational purposes only, as a starting point for discussing the diagnosis and treatment of canine liver disease with a qualified vet.

Symptoms and Diagnosis

Symptoms of a brain tumor can include:

• Behavioral changes, such as increased aggression or confusion;
• Seizures;
• Diminishing vision;
• Hearing loss;
• Persistent circling (in one direction);
• A head tilt (on one side);
• Ability to turn only in one direction (left or right);
• Difficulty walking or standing;
• Hypersensitivity to pain;
• Eating from one side of the bowl only.

Dogs won't necessarily have all symptoms. Seizures are commonly reported, but Timber never had them. Some symptoms can be indicative of other medical conditions.

A definitive diagnosis of a brain tumor requires an MRI scan. It's probably safe to say that most pet owners don't proceed with an MRI due to the difficulty in accessing this medical procedure, as well as the significant cost. Brain tumors in dogs are often diagnosed by the vet based on a physical assessment, various tests to rule out other conditions, and the owner's observations.

We don't have access to an MRI where we live. Even if we did, my beautiful Timber had a significant heart murmur and I wouldn't have been willing to risk putting him under anesthesia for the test. It's hard not having a definitive diagnosis but at the same time, we have to ask ourselves if the test is worth the risk. A vet I very much respect once said to me, if the results of the test wouldn't change how you treated your dog, then is it worth doing? In Timber's case, he was already old with other medical conditions; we would not have pursued any other treatment other than supportive care (more on that below).

Your vet can run bloodwork and xrays to rule out other conditions that could cause one or more of the same symptoms. Along with your observations and a physical exam, the vet may be able to tell you whether or not he believes your dog likely has a brain tumor.

What I First Noticed

Behavioral Changes

Hindsight is often 20/20. The first behavioral change I noticed was that Timber started becoming a little hesitant to approach other dogs. He used to love giving a quick greeting before running off to do his own thing... but he began stopping in his tracks to look at the dog first, then would tentatively approach, saw hi, and then off he'd go. I figured his eyesight was failing and his arthritis was getting worse (both of which were true) so perhaps he wasn't as interested in other dogs anymore.

The second thing I noticed was this weird thing where he started eating only from one side of his bowl. Once he was finished all the food on that side, he'd wander off - unless I rotated the bowl for him, then he'd eat all the rest too. He was never a "food hound" so I figured it was just another finicky quirk of his, and he was off to do something more interesting.

The third behavioral change was that he'd became a little reluctant to sit or lie down in the car. Timber had always been such a great traveler; he'd promptly lie down and relax, so quiet that it would have been easy to forget he was even there. I thought that perhaps his worsening arthritis was making it harder for him to get comfortable in the car, so he preferred to stand.

All of these changes happened within perhaps 3 to 4 months.

Head Tilt

Timber, like many dogs, liked to sleep on his side with his head hanging over the edge of his bed. He was doing just this one evening when he woke up. He stood up and was noticeably leaning to his right side. His head was tilted in the same direction - so much so, that the lower ear was pointed at the ground at a 45 degree angle.

Timber came to us with very bad skin & coat, as well as ear issues that took many months to mostly resolve (and would recur intermittently). "Brain tumor" wasn't something that crossed my mind when I saw his head tilt; I thought his ear was bothering him again. So I cleaned it, every day.

When Timber's head tilt first appeared, his appetite started to wane. He was never a good eater to begin with so this was concerning but not unusual. I was able to coax him into eating a reasonable amount, as long as I hand-fed him. His appetite got better every day so I thought that the ear cleaning was helping him. His head-tilt got less and less pronounced, but was still there.

Eventually, he stopped improving. That's when I started wondering if maybe it was something more serious. Off to the vet we went. The vet suggested that he might have a middle-ear infection. He mentioned other causes as vestibular disease (our previous old dog had this, and this wasn't the same), a stroke, or a brain tumor.

Not particularly worried, we went home with a course of antibiotics. Timber didn't get better, though; he actually got a little bit worse. That's when the vet started leaning towards the possibility of a brain tumor, based on:

• With vestibular disease, Timber should have been steadily improving;
• With a middle ear infection, the antibiotics should have caused him to get better;
• With a stroke, he would have stayed the same or gradually started improving;
• So, with his symptoms, that left a brain tumor as the probable cause.

Treatment Options

As expected, there are the usual options for treating cancer: surgery, chemotherapy, radiation, and medical / supportive (palliative) treatment. I won't go into the details of each here; you can find more information about them here.

Here are some things to consider when deciding on a course of treatment:

• Likelihood of success:
  What's the probability that the tumor can be successfully treated (or removed), and your dog can have a good quality of life afterwards? Tumors can be extremely variable.

• Side effects and quality of life:
  Reactions to treatment(s) vary from dog to dog. Some dogs tolerant treatment very well and recover relatively quickly; others struggle. In some cases, it's not necessarily the treatment that can affect the dog's quality of life - it can be the simple act of taking him to the vet! The vet clinic can be a stressful place for some dogs, especially when coupled with being poked and prodded. Sometimes it's more of a kindness to simply provide palliative or supportive care.

• Chance of recurrence:
  What if the likelihood of the tumor returning is high - would it be worth the stress to the dog, or the cost to the owner? I know it sounds callous to talk about cost when considering medical treatment, but it is a reality of life.

• How much extra time it'll get your dog:
  What if your dog had to undergo months of treatment, only to get him an extra 6 months? Would it fair to him to get him treated?

• Other health conditions:
  If your dog is older, then he or she may have additional medical conditions to take into consideration. Treatment for the brain tumor may buy him extra time - but how much extra, and at what cost? The brain tumor may be treated successfully, but your dog's other health issues may still put your dog's quality of life in question, regardless of the brain tumor. Treatment for the brain tumor may worsen your dog's other medical conditions and/or make his life more difficult. It becomes a matter of weighing whether or not the likelihood of him feeling better, and for how long, is worth the risk and the expense.

I chose to take the palliative treatment route for Timber. He was already nearing the end of his natural life, so even if any of the other options were viable for him, he likely wouldn't have lived much longer. That said, he wasn't a candidate anyways due to a severe heart murmur and spondylosis. I didn't want him to endure vet visit after vet visit, and the side effects and recovery time after treatment. I wanted him to end his life happy, at home, enjoying lots of walks and treats ... even if his life was shorter.

Prognosis

Unfortunately, the prognosis for dogs diagnosed with brain tumors is generally poor. It depends on the type of tumor, treatment, and whether metastasis has occurred. Here's a good medical write-up about brain cancer in dogs. It seems that a prognosis of weeks to months is common, although some dogs can live a year or more with treatment.

In Timber's case, he had a good quality of life for about 2.5 months after he was diagnosed with the brain tumor. Other, non-specific symptoms had been seen a few months earlier but I hadn't connected them at that time with anything out of the ordinary.

How to Help a Dog With a Brain Tumor

I revamped the house a bit to help make Timber's life easier and to help keep him safe. Here are the things I found the most effective:

• Cover hard / slippery floors. Timber's sense of balance was affected by the head tilt and his vision was failing. He would often slip on the hard floors so I put down non-slip rugs (and rug-runners, which are cheaper especially if you have lots of floor to cover). Carpeted stair treads provided much more traction on stairs.

• Be prepared for accidents in the house. Timber never lost his mind; he was well aware that he wasn't supposed to go in the house. That said, he had a lot of accidents - the steroids he took to reduce the swelling in his brain made him drink a lot more, which meant he also had to pee a lot more. Plus he also wasn't always able to completely void his bladder when he did go, since his hind end was so much weaker and he couldn't maintain the posture long enough.

  Cover the areas your dog spends the most time in with waterproof drop cloths or something similar. You can get re-usable / re-washable dog incontinence pads as well (or just use the human version, which are often cheaper). I also kept a stash of disposable incontinence pads too. Although they're more expensive since you can't re-use them, they helped to maintain my sanity when doing yet another load of laundry just felt overwhelming.

  My arsenal of cleaning supplies also included:

  • A carpet cleaner. The one I have is the BISSELL ProHeat 2X Lift Off Pet Carpet Washer and Shampooer. I keep the 'Lift-Off' portion constantly stocked with a diluted vinegar solution. I'm fortunate that I work from home; if I wasn't quick enough to get Timber out the door and he had an accident, I immediately sucked up as much urine as possible with the carpet cleaner. When no more was being sucked up, I then cleaned the rug.

  • A cleaning solution. I find that any type of soapy or sudsy cleaning solution ends up attracting more dirt and I have to clean more often. I use only plain white vinegar solution first, liberally spraying and rinsing the stain two or three times (and sucking up the liquid each time), before rinsing a final time with just plain cool water. Do NOT use hot water or the stain may set. After sucking up the water, I sprinkle with baking soda to neutralize the odor and vacuum it up once the baking soda is dry.

    I've been able to handle most stains this way. If need be, I follow it up with Folex carpet cleaner - I spray it on, leave for up to 20 minutes or so, then use the carpet cleaner to suck it up before rinsing.

• Use an assistive harness. Stairs can become difficult to navigate if the dog is already off-balance or is having vision problems. A simple mis-step can result in a torn ligament which can make walking even harder as well as painful. Be safe, rather than sorry.

• Gate off the staircases. It's a scary thing to see your wobbly dog wobbling precariously close to the staircase. Avoid a disaster by gating it off, and keeping the gate closed all the time unless you're there to supervise.

  It may sound silly, but I found this one thing difficult to handle emotionally. Timber always followed me everywhere. It wasn't practical to get his harness and help him up and down the stairs all day long, so many times I had to keep him safely gated while I quickly did whatever I had to do. I ended up moving a lot of stuff up to the same level of the house Timber normally hung out, so that I didn't have to leave him as often. That way he still felt engaged and close to me.

• Raise food and water bowls. Wobbly dogs find it harder to access their bowls, especially when they're low to the ground. Place bowls on a raised platform - it doesn't have to be fancy, just sturdy (I used plastic storage bins that I already had in the house). I placed a towel on top of the platform to soak up drips, and place the bowl on top of the towel.

  Note: dogs who are prone to bloat, a life-threatening condition, aren't supposed to eat or drink from elevated platforms. Ask your vet for advice.

• Put multiple water bowls around the house. Many dogs with brain tumors will pace restlessly. Combine that with weak hind legs and possible increased thirst from medications, water bowls in areas your dog spends a lot of time will make it easier for him to access when he needs it.

• Turn on a light at night. In Timber's case, he started losing his vision. More light helped him see better and feel more secure. I used a lamp with a dimmer switch so that I could flood the room with a soft light, making it easier for him to see yet not so bright that it would make it hard for him to get a good sleep. Make sure cords are out of the way to prevent a tripping hazard.

• Remove obstacles along frequently used paths. Timber tended to make right turns only (he could turn to the left, but with great effort). So along the paths he normally took through the house and yard, I made sure that he wasn't going to bump into anything dangerous or be blocked by an obstacle if he made a turn to the right.

• In winter, shovel pathways around the yard and cover them with sand or volcanic mineral for traction. Spread generously to prevent slips and falls that could result in a painful injury for your dog. Pay extra attention to any slopes or curves. You may need to re-apply the traction material periodically to keep the pathways safe.

When to Euthanize

Deciding when to euthanize is never easy, and rarely is it a clear choice. All the usual considerations of when to euthanize come into play - is there pain that cannot be managed? Does your dog still enjoy his usual activities? What is the prognosis? How is the disease expected to progress?

Euthanasia is a very personal choice. I can't tell anyone when the right time would be, but perhaps it will help to read my experience.

Discomfort and Pain

Apparently dogs with brain tumors "may" experience headaches, as well as pain from other sources. I don't know if Timber did; he was on pain meds ever since we adopted him as a senior, due to severe spondylosis. I gave him a higher dosage of pain meds in the end (with the vet's blessing), just to try to be sure he wasn't experiencing pain.

Timber had taken Cannabidiol (CBD) oil for a while (read more about CBD use in dogs here). It worked amazingly well for pain control for his spondylosis - far better, and without side effects, then all the pharmaceuticals he was taking. I continued to give it to him when he had his brain tumor, and in higher doses. Honestly, I can't say whether or not it had any effect on the brain tumor but at least it helped to minimize any pain he was feeling.

I am not one of those people who scoffs at western medicine. In fact, I think it has helped a huge number of people and pets and firmly has its place in health care. That said, we all know that each of us is an individual and our bodies all react differently to various substances. My dog was prescribed Tramadol for pain (which made him crazy anxious), as well as Gabapentin (which made him very weak in the hindquarters), and of course Metacam (which had no effect on pain control, but made him lose his appetite).

After a couple of weeks on CBD oil, Timber was able to drop all of the pharmaceuticals. He was much more comfortable. I wouldn't have believed it but I saw it with my own eyes. After that he only took the pharmaceuticals if he was having a hard day and needed a little extra. Interestingly, he seemed to be better able to tolerate the drugs so long as he was also taking CBD oil too.

Talk to your vet if you are interested in giving your dog CBD oil. Not all vets are familiar with it and many are reluctant to give their blessing. You may need to consult with more than one.

Interest in Life

One night, I could hear Timber pacing around trying to get settled. He'd go to one bed, lie down for 30 minutes or so, then get up again and try with a different bed. I got up to sit with him. As I watched him pace, all I could think was, it's time - until he looked up at me, eyes bright and alert. I sighed, and thought, it's not quite time yet.

His interest in what I was doing, where I was going, where we were going for a walk, when we were going for ANOTHER walk ... all that stuff still interested him. Life was unquestioningly more difficult - but it was clear that he wasn't ready to go yet.

Ability to Enjoy His Favorite Activities

Many of the symptoms of a brain tumor in dogs can have a significant impact on a dog's enjoyment of life. If your dog struggles to stay upright, to walk, and to eliminate, or repeatedly has seizures (which can be frightening and confusing for him) .. you have to ask yourself what kind of quality of life he has.

Early on, shortly after his diagnosis, Timber was holding one back leg up off the floor - but only when he was inside. When he went for a walk - which he was always game to do! - he used that leg just fine. It was baffling. I mentioned it to our vet, who said that brain tumors can cause dogs to do weird stuff. If the leg works outside, it should work inside, too. The vet examined the leg and said he didn't believe that it was painful in any way. So I continued to walk Timber, and he continued to eagerly head to the door every time he thought there was a chance of a walk.

Timber loved to walk. He was one of those dogs who could run for days if we let him! His running was beautiful and effortless, despite his advanced age. When his head tilt was at its worst, he could barely stand up - I had decided to let him go in peace if we couldn't resolve that head tilt. I was lucky to get about 2.5 extra months with him where the tilt was minimal ... but once all the medications stopped working, I had to face the heartbreaking fact that he would not be able to live a life that was meaningful to him.

Caregiver Fatigue

Timber, before the brain tumor, was an easy dog: gentle, kind, calm, happy with several hours of hiking each day, a few blissful sleeps on comfy beds, with playtime and kisses thrown in. After diagnosis, caring for him became much more complicated - hand-feeding (because his appetite waned even further, plus his loss of vision), cleaning up after accidents, doing lots of laundry, re-configuring the home and yard to keep him safe, and so on. There were moments where I was exhausted and would have to go take a break (usually a nap).

While I think most of us would like to say that we could care for our pets forever ... I also think that most of us know, deep down, that isn't true. Perhaps we could, in a fashion, continue to offer care ... but unless we are feeling well - mentally, emotionally, and physically - it's very difficult to provide the best of care to our pets. Pets are intuitive and can sense when we're stressed ... they love us, and surely don't want to be the cause of our stress! Nor would we want them to feel like they are. It can be a hard thing to accept, but caregiver fatigue or burnout is a very real and common issue.

In Timber's case, I didn't get to the point where I was completely burnt-out; his medication simply stopped working one day and I knew it was time. His head-tilt returned, badly, and prevented him from being able to easily stand up straight, let alone go on his much-loved walks. I spoiled him rotten for a few days, then let my beautiful, gentle old boy go peacefully at home, on his favorite bed.