Rise Pet Health Veterinary Oncology in Laguna Hills, CA
Exceptional Treatment and Exceptional Care
David Heller
DVM, MS, DACVIM
Board-Certified in Oncology
Jennifer Pierro
DVM, MS, DACVIM
Board-Certified in Oncology
Rise Pet Health provides advanced, compassionate cancer care led by experienced, board-certified veterinary oncologists in Laguna Hills, CA. Dr. David Heller and Dr. Jennifer Pierro bring nearly 40 years of combined clinical experience to pets and families navigating a cancer diagnosis. With advanced technology, a collaborative specialty team, and thoughtful treatment options, we’re here to help you understand what comes next and support your pet through every stage of care.
The Rise Oncology Difference
Compassionate Care is the ❤️ of What We Do
Providing compassionate care for our cancer patients and their human caregivers is our north star. We provide information in easy-to-understand terms with realistic goals and expectations.
At the Forefront of New Treatments
Our team is constantly evaluating new diagnostics and treatments for our cancer patients. Some of the latest diagnostic innovations that we utilize include chemotherapy sensitivity testing of lymphomas and genetic sequencing of various tumors.
Caring for Your Pet with Cancer is a Team Sport
One huge benefit at Rise is the direct access to our team of specialists. Cancer is a multi-dimensional disease. Working together with our boarded doctors in surgery, internal medicine and neurology allows us to truly attend to the holistic needs of your pet. We also work in collaboration with your primary veterinarian to ensure continuity of care.
Advanced On-Site Diagnostics
Rise offers onsite access to advanced imaging and diagnostic technology, including MRI, CT, digital fluoroscopy, digital X-ray, and ultrasound. Our on-site diagnostics eliminate the need for outside referrals and support accurate diagnosis and prognosis for your pet.
24/7 Emergency and Critical Care Support
Rise provides emergency and critical care 24 hours a day, 365 days a year. If an oncology patient develops an urgent complication, our hospital has an ICU and board-certified critical care specialists available to provide additional support.
When Should My Pet See a Veterinary Oncologist?
You do not necessarily have to wait until every detail of a cancer diagnosis has been established before consulting an oncologist.
Your veterinarian may recommend an oncology consultation if your pet:
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Has been diagnosed with cancer
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Has a mass or tumor that may be cancerous
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Has abnormal biopsy or cytology results
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Needs cancer staging or additional diagnostic testing
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May benefit from chemotherapy, immunotherapy, targeted therapy, or another cancer treatment
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Has cancer that has returned or stopped responding to treatment
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Needs a second opinion about a cancer diagnosis or treatment plan
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Requires palliative care or additional help managing cancer-related symptoms
An oncology consultation can help clarify the diagnosis, identify appropriate next steps, and give your family a clearer picture of the available options.
Rise Veterinary Oncology Services in Laguna Hills, CA
Cancer is not one disease, and treatment can vary considerably depending on the type of tumor, its location, whether it has spread, and your pet's overall health.
Our oncology team evaluates and treats many forms of cancer in dogs and cats.
- Lymphoma and leukemia (B-cell and T-cell lymphoma, acute and chronic leukemia)
- Mast cell tumors (low- and high-grade tumors)
- Hemangiosarcoma (tumors affecting the spleen, liver, heart, skin, and other areas)
- Bone cancers (osteosarcoma, hemangiosarcoma, fibrosarcoma, and others)
- Liver and biliary tumors (hepatocellular carcinoma, biliary carcinoma, cholangiocarcinoma, and more)
- Malignant melanoma (oral, cutaneous, and nailbed melanoma)
- Anal sac carcinoma (both primary and metastatic tumors)
- Lung and pulmonary tumors (lung metastasis, pulmonary carcinoma, pulmonary histiocytic sarcoma, thymoma, lymphoma, etc.)
- Squamous cell carcinoma (tumors affecting the mouth, skin, and other areas)
- Histiocytic sarcoma
- Soft tissue sarcomas (low, intermediate, and high-grade soft tissue sarcomas such as fibrosarcoma, nerve sheath tumor, myxosarcoma, and others)
- Bladder tumors (transitional cell, urothelial carcinoma, etc.)
- Thyroid tumors (thyroid gland carcinoma, thyroid gland adenoma, functional and non-functional thyroid gland tumors)
- Intestinal and gastrointestinal cancers (intestinal carcinoma, intestinal lymphoma, leiomyosarcoma, gastrointestinal stromal tumors, and others)
- Oral tumors (oral melanoma, squamous cell carcinoma, fibrosarcoma, acanthomatous epulis, and other growths)
Treatment recommendations vary from patient to patient and may include:
- Chemotherapy
- Metronomic chemotherapy
- Immunotherapy including the canine melanoma vaccine, Gilvetmab, and Elias Cancer Immunotherapy (ECI)
- Monoclonal antibody therapy
- Cancer vaccines
- Electrochemotherapy or ECT
- Intratumoral injections
- Tumor stenting
- Molecularly targeted therapies that disrupt the specific pathways driving tumor growth, including kinase inhibitors such as Palladia (toceranib), DNA repair inhibitors, and anti-angiogenic agents
- Supplements and nutritional support when appropriate
- Pain management
- Palliative care
Our oncology services also include:
- Oncology consultations and owner education
- Diagnostic imaging for cancer staging with in-house access to Digital X-rays, Ultrasound, CT scan, MRI and Fluoroscopy
- Cytology and biopsy procedures of internal and external tumors
- Bone marrow sampling
- Genetic sequencing of tumor DNA to guide precision, personalized therapy based on each patient’s unique cancer profile
- PCR and flow cytometry testing for classification of lymphomas and leukemias
Targeted Tumor Treatment with Tumor-Specific Electroportation (TSE)
What to Expect at Your Pet's Oncology Appointment
Your first oncology appointment is an opportunity to gather information and develop a clearer plan.
Our oncologist will review your pet's medical history, previous testing, current medications, and any pathology or imaging results that are already available. We will also examine your pet and discuss how they have been feeling at home.
Depending on the diagnosis, additional testing may be recommended to confirm the type of cancer, determine its stage, or assess your pet's overall health before treatment.
We will then talk with you about:
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What we know about your pet's diagnosis
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Whether additional testing may be helpful
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Available treatment options
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The goals of each treatment
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Potential side effects
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Prognosis when it can reasonably be estimated
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Quality-of-life considerations
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Your family's questions, concerns, and goals
Choosing cancer treatment is rarely a one-size-fits-all decision. Our role is to give you the medical information and guidance you need to decide what makes sense for your pet and your family.
Ready to book your pet's consultation?
Learn More About Cancer in Dogs and Cats
Certain cancers have their own symptoms, diagnostic process, treatment options, and expected outcomes. Explore our additional oncology resources for more detailed information about specific conditions.
Oral Tumors in Dogs and Cats
Explore common types of oral tumors, signs that may indicate a growth in the mouth, diagnostic testing, treatment options, and how our oncology and surgery teams may work together.
Lymphoma Care at Rise Pet Health
At Rise Pet Health, our oncology team brings focused experience and advanced treatments to pets diagnosed with lymphoma. We use the latest diagnostics and therapeutic tools to design a tailored treatment approach that fits your pet's needs. From chemotherapy protocols aimed at achieving remission to supportive care that helps maintain comfort and quality of life, we guide you through each step with clear communication and compassionate support.
For dogs:
Lymphoma is a cancer arising from white blood cells, also known as lymphocytes. These cells play an important part in the function of the immune system. Lymphocytes arise in the bone marrow, then they travel through the lymphatic system to the lymph nodes, where they reach maturity. Much of the lymphatic system lies within the gastrointestinal tract, though some lymph nodes can be felt externally. Because it extends throughout the body, lymphoma can develop anywhere.
Most dogs develop nodal lymphoma, also known as multicentric lymphoma. This form is typically classified as non-Hodgkin's lymphoma. This means that it is systemic and typically involves lymph nodes throughout the body. Most, but not all, types of canine lymphoma are high-grade, meaning they are cancers of immature lymphocytes. These are white blood cells that have suddenly stopped maturing, but are reproducing at a rapid rate. Most lymphocytes are either B cells or T cells, and they each have distinct functions. As in human lymphoma, about 80% of canine lymphoma is B cell variety.
Lymphoma can show up in different ways, depending on where the cancer is in the body. Owners often notice the following symptoms or behaviors:
- Firm, painless swelling of lymph nodes under the jaw, in the armpits, or behind the knees
- Unexplained weight loss
- Low energy
- Changes in appetite
- Increased thirst and urination
- Trouble breathing or swallowing
- Skin sores
- Abdominal distention
A diagnosis of lymphoma is usually made with a fine needle aspirate of a lymph node. We also need to do bloodwork (blood count, chemistry panel, urinalysis). In many cases, bloodwork is quite normal. We recommend staging tests (chest x-rays and abdominal ultrasound) to evaluate the extent of disease (staging). Occasionally a bone marrow sample is recommended, but this is not needed for most patients. We can determine the phenotype of lymphoma (B or T cell) using molecular diagnostics (flow cytometry, PCR) or biopsy with immunohistochemical stains. This is an important part of the diagnostic plan because the B or T cell designation is the most important prognostic factor in dogs. It can also help guide specific treatment recommendations.
Treatment for high-grade lymphoma involves a multi-agent protocol called CHOP. This is an acronym for the drugs that rotate weekly for up to 25 weeks. This protocol is the most effective for canine lymphoma, but there are others available. About 10-15% of dogs have side effects with treatment, and our goal is that they go into remission and have a good quality of life during therapy.
The prognosis for dogs who are untreated is about 1-2 months. With steroids such as prednisone alone, dogs can live 2-3 months. For all dogs undergoing CHOP chemotherapy (B and T cell), about 90% will go into remission, and there is an average life expectancy of approximately 1 year. B cell dogs do better, and T cell dogs generally do worse. 5-10% of dogs can experience a cure, meaning that they will never come out of remission. For those that come out of remission after treatment, we can re-treat them.
The important thing to keep in mind is that most cases of lymphoma are treatable and respond well to chemotherapy. Most dogs can survive longer while maintaining a good quality of life with lymphoma treatment. Please contact our Oncology Department to schedule a consultation if your dog has been diagnosed with lymphoma or has any of the signs described above.
For cats:
Lymphoma is the most common cancer diagnosed among cats. The disease arises from white blood cells (lymphocytes). These cells play an important part in immune system function. These cells are produced by the bone marrow, then they travel through the lymphatic system to the lymph nodes where they reach maturity. Most of the lymphatic system is in the gastrointestinal tract (inside the body), but some lymph nodes can be felt externally. The lymphatic system is located throughout the entire body, so lymphoma may arise anywhere.
Unlike dogs, most cats develop extra-nodal lymphoma (particularly gastrointestinal lymphoma), and the type of lymphoma we see in cats is generally non-Hodgkins lymphoma. This basically means that it is systemic, and typically involves organ systems (intestines, kidneys, nasal cavity) and some lymph nodes throughout the body. Most types of feline lymphoma are high-grade, meaning that they are cancers of immature lymphocytes. These are white blood cells that have suddenly stopped maturing but are reproducing at a rapid rate. Recently, we have been diagnosing more and more low-grade lymphomas, particularly in the GI tract. These must be diagnosed with a biopsy or molecular diagnostics, and are characterized by the presence of mature, adult white blood cells. This disease usually has a less aggressive clinical course.
Feline lymphoma has a wide range of clinical signs that are typically dependent on the particular organ system involved. For example, cats with nasal lymphoma may have nasal discharge or bleeding, congestion, or deformities of the face. Other clinical signs seen in cats include the following:
- Lethargy
- Loss of appetite
- Hiding behavior
- Vomiting/diarrhea
- Increased urination (renal lymphoma)
- Upper respiratory issues
- Difficulty breathing
A diagnosis of feline lymphoma is usually made with a fine needle aspirate or biopsy of the affected organ. This procedure is important so that we can collect cells for pathology analysis, to confirm the diagnosis of lymphoma and determine how to best treat it. Your oncologist may also recommend other tests to determine the extent of the disease and overall health. These tests include general bloodwork (blood count, chemistry panel), chest x-rays and abdominal ultrasound imaging. The details of these tests will be discussed during your initial consultation with our oncology team.
All cats who are diagnosed with lymphoma should be tested for infectious diseases that are known to cause lymphoma, including feline immunodeficiency virus (FIV) and feline leukemia virus (FeLV). For nasal lymphoma or Hodgkin's lymphoma, a CT scan may be recommended. In some patients, a bone marrow sample is recommended.
Treatment for high-grade lymphoma involves chemotherapy, often using a multi-agent protocol called CHOP. This is an acronym for the drugs that rotate weekly. It generally involves 16 doses of chemotherapy along with an oral steroid over 5-6 months. An oral chemotherapy (lomustine) may be recommended for some cats based on disease particulars or patient characteristics. This is given once every 3-4 weeks for at least 5 doses. About 10-15% of cats have some side effects with treatment. The main goals are to get the lymphoma into remission and to provide good to excellent quality of life during treatment. Chemotherapy side effects are typically mild and last 1-3 days. Other treatments, including surgery and radiation therapy, may be recommended depending on case specifics.
For low-grade lymphoma, treatment consists of steroids and oral chemotherapy (chlorambucil) administered at home. Cats may be treated for multiple years with this protocol.
The prognosis for cats varies with grade, viral status and location.
High-grade versus low-grade:
For high grade disease, the prognosis for cats who are untreated is a few weeks. With steroids alone, cats can live 1-2 months. For cats undergoing multi-agent chemotherapy, about 65% will go into remission, and there is an average survival of 6-9 months. For cats with low grade lymphoma treated with oral chemotherapy, about 90% will experience clinical remission. Survival times range from 1-3 years.
Retroviral status (FeLV or FIV infection):
Cats infected with feline leukemia virus and/or feline immunodeficiency virus have significantly decreased response rates to chemotherapy and shorter survival times (typically just a few months).
Location of lymphoma:
The prognosis with treatment differs based on the anatomic location of the disease. For example, cats with lymphoma confined to the nasal cavity can experience survival times of multiple years with appropriate therapy, while cats with renal (kidney) lymphoma have a median survival closer to 6 months.
It is important to note that initial response to therapy is VERY important for long-term prognosis in cats. Those that achieve complete remission can enjoy extended survival times.
- Cats typically develop organ-system specific lymphoma as opposed to nodal lymphoma. For example, cats can get nasal (nose) lymphoma, renal (kidney) lymphoma, mediastinal lymphoma (chest cavity), among others. In some cases, a cat may have involvement of more than one organ system.
- Indolent or low-grade lymphomas (particularly of the GI tract) are more common in cats.
- Cats occasionally develop Hodgkins-like lymphoma. This develops as enlarged lymph nodes around the head and neck area and is diagnosed based on the presence of particular types of cells. In most cases, this type of lymphoma can have a better prognosis than non-Hodgkins lymphoma.
- Cats that achieve complete remission can have extended survival times
Frequently Asked Questions About Veterinary Oncology
Many dogs and cats are able to complete chemotherapy protocols with mild to no side effects. Most pets tolerate veterinary chemotherapy better than many people initially expect. While side effects can occur, veterinary chemotherapy protocols place a strong emphasis on maintaining quality of life.
Generally, dogs and cats receiving chemotherapy feel normal the day they are given the treatment. Perhaps 3 to 5 days later, a pet parent might report that their pet does not feel 100%; however, within 24 to 48 hours, the pet is back to their normal self until the cycle continues with the next dose of drug. Some pets may experience temporary changes such as decreased appetite, lower energy, vomiting, diarrhea, or changes in blood cell counts. Your oncology team will monitor your pet closely and may adjust the dose, timing, or medication if side effects become significant.
More serious reactions are possible but occur less commonly. We will explain what to watch for at home and when you should contact us. Fortunately, the need to hospitalize pets due to chemotherapy-related side effects is uncommon, and some studies show that hospitalization is necessary in less than 10% of patients receiving chemotherapy.
Most dogs and cats experience little to no significant hair loss during chemotherapy, although the response varies by breed and coat type. Cats may lose whiskers or some of their outer coat. Certain breeds, including Poodles and several terrier and doodle-type breeds, can experience more noticeable hair loss. Hair generally grows back after chemotherapy is completed or treatments become less frequent.
Yes. Cancer treatment can have goals other than a cure. Depending on the disease, treatment may slow cancer progression, shrink a tumor, relieve symptoms, improve comfort, or help your pet maintain enjoyable daily activities for longer. Your oncologist will explain the goal of treatment before you begin so you understand what the recommended therapy is intended to accomplish.
Many pets continue walking, playing, eating, interacting with their families, and participating in their usual routines during treatment. Your pet's activity may occasionally need to change depending on their diagnosis, treatment, energy level, bloodwork, or recent procedures. We will provide recommendations based on your pet's particular situation.
Our team assesses your pet's comfort throughout treatment using physical examinations, medical findings, and changes you notice at home. Pain management may include medication, changes to the cancer treatment plan, supportive care, or collaboration with another Rise specialty when appropriate.
The schedule depends on your pet's cancer and treatment plan. Some therapies require frequent visits early in treatment, while other patients may return less often for monitoring. Your oncologist will outline the recommended schedule and explain what testing may be needed at each stage.
Yes. An oncology treatment plan can change based on how the cancer responds, how your pet tolerates therapy, and your family's goals. Treatment may be adjusted, paused, changed, or discontinued when appropriate. Some pets also transition from active cancer treatment to monitoring or palliative care.
Ask your oncologist before scheduling grooming while your pet is receiving chemotherapy. There may be certain periods after treatment when we recommend avoiding grooming facilities or contact with other animals. Your oncology team can give you guidance based on your pet's treatment schedule.
Many pets can continue their usual parasite prevention, but treatment recommendations can vary based on your pet's medications and health. Ask your oncologist before making changes to any medications or preventive products during cancer treatment.
Talk with your oncologist before scheduling vaccinations while your pet is receiving chemotherapy. Some cancer treatments affect immune system function, which may change the timing or type of vaccines your veterinarian recommends. Your oncology team can coordinate with your primary care veterinarian to determine an appropriate plan.
Yes. Cancer can behave differently between species, and treatment recommendations also vary based on the specific cancer, breed, age, overall health, and individual patient. Your oncology team uses these factors when selecting therapies and monitoring your pet's response.
Quality of life involves more than any single symptom. Appetite, comfort, mobility, sleep, interaction with family members, interest in favorite activities, and the balance between good and difficult days can all provide useful information. Our oncology team can help you evaluate these changes over time and discuss quality-of-life assessment tools when helpful.
Yes. Many cancer patients benefit from more than one veterinary specialty. At Rise, our oncology team can collaborate with specialists in surgery, internal medicine, neurology, critical care, and diagnostic imaging to coordinate care when multiple services are needed.
Bring any medical information that has not already been sent to Rise, including:
- Previous medical records
- Bloodwork and laboratory results
- Cytology or biopsy reports
- Imaging reports or images
- A current medication and supplement list
- Notes about recent symptoms or changes at home
- Questions you would like to discuss
Having this information available can help your oncologist better understand your pet's medical history and determine which next steps may be appropriate.