Dr. Angie Krause (00:00)
Welcome back to Tails of Truth where we tell the truth about veterinary medicine. I'm Dr. Angie and this is my co-host and veterinary nurse extraordinaire Jojo. And today we are joined by Dr. Brooke Fowler, a veterinary oncologist here in Boulder and a personal friend of mine who I probably text at least once a week about a case. And you always respond. You always respond. You're always there for me. Thank you so much.

Brooke (00:23)
with that.

JoJo (00:24)
Hahaha

Brooke (00:26)
It's

easy to text when I can send you like five words back. And I'm like, at red light, yes, please treat. And it's easy, you make it easy.

Dr. Angie Krause (00:33)
Yes,

totally.

JoJo (00:38)
We just discussed that Dr. Angie's texts are so short that I'm like, is she mad?

Dr. Angie Krause (00:40)
Ahem.

Brooke (00:45)
You have to, you can only do that with your people. Otherwise people think you're pissed all the time. And I'm really just trying to text out a red light, which is super not okay for anybody who's listening. I'm not condoning it, but I do it.

Dr. Angie Krause (00:47)
Yes.

JoJo (00:47)
Yeah.

Dr. Angie Krause (00:57)
Yes. Yeah, Brooke and I will text like three words. Yes, that's good. And then we know we're not mad at each other because I'm literally in the room with a patient and she's at the red light. It's fine. We get the information we need. So thanks for joining us because we want to talk about all things veterinary oncology today.

Brooke (00:57)
⁓ there you go. Yep. No.

Totally fine.

very happy to be here. Thanks for having me. This is fun.

Dr. Angie Krause (01:18)
And I,

good, I wanna start by asking you why dogs and cats get cancer. Brooke, tell me, because this is the first thing people wanna know. Is it something I did? I'm sure you get this too. I did this. It was a vaccine of food and EMF, you know, wherever, pollution, genetic. Yeah.

Brooke (01:26)
Ooh.

huh. Yup. Totally.

Yeah.

The answer is multifactorial, of course, right? Like

there's not a great answer, but I'm going to tell you what I tell people when they ask me. Of course there's environmental things that we're exposed to the same things. There's been some studies on and off about lawn pesticides and then they say it does, and then they say it doesn't. Like we're all living in the same carcinogens, the same radon, the same things.

The good news is your pets don't smoke cigarettes and get sunburns. So perhaps their exposure is mildly better than ours. But it's overall nothing people are doing or not doing. I know there's a lot of hullabaloo about the food. Is it the food? Is it the food? And the answer is honestly, we don't know, right? Maybe. I'm willing to acknowledge it's a possibility. We don't know. There are some lovely, lovely, very nerdy studies that have gone to look at some of the genetics.

specifically Boston Terriers and a particular brain tumor called a glioma. And basically they went back and tried to genetically dissect like where in the line could we re-breed things so that this doesn't happen. And they essentially figured out that in order to not have gliomas as part of Boston Terriers, we need to not have Boston Terriers. And it sort of begs the point, like once we decided to do this genetic bottleneck thing and breed for

Dr. Angie Krause (02:51)
⁓ wow.

Brooke (02:57)
pretty colors and merles and blue eyes, color dilutions. I see a lot of cancer in color dilutions, but the Harlequin Danes, yes, because we're breeding for a phenotype for how things look. And it ends up coming with the sidecar of other things. Golden Retrievers, Bernese Mountain Dogs, these are inherent in breeds and there's studies that show it is genetically built into some of those breeds. And so yes, people go into breeders and they try to find breeds that don't have them.

Dr. Angie Krause (03:04)
⁓

Brooke (03:27)
It's challenging, it's tricky. And that's by the way, not to say that I see plenty of mutts with cancer too. So it's not just that. And I think the other part is cancer is inherently part of our story and their story. It's what happens, it's called Immunosenescence As the immune system starts to wane and our ability to check the DNA, you go get a sunburn, right? And your skin's gonna peel afterwards. And what is happening is your body is going, okay, like all of this DNA, no, sun, bad, off.

Dr. Angie Krause (03:33)
Mm-hmm.

Brooke (03:55)
and you shed, right? You peel. What happens is you age is your DNA gets worse at that. And there's some genetic things that people carry. You've probably heard of the BRCA mutation. That is literally a mutation in your DNA proofreading enzymes that does not work. And as we age, that gets worse. So you'll find most cancers happen in 85 and older humans, and it happens in geriatric pets. And it's just a normal part of aging, which sucks, but...

I'm saying this because a lot of people love to blame themselves. ⁓ what did I not feed him? what, we live by power lines or, and the truth is it's none of that. It's a lot of things and really very little has to do with what we're doing to them. That was a really long answer. Are you still here? That was good. Yes, I love being juicy.

Dr. Angie Krause (04:38)
That's gonna be... Yeah, well, it's... It's... good.

JoJo (04:40)
No, it was so good! It was...jeansy! Yeah,

was good!

Dr. Angie Krause (04:45)
I want

everyone to let themselves off the hook. Mostly, like it's okay. It's okay.

Brooke (04:48)
Yes, yes. That is the first

thing. I mean, I am the oncologist and I don't mean to bring the story down, but I went on vacation and my dog died when I was gone. And yes, like that's so sad. We can have like the moment of sadness for that. my point is I am the queen of this and I did not know she was sick until she was sick. You cannot always know. It's not your fault. Crap happens.

Dr. Angie Krause (05:02)
Yeah.

Yeah.

Yeah, you can't know.

Yeah, and we're all gonna die. And I think it's okay to give our dogs and cats permission to die too, which is a controversial thing to say. But in our culture, dying is just seen as a failure. It's not okay.

Brooke (05:27)
And it's not, it's the opposite. Like it's a gift. When you are suffering and you are bad, it is the most selfless thing you can do to another being, a human, a dog, whatever. It's a gift.

Dr. Angie Krause (05:39)
Yes,

absolutely. So we have little control over so much, but what do we have control over for the next dog or the next kitten? What are things that you do for your pets?

Brooke (05:45)
Yes.

Huh, well, I'm a real human. I'm a single mom with currently five dogs. Let's maybe, you know, nobody judged that one. So I guess I'm saying that and I say it to people who end up as my patients and clients. I'm a real person with real limitations. My dogs don't get fed all natural things that I am cooking for them every day of the week. And perhaps that is the best way to do it, but I'm telling you as a real human being.

my dogs get kibble and some kitchen-fed things and some things because that is the best that I can do for those dogs. So I guess what I'm telling you to answer your question in a very circumlocutious way is what I am doing for my dogs is the best that I can do for my dogs. And is that what is ultimately prescribed for perfection and long longevity? I don't know. I don't know that we know what's the best for our dogs. mean, anybody who's listening to this podcast, I would say,

or is coming to see the oncologist you're listening, it's because you care. I think that seems like an arbitrary thing, but like you're already there. Like, you you're not getting Walmart brand dog food. So yes, like a high quality food is probably relevant. Whether that's fresh or not fresh or raw or not raw, I'm sure there's tons of opinions about that, but like.

Dr. Angie Krause (06:58)
Yeah.

Brooke (07:12)
The fact that you're looking into this at this point in time, like you're good. That's like really where the baseline is. And the reason I'm skirting the question is because we don't know. We don't know how to prevent this. There are certain things that show up in certain breeds. know, there are certain breeds maybe you'd avoid, but like I have a golden retriever and they're known for having cancer. is, yes, they are. And there's one right here, like under my feet right now. So. ⁓

JoJo (07:30)
I know, heartbreak. It's like, yeah.

Dr. Angie Krause (07:34)
Yeah.

Brooke (07:40)
I don't know how to answer your question, Angie. I don't know that there is a magic way. Yeah?

JoJo (07:42)
I appreciate the way you answering it, Brooke, because it

Dr. Angie Krause (07:44)
Yeah.

JoJo (07:45)
is,

think we see a lot of people, especially in the holistic realm, who come in and it's so rigid that the human is losing their quality of life in the process of caring for their dog or cat, and then they still get cancer. And it's that moment of like, I thought I did everything right. And they lost part of their own quality of life in the process.

Brooke (07:54)
Yes.

Yes.

Yes.

know, and the guilt, but the guilt that you live in in that time period, you're, you're missing all the joy. And I philosophically, fundamentally, right, like, I see the life of your pet as, like, I see life in general, right? Like you've got, you can't get something that you don't give as a general rule, right? Like,

JoJo (08:07)
Yeah.

Dr. Angie Krause (08:13)
Yeah.

JoJo (08:13)
Uh-huh.

Brooke (08:29)
You get all of the joy from your pet in their life. That's what you get. You get that joy and then you pay for it in the end, right? Because we lose them before we want to. And so if you're screwing up this part by making yourself crazy and they're not doing the right things and my God, I should have been doing this and doing that. You're missing the part that you're getting. Do your best, love your dog, cook for them sometimes, let them eat yummy things. I don't know, just, that's it.

Dr. Angie Krause (08:57)
I totally agree. And after doing integrative medicine and being hired by people that feed raw or home cook or do all the things, I can't say that I see cancer rates in that population be any less. Now there are certain diseases I see less of, see less pancreatitis, I see less ear infections, but beyond that, I don't see less cancer. And I see these people like, I...

Brooke (09:14)
Yes, I believe that.

Dr. Angie Krause (09:22)
I minimally vaccinated, I fed raw, I did all these things and my dog still got lymphoma at seven and it's sad. But I believe you and one thing you said to me several years ago, I think I had just gotten out of like a bad relationship and I sent you these two pugs and I was like, Brooke, I'm gonna adopt these pugs. Should I do it? And you said, you're never gonna regret having more love. And you said, get the dogs, get the love.

Brooke (09:29)
Yep. That's sad.

JoJo (09:48)
I'm

Brooke (09:49)
Yes! Did it work out?

Dr. Angie Krause (09:51)
No, they didn't pick me. They didn't pick me. I don't know. They picked somebody else. It's really hard to get a pug. But I, I've remembered that and it's changed the way I felt about animals and my patients. And I think that the more we can love and the more we can relax. And when people come into my office with their puppies,

Brooke (09:54)
Why? ⁓ that was stupid on their part.

Dr. Angie Krause (10:18)
and they're really uptight because there's definitely, there's this fear that comes from the last dog. And I really just try to say, enjoy your dog. Love this time. Don't let it slip by worrying about feeding the right kibble or the right this or that, because the truth is the difference between one kibble and the next is just not as much as you might think. It's really so small, so small.

Brooke (10:27)
Yes.

with you.

And

fundamentally, one of the things that at least I love the most about dogs. So like I mentioned, there's a golden under my feet, right? when I go to work in the morning, that dog goes to the door and he's like, that's it. I live alone for the rest of my life. This is it. This is it. I'm done. I'm done. And then I come home and he's like, holy crap, you came home. I had no idea you were coming back. This is my best neighbor, right? And so that's the sort of thing I sort of go through clients when we're talking about chemo and I'm like, it has to be good now.

JoJo (10:56)
Hahaha!

Brooke (11:09)
Your dog has no concept of what the future is or what the past is. Today's the day. That's all there is. And that is what we fundamentally love about them. They teach us that we should do it back to them. Why shouldn't we be the same to them that they are to us? They live in the moment. They just enjoy us. It doesn't matter. I mean, you could do anything to your dog and they come back for more. So why are we perseverating over all of the details? They wouldn't want that for us. If they could speak, they would say like, Hey dude, chill out. Let's just snuggle on the couch.

Dr. Angie Krause (11:26)
Yeah.

Brooke (11:39)
That's all they want. That's all you have to do.

Dr. Angie Krause (11:40)
Yeah.

Yes.

JoJo (11:41)
That leads

me to a question. me ask. like two decades ago, I worked in oncology. That's what I did when I came out of school. I imagine, what's, pet. Yeah. Yeah. Yeah. I was an oncology nurse straight out of school in Beverly Hills of all places. So I would see, and I'm sure it's changed back then. People would come in, spend over $10,000 to get five more weeks of life with their animal. And the quality of life was pretty

Brooke (11:48)
Ooh, okay. Human or pet?

Wow.

JoJo (12:11)
pretty crappy. And so how has oncology improved? Like what are people experiencing when they come in now? Maybe it depends on the cancer and the treatment and all of that.

Brooke (12:22)
I do think it does. And I honestly think it really is dependent on the oncologist you're talking to. Like we each bring, it's a scary thing to think about that medicine is actually an art and not a science, but it really has a lot to do with the person who you're speaking to. And you do end up getting opinions, right? So you can do radiation or you can do radiation are the exact same words, but not the exact same meeting. So I think to your point, find a practitioner.

that you fundamentally align with, right? That whose goals are your goals and not just like the science and the textbook and things like that. So that's the first part, right? And there are some oncologists that swing more towards we're gonna do everything and that's what we're taught in medical school, right? To find solutions, right? Angie, isn't your mind always going like, hey, okay, okay, this didn't work. What's the next thing I can think of? What's the next prognosis? And that is how we're trained. ⁓

JoJo (13:09)
Right.

Well, yeah, because you can do that, right? They do that in human medicine too. They know how to cure cancer. But curing cancer doesn't mean you have quality of life and you cause another set of issues a lot of times.

Brooke (13:31)
And so my answer to you, I'm hedging again. I'm sorry, I'm answering nothing directly. There are some people who still do that. And there are some people who show up with that goal. I think most people who show up to talk to me about what we're gonna do for their dogs and their cats come with the notion of, don't want to harm anything. I don't want to harm anything. then we make changes to the same, it's the same stuff, right? It's the same stuff that five week dog got, but.

Maybe I give a lighter dose of chemo to start to make sure you're gonna tolerate it. And these are things that if you ever, anybody who's listening goes to an oncologist, you can arm yourself with these sorts of questions like, where are we gonna start in this treatment regimen? Okay, I agree to do chemo. Where are we gonna start in that dose range? Philosophically, I start at the bottom. Hey, the range is 200 to 300. I'm gonna start you at 200. And if you crush it, let's go to 300 as opposed to the opposite way. Hey, let's back off. You don't feel great.

And I think as we've sort of gone along in the process too, we've developed a lot of things in the middle, right? So there's like this treatment up here, radiation, like totally useful and great. And I am not knocking radiation by the way, ⁓ but it's intense and it's expensive. And there have been some findings, that's not good grammar, but we all know what I meant, ⁓ along the way that have come up with that middle ground. Cause the truth is Jojo, you're right. Most people don't want.

They want something in the middle. They want something that maybe can get us quality for those five weeks or maybe can get us five weeks, but without breaking the bank, that's real, and breaking their pets, because nobody wants to look back on their pet's life and feel like they did wrong by them.

JoJo (15:07)
Mm-hmm.

Dr. Angie Krause (15:13)
That is real.

JoJo (15:13)
Well, and so often we are buying time for ourselves more than the animal. Yeah.

Brooke (15:18)
Yes. Yeah, well, they don't know. I don't think they

know at least. Maybe they do and they're just that much better than we are. They're just so good at everything. But you're right, we're buying time. So it can't be bad time. It can't be because, it can't be. Sorry, I had a thought and then I unthought it then I rethought it again and that's just what you saw. A little tiz up there for everybody.

JoJo (15:36)
haha

Dr. Angie Krause (15:37)
⁓ Well,

let's talk a little bit about some common cancers like a mast cell tumor. Probably a lot of people listening have had a dog with a mast cell tumor and it seems like we have so many more things to do. And isn't there a new drug that's out? Or at least yes. Yeah. Yeah.

Brooke (15:57)
Are we talking about Stelfonta or Gilvetmab Okay, yes.

Listen, we're progressing like humans are progressing. And we tend to ride their coattails. What usually happens is drugs go through dogs and not really cats, more dogs, beagles, right? Laboratory dogs, and then they go into people. And then we don't get access to it because they're expensive. And then eventually it sort of comes back to us when the drugs start to get more.

Dr. Angie Krause (16:13)
Mm-hmm.

Brooke (16:23)
financially available and things like that. So yes, there are drugs out there. Mast cell tumors are super common. They are the most common skin tumor in dogs. There are certain breeds. I say anything that can come in brindle, you know, that like tiger striping for anybody who's listening who doesn't know what brindle is. Anything that comes in brindle is predisposed. Boxers and Boston terriers and pit bulls and things like that. And they do tend to grow them.

there is a huge range in the behavior of those tumors. So I have dogs who've got mast cell tumor sitting on their body and we go to do a dental and the vet goes, ⁓ we should take that mass off while we're there. And it comes back as a mast cell tumor ranging from that to, my gosh, this could grow very quickly and become a problem. And so getting that diagnosis is often incredibly scary because now you're dealing with a tumor. I will say before you panic,

Some of them are very boring and some of them are very aggressive and it just takes a little bit of looking into and usually removing to get a grade to know which one you're working with. And then I don't know, do you want me to delve into the treatments? I don't know how in depth you want me to get with this. Ranging from surgery all the way to bring your question to light, Stelfonta is an injection. You basically inject the mast cell tumors.

Dr. Angie Krause (17:26)
Mm-hmm.

Brooke (17:43)
Statistically speaking, because I speak in statistics when I talk to my clients, about 83 % of mast cell tumors will resolve with one injection alone, which is amazing. The con to that is that when you give this injection, I say to clients, it is like throwing a Molotov cocktail into a tumor. You basically create like a very large necrotic wound that heals over time. it's not a...

and like, it's just a little injection and it goes away. You gotta end up dealing with a wound that closes itself over time. But again, this is exactly JoJo's question. There's a million middle grounds now. We are coming up with more stuff in the middle because we know that surgery works and we know that we can do nothing. And most people are looking for that, intralegional injections of a steroid, a treatment called electro chemotherapy. There's a lot of ways to skin the cat.

as it will.

JoJo (18:36)
Hahaha.

Dr. Angie Krause (18:37)
Okay, I love it. So there's a lot we have to offer and what about with hemangiosarcoma Where are we with that? I hate that so much. Still hate. Yeah.

JoJo (18:44)
Ugh.

Brooke (18:44)
Oof. Yeah, yes, nobody likes hemangioma. I

also don't like hemangiosarcoma We have up to this point made some advances, but they're marginal. Like, hey, if you add, mean, hey, integrative lady, like there's turkey tail mushroom, there's yunnan baiyao there's Chinese herbs. And I would say of all the cancers, that's the one that East and West works nicest together. There's actually studies for both those things. So.

We've made some advances, beta blockers can be useful, but for the most part, we haven't done a lot of things to change that exact timeline. I know that there are some studies ongoing that are looking at some drugs. I honestly have to tell you, I don't exactly know where they are. I think CASE was doing one. I believe CSU was doing one. We're starting to play a little bit more with the immune system.

some of these cancers are starting to come out and be like, I mean, it's because we're following human medicine, right? Human medicine is starting to look at, okay, the immune system allowed this cancer to exist here. How do we now turn around and make the immune system fight? And there's been a lot of not successes in that category, right? Like tumor vaccines and things like that, not super successful, but we are starting, the technology is getting better where we are starting to do things that we are better able to get that immune system. And I think that's where that study is going.

But up till now, my answer is pretty lame. It's the same. We're hopeful. Go ahead.

JoJo (20:10)
Well, I love to hear

that you didn't buy out because back then it was like what that was woo woo and now it seems so mainstream.

Brooke (20:17)
my God, there's like full on in vitro studies in petri dishes, it inhibits hemangiosarcoma cell lines. And so why not? Well, when we're dealing with a cancer with a horrible prognosis, I think the pendulum swings towards why shouldn't we try something as opposed to like, what for sure is it gonna do for us? And so we have some more room to play with some other things when it's not a good prognosis.

Dr. Angie Krause (20:38)
Right.

So if you had a 10 year old dog with a suspected hemangiosarcoma so bleeding in the abdomen, would you remove the spleen?

Brooke (20:49)
Yup. Yup.

Dr. Angie Krause (20:55)
as an oncologist, if it was your dog. Would you do it? Yeah.

Brooke (20:57)
Right? I'm thinking your answer

to your question. So I'm going to tell you both sides to that. So for me, and again, I'm sharing this so people know finances would be an issue. would have a hard time coming up with, you know, $4,000 for a splenectomy or more and the chemo to treat afterwards. And so I'm speaking to that because I know that there's a lot of guilt in those moments where people feel that they should, but maybe cannot. And so...

Dr. Angie Krause (21:15)
Mm-hmm.

Brooke (21:27)
Again, I always say your dog loves you the same way that you love your dog. They would not want you to put yourself in a bad place for them in the same way that you don't want them to put themselves in a bad place for you. So that would be a struggle for me. but the one good thing sort of about this cancer, right? There's not anything good about this cancer is it's not an insidious disease process. So it's not painful. And those dogs live amazing. That you take that spleen out and yes, it's not good. Eventually.

this cancer is going to be the thing, but it's not a slow decline of every day is a little worse and a little worse and a little worse. What we tend to hear is we take those spleens out and even when we get the bad news, those dogs feel damn good for the time they have left and they get four or six or depending on how you choose to intervene, extra months of time. So the answer is would I take my pet spleen out? Yeah, I think I would. If I had the money to do it.

Yeah, I think I would because the quality afterwards, they recover quickly. And most people end up saying things like, you know, it's weird. He didn't used to go this far on his walk and now he does. There's usually like a sort of insidious onset to the disease that they're unaware of. And then that spleen comes out and they're like, he hasn't felt this good in two months. And we're like, ⁓ okay. So yeah, I think I would to answer. Would you? Would you JoJo?

Dr. Angie Krause (22:23)
Mm-hmm.

Yeah, would you Jojo?

Brooke (22:55)
I mean,

JoJo (22:55)
I

Brooke (22:55)
we're all pet owners. love our pets.

JoJo (22:55)
know I know I think I tend to be

really practical in terms of am I open for the recovery? Is my dog wanting to go for treatments? so I think it's all going to be dog dependent. I don't think it's that simple and straightforward. And obviously financially, I don't know what chemo costs this these days. I don't, can you really do a splenectomy for 4,000? That was a shockingly low number.

Brooke (23:04)
There's no right answer.

Dr. Angie Krause (23:21)
You,

you can at boulders natural animal, but we're not hospitalizing that night for $4,000. It's just a day practice splenectomy. If you did it at case, cause we had one last week, I think it's like $7,000 at case with hospitalization, assuming everything goes well.

Brooke (23:31)
Thank

There you go.

JoJo (23:36)
Yeah, and then how much is a chemotherapy?

Brooke (23:39)
⁓ ranges. The answer is it's about, it's four doses of doxorubicin is the gold standard. And by the way, that's not the only option. There's other, there's other, other middle ground chemotherapies that are oral, something called metronomic chemo, two pills that you can get anti-inflammatories and a low dose of chemo that are incredibly effective. Well, as effective as doxorubicin. And ⁓ I would say,

four doses of chemotherapy all in will run you somewhere around maybe just south of 4,000.

JoJo (24:10)
Okay, so we're talking like rough range 10k for four to six months of quality of life. That's how I would approach it. I'd be like, is that is that what we want to do?

Brooke (24:16)
Yes.

They live great time, but that is a lot of investment. And we're not stating that the dogs are not worth it. Our dogs are worth it, but everybody has to be in a good place.

JoJo (24:24)
Yeah.

Yeah.

Ugh, they're just never easy answers. Angie, you didn't answer.

Dr. Angie Krause (24:33)
Absolutely.

Brooke (24:36)
Yeah, I know you're next Angie.

Dr. Angie Krause (24:36)
I, yeah,

in this season of my life, I would not because that $10,000 is not something that I have. And I, because I've seen this play out so many times, I know exactly what it looks like. And so I would say, I can't do that. Now, I mean, if I had endless amounts of resources, I actually might. And if I had someone to help me,

Brooke (24:43)
Same. Same.

Dr. Angie Krause (25:02)
through it, but as a single mom of two kids that, you know, there's all this stuff going on. I don't even know if I could organize the chemo and like it, you know, I

Brooke (25:04)
Yep, yep.

Yep. Yeah. Get

them to their appointments. A thousand percent. And I love that we're speaking about this right now because I really do encounter a lot of this with people. They come to find out the stats and the details and like, this is how long they live and this is what it is. But like all of those soft things and Jojo, you brought up a great point too. That goofy golden retriever underneath my feet, he could care less where he is as long as someone's touching him.

Dr. Angie Krause (25:16)
Yeah.

Brooke (25:37)
And then there's the other spectrum where there's the dog who's scared to death to get in the car, to go to the vet clinic. That's all quality of life. And yours is part of that too. And I think we want to dismiss our part, our part in the cooking for our dogs and the things like, they want us to be well too. Our pets want well for us because they're the best. They want everything good. Cause there's nothing wrong with dogs and cats. They're the mazes.

JoJo (25:59)
Yeah. Well, I like you said

earlier, chemo diarrhea and being up in the night, like all of those things. Like if you have a newborn at home and you're also doing that. my.

Brooke (26:05)
Yes.

Yes,

Permission to be real and acknowledge those truths and doesn't make you a bad person.

JoJo (26:14)
Yeah.

But that takes our industry being open to having those conversations and not shaming.

Brooke (26:23)
Yes.

Correct. Correct. And it goes back to finding the right practitioner again, like somebody who's going to like get in there and be like, okay, no judge, this doesn't work for you. Let's find something that does. Let's continue to have, I'll be on your team. We'll be a resource for you when you have questions. That's how that needs to look.

Dr. Angie Krause (26:24)
Yes.

JoJo (26:25)
I'm just going to name that.

Yeah, this is where Dr. Angie is great when she does consultations and she speaks to the quality of life of every person, every being in the home. like just let's be practical about what this looks like and not just the end goal

Brooke (26:47)
Yep. Yep.

Dr. Angie Krause (26:48)
Yeah.

Yes, because of the matriarchs of the house, we are making everything happen for everybody. And so I didn't tell my clients, I'm like, if you're not okay, your dog's not going to be okay. So what do we need to do to make you okay? So this was such a great conversation, Brooke, where, where can people find you? Because you offer telemedicine. You will talk to people about their dog's cancer diagnosis.

Brooke (26:54)
It's a symbiosis.

100%. 100%.

Same, loved.

Absolutely.

Yep, so that's my preferred way to see people is to do a virtual consult. It's nice, it's easy, dogs don't have to go to the vet, the cats don't have to go to the vet. We keep talking about dogs, but think about cats at the vet, right? People are so happy to not stuff their cat into a carrier and have them hate them for two straight days. So we have a website, it's vetcancerservices.com.

We can also be found, we have a phone number, 720-414-0116 if you Google us, Veterinary Cancer Services. Absolutely. I am not schooled in holistic medicine, but I like to say I take a holistic approach. I am open-minded to all the things. In fact, I'll kick you right back to Dr. Krause over here to be like, I don't know about those herbs. She'll talk to you about those, but.

we just have to look back on their story and feel like we did the right things. That's all I want for my clients. That's all I want for their dogs. You have to feel good about the story that you lived. And for some people that's do everything and for some people that's risk nothing and whatever that looks like in the middle, it's very different. ⁓ But thank you for plugging me. I appreciate it. Yeah.

Dr. Angie Krause (28:30)
Yeah. my gosh.

You're my favorite oncologist and I'm so happy you could come hang out with us. And I, I've already thought of like three different topics we need to have you back for. Let's do it. And we need to have a whole episode for cats. They, they need their own. Yes. We'll do it. Yes. We love our cats. Okay. Well, we'll see you next time. Bye.

Brooke (28:35)
Thanks. This was lovely.

Game on.

I know we really did give cats the chef today. I agree with you. Let's do cats a different day. We love you cat people. They exist too.

JoJo (28:46)
Yes.

Brooke (28:57)
Thank you so much.

JoJo (28:58)
Bye.

Brooke (28:58)
Bye.