Science Digest: What are the prevalence and risk factors for survival in dogs and cats with cancer admitted to the ICU?

10 June 2026

Dogs and cats with cancer may be hospitalised in the ICU due to various causes and managing these patients can be complex due to the number of available treatment options, high emotional burden, and financial implications.¹ Improving knowledge of prognostic factors for ICU patients with cancer may help clinicians with decision-making.

A new prospective study by the Royal Veterinary College, published in the Journal of Veterinary Emergency and Critical Care, has described the prevalence, risk factors and survival outcomes of 114 dogs and 38 cats with cancer admitted to a veterinary ICU.¹

For each patient that had a definitive (cytologic or histologic) or presumptive diagnosis of cancer, the reason for ICU admission, clinicopathologic data, diagnostic imaging results, treatments, survival to discharge and at 90 days post-discharge, and date of death, if applicable, were recorded.

The prevalence of patients with cancer in the ICU was 14%. Most cases involved newly diagnosed patients and unplanned admissions, with most dogs and cats admitted due to oncologic reasons.

The most common reasons for ICU admission were respiratory support (32% of cats and 20% of dogs) and cardiovascular instability (21% of cats and 20% of dogs). Other reasons were transfusion dependency, postoperative care, seizures/mentation monitoring, and monitoring of electrolytes/fluid balance.

In dogs with a definitive diagnosis, carcinoma was the most common tumour type (37%), followed by sarcoma (24%) and hematologic (21%), while in cats, the most common type was hematologic (64%).

Survival to discharge was 61% in dogs and 45% in cats, and at 90 days post-discharge, it dropped to 40% in dogs and 21% in cats, thereby fewer than one-third of dogs and one-fifth of cats were alive beyond 3 months following discharge. The majority (88%) of deaths resulted from euthanasia. The median survival time for all-cause mortality was 11 days for dogs and 4 days for cats from hospital admission. Of the patients with confirmed metastasis, all dogs and all except one cat died during their first admission (all were euthanized except one dog and one cat).

Several prognostic factors for survival were found that can help inform more accurate prognoses and identify the most critical patients. Dogs and cats who received surgical treatment had a significantly reduced risk of death compared to those who had medical management alone, and those receiving chemotherapy had improved survival compared with no chemotherapy. In dogs, normal serum albumin concentration was associated with reduced risk of death compared with hypoalbuminemia. Dogs admitted primarily for oncologic reasons had a higher risk of death than those admitted for non‑oncologic reasons.

Limitations of the study are the relatively small number of patients (particularly for the feline population, for which some parameters may not have reached significance in the survival analysis due to type II error), lack of standardisation in diagnostic and therapeutic approaches, and the possible influence of both euthanasia bias and the severity of potential comorbidities on survival. As the study was conducted in a single referral centre, the findings might not translate to other centres or different regions.

Take home message

Cancer was common in this ICU population (14% of patients) and mortality at discharge and at 90 days post-discharge was high, with most deaths resulting from euthanasia. The most common reasons for ICU admission were respiratory support and cardiovascular instability. Hypoalbuminemia in dogs and the presence of metastatic disease in both dogs and cats were associated with poorer prognosis, which can inform more accurate patient prognoses.

Reference

¹Mattavelli C, Guillén A, Humm K, Brodbelt D & Cortellini S (2026). Prevalence and Risk Factors for Survival in Dogs and Cats With Cancer Admitted to the ICU. Journal of Veterinary Emergency and Critical Care. https://doi.org/10.1111/vec.70105