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Bisphosphonates: When Amputation isn't an Option
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The Rainbow Bridge

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29 June 2010 - 9:38 am
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What does a pawrent do when their dog, who has just been diagnosed with osteosarcoma, isn't a good candidate for amputation?

The most common advice given by veterinary professionals would be to explore pain management options, such as Fentanyl combined with a non-steroidal such as Deramaxx. The downside is these types of drugs can leave dogs in a fog, and rarely do they provide permanent pain relief from bone cancer. Plus, the side effects of long-term heavy use, such as gastrointestinal damage, may reduce quality of life.

Another option for some is radiation therapy, a pain management technique that aims intense beams of radiation at tumors to help shrink them and reduce pain. Unfortunately, this is only available in a few select clinics.

More recently, there is a promising new option for non-amputation candidates: bisphosphonates. You've probably heard of them: Fosamax and Boniva are two. This class of drugs is used in human patients with osteoperosis, or those with prostate or breast cancer that has metastasized to bone.

Now, many veterinary oncologists are using bisphosphonates for canine patients, to build and stabilize bone, and effectively manage pain. In some cases, bisphosphonates can also be used for dogs with osteosarcoma metastasis to bony areas such as the spine or skull.

Typically, non-amputee dogs being treated for osteosarcoma are given the bisphosphonate drug Pamidronate. This drug is given as a two hour IV injection every four weeks. Pamidronate may also be given in conjunction with radiation therapy for pain control.

At the Veterinary Cancer Center (VCC), dogs have the most powerful bisphosphonate available; Zoleddronate. For the last year, the VCC team has conducted a Zoledronate clinical trial on dogs with bone cancer, and so far, the results are promising.

Zoledronate Bisphosphonate Trial in New Mexico

Zoledronate is one of the most promising bisphosphonate drugs available in veterinary medicine. Zoledronate is administered as a quick 15 minute IV drip, and can provide long-lasting pain control within 24 hours of the injection. The effects can last up to one month, and can even increase bone production to help form new bone. Dogs can stay on this treatment indefinitely. Several studies indicate that Zoledronate can also kill cancer cells locally and possibly prevent metastasis to other areas.

At over $1,000 per dose, Zoledronate is also one of the most expensive bisphosphonates. Which is why Dr. Kelly is so excited that her clinic is able to provide this drug at no charge to qualified canine candidates. After a year of studying its effects on patients, she says that so far the results have been "beautiful":

https://youtube.com/watch?v=8xnmx6wFclo%3Ffeature%3Doembed%22+frameborder%3D%220%22+allowfullscreen%3E%3C

The Veterinary Cancer Care center looks forward to helping as many bone cancer dogs as they can while funds are available for this trial. If you know a dog with osteosarcoma who is not a candidate for amputation, be sure to contact the VCC and ask them about the Zoledronate trial.

For further reading, please see:

Many thanks to the good people at the Veterinary Cancer Care for sharing this information with us. Catch our other interviews with the VCC:

Veterinary Cancer Care P.C. is committed to providing compassionate, high quality treatment to all pets with cancer. Using state of the art therapies, nutrition and kind care, we treat the whole patient, not just the cancer. To alleviate the hardships of cancer, our staff provides a positive family atmosphere, filled with love and hope. We hold a great respect for the human-animal bond, and will always honor your relationship with your pet above all.”

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29 June 2010 - 11:23 am
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Cool stuff, Rene.  I'm at work, so I don't have time to read it all, but will be back later.

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29 June 2010 - 9:15 pm
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Excellent information.  I had tried to get PEZ on bisphosphonates for some time when she was first diagnosed with OSA, but vets, oncologists and surgeons in my area were not open to this treatment, which is why we went down the Chinese med route.  Eight months after being first diagnosed, PEZ ended up having to get amputated anyway due to a severe fractured leg after falling down the stairs.  The good thing is her lungs were clear and the only sign of the cancer was in her humerus bone.  We will be starting bisphosphonate treatment in about two-weeks after PEZ recovers in addition to Metronomic Chemotherapy.  So, thanks for the information.

smile

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29 June 2010 - 11:31 pm
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You're very welcome, glad it was useful. It's something we didn't know a lot about at first but now that we do know, we'll be spreading the word. Stay tuned to our Downloads blog , more info to come.

Good luck with the treatments, we can't wait to hear more about how it goes. Paws crossed for much success!

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csmpez
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1 July 2010 - 9:23 pm
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Rene,

I was reading a post the other day and can't seem to find it that discussed metronomic chemotherapy.  I believe it was a post by you providing a link to where a oncologist/vet was using a new chemo drug in pill form with great success.  I believe the drug started with an "A" but can't recall the exact name.  If you could let me know where I can find this information that would be great.  Thanks.

 

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1 July 2010 - 9:40 pm
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csmpez said:

I was reading a post the other day and can't seem to find it that discussed metronomic chemotherapy...

Perhaps you're thinking of this information we recently posted from Veterinary Cancer Care in the Tripawds Downloads blog :

Metronomic Protocol: A Primer for Pawrents
June 17th, 2010 by jerry in Canine Cancer

Or, maybe our video interview with Veterinary Cancer Group's Dr. Mona Rosenberg discussing Metronomics:

Dr. Rosenberg’s Thoughts on Metronomics and Supplements
April 10, 2010

Otherwise, review the list of links to information about metronomics for cancer in dogs we compiled based on Jerry's experience.

Hope this helps.

csmpez
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1 July 2010 - 9:58 pm
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Excellent!!!  That's exactly what I was looking for.  Thanks a bunch!!!

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2 April 2012 - 6:25 pm
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My great dane, Sophie, was diagnosed with osteosarcoma this weekend and my wife and I are both devasted.  We lost another dane, Daisy, just two years ago to lymphoma.  As we researched our options, we quickly decided that amputation and chemo was out of the question.  Sophie is large for a female, 175 pounds, and there are many steps and steep inclines in our house and yard, and we don't want to risk her falling and getting injured.  I contacted the canine oncologist we used with Daisy and she mentioned she is currently using the biophosphate, Aredia, with much success.  We are going to head out to Memphis this Thursday to talk with her and I'll let everyone know how it went.  The radiographs on Saturday showed no cancer anywhere else--though I know that microscopic cancer cells are usually present and can't be seen on radiographs--so we are very hopeful that we can get some additonal quality time with our very special girl.

The Rainbow Bridge

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2 April 2012 - 8:09 pm
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Welcome Sophie and family. We're so sorry you are going through cancer again, we know the first time is bad enough, and twice is just even more devastating. I can't imagine. At least you know how to research and make decisions after going through it before; you're doing great. 

Amputation is definitely not right for every dog, and only you know Sophie best. Whatever you decide is the best decision for her and your pack, because it's made with her best interest in mind. 

We would love to hear more about this other bisphosphonate, so please consider starting a new topic with "Aredia" in the title. I know lots of folks want to know more, and we also want to hear about Sophie. We'll be here every step of the way for you, with or without amputation.

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The Rainbow Bridge

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15 February 2014 - 5:17 pm
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I want to start including success stories about bisphosphonate treatment so here are a few, and hopefully we'll have lots more in the years to come!

Osteosarcoma Treatment with Aredia

Sophie the Miracle Dog Update

CHANCE GETTING A SECOND CHANCE WITH A CLINICAL TRIAL

Six Months On, No Amputation

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