Caring for a Three Legged Dog or Cat
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I am soon to start metronomics .
I assumed Simon would be getting Cytoxan to reduce cystitis. One of the vets I consult with, ( one of the vets involved with the vax trial) is using Lasix.
not sure what is standard of care vs vet preference.. thoughts?
Cytoxan is the chemo drug that can cause cystitis and Lasix is the diuretic that may prevent it, although as far as I know there are no actual studies that proves it works. I gave my dog Tazzie Cytoxan and she did not get the sterile hemorrhagic cystitis but I did have to discontinue it due to UTI.
Pam
thanks for the reply.. I must have made an error in my notes:
I thought the protocol was :
cyclophosphamine
Cytoxan
piroxicam
Lasix
doxycycline
mitoxantrone,
So, now I realize that Cytoxan and cyclophosphamide are cancer agents,, where you use one or the other.
I read that doxy is out of favor and you'd need such hi doses that it would be toxic. Some people on the forum are using doxy. My onco vet doesn't. Isn't doxy outdated?
Piroxicam. I will probably use this as my dog is on galliprant. so why not drop the galliprant and add piroxicam?
Lasix is used by my 2nd opinion onco vet,, I have to see what my primary offers, suggests,
Mitoxantrone,, not sure where on the forum I read about this,
I read that some or someone had discussed that they used thalidomide instead of piroxicam because it is useful in preventing lung mets in oseteocarcoma. that interested me and I made a note of it.,
re cap: My 2nd opinion vet would rx cyclophosphamide and Lasix every other day.. she would add piroxicam when I mentioned my dog was on galliprant.
What would you rx for cutting edge standard of care,? Because Simon can't get the vaccine. I'd like to be smart about my choices... It seems that there are more than one correct combo. And I know my onco rad vet might offer a few combos and I can have input as well.
thoughts? and thank you for taking your time,, it is a blessing to have your help and advice.
Hey there, I am not a vet but my pup is on metronomics
for soft tissue sarcoma. Cyclophosphamide and Cytoxan are different names for the same drug--Cytoxan is a brand name. Smokey is on cyclophosphamide and galliprant. We went to UC Davis and their metronomics
protocol is cytoxan with an NSAID--no mention of doxy or anything else. It is my understanding that cyclophosphamide is the standard but some vets are using different chemo agents, like Mitoxantrone. I looked that one up because I had not heard of it. Looks promising but I would ask about effectiveness as compared with cyclophosphamide. I would assume that Davis, as a teaching hospital, is on the cutting edge in what they do but who knows. They are definitely all about 'evidence-based' medicine and that is not always 'cutting edge' 
. Smokey can't tolerate any NSAID so he is getting galliprant in the hopes that will serve the same purpose but I don't think there is any evidence out there to back up my theory. He is also getting ArmorUp. We have no sign of cystitis after 4 months on cyclophosphamide so all paws crossed! Has Simon taken NSAIDS before? None of my dogs can tolerate them (GI upset) and 3 are GSDs. No harm in trying piroxicam instead of galliprant (well, except for possible GI upset....but it HAS to be cheaper, right?!?) but you might discuss further with your vet.
xoxo,
Martha, Codie Rae and the Oaktown Pack
Woohoo! Tripawds Rule!
Regulator of the Oaktown Pack, Sheriff of the Oaktown Pawsse, Founding member and President of the Tripawd Girldogs With 2 Names ROCK Club, and ... Tripawd Girldog Extraordinaire!
Thank you for your reply and clearing up my confusion with the two cancer meds being the same one generic one brand name, many thanks. Did uc davis give a diuretic to prevent cystitis? I honestly can’t remember if Simon has nsaids. . But I will look into his records. I’m thinking no. He is on Galliprant now but I would consider a switch when doing the metronomics ,
My Dobe Nitro eventually went on Galliprant when his kidneys were failing, as this is supposed to be easier on kidneys that other NSAIDS.
Paula and Warrior Angel Nitro
P.S. Our metronomic protocol was Cytoxan and Piroxamide
Nitro 11 1/2 yr old Doberman; right front amp June 2014. Had 6 doses carboplatin, followed by metronomic therapy. Rocked it on 3 legs for over 3 years! My Warrior beat cancer, but couldn't beat old age. He crossed the Bridge peacefully on July 25, 2017, with dignity and on his terms. Follow his blog entitled "Doberman's journey"
"Be good, mama loves you".....run free my beautiful Warrior
Thank you for your reply. My understanding is that galliprant doesn’t do what the nsaids do to help the metronomics ? Thoughts on that?
I don't have any info on that....galliprant was new on the market when we had to get Nitro off the NSAID's. He was finished with the metronomic therapy at this point.
Paula
Nitro 11 1/2 yr old Doberman; right front amp June 2014. Had 6 doses carboplatin, followed by metronomic therapy. Rocked it on 3 legs for over 3 years! My Warrior beat cancer, but couldn't beat old age. He crossed the Bridge peacefully on July 25, 2017, with dignity and on his terms. Follow his blog entitled "Doberman's journey"
"Be good, mama loves you".....run free my beautiful Warrior
Galliprant is an NSAID that works via a different pathway than the others so I am not sure if anyone knows yet what this might do in the metronomic protocol. The standard of care NSAID is piroxicam or meloxicam although some vets think Deramaxx may also be helpful in this way. Our local oncologist does not use doxycycline or Lasix with the metronomics . Her choice is piroxicam (if tolerated) and Cytoxan every other day.
CCNU used to be used as a metronomic but many dogs develop elevated liver enzymes on this drug so I think it is used for other cancers but not OSA. Some vets have also used Leukeran but I do not know anyone that uses mitoxantrone yet. Palladia is also an option.
Pam
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