Bye Bye Palladia….Hello BP Medicine

Hi everyone.  I have not posted in a while because there was nothing to report.  We have been enjoying time with Rosie.  Everything was status quo until 2 or 3 weeks ago.

One Sunday evening a couple of weeks ago Rosie started acting extremely anxious pacing the rooms, laying down but not getting comfortable and then walking around and pacing again.  She started digging outside which she did not do previously.  It is not like she was digging with a purpose.  She would dig in one direction and then turn around and dig and throw dirt back in the hole she previously dug.  It was more of an obsessive compulsive type of behavior. 

Our normally laid back lab was acting like an extremely stressed out dog.  I emailed the oncologist and she told me to stop the Palladia for a week.  We did that and Rosie’s behavior went back to normal.  The next week we started Palladia again.  After two treatments I noticed that she seemed more anxious but I wasn’t sure.  We gave her the third treatment that Friday and over the weekend she became much more anxious with shallow breathing, racing heartbeat, and pacing around the house and shaking nervously.  I again emailed the oncologist and she said to stop the Palladia again and we brought her in Wednesday for her regular checkup.

Rosie’s blood pressure was very high.  Everything else appeared normal.   The oncologist thinks this is caused by the Palladia.  High blood pressure is one of the side effects of Palladia.   The oncologist prescribed blood pressure medicine for Rosie.  Right now the Palladia is stopped and we are concentrating on bringing her blood pressure down.  I don’t know if the increase in blood pressure is temporary or not.  It is possible Rosie may have to stay on the blood pressure medicine indefinitely.  She said that it is possible, after the blood pressure is stabilized, to go back on Palladia together with blood pressure medicine.  However, at this time I am leaning toward not going back on Palladia.  Rosie has been on it two years and has gained two years of life because of it.   However, these current side effects have scared me.  I am hoping they are not permanent.  Rosie just started the blood pressure medicine yesterday.  So I still see some anxiety.  We go back next week to have her blood pressure checked again.

If your dog is taking Palladia please talk to your oncologist about checking the dog’s blood pressure.  In humans high blood pressure is called “the silent killer.”  In people it often has no symptoms.    Better safe than sorry to have it checked.

Good luck to everyone and I’ll let you know how Rosie’s check up goes.

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

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)

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.

Rosie is Feeling Better

I wanted to give an update to let everyone know that Rosie is feeling better.  She has been back on her regular diet for the last 3 days with no problems.  We restarted the Palladia this evening.  So far so good.  No stomach problems.  So I am guessing it must have been something she ate and not the Palladia that upset her stomach.

10 Months on Palladia and Now She Starts Vomiting?

Yes.  Rosie has been on Palladia for just over 10 months with no side effects.  Only once did she experience vomiting and that was early on when I was trying to change her food.  Therefore, I was quite surprised when her dinner and meds came back up last night.

We don’t know what has caused it.  Is it the:

• Palladia  (Vomiting is one of the side effects.)
• Mast Cell Tumor (The cancer itself can cause nausea.)
• Something she ate (Vomiting occurred shortly after her walk.  Did she eat something outside?  Hubby says he didn’t see her eat anything.)

Of course this happens on a Friday night on a holiday weekend when all the regular vets offices are closed.  So I call the nearest 24-emergency clinic and told them what happened and that she was on palladia….and the girl asked me “what’s Palladia.”  I said never mind and called the 24-emergency clinic located at the oncology office.    They said not to give her any food or water for 6 hours and if she is still having symptoms after that to bring her in.  At 4:00 a.m. the next morning she was still having dry heaves. 

At 7:00 a.m. we went to the nearest regular vet’s office and luckily they have facilities to do testing.  So Rosie was seen by the vet, who was very good, and they ran blood work to try to see if possibly the cancer came back and was causing stomach upset.  Everything was in the normal range.  The white blood cell count was at the very lowest end of the range, but still in the normal range.  The vet said that was to be expected for a dog taking chemo.  They gave her 2 shots for nausea and vomiting and told us not to give her any food until this evening.  Only water for today, and then 1/2 her normal meal this evening along with her Prilosec and Metoclopramide for nausea. 

We are back home now.  Rosie is resting.  I’m wondering what she could have eaten that might have caused it.  I was chopping an onion yesterday.  Possibly did a piece fall on the floor and she ate it without me seeing?  Did she manage to convince DH to give her a Chicken and cheese ravioli last night?  DH says he didn’t.  Did she eat something while out on her walk?   We may never know the answer.   We will keep an eye on her this weekend and check with the oncologist on Tuesday when she is back in the office.

One Year Since MCT Diagnosis

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.

Rosie is Our Christmas Gift Again This Year

Last year when we adopted Rosie  she was our Christmas gift to ourselves.  This year she is our Christmas gift again because she is still with us.  Back in August or September I wasn’t sure she would still be here by Christmas.  We are very thankful to have her with us this Christmas.  

Yesterday I realized how lucky we were to still have her when I took her to her regular vet to check her ears.  He was very pleased with how healthy Rosie looked.  He said he euthanized a dog yesterday that had mast cell cancer diagnosed about the same time as Rosie’s initial diagnosis. 

I told him that we adopted Rosie one year ago.  He said something that made me think.  He said some things (like her adoption) happen for a reason.  I think maybe we were meant to have her during this time in her life to take care of her.  Her previous Mom was busy fighting her own personal battle with cancer and it would have been extremely difficult for her to take care of Rosie as well.

Going through this process makes you take every day as it comes.  We have no idea what the future holds.  I don’t know if Rosie will be with us next Christmas, but I can’t worry about that.  We are just thankful she is here now and are thankful for each day we have with her.   Hopefully, there will be many more.  Our dogs can help teach us to enjoy the moment and not worry about the future.

For those fighting this cancer battle, our thoughts and prayers are with you especially during this holiday season.  May you have peace and comfort during this time.

Enjoy today and try not to worry about tomorrow.  Merry Christmas and Happy Holidays to everyone!

Mast Cell Tumors, Palladia, Diet, and Side Effects

Why is diet so important for dogs with cancer and specifically for dogs with mast cell tumor cancer (MCT)?  Furthermore, why is diet even more important when a dog with MCT cancer is on Palladia?

I have been researching dog cancer diets and getting information from our veterinary oncologist, and am considering a visit to a local holistic veterinary oncologist.  (At that statement, many owners of dogs with cancer will be appalled that I have not already been to one!  Meanwhile, the non-dog owners, and probably some of my friends and family will roll their eyes and say I have gone way off the deep-end now!  That is ok.  I can take it from both sides.) 

If you have a dog that is recently diagnosed with cancer, I recommend visiting with both a veterinary oncologist and holistic vet.  This method provides both the standard medical treatment plan as well as a holistic treatment plan, including diet.

Be aware that ANY change in what the dog usually eats can cause an upset tummy or diarrhea in a dog.  This is especially a problem for dogs with mast cell tumor cancer because the histamine released by the mast cell tumors can upset the dog’s stomach.   For more information on that, I recommend reading article on the Dog Cancer Blog at http://www.dogcancerblog.com/why-use-stomach-medication-for-mast-cell-tumors/. 

Furthermore, often the treatments, including Prednisone and Palladia, have side effects that can upset the stomach or cause diarrhea or worse.  Palladia’s gastric side effects can potentially be serious which is why often oncologists prescribe supplemental medicines, along with the Palladia, to protect the dog’s stomach.  If the dog has diarrhea, or bloody stool, for example, that would stop the Palladia treatment at least temporarily.  For more information on Palladia side effects see http://www.drugs.com/vet/palladia.html.  Rosie’s oncologist took her off of Prednisone when she started on Palladia.  She stated that both medicine might be too hard on her sensitive stomach. 

I can’t emphasize enough to TALK to your veterinary oncologist BEFORE making any changes to your dog’s diet, especially if you dog is taking Palladia.  Learn from my mistake.  I tried to change Rosie to a premium “grain-free” dog food shortly after starting Palladia and Rosie got diarrhea.  Rosie’s oncologist was not happy with me at the time because she could not tell if the diarrhea was from the food change or from the Palladia.  She had no choice but to stop the Palladia treatment until the diarrhea was under control.  Rosie went several days, almost a week without receiving Palladia.  This was scary to me because I had read online about several dogs whose cancer quickly returned once the Palladia was stopped.   I was given instructions to NOT change her diet until after Rosie was on Palladia for 12 weeks.  Once Rosie went back to her regular food, she did not experience any more diarrhea and has had a successful Palladia treatment to-date.

Now, Rosie’s oncologist has approved for me to SLOWLY change Rosie over to a grain-free diet.  It is important to make any diet change gradually so as to not upset the dog’s digestive system.  If there is diarrhea or bloody stool, the Palladia again would need to be stopped and we would run the risk of the cancer returning.  So I don’t want to risk that because of the diet change.  

Lots of information is available online, sometimes conflicting information about diets for dogs with cancer.  Many people recommend home-cooked meals.  Some recommend raw diets.  Some recommend specific brands of grain-free dog food.  Many recommend additional supplements and enzymes.  This is why I recommend talking to your oncologist and a holistic vet so that, with you, they can provide a specific diet for your dog’s cancer and your situation.

Since I work full-time and Rosie eats 4 small meals a day to prevent stomach upset and diarrhea, home cooking was not very feasible for me.  So I am in the process of gradually changing her over to a natural, premium grain-free dog foood which my veterinary oncologist recommended.  I’m not going to recommend any specific food in this blog.  I urge you to discuss the topic with your oncologist and holistic vet.

Dr. Dressler has some good information on diet on his Dog Cancer blog, www.dogcancerblog.com and more specifically in his book, which has additional information on diets for dogs with cancer.   I have some links on the right side of this blog also with additional information.

Good luck to each of you.

National Cancer Institute – Learning From Dogs

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

Week 6 Oncologist Follow-Up – “Normal As Normal Can Be”

YEAH!!!   HOORAY!!!!   WHOOHOO!!!!  No signs of Cancer!!!!  Yippee!!!     Go, Rosie, Go!!!!!  Yeah!!!!

OK.  Let me get ahold of myself.   I’d like to compare Rosie’s situation 6 weeks ago to today. 

Six weeks ago Rosie was diagnosed with:  “Mast cell tumor grade 2, right inguinal area removed x 2 (2 tumors) with documented metastasis to the right inguinal lymph node, mitotic index of 20 per 10 high-powered fields.”  My layman doggie mama interpretation of this is that she had 2 Mast Cell Tumors (lumps) in her lower abdomen which were removed, but the cancer spread into the nearby lymph node and surrounding tissue.  The high mitotic index might indicate an aggressive cancer.

Six weeks ago her 2-week old surgery incision on her lower abdomen was red, ulcerated, and not healing.  Today it appears to be healed.

Six weeks ago the ultrasound showed another lymph node in her chest was enlarged, but it was in a location where they could not aspirate or biopsy.  Today the ultrasound showed that all lymph nodes were normal.

Six weeks ago the ultrasound showed a tiny spot on her spleen.  Today the ultrasound showed everything normal.

Six weeks ago while at the oncologist, Rosie was acting as if she did not feel well.  Today Rosie appears to feel great.

Six weeks ago the oncologist thought that Rosie might only live another 2 or 3 months if we did nothing.  Today, who knows?  I didn’t ask that question.   There appear to be no signs of cancer today and I’m happy with that.

So, what was the difference between 6 weeks ago and today?  6 weeks of chemotherapy treatment with the newly FDA approved chemo drug for dogs called Palladia.

Needless to say, my family and I are ECSTATIC!  This is the best news we could receive. 

Now for the disclaimer.  Please realize that this is only one dog’s experience and not necessarily representative of all dogs experiences with this drug.  I am NOT a vet.  I have NO knowledge or expertise regarding this disease or treatment.  I’m just one dog’s mama trying to do the best I can for my dog; and I’m just sharing our one dog’s experience.  Hopefully, you will not be in this situation; but for those who are, I hope this will help you ask questions and further your dialogue with your dog’s oncologist.