Mosey has been back on Palladia for a full month. We received really good news yesterday…at our monthly check up with the oncologist we learned that, not only has the tumor not grown, the tumor has shrunk a tiny bit! We compared x-rays from December and then had the radiologist confirm. We are ecstatic as we did not dare to hope that the tumor would cease to grow for a bit…the icing on the cake was the shrinkage. So we are staying with the Palladia as we think this is what is causing the good prognosis. That means we need to deal with the side effects. Mosey suffers from very soft stools a few times a week. We also learned that there are increased levels of protein in his urine which means yet another drug to counter this condition. The following article from The Dog Cancer Blog offers valuable tips and advice for dealing with side effects from Chemotherapy.
Chemo side effects: What should I do?
Chemotherapy does have side effects that need to be considered. About 5% of these will require your pet to be hospitalized, on the average, and there is a 1% chance of fatal reactions overall with chemotherapy.
Although I have not seen any published data, unpublished estimates on overall risks of any side effect are roughly 25-40%. This means that about one in three dogs will have some kind of adverse effect, but it could be a mild one.
Some of these milder side effects include loss of appetite, vomiting, and diarrhea. Other adverse reactions include lowering of white cells (leukopenia, which causes immune system suppression), heart damage, lung damage, kidney injury, anemia, blood clotting problems, liver injury, and others.
Of course, this is a summed list for many different drugs. A given drug will not have all of these. You should certainly be aware of side effects with all drugs but particularly Doxorubicin (Adriamycin), cyclophoshamide, prednisolone or prednisone, Lomustine, Palladia, vincristine, L-asparaginase, and more.
You should ask your veterinarian or oncologist about the specific effects of your dog’s treatment, and what to watch for.
For example, keeping track of body weight is quite important during cancer care. You may need to increase the amount of calories your dog consumes. When muscle is lost, the amino acids loss in the body hinder the immune system and the lining of the intestine.
Similarly, it is also important to monitor your dog’s rectal temperature. The reason for this is that a low white blood cell count can often lead to infection in the body. Most commonly, infection will produce a fever. Most chemotherapy drugs used in cancer protocols can cause low white blood cell counts.
If your dog is drooling or smacking his or her lips, it could be a sign of nausea or too much acid in the stomach. Usually this means we need to temporarily rest the stomach, then go on a special diet, offer antacids like cimetidine, give ginger, and consider branched chain amino acid supplements to help restore stomach or intestinal health.
Keeping an eye on the quality of the stool is vital too. Many chemo drugs will cause diarrhea. If this occurs, your vet should also temporarily change to a highly digestible food, and consider using something to help with the diarrhea. Slippery elm, pepto bismol, kaopectate, or other medications and supplements can all help.
The Dog Cancer Survival Guide has more information about what you can do to help with some of the more serious side effects by giving certain supplements. Please consult with your veterinarian and the Dog Cancer Survival Guide for proper doses for your individual dog.
Best to all,
Mosey is a happy, goofy, beautiful golden retriever with a voracious appetite, very treat motivated, and a total love bug. His energy level is excellent for a 10 1/2 year old so nothing prepared me for the cancer diagnosis. Here is our story:
Mose has slept for years on a big, puffy, pillow type bed. One night, a few days before Thanksgiving, he woke up and started breathing very heavily…almost panting. He moved off his bed and onto the floor. I got up, sat beside him and started petting him to relax him. He stopped the panting after a few minutes, went to sleep and was fine the rest of the night. This happened a few nights in a row. I thought it was odd, but I didn’t panic as he was fine the rest of the time. A few days later I noticed he was breathing a bit harder than usual during the day…not after any activity, just as he was lying around the house. Again, this was so slight that it didn’t raise any concerns but, after a week of the 5 minutes of heavy panting at night business, I decided to take him to our vet. I honestly expected them to tell me he had allergies or something similar.
Our local vet checked him out and asked if she could take some x-rays. The first shock was when she told me he had a mass surrounding his heart and that there was nothing they could do here in Taos. She referred me to specialists in Albuquerque and told me “Keep him very calm, don’t go on any walks or any other activity and call me on my cell in an emergency…like if he collapses.” What? OK, so now the panicking started.
This was on a Thursday afternoon and our appointment with the specialist was not until the following Tuesday morning. My husband and I spent a very long, tense and sad few days, lots of crying and frustration with the wait. It didn’t help matters that we had a big snowstorm and sub-zero temperatures forecasted the day of the appointment. Taos is 2 1/2 to 3 hours from Albuquerque and we had an early morning appointment so Mose and I left Monday mid-day to beat the weather. Let me tell you…sitting in the hotel room waiting for the next day was one of the longest nights of my life.
We first met with a cardiologist who, after an ultrasound, told us that the mass had not gone into his heart and that, for his age, his heart was very strong. Some good news! Then she referred us to the oncologist who had us do an abdominal ultrasound which revealed no major abnormalities. They aspirated some of the mass for analysis which showed degenerating cells…probably cancerous. The oncologist created a report for me which states:
“Mose has been diagnosed with an intrathoracic mass that extends to the heart base (also called heart based mass). There are generally four common differentials for a tumor in this location. They are lymphoma, thymoma, ectopic thyroid carcinoma and chemodectoma. The aspirate results have ruled out lymphoma. These other three potential cancers are all epithelial which is what the pathologist thought the cancerous cells were most consistent with. Thymoma is a cancer of the thymus, an organ involved in development of white blood cells in embryos and babies. When cancerous, it is most often treated surgically although it is also responsive to radiation therapy. Ectopic thyroid carcinoma is when a remnant of thyroid in the chest becomes cancerous. These tumors are best treated with surgery although many are non-surgical. If non-surgical, they can be treated with either radiation therapy (if site is appropriate) or chemotherapy. Chemodectoma is a cancer of the cells at the base of the heart involved in sensing blood pressure and position. Chemodectomas are generally slow growing cancers and have not been particularly responsive to most therapies. If possible, they are removed surgically but they are only rarely surgical.”
I met with the surgeon Wednesday evening to determine the next steps. First was to have a CT scan to get additional info. We had the CT scan performed on Thursday morning. The results showed the cancer was inoperable. They ruled out 2 of the 4 potential cancers. The oncologist said, based on the CT scan findings, that she believes it is an ectopic thyroid carcinoma but it could also be chemodectoma. They also found 2 lung nodules which makes them think it is also a metastatic disease.
You can imagine my week of crying, bargaining with God, and researching everything in sight. Mose has always eaten healthily, but I am amping up his diet by starting an anti-cancer holistic program. He started taking an anti-cancer drug called Palladia last Friday. We are waiting to hear from Colorado State University, Ft Collins to find out if he is a candidate for radiation therapy. If not, the oncologist recommends we watch what the Palladia does (or doesn’t do) and then discuss chemo.
The only good news is that, except for a little bit of panting once in a while, he is symptom free. Great appetite, energy appropriate for a 10 yr old, no pain…his normal goofy self. This is the hardest thing I have ever gone through. My friends and family have been amazing…listening to every detail and offering support and guidance…but, especially now during the holidays, I don’t want to continue to bum them out with my sadness.
These blog posts are designed to help me keep track of Mosey’s situation. It is such an overwhelming and confusing time. I want everything I learn, try and experience to be organized. I hope our story helps others on the same journey.