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Handling Metronomics Safely?
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Member Since:
1 January 2010
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18 June 2010 - 9:54 am
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Holly will be starting on metronomics on Monday.  Our vet had the prescription sent to a compounding pharmacy who mailed the month's supply to me.  Do I need to be careful in handling the pills?  She'll be on cyclophosphamide - they are 6mg capsules, which she'll get once a day.  I asked our vet and he didn't think I needed to worry about it, and the pharmacy didn't put any warnings on the label or in the package they sent.  I am pretty sure Holly is the first dog at our vet's practice to use metronomics .

And I'd like to start her on fish oil at some point.  Our vet said he'd like to wait until after she's started her metronomics to be sure we're not introducing too many things at once.  He also said he would use a prescription (which his office will fill) grade fish oil.  Is there a big difference in pharmaceutical grade fish oil and what I can get in the drug store or pet store?  And what amount should I give Holly? She weighs 30 pounds.

Pam, I've never posted on the ask-a-vet forum before, but I just want to say I have read so much of what you post and really appreciate all of the help you provide to us! 

Thanks,

Susan

Holly joined the world of tripawds on 12/29/2009. She has a big little sister, Zuzu, who idolizes Holly and tries to make all of her toys into tripawds in Holly's honor. And she's enjoying life one hop at a time!

http://anyemery.....ipawds.com

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18 June 2010 - 10:19 am
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anyemery said:

Do I need to be careful in handling the pills?

Is your vet an oncologist? It's clear he's not familiar with metronomics . Read Jerry's post for complete details about his metronomic treatment for osteosarcoma. We were given specific instructions not to handle the Cytoxan (cyclophosphamide) directly, and even provided with gloves by the board certified veterinary oncologist who filled the prescription. She also gave warning about children or other dogs not coming into contact with Jerry's urine after he had his dose. Even I think this may be overkill, but I am no vet.

Regarding the "prescription" fish oil ... sounds like your vet may be trying to sell you one more thing. It is important, however to use supplements that are third party tested. K9 Omega is a certified organic fish oil supplement made by Aloha Medicinals, the makers of K9 Immunity. No prescription required, and they certainly know what their talking about. We just gave Jerry high quality over the counter fish oil pills – once a day in the morning. Here's complete details about his cancer diet and supplements.

be careful hadndling cytoxanImage Enlarger

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

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18 June 2010 - 11:00 am
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Thanks, Admin!  One of the reasons I posted was I read through Jerry's information and saw that you used gloves.  My vet is not an oncologist, and I am fairly certain he had never heard of metronomics before I brought it up.  I think "an ounce of prevention is worth a pound of cure" fits the bill in this case...  I'll get some gloves.  Did your vet also caution you about Jerry's poop?  I wonder if urine is of more concern than poop?

And I was wondering about the fish oil... I take it for my cholesterol and my doctor didn't think I needed pharmaceutical grade fish oil!  I just need to figure out the dosage for Holly.  I'll read through Jerry's diet posts, too. 

Thanks,

Susan

Holly joined the world of tripawds on 12/29/2009. She has a big little sister, Zuzu, who idolizes Holly and tries to make all of her toys into tripawds in Holly's honor. And she's enjoying life one hop at a time!

http://anyemery.....ipawds.com

On The Road


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18 June 2010 - 11:27 am
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The pee was definitely more of a concern than the poop, but other pets should not come into contact with either considering that ounce of prevention.

For fish oil, Aloha Medicinals recommends "...1 softgel per 20 lbs body weight per day." FYI, their K9 Omega is, "...1000 mg of fish oil concentrate each."

You – and your vet – might also find this report Aloha published informative:

Fish Oil and Chemotherapy: DHA omega-3 may improve chemotherapy outcomes: Study

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

Wesley Chapel, FL
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13 September 2009
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18 June 2010 - 2:54 pm
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Not to freak you out… but all chemo must be handled with gloves…

This was taken from the Toxicological Information section of the MSDS (Material Safety Data Sheet) for cyclophosphamide.

 


Chronic Effects on Humans:


May cause damage to the following organs: bladder, bone marrow. 


Other Toxic Effects on Humans:


Hazardous in case of ingestion. Slightly hazardous in case of skin contact (irritant, permeator), or inhalation.

Special Remarks on Chronic Effects on Humans:


May cause adverse reproductive effects and birth defects (teratogenic). May cause cancer. May affect genetic material (mutagenic)


Special Remarks on other Toxic Effects on Humans:


Acute Potential Health Effects: Skin: May cause skin irritation. Eyes: May cause eye irritation. Inhalation: It may cause respiratory tract irritation. Ingestion: May be harmful if swallowed. It may cause nausea, vomiting, stomatits, hemorrhagic colitis, diarrhea. Chills, fever, and sore throat may also occur and indicate leukopenia and/or infection. Unusual sweating and flushing of the face, swollen lips may occur. It may affect the cardiovascular system (tachycardia, cardiac tamponade, cardiotoxicity.) Cardiotoxicity is a less frequent side effect. Tachycardia associated with fever or chills and shortness of breath may be a sign of cardiac toxicity including acute myopericarditis. It may also affect metabolism (acidosis), blood (aplasitic anemia, hemorrhage, leukopenia, thrombocytopenia, myelosuppressioin), skin (apolecia, nail disorder, skin discoloration), endocrine system (hyperglycemia, antidiuretic hormone disorder), the urinary system (cystitis, renal failure, hyperuricemia, hematuria, dysuria), respiratory system (shortness of breath or dyspnea, pneumonitis, interstitial pulmonary fibrosis. It may also be neurotoxic and affect behavior/central nervous system (ataxia, dizziness, agitiation, changes in mental status, seizures, cerebular dysfunction, coma, headache, polyneuropathy, fatigue, confusion). It may affect the liver and cause hepatitis. It may also cause allergic reaction (anaphylaxis). Chronic Potential Health Effects: Ingestions: Prolonged or repeated ingestion may have similar effects that of acute ingestion.
 
 
Angel Jake's Mom


 

Jake, 10yr old golden retriever (fractured his front right leg on 9/1, bone biopsy revealed osteosarcoma on 9/10, amputation on 9/17) and his family Marguerite, Jacques and Wolfie, 5yr old german shepherd and the newest addition to the family, Nala, a 7mth old Bengal mix kittie. Jake lost his battle on 11/9/2009, almost 8 weeks after his surgery. We will never forget our sweet golden angel… http://jakesjou.....ipawds.com ….. CANCER SUCKS!

Los Angeles
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18 June 2010 - 5:14 pm
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Hi Susan,

I do use gloves to handle the cytoxin and am very careful about not letting the bottle touch any surfaces.  I also store it in a plastic baggie so that it can't contaminate anything else.  I know that might be overkill.  When I picked up my first prescription, the tech told me to use gloves. Then when I picked up my 2nd prescription, another tech told me that when cytoxan is in capsule form, you don't need gloves. It's in the white powder form where you do.  But regardless, I still use the gloves.  It did give me a little bit more comfort knowing that though if that's the case.  

Thanks Angel Jake's Mom for posting this toxicology information - I didn't know what the effects would be if I came into contact with it so this is very helpful.    Also regarding the pee and poop, I didn't know that other pets shouldn't come into contact with this.  But how do you know and control this?  Mackenzie and Kobe are always in the yard together so I have no way of knowing if Kobe is stepping on her pee, etc.    I also wanted to mention that my vets said that if pets drink out of the same water bowl that that's ok - shouldn't be a problem (hope this is the case since Mackenzie and Kobe share their water bowls.)

 

Thanks Susan for posting this - it's very helpful to me too while going through this therapy.

Kami

smile 

My sweet golden Mackenzie.  She became my angel on Dec 29, 2010 at the age of 8 1/2  although she was always my angel from the time we brought her home.  She was diagnosed with osteosarcoma in Sept 2009 and officially became a tripawd (front leg) on Nov 5, 2009.  She will be forever in my heart and now she's running free with all of our other tripawd heroes.  I love you Mackenzie!

Member Since:
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18 June 2010 - 5:34 pm
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Kami

 

My boy Titan was prescribed chemo pills from Rite Aid and they never explained anything to me. I knew in the back of my head I had to be carfeful with them but I was so emotionally and physically tired that when I got home I gave 1 pill to Titan. Needless to say even though I washed my hands throughly after I gave him the pill I ended up with eye infections so be very careful handling them.  Hope all goes well with you guys

 

Heidi and Angel Titan

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19 June 2010 - 9:08 am
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Thanks everyone for your posts.  This is all helpful information - and I will find gloves to use when giving Holly this med.  Thanks Angel Jake's mom for the information you posted - it didn't freak me out, but it is helpful knowing what the effects could be.  And thanks also to Heidi - it puts it into perspective that just one time handling it could cause a reaction.

So... next question... What kind of gloves do you use?  Rubber gloves, latex gloves or non-latex gloves?  I've been trying to find small, non-latex rubber gloves - for some reason I keep thinking that latex will have a taste that Holly won't like.  I can't find non-latex gloves small enough for my hand.  I know I can get Platex rubber gloves in the right size for me - will those do?  I'm wondering if the oncologist who our vet consults with would have gloves she can give (or sell) me.

Thanks again,

Susan and Holly

Holly joined the world of tripawds on 12/29/2009. She has a big little sister, Zuzu, who idolizes Holly and tries to make all of her toys into tripawds in Holly's honor. And she's enjoying life one hop at a time!

http://anyemery.....ipawds.com

Los Angeles
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2 November 2009
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19 June 2010 - 9:37 am
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Susan,

I use the medical latex gloves (powder free).  Your vet should have some to give you but I also buy these at Target and Walmart.  They come in bulk packs (50 to a box, etc) and can be found in their pharmacy area.  Not too expensive either - $4 - $5 per box of 50.   These seem to work pretty well to and slip on and off pretty easily too.   I put Mackenzie's pills in a pill pocket so she doesn't mind eating it at all (but if I recall, Holly doesn't like pill pockets?) so you might want to find something she does like to put the pills in. 

Good luck!

Kami

 

My sweet golden Mackenzie.  She became my angel on Dec 29, 2010 at the age of 8 1/2  although she was always my angel from the time we brought her home.  She was diagnosed with osteosarcoma in Sept 2009 and officially became a tripawd (front leg) on Nov 5, 2009.  She will be forever in my heart and now she's running free with all of our other tripawd heroes.  I love you Mackenzie!


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19 June 2010 - 9:42 am
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I would use gloves (latex are fine) but the risk from Cytoxan in capsule form is very low (higher risk with tablets).  I used a hemostat to put Tazzie's pill in a pill-pocket so I never had to touch it.

Any fish oil is fine as long as it is mercury-free.  I used to use 3V Caps because they were so concentrated but they went off the market so now I buy Natures Made double strength for my big dogs.  You need to use a pretty high dose for anti-cancer effects so Holly should get 1200 mg twice daily (this number refers to the amt of omega 3 oils so add up the total from the EPA and DHA). I would have started the fish oil at the time of diagnosis and I would also consider Power Mushrooms or K9 Immunity .

Pam

Los Angeles
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19 June 2010 - 9:43 am
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Oh and Susan I meant to add that these are disposable - you want to use disposable and throw away each time after you give her the cytoxin. 

My sweet golden Mackenzie.  She became my angel on Dec 29, 2010 at the age of 8 1/2  although she was always my angel from the time we brought her home.  She was diagnosed with osteosarcoma in Sept 2009 and officially became a tripawd (front leg) on Nov 5, 2009.  She will be forever in my heart and now she's running free with all of our other tripawd heroes.  I love you Mackenzie!

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19 June 2010 - 9:44 am
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I also used the latex powder free. It didn't bother Titan at all.  You may just have to stick the pill down her throat. I liked those gloves because when you took them off you could peel them off inside out

 

Heidi and Angel Titan

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19 June 2010 - 6:24 pm
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anyemery said:

I know I can get Platex rubber gloves ...

We'd recommend disposable gloves and seriously doubt Holly will mind them being latex.

Active Forever has all sizes of gloves... winker

 

[Image Can Not Be Found] Invacare Powder Free Latex Exam Gloves - Size - Small 100 per box Box of 100

Invacare Powder Free Latex Exam Gloves are non-sterile ambidextrous examination gloves designed for use in numerous settings. These latex exam gloves are powder free to eliminate skin irritation typically associated with powders. With a textured finish and high tensile strength, Invacare Powder Free Latex Exam Gloves also feature a beaded cuff to prevent roll down suring use. Buy your Invacare Powder Free Latex Exam Gloves from ActiveForever.com today!








 

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

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23 June 2010 - 11:55 am
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Thanks, everyone!  Holly's been on metronomics for 3 days now - and I'm using disposable latex gloves without any issues.  I also have her on fish oil, so thanks for the dosage, Pam!  I'm just putting the pill down her throat and following it with a cheese chaser.  That seems fine to her. big-blink

Holly joined the world of tripawds on 12/29/2009. She has a big little sister, Zuzu, who idolizes Holly and tries to make all of her toys into tripawds in Holly's honor. And she's enjoying life one hop at a time!

http://anyemery.....ipawds.com

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