Caring for a Three Legged Dog or Cat
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Hi Pam
Another chemo question, although I don't have All the information necessary for a 'good' description of the possible problem yet. He had a cardiac ultrasound today, because he is scheduled for Adriamycin tomorrow and I have been a bit worried (the needless worry kind) about his panting. I am writing a bit prematurely given I am scheduled to drop him off for chemo at 8 in the morning. Overall he was in excellent form this weekend as of a trip to a decent dog park.
We just got back from the ultrasound. That is an interesting machine that provides good information, for sure. Overall, things seemed good from what the vet doing the US said. But near the end on the left side, he did find less contraction than he liked in one layer (the bottom layer) whereas contraction in the other two layers were good. He said he couldn't say it that was the result of age or chemo. I never viewed lively 8 yr old Tazzie as old, but I suppose many people who see his shaved 3-legged incarnation think he is is old, or at least a lot of people mistakenly assume a dog is old if it has cancer.
(There was also a very small murmur somewhere else that he detected on the right side - sorry I don't remember the names - which did not seem to concern him at all.)
Regarding the contraction issue, the US vet was going to have to make some calculations to figure out whether things fell in the normal range or not. He couldn't say from seeing the US alone. He said my vet would use that information to decide if the chemo was suitable. (She is working tonight, so with luck she will get the results (from a different clinic) and sort this out tonight.)
My question is what a person does if they switch chemo drugs once they have started one protocol and the implications of doing that? As you know we are alternating Adriamycin with Carboplatin. We have only had two treatments, one of each. I assume we would just switch to carboplatin if she decided the adriamycin was not suitable. (I suppose the vet here could call the oncologist in Calgary to see what they do if they have a heart issue arise, but I don't know if that would be particularly helpful.)
As for the implications, would that be the same as beginning chemo with the last treatment which was carbo? I understand the adriamycin does not help unless the patient gets at least three rounds.
Although I want to treat the OSA, I don't want to kill him even more prematurely due to heart or kidney failure. We could just leave it up to the numbers calculated by the ultrasound results. Or I could say - no more Adriamycin - and pull a switch.
Susan
I was just reading the notes I found on the web when Tazzie was first diagnosed and it says to have a cardiac US if planning to use Adriamycin. That might have been a very good thing to have done!
I did not use Adriamycin on my Tazzie since she already has borderline function. The fractional shortening for a dog is usually in the 40-55% range. I personally would not give Adriamycin if it was below 30% but your oncologist may differ. There is an expensive drug (Zinecard?) that can protect the heart muscle but I have never used it.
If you need to drop the Adriamycin you would continue with carboplatin alone every 3 weeks for a total of 4-6 doses.
My personal opinion would be to drop the Adriamycin if there is even borderline heart function, since once the muscle is damaged there is no healing it and there is no proof that combo therapy increases survial with OSA anyway.
I do give Tazzie 100 mg of CoenzymeQ10 daily to benefit her heart and liver. I use the NatureMade human product.
Pam and Tazzie
Pam
Thanks for the quick response. And thanks for mentioning Zinecard and Coenzyme Q10. Great ideas.
The ultrasound results arrived when I dropped Tazzie off this morning. I don't know the specific values but the vet said they were a bit low. She was going to do the EKG, blood values and go from there. So I think she was leaning to using Adriamycin if everything else checked out - but hopefully she will phone (this person is communicative). She is a GP vet. There is no oncologist here. But this vet seems very good, so that should be okay and we can probably find an oncologist to consult when needed.
Speaking of which . . . I am afraid something else came up last night. I was brushing Tazzie's fur and felt a hard lump around his right hip. It feels bony and probably about an inch in diameter. It feels like the spine and bone mets I felt on a young lab I met at a clinic a few weeks ago. I can't think of anything else they could be. I won't get too upset until we find out more, but had kind of thought we'd be okay for at least a few months. You never know.
Anyway, this new development is not appropriate for the 'ask a vet' forum, so I'll post in a different heading if we find out more.
Susan
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