Archive for the ‘Diagnosis’ category

My Dog has Mast Cell Cancer. Tell Me About Palladia Results and Side Effects

January 31, 2011

I receive this question a lot.  First of all, I am NOT a vet.  I am just a dog owner who has been dealing with mast cell tumors and Palladia treatment for the last year and a half.  So, I will share with you the resources I have gathered so hopefully it will provide you information and save you some time.

My dog has a lump.  Now what?  Go straight to the vet and get it aspirated.  Don’t waste time watching it.  If you are lucky it is only a lipoma and you have peace of mind.  If you receive the bad news that it is a Mast Cell Tumor (MCT) hopefully it is the best case scenario that you have caught it early and your dog lives a long life.

However, if you receive a diagnosis of MCT ask your vet some questions.  What is the grade?  Is it a I, II, or III.  A grade I means they caught it early.  If it is II or III ask your vet what the lab results say about it.  Both of those MAY require additional treatment.   Also, ask what is the Mitotic Index.  You want it to be below 5 out of 10.  That is another measure of aggressiveness and can be correlated to life expectancy.  The higher the index the shorter the life expectancy.  See Dr. Dressler’s article about grades of MCT and Mitotic Index:  http://www.dogcancerblog.com/dog-cancer-decisions-in-the-gray-zone/

Once you have a diagnosis, I recommend going to see a veterinary oncologist.  They have much more experience in dealing with cancer and can tell you about all the treatment options available and recommend which one or combination of treatments they recommend.  Palladia is only one treatment option.  There are different types of chemo, radiation, palladia, and Masivet to name a few.  Talk to your oncologist about all treatment options and which one is best for your dog.  You may decide that no treatment is best for your situation.  Every dog’s situation is different, please discuss it thoroughly with the oncologist.    Here is a link to help you find one:  http://www.acvim.org/websites/acvim/index.php?p=3

Whether or not you decide to get treatment or decide on no treatment at all, I recommend going to visit a holistic vet who can recommend other supplements to support your dog.  Your oncologist might even recommend one.  Here is a link to help you find one:  http://www.holisticvetlist.com/

It is extremely emotional to deal with all of this and try to make the necessary decisions.  Get support for yourself.  Yahoo has a great dog cancer support group at:  http://pets.groups.yahoo.com/group/CanineCancer/

Since the treatment we chose for Rosie’s situation was Palladia that is what I will discuss.  However, this does NOT mean it is better than other treatments or is right for your dog.  Talk to your oncolgist regarding the treatment for your dog.  It is just the only one I have any experience with.

Palladia affects all dogs differently.  In some it works and in some it doesn’t.   See Dr. Dressler’s articles about Palladia.    http://www.dogcancerblog.com/will-palladia-work/  and  http://www.dogcancerblog.com/first-dog-cancer-drug-fda-approved-but-not-great/.

Some experience side effects the most common being diarrhea and vomiting.  There are others some of which can be severe.   Check out other dog owner’s experience with Palladia who took our survey on this site:   https://rosiesroad.wordpress.com/2009/10/28/305/.  Also, read information from Pfizer about the Palladia at:  http://www.palladia-pi.com/Palladia_PI.pdf.    Sometimes the oncologist may adjust the dosage or temporarily stop the Palladia for a short period of time and then restart it to help relieve the side effects.  Also, they will likely provide supplemental meds to support the Palladia and help avoid side effects.  Still unsure about Palladia, ask your oncologist about a test that can be done to see if your dog has a “mutation” that Palladia successfully treats supposedly “80% of the time.”  That was according to my oncologist.  I don’t have much information on it but it would be worth discussing with your oncologist if you are considering Palladia as a treatment option.

Check out the links on the right side of this blog as there is a lot of information there.  Also read the comments from other dog owners.  My Rosie has been successful on Palladia but not all dogs experience the same success.

Be prepared.  Treating a dog with cancer no matter which treatment option you choose is expensive.  For no interest credit to help pay for it, check out care credit:  http://www.carecredit.com/index.html.   Also, check out the links on the right side of this blog under financial resources if you need other financial assistance.  Several links are listed.

Good luck to you as you research the best treatment options for your furchild.  I hope this information has helped in your research.   My heart goes out to you and I pray that your beloved furchild lives for many more years and brings much happiness to you and your family.

After One Year Rosie’s Palladia is Stopped (For Now)

September 1, 2010

After receiving Palladia for just over a year, Rosie is going to take a 2-week vacation from it.   This was decided with her oncologist after her latest 6-week check-up.  For the last couple of months Rosie has experienced a vomiting episode every couple of weeks and occasional loose stools.  During the first 10 months on Palladia she never experienced vomiting.

For the first time since she started Palladia Rosie’s lab test came back with an abnormality.  Her albumin (a blood protein) had decreased significantly.  So, the oncologist ordered a urinalysis which showed some protein but not enough to explain the entire protein loss.

The liver tests were normal.   The oncologist thinks that Rosie may be losing protein in her GI tract which may be related to the Palladia.   If so, if the Palladia is not stopped in time, it could cause permanent damage.  Therefore, she wants to take a break from the Palladia and check her again in 2 weeks.

A risk is that stopping the Palladia might allow the mast cell tumor with the 20 out of 10 mitotic index to come back.  That would be very bad.  Rosie has already beaten the odds of her diagnosis.  Initially she was only given 2 or 3 months to live after her diagnosis.  Now she has been doing great for a year.

All of this is hard to believe because if you look at Rosie she looks great!  You would not know she was dealing with something this serious.  Rosie has not acted sick.  She is happy, playful, and will eat as much food as you will give her.  She might get a little vomiting every few weeks but otherwise seemed fine.

So, I hope her blood proteins bounce back.  I would feel horrible if we did not stop the Palladia in time and caused permanent damage.  

We hope and pray that Rosie’s blood proteins will improve and that the cancer stays away.  I’ll post an update in a couple of weeks.

One Year Since MCT Diagnosis

June 16, 2010

It has now been one year since Rosie’s initial diagnosis of Mast Cell Tumor, grade II, and Rosie is doing great.  Last year it started as a small lump on her lower abdomen.  The owner of our doggie daycare pointed it out to us and recommended we take her to the vet.   I’ll always be grateful to her for that.

The vet did surgery to remove the lump and was confident he got all of it and we didn’t need to do anything other than keep an eye out for any more lumps. 

Two months later in August 2009, it came back with a vengeance.  Another lump on her surgery scar.  Test results came back as Grade II MCT with a Mitotic Index of 20.  That was bad news.  The mitotic index can be an indicator of lifespan.  The higher the number the shorter the life span.  We took her to an oncologist who said if we did nothing Rosie may only have 2 months to live.

That was 10 months ago and Rosie is alive and well and doing great.  In August 2009, about 1 month after our oncologist received the initial batch of new drug, Palladia, we started Rosie on it.  3 times per week, two 50 mg tablets per day.  The oncologist warned me they did not know a lot about this new drug, but we could try it.  I’m glad we did.  For 10 months it has worked for Rosie. 

Yesterday Rosie went for her regular 6 week check up.  Her ultrasound was normal.  Everything was clear.  All her bloodwork and tests were normal.  Our oncologist was thrilled about how well Rosie was doing.   She said usually a dog with a mitotic index of 20 in August 2009 would not be here today.

Our oncologist recommended that we continue the Palladia treatment.  She believes the Palladia is suppressing the “mutation” (I assume of cells turning into cancer) and that if we stopped the Palladia the cancer would return.

So we continue on and Rosie’s life goes on.  Thanks to our vet, oncologist, doggie daycare owner, and Palladia, Rosie is still with us.  She brings a lot of joy and love to our lives.  We are so grateful that she is still with us.  

Good luck to everyone whose furbaby is fighting this disease.  Our prayers are with you.  Remember, there are success stories like Rosie’s.  There is hope.

National Cancer Institute – Learning From Dogs

October 23, 2009

The National Cancer Institute (NCI) published a report stating that studying pet dogs with cancer could help determine how to diagnose and treat cancers in people.  Read more about it here.

http://www.sciencedaily.com/releases/2009/10/091012225543.htm

Initial Visit with Doggie Oncologist

August 26, 2009

They really have oncologists for dogs?!  Yes they do….and they appear to be excellent.  So, after getting the grim diagnosis, Rosie and I head out to Gulf Coast Veterinary Specialists to see doggie oncologist, Dr. Endicott. 

At first, Rosie was very suspicious because she did not get her breakfast.  She’s a smart cookie.  She knows that the only other 2 times that happened, she came home groggy and with stitches.  That was NO FUN.  So, Rosie appeared a little nervous and scared.

However, once she saw we were not going to her usual vet but to a new place, she was estatic.  New people and new dogs to meet.   This was heaven for miss social butterfly.   Oh boy!  In we go with head held high, tongue hanging out, and tail wagging.   She gave a friendly greeting to every 2-legged and 4-legged friend she saw and she noticed the other 4-legged guys were pretty grumpy, and several 2-legged friends were sad.   She later found out why.

After waiting several minutes, Rosie and I were ushered into the back.  We met people whom I assume were technicians and eventually, Dr. Endicott.  She reviewed Rosie’s lab reports with me and that was very depressing.  The one after the first surgery was not great but not horrible.  The report after the 2nd surgery was downright depressing. 

Like Dr. Schneider, Dr. Endicott explained that there are grades I, II, and II in dog cancer, but she also explained the Mitotic Index, which is recently being relied upon more to be predictive as to the aggressiveness of the cancer.  They like to see a number 5 or less.  On Rosie’s first report it was 6.  However, on Rosie’s second report, it was off the chart.  It was 20.  Dr. Endicott was very concerned about that. 

Afterward they took Rosie and took blood, X-Rays, and performed an ultrasound.  When Dr. Endicott discussed the results it appeared the cancer had not spread as much as feared.  There was another enlarged lymph node but in a location that could not be removed or aspirated.  Therefore they will monitor it for changes.  There was a tiny spot on the spleen, but it was not what she would typically see with Mast Cell Cancer. 

She said Rosie was a good candidate for chemo.  So, you think the choice is done.  Oh no….it is a multiple choice question.  Which chemo?  Old chemo or new chemo and there are multiple types of old chemo.  Basically, it came down to effective rates for me.  60% for new chemo, Palladia, vs 30-40% effective rate with old chemo.   Plus new chemo drug is free; and Dr. Endicott showed me some pictures of her current patients with some pretty remarkable results after a few weeks on Palladia. 

After many tears and discussions with my husband, my sister, my mother-in-law, my vet, and almost anyone else who would listen, we decided to try Palladia.  The doctor loaded us up with medication for us to start when Rosie’s tummy was better.

Sometime during this process, my happy dog that came in looked like she was feeling ill and depressed.  Dr. Endicott saw that Rosie licked her lips and said that was a sign of an upset stomach.  I had no idea.  So, she gave Rosie a shot for nausea. 

When it finally came time for Rosie to leave, she had on a “Bite Not” collar to keep her from licking her incision.  Rosie looked unhappy and was ready to bolt out of the place.  Once we started to leave, Rosie did bolt and dragged me out of there.  I’ll probably have to drag her in next week when we go.

Going forward, the process will be that we give Rosie chemo tablets at home once every other day, and then take her to the oncologist once per week for a status check to see how’s she’s doing.

Here's a sample of the collar put on Rosie.
Here’s a sample of the collar put on Rosie.

Rosie 070

Diagnosis

August 26, 2009

Some have asked me how did we find out Rosie has cancer.  I have to thank the owner of our doggie day care, Penny, for that.  She first noticed a small lump one day in late May while Rosie was playing at doggie day care.  When Dave picked Rosie up for the day, she showed him the lump and recommended that Rosie go to the vet to get it checked out. 

So, we took her to Dr. Schneider and, at first it didn’t look serious.  Dr. gave us a choice of ointment or surgery.  Tried ointment for 10 days.  Didn’t want unnecessary surgery if it just ended up being a bug bite. 

However, area grew quickly and became obvious it was something else.  Dr. performed surgery to remove the lump in early June, and biopsy came back as Mast Cell Cancer.  However, it was believed that the surgery removed all cancer so no other treatment was recommended.

Two months later the lump came back at the top of her surgery scar.  It looked like it changed overnight.  So back to the vet Rosie went.  Dr. performed surgery to remove the lump and enlarged lymph node he noticed.   Lab results came back as Mast Cell Tumors in lymph node and surrounding tissue.   The cancer had spread.  This was bad.

Dr. Schneider asked if I wanted him to talk to an Oncologist but warned it could be very expensive.  Chemo could run up to $10,000! Yikes!  But I asked him to go ahead and talk to the oncologist.  I at least wanted to know how far the cancer had spread and discuss treatment options.  That was Friday.  Monday, he called back.  That was an agonizingly long weekend.  However, Dr. Schneider sounded much more positive on Monday because the oncologist told him about the newly released drug, Palladia, and it was FREE!  I got the info and called the doggie oncologist to set up an appointment.