Caring for a Three Legged Dog or Cat
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Howdy all!
It has been a rough couple of weeks for Lily (and me). We went in last week for our restaging (before 4th dose of Carboplatin). We are fighting OSA and are almost 3 months post amputation of left front leg...Everything looked good except for the abdominal ultrasound. It revealed 3 masses (one at least 3cm x 3cm and the other two just millimeters in diameter) in the spleen that weren't there two months ago. Given the potential risk in the future for rupture (and the fact that Lily is so stoic and wouldn't show me that anything is wrong until it's too late), I opted for splenectomy while she's otherwise healthy and strong...Splenectomy was last Friday (8/24/12) and she is recovering well at home!
Got the histopathology results back today which confirmed that the splenic masses were metastatic OSA...Lily's OSA hasn't played by any of the 'usual' rules, thus far...She's receiving chemo treatment at A&M and they have recommended that we change the chemo to Doxorubicin instead of Carboplatin (given the treatment failure). I'm for the change but am worried about the cardiotoxic effects of the Doxorubicin. I'm a Physician Assistant and am somewhat familiar with some oncology treatments such as Dexrazoxane. Dexrazoxane is given to humans as a cardioprotectant when they are on Doxorubicin and has shown to markedly decrease the cumulative cardiotoxic effects of Doxorubicin. I've done a cursory literature search and have found a few articles where Dexrazoxane has been used in the veterinary realm successfully...does anyone have any experience with this? Any thoughts on this as opposed to just using CoQ10 supplementation as a cardioprotectant?
I know the probability of cardiac side effects is low but 'm having a hard time with this because I would hate to see any cardiac side effects decrease the quality of Lily's remaining life...Even if you don't have any thoughts on the Dexrazoxane, I'd love to hear from some pup pawrents who's pup is or has been on Doxorubicin and what their experiences have been!
Thanks!
Allison and Lily (the asplenic Tripawd)
- so much has happened and we are missing enough 'parts' now that I think I could write a country song about a 3 legged asplenic dog! I'll just add something about her being in the rain and not knowing who her daddy is!
Lily is 9 y/o Shepherd/Lab/Pit mix who was diagnosed with osteosarcoma 5/26/2012. Left front ampuversary 5/29/12. Eastern and Western medicine used to attack the cancer. Splenectomy secondary to mets 8/24/12. Mets to right rear femur, neck and lungs 9/21/12. Sweet Lily fought hard for 4 months and earned her wings on 9/27/12. Run free and chase those squirrels my love bug!
Allison and Lily,
Wow, you two have been through a LOT lately, I'm so sorry. It's a good thing you have a medical background Allison, at least you know more than the average bear.
I don't have any experience with dexraoxane but we do have some info on doxo side effects that you might find helpful:
Cisplatin and Doxorubicin Side Effects in Dogs
and when I searched for "doxorubicin side effects" in the forums, this is what I found
It's so hard to know what the 'right' decision is at a time like this. Whatever way you decide to go, as long as you make it with love you can't go wrong.
I'll just add something about her being in the rain and not knowing who her daddy is!
And you also have to mention your broken down truck and no money in the bank!
Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet
Hi Allison and Lily,
Sorry, I have no experience with Dexrazoxane but will ask the oncologist about it on our next visit. My dog is also on Doxorubicin (he gets alternating treatments of Carboplatin and Doxorubicin). They did do an echocardiogram of his heart before starting the Doxorubicin to make sure that his heart would be able to take it. He is only 2yrs old though, and an otherwise very healthy dog. The only side effects I've seen so far from the Doxorubicin is soft stools which started 3-4 days after the treatment and lasted for several days. He never missed a meal and has never acted "sick". And I know they're giving him the high end of the dosage scale because he is so young and has been doing so well on it (so far). But I do worry about the cardiac effects as well, thanks for mentioning the Dexrazoxane, I'll definitely look into that.
Wishing Lily a speedy recovery on her splenectomy! I'm sure she'll be up and about in no time! Dogs make much better patients than we humans do!!!
Right hind limb amputated 7/3/12 for OSA, started on alternating cycles of Carboplatin and Doxorubicin and oral Palladia. Single lung met 9/1. Met in the neck muscle removed 9/30. Large mass in sublumbar lymph node 10/2. Rescue chemo with ifosfamide 10/6. Mets to the rib and axillary lymph node 10/21. Started Leukeran and Pred 10/25. Wookie left this Earth for a far better place on 12/4/12. I miss you, Boo, you were my heart.
I only treated 1 patient where the oncologist prescribed the Dexrazoxane because he was a Doberman with borderline heart function. It worked well but I recall it was pretty pricey!
We do use a lot of doxorubricin at our clinic and the main side effect I see is vomiting/upset stomach which is usually prevented with an injection of Cerenia prior to chemo. Doxorubricin also can cause some serious issues if given out of the vein so that is why most vets place a catheter and give a slow infusion over 30 minutes or more.
Pam
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