Caring for a Three Legged Dog or Cat
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Osteosarcoma 13 1/2 year old chocolate lab
Hi, I can't find alot of info about the success of Palladia vs. the traditional chemo protocols for mast cell tumor. My Zoe has an usual mast cell tumor that is growing in her front leg, into the muscle of her forearm. The options given were to amputate because they would be unable to just remove the tumor due to its location. The lymph node, bone marrow, and ultrasound/xrays are clear but they did find a rectal mass, that upon needle biopsy showed just inflammation but are unable to get regular biopsy due to its location w/out surgery. I decided to proceed with amputation and follow with chemo and monitor growth of rectal mass. I hate to put her through harsh chemo treatments after all that she will be going through. Palladia seems to be easier to administer and maybe has better tolerability/less side effects?
Any thoughts or info would be greatly appreciated,
Thanks, Karin
Hey Karin - hope you don't mind if I piggy-back on your post. I was about to make a Palladia post as well.
Yoda's chemo for his osteosarcoma didn't work. He has five lung mets. Guess they popped up quite fast since he just had a clear x-ray three weeks ago (they did one yesterday because he devleoped a cough - his energy and spirits are still great though). Anyway, Yoda's oncologist listed Palladia as a possible treatment. My understanding is it's something that's now being tried on other types tumors than mast cell. Yoda's oncologist gave it a 15% chance of having an effect and gave side effects a 75% chance. The Palladia itself would be free, but there would be a lot of lab work to pay for that may be more than I can do. She's going to e-mail me the details and then we'll see.
So anyway, I'd be interested in anything you can tell us on the subject of Palladia too.
Thanks!!
Yoda&Mom united: 9/5/06 …….… Yoda&Leg separated: 6/5/09……… Yoda&Leg reunited: 10/14/09 ……… ……………….………….………….……. Yoda&Mom NEVER separated! …………………….….……....….…… Though Spirit Yoda currently free-lances as a rabbit hunting instructor for tripawds nationwide
No I don't mind at all. I'm so sorry to hear about Yoda's mets. I'm new to site but I love the Yoda stories, he is a stand out! It breaks my heart to hear the bad news, I can only imagine what you must be going through.
About Palladia, I know that it is indicated for mast cell tumors, but I have read that they could see the potential for it to treat additional types of cancer as well. I am a pharmacist, so I am somewhat familiar with the way drug companies work. They have to have indications for drugs, but post market they realize they work for others things and use off label. Please let me know what your vet says. I think they have to monitor white blood cell counts but I'm not sure how often. I was concerned about side effects too, its hard to tell, they have to report everything, with it being so new you just don't know. I'm hoping to find out more info too.
Hang in there, Yoda is a unique and special boy, if anyone can beat the odds, I think its him.
Sorry to hear about Yoda's lung mets, but there's still so much you can do! Just another little hicup in this rollercoaster of a situation! 😛 I wish you guys the best of luck and please keep us updated on what you chose to do for treatment (cuz lord knows most of us will be there eventually...).
<3 Laura and Jackers
Right now Palladia can only be used by board-certified oncologists or internists but I will tell you what I know. Palladia is a tyrosine kinase inhibitor so it works best on tumors expressing this gene. Its label indication is for advanced grade II or grade III mast cell tumors. Not all mast cell tumors express the tyrosine kinase gene and there are few labs that can run this test on the biopsy sample. I am not exactly sure of the stats but I believe that up to 75% of mast cell tumors expressing the gene responded in some way and even about 25% of those without the gene improved. Surgery and chemo or radiation are still indicated as determined by an oncologist. Side effects are mostly on the GI tract but low white cell counts and elevated liver enzymes have occurred.
I talked to our oncologist about this drug as a rescue for other cancers (such as OSA) and as long as the major bulky tumor has been removed (amputation) it may be worth trying for microscopic disease or early lung mets. This is one of the reasons that I have been xraying Tazzie every 3 months because if this drug would be tried earlier is better than later. I can't comment on price but I do know that the drug should be released to general veterinarians in early 2010.
I think it is definitely worth a try for mast cell dogs and may help OSA patients with lung mets. Oncologists using this drug will share their info with Pfizer to help determine which cases may benefit and to see how many dogs have side effects.
Pam and Tazzie
My dog was diagnosed with stage III mast cell tumors with a mitotic index of 13 per 10 high power fields. In other words; bad news! I had the tumor (on his leg) removed and started on chemo. I also had options for radiation, which I declined. The first chemo med was vinblastine. It kept things in check for about 2 months, until regrowth of the tumors began. We then switched to CCNU and it had no effect. Next came Palladia. Initially it shrank the tumors dramatically. I was amazed. However he started having some minor internal bleeding (which is a relatively common, and potentially life-threatening, side effect of Palladia), so the oncologist reduced his dose. Over the next 4 weeks the tumors were mostly unchanged. But, then they started growing again. The dr. increased his dose back to the recommended leve, but it had no effect. He's now off Palladia because of progressive disease.
I would recommend that noone get too excited about this med. The company wants to make it sound like a wonder drug, but even according to their own drug trials it's marginally effective for a short period of time, and carries with it significant side effects. In addition to antihistamines and prednisone, my dog also had to have omeprazole magnesium (prilosec) and Sucralfate to mitigate bleeding issues. He was lucky not to have some of the other side effects, which occur frequently (vomiting, diareahh, lethargy, loss of appetite, etc.)
His oncologist gave me three final options: 1. surgery followed by radiation. Which in his case isn't really viable because of the location and size of the mass. He'd likely have an open wound with the potential not to heal. 2. amputation of the leg. I wouldn't do this to any dog of mine, but in this case it's even less appealing because of the stage and mitotic grade of his tumor....indicating the high possibility that other tumors are present in his body. and 3. try another chemo drug....with very low odds of having a positive effect because of the nasty way mast cell cancer builds resistence.
So, considering he's otherwise very healthy and mobile right now, (he doesn't even know he's sick) I've decided to let him live out his remaining days in peace and fun.
I don't regret giving him Palladia because it's probably given me some extra time with him. Just don't expect a cure.
wayne said:
I would recommend that noone get too excited about this med.
Thank you for the feedback Wayne. Its always great to hear about other's expereines with new treatments. Please consider registering so your posts will appear immediately without requiring moderation.
We'd love to hear more about your pup and why you don't feel amputation is a viable solution for extending quality of life in cancer dogs. Please start a new topic or create a Tripawds Blog if you care to share.
Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet
Wayne,
We all do what we believe is in the best interest of our puppies. I am curious though about your statement against amputation. Most dogs recover very nicely from amputation. In my case with Emily, she actually did better the day after the amputation than she did before it. Amputation removes the pain as well as the cancer site. We have hang ups about amputation that dogs do not have. They are happy to be out of pain and if we assure them all is well then it is. Until I realized what pain Emily was in I didn't think I could choose amputation either but I have absolutely no regrets. Tripawd dogs can do everything other dogs can do! Emily still runs across the yard to jump on the trampoline. Please do not disregard amputation as an option. Emily is now 3 months post-amputation. Instead of mourning her death we are enjoying our time with her.
Debra
Debra & Emily, a five year old doberman mix, who was diagnosed with an osteosaecoma. She had a right rear leg amputation on May 19, 2009. On November 10, 2009 she earned her wings and regained her fourth leg.
Well, this comes really late and I don't know if Wayne will stil come around, but I wanted to echo that Yoda did demonstrably better physically after his amputation in a couple ways: 1) He was willing to hop right back in the car again (something he had inexplicably resisted for the last year or so) 2) He was suddenly much much better at catching a tennis ball in the air. And those are just the things he does better. He can and has mastered everything he could before, just not for as long (but plenty long enough for life to be worth living). The only thing he hasn't done since his amputation is catch and kill a rabbit and I honestly think he could do that too (he came very close) if I didn't keep getting in the way.
Yoda&Mom united: 9/5/06 …….… Yoda&Leg separated: 6/5/09……… Yoda&Leg reunited: 10/14/09 ……… ……………….………….………….……. Yoda&Mom NEVER separated! …………………….….……....….…… Though Spirit Yoda currently free-lances as a rabbit hunting instructor for tripawds nationwide
Hi, I can't find alot of info about the success of Palladia vs. the traditional chemo protocols for mast cell tumor. My Zoe has an usual mast cell tumor that is growing in her front leg, into the muscle of her forearm. The options given were to amputate because they would be unable to just remove the tumor due to its location. The lymph node, bone marrow, and ultrasound/xrays are clear but they did find a rectal mass, that upon needle biopsy showed just inflammation but are unable to get regular biopsy due to its location w/out surgery. I decided to proceed with amputation and follow with chemo and monitor growth of rectal mass. I hate to put her through harsh chemo treatments after all that she will be going through. Palladia seems to be easier to administer and maybe has better tolerability/less side effects?
Any thoughts or info would be greatly appreciated,
Thanks, Karin
Walter said:
I can't find alot of info about the success of Palladia vs. the traditional chemo protocols...
Hi Karin, that's exactly why this topic was started. You might want to check this other thread going about Palladia which has links for more information. Please consider registerring and your posts will appear immediately without requiring moderation.
Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet
Karin,
There are several chemo protocols for mast cell tumors. Prednisone and vinblastine are commonly used. Pred is a tablet and vinblastine is an injection that is given IV by your vet. Vinblastine tends to be pretty benign as far ac chemo drugs go but it can still cause a low white cell count and nausea or vomiting.
Some oncologists prefer CCNU (Lomustine). This is a pill that you give at home every 3-6 weeks. It can shrink existing mast cell tumors and slow the progression of the disease. It also can cause low white cell or platelet counts as well as elevated liver enzymes in some dogs. This is usually reversible but can be permanent and fatal.
Palladia can be given alone or in addition to chemo. By itself the most common side effects are vomiting and diarrhea. Since I have not used this drug I can't comment on side effects if given with chemo, but I would sure give it a try if my dog had mast cell cancer.
I hope that your dog feels better once the tumor has been removed.
Pam
Dr. Demian Dressler, author of the Dog Cancer Survival Guide, recently posted about Palladia and had this to say about it:
"Now, if we look at Palladia, a much smaller portion of dogs with mast cell tumors respond (for more on these stats, click here).
Of all the dogs with mast cell tumors treated with Palladia, 42.8% responded to treatment. And this response lasted between 11 and 18 weeks, depending on how we define duration of response. This means that the tumor started growing again after about 4.5 months in those dogs that responded.
This does not mean that Palladia is “bad”. Rather, this is simply the reality of what this chemo drug offers. For some, this can be defined as a successful approach. For others, it may be that this is viewed as “not working”."
Read more in his post, "But Will Palladia Work?"
Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet
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