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4 or 6 cycles of carboplatin?
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PA
Member Since:
12 March 2015
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8 May 2015 - 6:26 pm
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Homer went through surgery really well.

The chemotherapy is making him really really fatigued.  He is on a 3 week cycle but, again before his 3rd cycle, he had to wait an extra week for his white cells to come up to a safe level to give the next round of chemo.  The oncologist wants him treated every 3 weeks, not 4, but this so far has meant extra exhausting trips to the vet - for multiple blood draws and the oncology center - just to be sent home because his counts are too low (which we knew at 3 weeks!).  I am going to be insistent that we do every 4 weeks.  We can literally tell when his counts are low.  

I did see one article on this site about 4 v 6 cycles.  I am wondering if anyone else has any other information.  I don't think he will tolerate 6, but our oncologist is fairly inflexible, to the point where we are thinking of going elsewhere.  If I can get good information, and we have to part ways, then I will find another oncologist who can give him artemesinin - or whatever else he can take as ongoing maintenance.  I am concerned if we opt for 4 cycles, he will get rid of us.

I am also asking how much of the fatigue is permanent?  I know in people it can very well be and I am concerned about quality of life.

Any one who knows anything about doing 4 vs 6 cycles, please let me know!!!!

Thank u all.

Virginia







Member Since:
22 February 2013
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8 May 2015 - 10:32 pm
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Okay, the computer geeks will have to pull up the links for you, but yes, there is great information here. Thenonenthat is verynhelpful was put forth bynournown Katy, Jackson's mom.

My interpretation was there was no real statistical difference between having four (or five) rounds versus six. I can tell you it varies here in the site. just guessing, but my sense is most dogs nowdays are having four rounds, maybe five, but fewer javing six. Again, not saying this is accurate, but just my gurpess.

Now, back to adorable Homer and his own experience!! I can CERTAINLY understand why you are hesitant to continue and do not blame you one bit for hesitating to proceed.

AND, I can certainly understand why you are possible seeking another Oncologist who is FLEXIBLE and listens to YOU!!..

Most dogs do sail through chemo. Some do have a bit of lethargy for a few days...not generally the whole time!

My Happy Hannah had FOUR rounds and her Onco. just graduated from Clemson (two yrs ago) and said that is what they sere teaching. She said the earlier mindset was more is better but they don't teach that anymore.

I know this isn't for me to say, but I just don't "feel right" about the way this Onco is handling things. I do find it disturbing that Homer is feeling poorly pretty mich the whole time. Just curious if the dose was ever lowered?

Has Homer's energy level continued to drop...and stay xropped...after each session! And yeah, it seems unnecessary to keep having you come back for bloodwork and do all that driving when you already no the outcome.

Gosh, I know Imw rambling, but I woukd first find anoher Onco.....and second, find another zonco! Homer's quality is being compromised. To do a fourth treatment without him feeling better first just doesn't "feel right".

Again, my onco recommended four rounds and I was very pleased with the results!!

Se ding lots of hugs and love!

Sally and Alumni Happy Hannah and Merry Myrtle too!

Happy Hannah had a glorious additional bonus time of over one yr & two months after amp for osteo! She made me laugh everyday! Joined April's Angels after send off meal of steak, ice cream, M&Ms & deer poop!

Rio de Janeiro, Brazil
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8 May 2015 - 11:26 pm
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Hello.  As Sally says, the "protocol" depends on the Onco.  My Johnnie's protocol was: 6 rounds of carboplatin every 3 weeks.  From the 2nd to the 3rd cycle he did have a reduction in energy and white cells where on the lower level but not so much as to postpone the chemo.  I started giving him "K-9 Immunity Plus", 3 chews in the morning and 3 chews with lunch.  For the rest of the treatment his blood counts were quite good. I credit this to the K-9 Immunity .  He also used Cerenia for nausea.

Keep us posted about Homer.

regards,

Daniela & Johnnie

Our awesome Golden Boy was diagnosed for OSA in April 2014 in the proximal humerus, front-leg amp on 05/20/2014. Finished chemo (Carbo6) on 07/10/2014. Ongoing treatment: acupuncture + K-9 Immunity Plus ( 3chews) and home-cooked no-grain diet.   Stopped Apocaps because of liver issues.   Liver issues: controlling altered enzymes with SAM-e and Milk Thistle.  October 17:  started having seizures.  Taking fenobarbital for seizures.  April 18: started prednisone.

Maryland
Member Since:
28 March 2015
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9 May 2015 - 4:28 am
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We did Carbo6. Ellie also had some fatigue after each round (we knew exactly what day it would hit), but she had low blood counts only once. After that first low count (when she came in for Round 2), the onc lowered the dosage and she never had low counts again. Each dog is different, and the dosage needs to be adjusted (I'm not a vet, just seems logical). So my first question is whether your onc has lowered the dosage? 

Carbo4 vs 5 vs 6? My head hurt reading some of the literature about the best protocol. I'm a scientist by training, but I couldn't make heads or tails of it. One thing our onc told us though, is that the price of carbo has come way down since it was first introduced (like 40% or something) so it was just too expensive to consider more than 4 rounds years ago. Now, she usually does 5. We did 6, just because Ellie tolerated the chemo well overall and some literature seemed to say that 6 was better (at least as far as I could interpret it).

Denise, Bill and Ellie.

Active 10+ Pyr mix suddenly came up lame with ACL tear in left rear leg. Scheduled for a TPLO but final pre-op x-rays indicated a small suspicious area, possibly OSA, which could have caused the ACL tear. Surgeon opened the knee for TPLO but found soft bone. Biopsy came back positive for OSA. Became a Tripawd 9/18/14. Carbo6 with Cerenia and Fluids. Pain free and living in the moment. Crossed the Bridge on 7/12/15 after probable spread of cancer to her cervical spine. A whole lifetime of memories squeezed into 10 months. Here's her story: Eloise

PA
Member Since:
12 March 2015
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9 May 2015 - 5:01 am
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Thank you, everyone.

Homer has experienced what is known as a 'double nadir' with Carboplatin.  The oncologist said that, for some reason, they are seeing it a lot more than they used to in the past.   There is a second drop in blood counts, at about three weeks with Homer.  So he has been wiped out tired the day of his treatment and the first week is a total lump.  Second week improves, third week better first and then - whomp - he gets beat down again for a few days.

I have ordered the K9 immunity plus to try.  Thank you .  I hope this helps.  I can see when he is good and bad, so I don't think I will 'fall for' placebo effect by proxy!  I will report back when I receive them on Monday.

I also saw about apocaps and artemesinin while looking at the provided link.  I knew that artemisinin was being used a lot these days, but I thought Homer had to wait for chemo to be over.  I am not seeing that.  The apocaps may be the same sort of thing?  Anyway, I want to try the K9 plus first - change one thing at a time - before adding other stuff.

My primary vet knows about nutrition apparently, so we can ask about dietary changes too.  Again, one variable at a time - otherwise I wont know what helps and what doesnt.

My hope is that the k9 plus may help with his counts, and then 4 v 6 wont be as critical an issue for quality of life.

Thank you.  Any more experiences with 4 v 6, I would still love to hear about.  

PS - At the last vet visit, we met a greyhound with OSA going for surgery.  They saw Homer with his tripawd harness and were so excited to see a tripawd. They said they were hoping to find one to ask for support.  Well, we gave them lots of info - including to study this site!  big-grin

On The Road


Member Since:
24 September 2009
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9 May 2015 - 9:46 am
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homer630 said
I did see one article on this site about 4 v 6 cycles...

Glad to hear homer is doing well!

Some of the Tripawds News blog posts and videos go way back, so in case you missed these...

How Many Chemotherapy Sessions are Best for Osteosarcoma in Dogs?

Bone Cancer Treatment News for Dogs and Cats

Canine Bone Cancer Treatment News with Dr. Mona Rosenberg

Chemotherapy Session for Daisee Dog

Note the date on some of these, but Daisee's doctor shared some still very relevant information about chemo side-effects.

Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet

PA
Member Since:
12 March 2015
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11 June 2015 - 4:37 pm
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I wanted to update my thread:

Homer has been getting the K9 immunity plus and I think it has helped him.  He did not have any of the serious cell count drops with this last round of chemo.  He finished round 4.

We did get a bit fed up and went for a consultation today at U Penn with a very helpful and caring oncology resident.  At Penn, they typically do 3 cycles of carbo and 3 of Adriamycin.   I think my wife and I are pretty much settled on opting to stop at 4 rounds.  There is no real demonstrated benefit to most of these therapies - at least enough for us to push him through more.

We did talk a lot about metronomics and we have a concern about Cytoxan and the possibility of cystitis.  Who know how long we have together, and waiting a month or more for his bladder to heal would not be acceptable to us.  She did discuss palladia, but again she said the data with osteosarcoma is not clear at all.

The data is less clear in the medical literature about Artemisinin , but I am going to explore that further with my primary vet who specializes in herbal remedies.  If it has a low side effect profile, we may opt for that.

We also are putting him back on Rimadyl, maybe a stronger NSAID if needed, as I think he's lethargy may be related to musculoskeletal pain and a touch of arthritis that is bothering him now that he is a tripawd.  He's such a big lazy lump right now. I hope it can give him so relief.

I'll read the threads about who has tried individual drugs, but it's really a crap shoot!


Member Since:
29 March 2015
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11 June 2015 - 6:51 pm
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4 vs. 6 rounds of chemo?  My first visit at at teaching hospital recommended 6 rounds - each 3 weeks apart.  I elected not to do the chemo treatments there and found another veterinary hospital and their recommendation was 5 rounds - each 3 weeks apart.  My pet completed four rounds - and twice his white blood cell count was too low to have his treatment.  Unfortunately before the 5th round, his blood work suggested that the cancer was already back.  We found a recommended oncologist to go to about that same time (fortunately).  He said 4 rounds was his recommendation and that more was not better.  Obviously the four rounds that we completed hadn't kept the cancer away.  I should say that it was carboplatin.  He did switch us to Doxorubicin to try for a couple of times then check his x-rays again.  He also recommended metronomic  therapy which we started at the same time as Doxorubicin (Piroxicam and cyclophosphamide pills).   My pet didn't experience noticeable side effects with the carboplatin.  He did have some GI issues with the Doxorubicin (but not severe) - my doctor's office mentioned that indicated they should adjust the dosage.  I hope this information is helpful.  I know that these are tough decisions to make.

Livermore, CA




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18 October 2009
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11 June 2015 - 7:11 pm
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Thanks for the input 4Chase.  Your future posts will not have to wait for approval.

Please consider starting your own thread so you can introduce us to you and your cancer warrior.

 

Karen and the Spirit Pug Girls

Tri-pug Maggie survived a 4.5 year mast cell cancer battle only to be lost to oral melanoma.

1999 to 2010

 

              Maggie's Story                  Amputation and Chemo

Member Since:
4 December 2013
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29 June 2015 - 5:04 pm
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hello Im super late In response. Im so glad your pup is doing better.

So listening to everyone, I feel I have been blessed with my oncologist putting up with me..lol

when we started chemo for my girls OSA he gave me the break down the plan, we want to do Carbo and Doxi alternating in order to avoid cellular resistance to the chemo to be abe to attach the cells. the plan was 3 and 3, but as she went through the sessions I was blessed that my girl had NO side effects, just a weird one of leaky bladder, which resolved in 3 days each time..(small price to pay) so he said since she was doing so well If Id like to continue to the 4th dose of each. I said absolutely as someone in health care, if you can keep zapping micorscopic cells that are probably not detectable and there is minimal side effects then you hit it from all directions. So we actually did 4 doxi and 5 carbo, the extra carbo was for me to deside what my next step was and I didn't want to give a chance for cells to come back with a vengeance in case there were any left. We tried Palladia but she had a odd liver reaction and he was on top of it.. and said nope no more.

definitely get someone that will work with you, who is willing to listen to your questions and actually "consider" them, not just brush them off. This stupid cancer is an everyday learning journey process that is specific to each animal not a general protocol.

 

Good luck

much love from us to you.

Angel Neka

7/4/2003-4/5/2016

2.5yr 3x cancer warrior survivor

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