Posted tagged ‘Mitotic Index’

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.

Advertisements

1st Checkup after Restarting Palladia

September 30, 2010

Rosie went back to the oncologist after having restarted Palladia two weeks ago.  All her blood work was normal; and she did not experience any nausea or diarrhea.  She is eating well.

However, her weight dropped 2 lbs in two weeks and the oncologist was concerned about that, but not enough to take her off the Palladia yet.  So, we will bring Rosie in for another check up in another 2 weeks and see how she does.

Starting Palladia Again

September 17, 2010

Rosie got the all clear from her veterinary oncologist.  Her blood protein had bounced back to normal….Yeah!

So, we begin again with the Palladia at the same dosage as she took previously.   However, this time, instead of waiting 6 weeks to check her bloodwork, they will check it in 2 weeks to make sure it is not doing any damage. 

We will keep you posted.

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.

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

September 29, 2009

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.

Week 2 After 2nd Palladia Chemo Dose

September 12, 2009
Rosie closed her eyes and stuck out her tongue when the flash went off!

Rosie closed her eyes and stuck out her tongue when the flash went off!

It looks like Rosie is saying “Eeewww” but I think she just closed her eyes during this shot.  Although it looks like she is sticking out her tongue at the camera.  I seem to be the only family member that has seen Rosie lick her lips.  See now I have proof.  I caught it on film!  

The oncologist says when she licks her lips it means she has a sour stomach or nausea.   Occasionally, first thing in the morning before she eats, she as licked her lips.   Other times right before meals I think several times she is telling me she’s hungry.  

Overall, Rosie sleeps during the day and has had energy in the evenings playing with her squeaky toys more than she did before starting chemo.  She is a happy girl.

Many thanks to Barks 5th Avenue, http://www.barks5thave.com/, Rosie’s doggie day care, for asking for prayers for Rosie and linking to our blog.   That was so nice of them.

I added a new link under Blogroll as I saw people who were searching for Palladia had found our blog.   This link is to the blog for Vodka, another yellow lab, with Mast Cell Tumors who fought the good fight. 

She was diagnosed in August 2008 and crossed over the rainbow bridge in May 2009.   Her owner has a lot of good information regarding both Palladia and holistic treatments.   I think it will help a lot of other dog owners going through this situation.

As I was reading, I noticed a lot of similarities between Rosie and Vodka.  Both are yellow labs, and weigh about the same.   Both were 9 years old when diagnosed.  Both had the same type of MCT with the lymph node involvement.  Both turned to Palladia. 

There are differences in the Palladia dosage.  They started Vodka out at 130 mg and backed off to 115 mg, but with Rosie they started treatment at 120mg and backed off to 100mg because of diarrhea.  Also, they started Vodka on standard human chemotherapy first before starting the Palladia in a clinical trial.

I am keeping Rosie’s diet the same as before starting chemo to avoid her getting diarrhea.  So far so good.   So I have not tried any other holistic treatment at this time.  I don’t want to do anything that might interrupt her digestive tract.

Rosie takes the following each day:

1 Prilosec each morning to prevent stomach upset.

2 Benadryl (25mg ea)  3 times per day to counteract the histamine released by the Mast Cell Tumors.

1 Metoclopramide 3 times per day about 30 minutes before meals to prevent nausea / vomiting.

1 ml Cromolyn Sodium (liquid medicine) 4 times per day added to her food to prevent nausea / vomiting.

2 Metronidazol 2 times per day to fight diarrhea.

Then every other day she takes 2 50mg Palladia chemo tablets.

So far so good.  We will keep on trucking.

Week 2 – Follow Up with Oncologist – Starting Over

September 8, 2009

Rosie (and what seemed like every other dog in Texas) went to see our oncologist vet this morning for her second weekly follow-up on her Palladia chemo treatments for the Mast Cell Tumor (MCT) cancer.  

Rosie had diarrhea yesterday morning but had not yet gone again before visiting the vet.  Also, Rosie only had 2 Palladia chemo treatments last week instead of 4.  They were stopped due to the diarrhea, which can be a side effect of Palladia chemo.

However, the good news is that Rosie’s blood and kidney function were normal and her incision was healing nicely.

So, the oncologist recommended getting Rosie back on the Palladia chemo at the reduced dose (100 mg instead of 120 mg) every other day starting tomorrow.  However, this time Rosie will receive diarrhea medicine on the days that she receives the chemo treatment.  This is in addition to the three anti-nausea medicines that Rosie takes as well.  These are precautions as the Palladia can cause stomach problems.

To further prevent stomach problems and diarrhea, the vet wanted Rosie to only have her dry dog food that she was eating before starting the chemo.  She didn’t want any changes in food or diet causing diarrhea.   She wants to limit the other variables so she can measure the effects of the Palladia chemo.

She said if Rosie’s diarrhea continues, she will either have to try lowering the dose one more time, or take Rosie off the Palladia chemo altogether and try another chemotherapy.  So I’m hoping the anti-diarrhea medicine works so she can stay on the medicine.  It has worked today anyway.

So, we just keep taking it one day at a time, as the cliche goes.