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My Metronomic Therapy

When I was first diagnosed with osteosarcoma, my Mom and Dad didn’t want to put me through chemotherapy, mostly because it was a six hour drive to the hospital, and, since doctors said that I only had a few months left even with chemo, we didn’t want any of our precious time to be taken up with poking and prodding and long drives.

20080321w_cytoxan02.jpg

We took our chances, hit the road, and beat the odds, but now, fifteen months later, the cancer devil has paid us another visit. We are prepared to beat the odds again, only this time, we’re going to do it with the help of something called “The Metronomic Protocol.”

Treating Osteosarcoma with Chemotherapy
Most of you know that chemotherapy can help dogs beat cancer. Usually, chemotherapy drugs are given in high doses every couple of weeks, and administered in an injection of some sort. Most of us aren’t affected by chemo drugs like people are; if the drugs are given correctly. And if a dog does experience side effects, the oncologists can lessen the doses and lengthen the treatment time. Our friends at Bone Cancer Dogs have a lot of good information about traditional chemotherapy for osteosarcoma.

When I got the bad news a few weeks ago, my Mom and Dad couldn’t rest without trying something that might give me more time on this earth. Dad did some research on different chemo treatments, and learned about the Metronomic Protocol. It’s chemo in a pill, and it can be done anywhere . . . even in an RV, on the road! It seemed too good to be true. At home chemotherapy?

Since we were going back to New Mexico for a while, my Mom found the wonderful women at the Veterinary Cancer Care clinic in Santa Fe, who are doing this therapy for their patients. We paid them a visit, and learned more about this option.

Why I’m On the Metronomic Therapy

20080321w_cytoxan01.jpgMy oncologist, Dr. Mullins, went over a few options with us, including surgery to remove my affected lung. Surgery is good for dogs that have no more than two tumors that are affecting less than 50 percent of a lung. But there’s a good recovery time involved, and at my age and where I’m at in life, we decided to pass on this option.

We also discussed standard chemotherapy. But Dr. Mullins says that at this stage in my cancer, there is only a 5 to 15 percent chance that standard chemo will work on me. There’s a slight chance that it could work better than expected, because my cells have never been hit with a blast of chemo. Still, the odds are slim, so with such a little chance of success, Dr. Mullins suggested that we try the Metronomic Therapy.

How Does the Metronomic Therapy Work?

20080331w_metronomics01.jpgMetronomic Therapy will allow Mom and Dad to give me frequent, low doses of three drugs that, when used together, will help stop blood vessel development in my lung tumors. See, if you starve a tumor of their main food souce, blood, they can’t grow! This is called the “Anti-Angiogenic” effect.

Dr. Mullins wants us to keep in mind that this therapy is not a cure, but rather a way to stop the tumors from getting bigger, and keep them from spreading into more of my lungs.

What Chemotherapy Drugs Am I Taking?

There are three drugs that I am taking:

Cytoxan: a chemotherapy drug that I take every other day. At this low, constant dose, it’s been shown to inhibit blood vessel growth. Mom and Dad wear special gloves so they don’t get it on their skin, and they check my pee a lot to make sure it’s not causing trouble.

Metacam: a non-steroidal drug with potent COX-2 inhibiting properties. I take this every day. COX-2 is a receptor that’s been found to play a role in tumor development, by slowing them down. In one study, 77% of osteosarcoma expressed the COX-2 receptor (Mullins et al JVIM 2005. Other non-steroidal drugs include the name brands of Piroxicam, Rimadyl, and Previcox.

It’s great that Metacam is part of this protocol, because that’s what I’ve always taken for my arthritis. I tried Previcox in the past, but it made me very sick. Once that happened, my Mom really didn’t want to give me any of these drugs. But now, she says it’s a “risk / benefit” thing. My doctor says that not only will the Metacam help slow down the tumors, but it will keep my muscles feeling good by keeping any tissue damage or swelling down. If my muscles stay healthy, then my body is that much stronger and able to fight back. So Mom is willing to take the chance of giving me a lower dose of Metacam every day, if it will help me kick cancer’s butt.

Doxycycline: an antibiotic, just like the ones you people take when you get sick. When given at low doses, Doxycycline can prevent blood vessels from forming and feeding tumors. It does not affect the existing tumor(s) though. Like Metacam, I take this every day too.

K9 Immunity and My Cancer Therapy

These are the three main drugs of my chemo treatment. On top of that, I’m an especially lucky dog, Dr. Mullins’ clinic is participating in a K9 Immunity trial, and I qualified for it! Now, I’m taking K9 Immunity and K9 Transfer every day. The doctor says that her patients have done exceptionally well on K9 Immunity when taken with the Metronomic Therapy, so we are really, really excited about this. I’ll tell you all about it later on.

Learn More About K9 Immunity Plus at:
K9Medicinals.com and DogCancer.net

My New Diet

20080331w_metronomics04.jpgMy diet and supplements have changed a little bit, and Mom has updated my Health Tips page. So far, I feel pretty great, like my usual self. I didn’t have any side effects, until just yesterday when Mom gave me a can of cooked mackerel for dinner, one of my favorite foods. It didn’t quite agree with me. Ick! I’m feeling better though, thanks to a big dose of pumpkin pulp last night.

The Metronomic Protocol is a relatively new kind of option for bone cancer dogs, and because studies are still out on it, Dr. Mullins can’t give a prognosis for how long the cancer can be kept far away, where it belongs! Still, she says that she has seen many dogs in her clinic do quite well on it, and I know that I’m going to be one of them!

Stay tuned, because in the near future, I’ll talk about:

  • Costs involved with different therapies for treating pulmonary metastasis
  • K9 Immunity and how it helps bone cancer dogs
  • Different diets for bone cancer dogs, and more!

Recommended Reading:

Metronomic Therapy for Canine Osteosarcoma Metastasis Jerry’s Experience

My Diet While Fighting Osteosarcoma

Cyclophosphamide vs. Chlorambucil in Metronomic Chemotherapy

More About Chlorambucil, Cyclophosphamide for Metronomic Chemotherapy

Dr. Rosenberg’s Thoughts on Metronomics and Supplements

Fighting Osteosarcoma with My K9 Immunity Clinial Trial

Morris Animal Foundation Studies Metronomic Chemotherapy

My Chemotherapy Check-Up: Dr. Mullins Gives Me an “A”

Jerry Update: Metronomic Protocol is Working!

39 Responses to “My Metronomic Therapy”

  1. I have more reading to do. Metronomic….

  2. My golden, Cosmo, is about 10 months post-osteosarcoma diagnosis and doing great. Just after amputation he had four rounds of carboplatin and tolerated it fine. Now (several months later), however, there are nodes of cancer in his lungs and we’re considering the Metronomic protocol. My question is: does anyone know what the dosage of Cytoxan should be? My vets prescribed just 25 mg every other day – which seems very low to me…

  3. Dear Admin:

    Did you notice that the metronomic protocol darkened Jerry’s teeth? Also, did you notice any discoloration on Jerry’s body after starting the protocol? I’m not too concerned about these issues — just curious.

    Thanks so much for your kind responses.

  4. Hi Admin:
    Another question. I just received my order of K9 Immunity and Transfer. Since I am now giving my dog the metronomic protocol in the mornings, do you think there’s any problem with giving the K9 with her evening meal at 5 p.m.? I’m trying to avoid so many pills at one time in the morning, and lunch isn’t as convenient for me to give the pills. Thanks.

    • Hi Marilyn, as far as we know, we were told that breaking up the K9 supplements is fine, or giving them all at once, whatever your dog will tolerate. But for the best info, we suggest calling the K9 Immunity people, they are really great about answering questions; 775-882-5959

  5. My 11-year-old Chesapeake Bay Retriever had her spleen removed last week because of a ruptured tumor and just started the metronomic protocol today (piroxicam, cyclophosphamide and furosemide). Does anybody know what time of day is best to give my dog the pills? Also, I’m giving her a fish oil supplement and considering using K9 Immunity as well. Anybody have an opinion about the effectiveness of K9 Immunity?
    Thanks so much for any help you can offer.

    • FYI: The BoneCancerDogs website recommends you give Cytoxan as one dose in the morning. Also be sure your pup gets lots of water and plenty of pee breaks throughout the day!

    • Thanks for asking Marilyn. You’ll find much more advice and help by searching the discussion forums than we alone can offer here in the blog.

      We attribute much of Jerry’s longevity to his K9 immunity and metronomic therapy. I do recall mention in one of the threads regarding time of day for administering Metronomics, just can’t put my finger on it right now.

    • Marilyn:

      My boxer didn’t tolerate the metronomic therapy well and we had to discontinue it. I do remember that the one of the side effects of the cytoxin was frequent urination, so they told me to give that to him in the morning so that he could go out frequently and relieve himself. I gave him all three medicines in the morning. Unfortunately, as I mentioned, he didn’t tolerate the medicine well and within a month the cancer had spread to his spleen, liver and kidneys. In addition to that he had an unrelated growth in his lung. We had to put him down on 3/4 and we are still trying to recover. I hope your dog does better with the therapy and it works for her. Good luck

      • We really appreciate your input Collette and are extremely sorry for your loss. Thank you for sharing this info which is certain to help others caring for their own cancer pups.

      • I had been giving the chemo in the evening, but I’ll switch to mornings. Thanks so much!

      • I just re-read your response and realize that I missed the saddest detail. I’m so sorry that you lost your dog. Thank you for taking the time to help me.

    • Hi Marilyn, do visit the forums and post your question there, but I just wanted to add that our doctor said morning was the best time for the chemo. You want to make sure your dog eliminates it out of her system throughout the day, it should not sit in there overnight. Just ensure lots of water is available and lots of potty breaks too.

      And yes, I agree with Jim, K9 Immunity is AWESOME! My oncologist is a true believer in it, and is in fact conducting clinical trials for it too.

      We hope your fur baby has a smooth recovery. We send our well wishes.

      • Thanks for your good words about K9. I ordered both K9 Immunity and Transfer. Plus, I’m adding fish oil to my dog’s food every meal. Please keep good thoughts for my sweet dog.

  6. Collette Martin January 31, 2009 at 7:10 am

    My 10 year old boxer has hemangiosarcoma and we just started the metronomic therapy this week. He did well the first two days but last night he started not feeling well, threw up and now has no appetite. I’ve got a call into my vet to see what I can do. Not sure if I should give him his medicine this morning because he is supposed to take it with food and of course he has no appetite. They were able to remove the 2 lb tumor from his abdomen three weeks ago and visibly there was no spread to other organs. Of course with hemangiosarcoma being a cancer of the blood vessels, the vet feels that there has probably been spread but we haven’t seen evidence yet. That is why we are doing the metronomic therapy. Any suggestions would be helpful.

    • Thanks for commenting! Sorry to hear your pup isn’t taking to the metronomics so well. We would definitely recommend NOT giving him the chemo pill without food. Please post your concerns in the Tripawd Discussion Forums where our growing community of members can provide much more help and advice that us alone. Best wishes to you…

  7. Hi,
    My beautiful 9 year old Lab Zoie was recently diagnosed w/osteosarcoma. She a hind leg amputated and 1 round of chemo. She got very sick. She also has advanced kidney disease. We are discontinuing the chemo….can you offer any help?
    Thanks,
    Annamarie

  8. Hi Gage, welcome to the tripawds community! Check out the discussion forums for loads of advice and support. We also answered the top ten questions about dog cancer and amputation there and here in the blog.

  9. Hi everyone! My name is Gage and I am a 10 yo rottie. I was just recently dx with osteosarcoma a few weeks ago, my mom has been deperately trying to deny the fact that I am sick, she cries and cries. I have spent alot of time with my grandma since my mom returned to school a year ago. Grandma noticed I wasnt feeling well and called mom to come home. Mom and Dad took me to the dr and I have been with them ever since. Last night I started coughing really loud an almost bark like cough. Mom says that I had my shots for kennel cough and she doesn’t know what it is wrong. My nose is runny and my mom has started me one antibiotics. I think your posts are helping her to better understand and will give her hope. Is there any advice or recommendations that you have for my mom? She worries alot. She is a Nursing Student and takes my vital signs constantly. Thanks.

  10. David and Karla Bruck April 4, 2008 at 8:07 pm

    We have been thinking about you Jerry, we have asked our friends, the “pink sisters”(Carmelite nuns here in ST. LOUIS) to pray for you! We are so excited for you and your new chemo pills! We will keep checking your site for updates.
    Keep the Faith!
    David, Karla and HEIDI

  11. Dawn,
    We are so sorry to hear about Stichie, and hope for a good outcome.

    About costs…my pawrents and oncologist are working on a chart that will show estimates for the different treatment options for treating lung metastasis. That should be up here very soon. For now, I will say that on the front end, the costs of metronomic protocol treatments are around $200 every 50 days or so, not counting the K9 Immunity that I am taking. There are less expensive ways to do the protocol that we will investigate, like getting the cheaper doxycycline from Walmart as part of their $4 generic prescription option. For now, the cost I’ve mentioned is a ballpark figure. I don’t know the exact costs of chemo yet, only to say that each treatment is about $600 (anyone care to correct me?). We will have a chart to you shortly.

    As far as if/how the therapy is benefiting humans, this type of therapy is being used with humans battling cancer. My Mom found a mention of it when Googling “metronomic protocol” and “humans.”

    Please let us know how Stitchie is doing. We send our love and thoughts your way.

    -Jerry

  12. Hi Erin,

    Please try not to worry about Taylor. My Mom and Dad tend to be ultra paranoid too, so you’re in good company. Remember, one day at a time. Take him to the vet and see what they think. It may be nothing. I have lipomas too, and they are harmless. If I had one near my butt I’d probably sit funny too!

    About that cough; well, from what the vets have told us, that symptom is something that happens very late in osteosarcoma. I cough sometimes, and we finally learned that it is because the tumor that’s in my lung may be bothering my esophagus, because it seems to be on top of it. That may be one reason why I cough, but really, I’ve been doing it for almost a year. My pawrents of course thought it was a sign that the cancer was back, and it might have just started a year ago, but I’m still doing great and that’s all that counts.

    I also lick my bed a lot, and I didn’t used to do that either until after my surgery. My Mom and Dad never connected the licking with my lost limb until recently, when someone else said that their dog does the same thing. And yes, we dogs do get the phantom limb thing sometimes.

    Please let us know what the vet says tomorrow, OK? Good luck! We send our love.

    -Jerry

  13. I’m sorry to hear of your diagnosis. Our friend Stichie just came back from vet and he has either Osteomitosis(sp)(bone infection or Osteosarcoma. I saw this posting on the acor.org for osteosarcoma because my daughter went through that battle ( successfully) last year. The ability to have pills is very interesting. What are the costs as vs traditional treatment? Also is this research being used to help human treatment?

  14. I’m very glad for this post today! As you guys posted a while back, I have a tripawd named Taylor who lost his leg to osteosarcoma 5 months ago. We have no confirmation yet, but I’m suspecting “it” may be back. He goes for his 2 month post-chemo check-up tomorrow.

    Lately ( in the past few days) I’ve noticed him having a “wet” cough every once in a while. My other issue is that he is an older dog, and for years has had a lot of lipomas over his body. Most are in random harmless places. There is one, however, that is on his upper, inside leg (lower butt-cheek) that makes him spread his legs a little. I’m afraid because if it gets bigger, I don’t think we can get it off, since he’s old and can’t get around on 2 legs. And even though his legs feel bumpless he’s been licking his remaining front leg more than usual. I’m paranoid about that too. When he lays down on his dogbed, I see him licking the bed where his other leg would be. I didn’t think dogs had the phantom limb thing.

    I’m sorry for the long reply, but I think you all know the stress, worry, and paranoia that comes with having a dog with cancer! If anyone has suggestions, they would be quite welcome!

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