Caring for a Three Legged Dog or Cat
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Hi Pam,
I was wondering; based on your experience with Tazzie and the side effects of Cytoxan, did you ever find or try an acceptable anti-cancer drug substitute to use in place of the Cytoxan (forgive me if you did and I missed that post)?
If a dog gets cystitis, what is the course of treatment, other than stopping the Cytoxan? Are there specific drugs that help get rid of the cystitis?
I'm writing an article for a publication and want to make sure I have my facts straight. Thanks for any insight you can provide.
-R
Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet
Hi Jerry and R,
I am interjecting in your question to Pam, but thought that Maximutt's recent post was relevant. Knowing you, you probably already caught that one. I am guessing the switch from Cytoxan to Leukeran might have been to avoid crystal issues, but do not know that. I sent a message to the oncologist who prescribed Maximutt's protocol earlier today, so I really hope to hear back, and will let you know if I find out more. But I bet she is one busy person!
This dosage of Cytoxan is far higher than the one recommended in the paper the Calgary oncologist recommended (25 vs. 10 mg, for the sake of lowering side effects). I'd love to read anything you write on the topic.
From Maximutt last week: "We started out with: Cytoxan (25 mg, one pill/day), Piroxicam (10 mg, one/day), and Actos (30 mg one/day). After 8 weeks, we switched from Cytoxan to Leukeran (2 mg, 2/every other day). If I remember correctly, Cytoxan can also cause crystals to build up in the bladder (??), causing some difficulty when urinating and blood in the urine (also painful), so we were also prescribed a medicine called "Lasix" (a diuretic) This was something that helps with urinating; this was only while Max was taking Cytoxan, though."
Tazzie 2
Even at low doses Cytoxan can cause cystitis. Some dogs get an actual infection and some just get inflammation with straining and bloody urine. Giving a diuretic (Lasix) may help reduce these side effects. It seems that females are more likely to develop this problem. In most cases the cystitis will resolve once the Cytoxan is discontinued but a small percentage of dogs will need sedation and flushing of the bladder along with DMSO or other anti-inflammatories. This can be a very painful problem so in general most oncologists will not use Cytoxan again if cystitis occurs.
The two other chemo drugs most commonly substituted are CCNU (Lomustine) or chlorambucil (Leukeran). CCNU can cause low platelets or elevated liver enzymes in some dogs. Leukeran is pretty benign but might cause bone marrow suppression. I had to stop Cytoxan in Tazzie because of a very bad bladder infection (Pseudomonas cystitis which took 6 weeks of antibiotics to resolve). I tried CCNU with my other dog Kona and her liver enzyme became too elevated but returned to normal after I stopped the drug.
Maximutt's Cytoxan dose does seem high. Tazzie weighs 185# and her dose was 25 mg once daily. Even a slightly elevated dose can increase the risk of problems so that is why most dogs need it compounded.
Metronomics is a new field so you will see many oncologists trying new drugs and combos to increase the success rate. Above all we should try to do no harm and since Tazzie is still in "prevention mode" I decided to only do the Metacam without a chemo drug. I might try a different drug later if she gets mets.
Pam and Tazzie
tazziedog
That info is really helpful and probably covers all the questions in my earlier post (haircut thread). Do you know what the Actos is used for in Maximutt's protocol? My vet is trying to figure that one out.
Tazzie 2
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