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Tripawds.com “Ask a Vet” Chat Session Transcript
Dr. Marie Mullins (Dr. Mullins)
December 02, 2008
(reverse chronological order)
admin : We'll post a transcript soon! Have a great night. Thanks again.
LuvYourPets : We love you too, Jerry!
jerry : Awwwww shucks....G'nit e all. We love you!
Barney B : Love to you all ....
admin : And don't forget to check out the 2009 Tripawds Tribute Calendar, ornaments and other new items in our CafePress store, just in time for the holidays [smiley]
admin : Yes thank you! [smiley]
jerry : And everyone else too, we appreciate your participation and great questions!
Dr. Mullins : You are very welcome everyone, have a great night. Jerry, keep up the good work....you are a hero!!!
jerry : Absolutely Dr. Mullins, you mean the world to us. Thank you so very much for being here.
Barney B : Yes, thank you Dr. M. and to Jerry and Admin
LuvYourPets : I have asked all of my questions and just want to thank you, Dr. Mullins, for spending this time with us. We REALLY appreciate you very, very much! [smiley]
admin : [smiley] While we have a couple great doctors online here, just wanted to remind everyone that there is now a dedicated "Ask The Vet" thread for Q&A topics in the discussion forums. Please be sure to read the rules there before posting questions ...
jakethesnake : Yes, thank you very much Dr Mullins! I have learned so much! [smiley]
Dr. Mullins : You are very welcome!! [smiley]
Dr. Mullins : The human product is used on many different tumor types, so it should theoretically work. It is a general immune supplement that would be helpful for any condition that is characterized by a weak immune system (such as cancer). There are not any reported drug interactions to date
tazziedog : thank you so much for your time!!!
Dr. Mullins : Yes, more specifically staying away from simple as opposed to complex carbohydrates. The simple carbs feed the tumor more than the healthy cells.
sandrathomas : would you recommend K9 immunity for multiple myeloma, while the dog is on prednisone and melphalan?
tazziedog : do you routinely recommend a low carb diet for cancer patients?
admin : We've got about ten minutes more of the good doctor's time here folks. Any last pressing questions?
Dr. Mullins : Not routinely. I have had some patients that have used it and not had any side effects. I am not in a place to commnent on efficacy at this time, sorry! I just don't have as much direct experience with it.
tazziedog : Are you using Artemisinin ?
jakethesnake : Thanks! [smiley]
jerry : Thanks, we've been wondering about that. Good question Jake.
Dr. Mullins : K9 Immunity is designed to be given in conjunction with chemotherapy. In people there is a reported decrease in chemotherapy related side effects when they are on the human equivalent supplement.
Dr. Mullins : Radiation therapy is typically used for osteosarcoma when an amputation is not elected by the parents (or the dogs). It is used to address the pain that is there from the bone tumor. So, if an amputation is elected, there is not a role for radiation therapy. Chemotherapy can be given along with radiation therapy to help it work better by causing additional tumor cell attack.
jakethesnake : As far as the K9 Immunity and Transfer Factor, is it better to wait until after the chemo treatments are done or would it be beneficial to give during the treatments?
admin : Just curious ... when is radiation considered instead of, or in relation to chemotherapy?
jerry : Sure did!
tazziedog : Thanks! It sure seemed to help Jerry
Dr. Mullins : The data is not completely matured yet, so basically too early to tell. What we do know is that it definitely improves their quality of life (with regards to activity level and appetite) and it seems to keep them asymptomatic when they have a low white blood cell count. Hopefully we will have some data soon. There is a preliminary paper that is in the publication stage reporting this info. Not sure when or where it will be published yet.
tazziedog : Do you have any success rates for K9 Immunity and Transfer Factor?
Dr. Mullins : No, not necessarily. Additional medications can be prescribed to help with specific side effects that are associated with each drug.
admin : Hi Doc! You prescribed Carafate and Pepcid when Jerry switched NSAIDs ... Any extra meds when switching chemo?
jakethesnake : Love ya Jer!
jerry : Thanks! I thought of you Jake, that's why I asked it [smiley]
Dr. Mullins : You would want to wait the same amount of time between all chemotherapies (usually 2 to 3 weeks) is good to allow the normal cells to recover.
jerry : How long do they have to wait inbetween switching?
jakethesnake : Good question Jer! I was just going to ask that! [smiley]
Dr. Mullins : Of course they can, as long as the bloodwork looks good.
jerry : Dr. M, if a patient is having a hard time with one kind of chemo (say, cisplatin), can they switch to carboplatin mid course?
Dr. Mullins : Metronomics can be an indefinite thing as long as your pet is tolerating the therapy. I like to treat for a minimum of 6 months if I am treating microscopic disease (can't see any metastasis) and indefinitely if I am treating tumors that can be seen.
Barney B : Dr. M. - regarding metronomic protocol. If the patient is showing no mets, how long can he be kept on the protocol? Is it an indefinite thing?
tazziedog : It seems like there is no standard chemo plan for osteosarcoma...
Dr. Mullins : Yes, anytime that you have two or more active agents against cancer, using both will give you better cell killing activity overall. Sometimes the cancer cells are resistant to one chemotherapy but may be responsive to the other. Using your most active agents theoretically should be able to take of the resistance factor.
Dr. Mullins : You are very welcome [smiley]
tazziedog : Speaking of chemo, do you think that there is a benefit to dual agent chemo like caboplatin/adria mycin?
jakethesnake : Okay, thank you. [smiley]
Dr. Mullins : Cisplatin has historically been a more effective drug against osteosarcoma but is A LOT harder on their system (especially the kidneys) and does not have any higher cure rates overall. So, I typically recommend carboplatin over cisplatin for the quality of life advantage.
jakethesnake : Hi Dr. Mullins! What are you thoughts about giving Cisplatin (with diuresis) versus Carboplatin?
LuvYourPets : Oh, that IS very interesting to hear.
jerry : Case in point; it ripped a hole in my gut!
Dr. Mullins : Previcox is the newest on the market that is the most specific for COX-2 of them all (ie that means should be easier on the kidneys and tummy). However, I think it is an individual tolerance. Some dogs do great on the older NSAIDs and cannot tolerate the new ones and vice versa. Giving the NSAIDs with food and Pepcid AC can help with any tummy discomfort.
LuvYourPets : Speaking of NSAID's, are there some that are less hard on a dog's digestive system & kidneys than others?
jerry : Hmmmm....thank you for clarifying that.
Dr. Mullins : Giving chemotherapy on the same day of surgery is typically done in human medicine because there is a high probability of stirring up cancer cells at the time of surgery. The thought is that employing the chemotherapy right away will get those cells before they have time to divide and move. There was one study in veterinary medicine that compared the survival times with chemo given the day of surgery and 14 days later and did not find a significant difference.
Dr. Mullins : Hi Jerry,
Dr. Mullins : Back to the doc's question: there is not a lot of supportive studies for this method of treatment yet, but hopefully there will be some day soon! My typical metronomic protocol is Cytoxan with doxycycline and an NSAID.
jerry : Some members here have been given chemo the same day of surgery, and they seem to have a very hard time with the side effects. Why do some docs do this?
tazziedog : Thanks!
Dr. Mullins : VIN is a veterinary information network that has a panel of experts in each field that answer questions that are posted. It is for doctors only.
Dr. Mullins : You are all very welcome, I am glad that I can help. To address the doc's question: yes, I have started metronomics prior to any evidence of metastasis as a prophylactic. With osteosarcoma, our cure rates are low and so the likelihood of having microscopic disease left behind is high. Starting the metronomics 2 weeks after conventional chemotherapy is a good recommendation.
admin : Can we assume VIN is a Veterinary Information Network of some sort? For doctors/members only?
Barney B : many, many thanks Dr. Mullins. I'll start by changing shampoos and getting culture.
tazziedog : Dr Mullins, Do you ever start the metronomic protocol after conventional chemo is done but prior to lung mets? I have seen some on VIN suggest that this might delay the onset of metastasis but I haven't found any supportive studies. Also, do you use an NSAID plus Cytoxan plus doxycyline?
LuvYourPets : Thanks, Dr. Mullins.
Dr. Mullins : A starting dose of benadryl is typically one mg per pound and round down based on the mg tablets (they come in 25 mg typically or 12.5 mg for the pediatric size). The benadryl is typically given 2 to 3 times daily.
LuvYourPets : Also, what is the dosage of Benadryl required for each pound of dog weight?
Dr. Mullins : Allergroom by Virbac (you can get this at the same place you get your Maleseb shampoo).
Barney B : I've actually been thinking that the Maleseb might be drying him out too much and making the itching worse. I will try an oatmeal shampoo - and if you have a fav that you'd recommend I'd love to have your opinion.
Dr. Mullins : Orally would be best for the itchies.
admin : benadryl orally? or liquid/cream mixed in the shampoo?
Dr. Mullins : Have you tried an oatmeal based shampoo? Those are sometimes more helpful. You can bathe up to two times a week with an oatmeal base. Adding in some over the counter benadryl can also be helpful for the itchiness, as well as flaxseed oil.
Barney B : He has patchy red spots - under his neck where there's lots of loose skin, and he is very itchy. I've been bathing every other week in Maleseb also.
Dr. Mullins : What kind of discomfort is Barney experiencing right now? I would be happy to help with some recommendations if I know what he is going through.
jakethesnake : Hi guys!
LuvYourPets : Hi, Jake!
jerry : Hi Jake!
jakethesnake : Hi everyone! Happy to be here! [smiley]
jerry : Dr. M, what are some things that can alleviate any discomfort Barney is having in the meantime?
Barney B : He goes back to the oncologist and will see the derm also next week - I will ask about a culture. Thanks!
Dr. Mullins : It sounds like the medications that you are giving are not completely getting rid of the bugs so when they are stopped, they just come right back with avengance. Getting it cultured may help to determine a medication that can completely get rid of it for good!
Barney B : He is seeing a derm. I'm not sure if they've cultured, but I will say that the rounds of keto. and cephalexin have been effective in the past - the infections just come back about a month post completion of the meds.
Dr. Mullins : Is Barney seeing a dermatologist? If not, is there a way that you can get a second opinion from one? Has the infection been cultured to see exactly which bug is growing there to determine the best oral medications for that?
Dr. Mullins : Hi Doc! Most of the papers recommend anywhere between 4 to 6 doses of carboplatin. Giving more than that has not been proven to be more efficacious and can lead to kidney problems long term.
Barney B : vet has Barney on ketoconazole and cephalexin now for the bacterial yeast. and is suggesting a "pulse" dosing schedule. Does that sound reasonable
admin : Hi everyone ... Let's try to save new questions until Dr. Mullins has addressed current concerns. Thanks!
Dr. Mullins : If he is done with his chemotherapy protocol, then the recurring infections are not likely to be due to that. The metronomic protocol is not typically suppressive to the immune system like traditional IV chemotherapy, so it should not be contributing either.
tazziedog : Dr Mullins, I am a vet near Seattle and I was wondering if it makes any difference to give more than 4 doses of Carboplatin. Some people on this site have had recommendations for up to 10 doses post-amp.
Barney B : as for diet - he's on Innova EVO, supplemented with carrots, broccoli, fish oil, flax meal, and CoQ10
Dr. Mullins : Great job, Barney!! Keep up the good work. Do you have him on any supplements or did you make any dietary changes for him?
Barney B : he had 5 IV rounds of adriamycin. he is on metronomic protocol now - and he's been having some recurring yeast and bacterial skin infections. do you think that's due to his chemo?
Barney B : Dr. Mullins -Barney's amp was due to histiocytic sarcoma and he is 9 months survivor right now
Dr. Mullins : Hi everyone!! I am very glad to be here.
jerry : Absolutely.
Barney B : Can we just fire away?
jerry : Hi everyone! Thanks for coming.
LuvYourPets : Hi, Sandra!
LuvYourPets : Hi, Dr. Mullins, I was just planning on watching the chat because I don't have a dog who has cancer at this time. Glad to have you here!
sandrathomas : Hello Everyone
Barney B : Hi Dr. Mullins - Barney the yellow lab here from Houston, TX.
jerry : Hi Doc, it's great to have you here, thank you!
Dr. Mullins : I'm here! 😀
admin : Dr. Marie Mullins will be with us shortly. She was my oncologist at Clinics in Santa Fe, NM and later in Denver, CO. Please stay tuned...
LuvYourPets : OK, I haven't been hitting the return button, but if other's can't see my duplicate messages, that's no problem. I just don't want to look foolish. 😯
admin : Duplicates seem to rarely occur and are user (PC) specific. Others do not see your duplicates. Also, the return key acts as the send function so don't hit return AND the send button.
LuvYourPets : Why does my thing keep sending duplicate messages when I only hit send once?
admin : Greetings Guests! Be sure to log in to participate in tonight's chat.
jerry : Don't miss tonight's "Ask an Oncologist" live chat with my vet, Dr. Marie Mullins at 5:00 p.m. PST. Be sure to register or log in to participate!
Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet
Tripawds.com “Ask a Vet” Chat Session Transcript
October 29,2008 (reverse chronological order)
jerry : Adios!
Titan : Titan says thanks everyone. We love all this positive love and support
LuvYourPets : Good luck, Titan! Our prayers and pawsitive thoughts will be with you.
OKim1 : I Love U GUYS
jakethesnake : We will!!! Big hugs to Titan!!!
jerry : Very pawsitive. Good luck Titan, we send our love and healing wishes.
LuvYourPets : Thanks for that info, Admin! I'll be watching!
admin : Go Phillies!
Titan : I wish everyone well, think positive thoughts for Titan tomorrow
admin : Thanks again!
admin : Dupes may be a server hiccup ...
Titan : Give Tazzie a GREAT BIG hug
jerry : Woof! Woof! Thank you so so much Doc!!!!
Titan : Jim I wonder if I get the duplicates from people submitting at the same time
LuvYourPets : Pam, you were great! I think these chats are wonderful!
tazziedog : Tazzie will be on number 3. We can schedule another chat later. I am going to go home and hug my dogs!I am still at work
Titan : Thanks Pam
LuvYourPets : I was just hear to learn, so I'm good.
jakethesnake : THANKS PAM!!!
admin : We'll schedule another chat again soon. And there is a new announcements forum where you all can schedule your own chat times. It is of course, always live also!
admin : My how time flies ... we had hoped to keep this chat session to an hour. So Pam, please feel free to wrap it up, or stay online if you like. Anyone got any final questions?
Titan : Is she going on #4
tazziedog : I will xray her next week after her chemo!
OKim1 : type o HOPE
OKim1 : Yes & thank you Pam ,ope Tazzie's x ray are clear
jakethesnake : VERY happy to be here!!!
Titan : I will have to find out I know he started this one about 2-3 years ago.
LuvYourPets : I think we're all very glad to have found this site! I learn so much here.
admin : We're happy you all found us!
tazziedog : New vaccine has been available for 2-4 years (2 brands). The disease is spread by wild animal urine usually in standing water. This is not the old lepto that used to cause liver failure and could cause vaccine reactions. There were 9 cases near Seattle just this summer.
Titan : Titan wants to add how happy were are that we found this site.
Titan : damn the duplicates are back
jerry : Hmmmmm....wow, good to know! Thank you so much. She was about to spend a fortune.
Titan : When did Lepto come out
tazziedog : I would be very careful giving vitamins. It can cause great harm to overdo calcium or phosphorus in a growing pup! If the dog is on a good quality large-breed food or a food like EVO I wouldn't supplement because the manufacturer already does. If she is feeding cooked or raw then it might be okay.
OKim1 : Buster had lyme disease
tazziedog : I would use the vaccine where you live. Lepto might also be a problem there and the new vaccine can prevent it. This new Lepto strain is causing acute kidney failure in dogs and the vaccine is a genetic subunit so pretty benign
jerry : Pam, do you recommend Multivitamins? If so, what kind? My friend Sasha wants to put her new kid, Troy, on vitamins. Last June, her baby Lalla passed away from bone cancer, and I think she's trying to avoid another episode, by putting Troy on multivitamins. Any thoughts?
Titan : You did do the VERY best for Jake. They really didn't know alot of this stuff until more recently.
Titan : Is it bad that I do the Lyme vacine shot and frontline
OKim1 : OMG the phillies winning in the 9th
tazziedog : Sorry! Now that we are in WA I use nothing but Heartgard
tazziedog : I would totally agree with that! In Wisconsin I had to use
Frontline. Now that we are in
jakethesnake : I have learned so much about diet on this site (from Jerry's diet) and others. I feel like I'm prepared to do all of the right things for another furry friend but I suppose I did the best I could for Jake. Just wish I knew all of this way back when!
Titan : I have given Titan the Lyme vacine along with Frontline. I am Newmarket, NH tick tick ticks
tazziedog : It depends where you live. Fleas and parasites can be harmful especially to an immunosuppressed dog and ticks can really spread some evil stuff! I like the new Comfortis pill and if you need parasite control Heartgard is pretty safe. Frontline is safer for ticks than the amitraz collars
Titan : Titan just came in my office barking. I guess he's saying hi everyone
LuvYourPets : don't be so hard on yourself, admin!
admin : That dupe was my fault!
OKim1 : yes the overkill of shots and flea meds
admin : And your thoughts on flea control in regard to cancer ...?
admin : And your thoughts on flea control in regard to cancer ...?
Titan : I would have loved to keep Titan "intact" and breed him but he was too damn strong and trying to be dominant. At one point he weighed more than me now we are about the same
tazziedog : I also think that proper diet is very important and I am an advocate of minimal vaccines. All dogs should have a puppy series (every 3-4 weeks until 16 weeks old) then one the next year, then every 3 years (I am talking about DHPP). Other vaccines like Bordetella or Lyme or the new Lepto might be needed every year depending on where you live
Titan : Interesting. Well I guess maybe that's why Titan's parents didn't have it because they weren't fixed
OKim1 : I wish now Buster would of been a dad
LuvYourPets : Hey ya, Titan!
tazziedog : It is easier to spay or neuter a puppy than an adult. Also, the shelters have a good reason to neuter before a pet leaves due to overpopulation. This is just a case of new info. I don't think anyone thought it was a problem until we started to see more ACL ruptures and cancer. Intact dogs can get these problems, too but much less commonly
Titan : Hey Vicki
Titan : I think it is because more people give their animals care. But I do wonder about environment etc...
LuvYourPets : Hi, EVERYONE!
jakethesnake : Hi there Vicki!
LuvYourPets : Hi, Jerry!
jerry : Hi Vicki!
LuvYourPets : Just want to let everyone know I'm here, but I'm staying in the background... learning
jerry : Pam, do you think that more dogs are getting cancer now? Or, that it's just being diagnosed now because people give more vet care to their dogs than in the old days?
OKim1 : Buster was neutered early I was afraid of cancer LOL
Titan : Do they try to push so early because of puppymills and overpopulation
admin : good to know ...
jakethesnake : Great info Pam!
tazziedog : Much more common in females. My current recommendation for big dogs is to let the female go through 1 heat and than spay. Try to let a male stay intact for 2 years unless he is aggressive, etc. This will also reduce ACL injury
jakethesnake :
Titan : We had to do Titan he was starting to think he was the boss of me trying to pull me down by my shoulders. Or when my hubby went away he thought he was in charge
admin : Is breast cancer more common in female dogs or equal to male dogs?
tazziedog : Spaying or neutering before 2 or 3 years in the giant breeds decreases the sex hormones which may play a part in bone development. I tried to delay Loki's neuter but at 12 months he was getting dog aggressive and peeing on my treadmill so he got the snip! Tazzie was spayed at 8 months before I knew better. But breast cancer is prevented by early spay, and that cancer is much more common. It is a dilemma
Titan : I know Titan's parents didn't have it (well at the time we got him) not sure about his litter mates
OKim1 : Buster had an acl repair too
jakethesnake : Jake had two ACL's on his back left knee(one wasn't done properly...diffe rent vet than one I am seeing now). I think that caused him bone trauma and contributed toward the Osteosarcoma
Titan : Not to sound dumb what would the neutering and spaying do. I had Titan done at 6 months what do they consider early
tazziedog : I looked for bone cancer in Tazzie's front legs because of her prior knee surgeries. All of that weight was pushed to her front end
Titan : YEAH
jerry : Ok, I'll tell Mom to stop beating herself up. She didn't know any better at the time.
admin : Did we mention how happy we are to have a vet on board here!?!?!
tazziedog : Jerry, don't feel bad! Big dogs like to have big fun and you can't keep them in a box. Rapid bone growth, genetics, and microtraumas all play a part. New evidence shows that early spay or neuter could also be detrimental
Titan : I don't think Titan ever had a bone trauma. He is definately not overly active. It was in his wrist
Titan : Thanks
tazziedog : Titan: try Mastiff Club of America. Tazzie does not have papers so I couldn't enter her DNA. They hope to develop a genetic blood test
jerry : Pam, when I was little, my Mom and Dad walked me too much, for a puppy. They always felt bad about this. Could all that walking have caused a bone trauma that caused my cancer?
OKim1 : chrondrosarcoma the weren't sure if it started in the bone or tissue with pathology report
Titan : Yeah they always list rotties and greyhounds but not mastiffs for bone cancer
admin : FYI: Links may not display properly in the chat box, and may get caught by the spam filter.
tazziedog : I do not think that Imuran would cause bone cancer. Lymphoma is possible due to decreased immune response. Bone cancers are probably secondary to microscopic bone traumas which is why large breeds get this cancer more often. And there is a genetic link with Rotties and Greyhounds
Titan : hmm I will have to look at his paperwork. We got him from a breeder in Mass. What website is the mastiff club so I can learn more
OKim1 : Pam, in your professional opinion. Buster has uveitis of the eye, was treated by specialist & given Imuran & pred & long term (over a year).then he got cancer. Is this a coincidence?or do certian RX lower the immune system. On Imuran warning it does state it might cause cancer I feel i saved his eye & lost his leg..
tazziedog : These giant guys have always been prone to bone cancer. The Mastiff club has funded a study for osteosarcoma. I am not sure about bullmastiffs but if Titan has an AKC # he might be eligible. You just need to donate a blood tube for his DNA
admin : nevermind!
admin : Just testing to see if this thing just crashed when I deleted a comment.
Titan : Titan does great on steps. Sometimes he sleeps in bed with me he is a little afraid of getting down so I help with a collar and leash. He does the dog ramp into my Tahoe no problem. Well first he acts like he is going to jump up on his own (next to the ramp) so I have to tell him no. We can't spare another leg.
jakethesnake : Jake only weighs about 60 lbs now so he is managable when going down the steps with the harness of course
Titan : I was surpised about Titan's diagnosis because we always tried to the right thing. We had him on adult food starting at 6 months to help him slow down his growing. Are you seeing more of this breed getting cancer?
tazziedog : I am afraid to let Tazzie do steps. I know that Jerry did okay with them. Does Titan do them?
tazziedog : I ha
jakethesnake : Jake's harness is great! It really helps me get him around... up and down the steps and in and out of the car!
Titan : haha
tazziedog : He would do anything for cheese!
Titan : You can tell he sees the camera and cheese
tazziedog : He is a ham! Tazzie only needs the harness to get in the van. She does well with it and it fits fine
Titan : Loki is so cute
Titan : How is Tazzie doing with the harness. I just got Titan's yesterday.
admin : Loki made it to the Friends gallery ...
jakethesnake : I love the names Pam!
tazziedog : Tazzie started it after her knee surgeries 2 years ago. I started my Dogue de Bordeaux on it at 1 year.
Titan : Did you start Tazzie on dasequin when she was a pup
OKim1 : yes Dr Dyms practice under dr pitcain & went to Cornell.. very $$ worth every penny
admin : Synflex is human grade, they just added beef flavor for pets!
tazziedog : I have to learn about supplements at conferences because they didn't teach us that at school.Make sure you have a holistic vet that knows the side effects of the supplements since some can react with other drugs! There are lots of different brands out there.
jerry : Whole Dog Journal is great. I've also heard good things about Dog Gone Pain too.
Titan : Ok. Trying to keep my head straight with all this stuff
OKim1 : whole dog journel... dog gone pain helps Buster move well..
admin : Synflex is a glucosamine supplement made from shellfish exoskeleton. The ad below will link to more details ... that blog post is still on the burner.
jakethesnake : Ok, thanks! All new to me!
OKim1 : dog gone pain
Titan : Thanks Pam
tazziedog : Titan: If he does not have arthritis the regular Dasequin is fine. Jake: Dasequin is a brand of glucosamine for the joints. It is not a bad idea to give some kind of joint support.
Titan : What is Synfle
xadmin : We believe SynFlex worked wonders for Jerry when it came to glucosamine.
OKim1 : vetri science maitake
jerry : Pam, what are some good resources you use to learn more about supplements?
Titan : I give Titan the dasequin while he is on chemo
tazziedog : I also give fish oil and SAME and milk thistle (the last 2 are for her liver).
Titan : Do you think it is ok to just switch titan to the one w msm? Is the other dasequin not natural
OKim1 : i use transfer factor for humans
jerry : Regarding K9 Immunity
: my oncologist started a clinical trial herself, so the cost of my K9 was free. It's a huge undertaking, but we hope more oncologists will do this. All ours had to do was ask Aloha Medicinals, and they approved it.
jakethesnake : Should Jake be on the Dasequin too during his chemo?
admin : Is Maitake different than the shroom used in K9 Immunity
?
tazziedog : I give Tazzie Dasequin with MSM because it is a natural anti-inflammator y. I have not done K9 Immunity
yet due to the number of pills Tazzie would need but I will consider it post-chemo.
OKim1 : onco support, human tranfer factor, hepato support, multi vit, omega, maitake mushroom
jakethesnake : Ok, I will!
admin : Jake: Search the blog for our post about the K9 trials jerry was in ...
jakethesnake : Jake has been on a restricted diet because of belly problems (meds) so I didn't want to add anything else yet
Titan : Is the K9 and transfactor ok to do with the chemo
Titan : Titan is dasuquin. Is the regular better than the other(it has something with it)
jakethesnake : I want to order the K9 Immunity
and Transfactor but have to order it
admin : Jerry took too many to list!
tazziedog : Let's talk about supplements. Who takes what?
Titan : It has really amazed me. I mean I knew he could do it. Everyone says he is so happy wagging his tail......
jakethesnake : THANK YOU PAM!!!
tazziedog : He is a big strong dog! He should be fine if he has had no problems yet
Titan : Yeah thanks Pam for taking the time out to do this.
Titan : I asked them to explain the blood tests to me last time. I wasn't sure what all the numbers meant. They said Titan is doing very well
tazziedog : Sorry I am a slow typist!
jakethesnake : and with everyone else too of course!
jerry : Likewise. Can't thank you enough Doc!
jakethesnake : Just wanted to say that I'm loving this chat line with Pam stuff!
Titan : See I am in NH which is alot smaller than NY so there weren't as many choices
tazziedog : Titan: the crash is due to the bone marrow not making enough white blood cells. The dog then gets sick with a fever or may need a transfusion
admin : Thank you Genie! (We'll post a transcript in the blog next week)
Titan : ok just making sure you are awake over there
jakethesnake : East Greenbush Animal Hospital in East Greenbush NY (near Albany)
Genie : I am the minutes taker. I need to concentrate!
jerry : Jake, where are you being treated?
Titan : Genie why are you so quiet over there
tazziedog : A lot of "regular" vets can do chemo. I had never given carboplatin so I went to an oncologist for the first. We routinely do chemo at our clinic for lymphoma and hemangiosarcoma. As long as your vet is experienced in the side effects it is ok
jakethesnake : yes, not often though... 2 or 3 a year
Titan : Has your specialist adminstered chemo before
Titan : Do they crash because of kidneys
jakethesnake : Yes, the specialist said he'd work with me... they have been great
Titan : I would see an oncologist
tazziedog : I think 8 is right for that plan. A few years ago a lot of docs tried the 2 drug plan but a lot of dogs crashed on the schedule!
jakethesnake : Okay, I'll talk with my specialist tomorrow about the generic form... is it bad that I'm not seeing an oncologist?
Titan : Jake are they offering you a financing plan or anything
Titan : They said Titan should have 8 but I have heard there is not much of a difference between 6-8 is that right Pam? I wonder why they didn't have Titan do the same drug plan as you
tazziedog : Tazzie is getting a total of 4 or 5 doses carboplatin. Titan is on a 2 drug plan so he needs more treatments
jakethesnake : wow
Titan : My chemo for Titan (8 sessions) is going to be $5200. That includes the blood test they do prior to each chemo
tazziedog : Ask if they have the generic. Generic Adriamycin also is cheap at about $45 per bottle. Remember you are paying for the oncologist's time! I paid $500 when I took Tazzie in for her first consult
jakethesnake : how many rounds does Tazzie and Titan need?
jakethesnake : but not 4000 dollars like I read somewhere, right?
Titan : I pay 500-600 a wack for Titan
tazziedog : Yes, you have to add in the cost of catheters, cbc, etc
jakethesnake : that certainly would be!
Titan : Is carboplatin the drug someone posted on here that their vet said it is going to be offered for less like $180 a round. If so that would be great
tazziedog : Tazzie needs almost 600 mg and a bottle that size costs me $110. For some reason the generic has gone down quite a bit in price this month!
jakethesnake : How much is it Pam?
tazziedog : Cisplatin needs to be done with saline diuresis to protect the kidneys. Now that carboplatin is generic I would ask for that!
OKim1 : yes, peace of mind
admin :
tazziedog : Kim, a fecal check is a good idea to check for parasites and bloodwork if not done in the last 6 months
jakethesnake : that's what I thought but that is what my specialist is offering
Titan : How is Tazzie girl
Titan : Ok no more duplicates now
tazziedog : Cisplatin was used prior to carboplatin but can damage the kidneys so isn't used much anymore
OKim1 : ok thank u...
tazziedog : Chondrosarcoma spreads much slower than osteo so an xray every 3-6 months is reasonable.
Titan : Pam we have gone this far so whats another couple of hundred
jakethesnake : I wanted to ask you about Cisplatin chemo
OKim1 : No dups here ..with a chrodrosarcoma.. . since it's 6months since surgery, i had x rays in aug which was clear, when should i repeat xrays? ps do u think appetite increase can be worms since no heartworm or flea meds?
jakethesnake : Jake is doing well thank you Pam
Titan : Hey Jake.
Titan : Ok I guess its just titan and I weird. Some comments have gray bold and then a duplicate
tazziedog : How is Jake doing?
jakethesnake : Hi everyone!
tazziedog : They all have their own plans! If you can afford it I think it is a good idea
admin : Hmmm ... please send us any anomalies, glitches, or bugs in the contact form with the OS and browser your using.
jakethesnake : Hi Jerry!
Titan : Thanks the oncologist didn't say anything about a 3rd xray.
jerry : Hi Jake!
tazziedog : Me either
Genie : I am.
jakethesnake : Not me
jerry : Not me.
Titan : Hey Jerry is anyone else getting duplicates of the comments on chat? Or is it just Titan and I
tazziedog : NO, the blood test is to see if the bone marrow can handle the chemo. Tazzie seems to need 3 1/2 weeks to recover. Only xrays or bone scans can see the cancer.
Titan : Thanks I will ask for it tomorrow. If it was spreading would it show up in the blood tests with levels getting lower? They do blood tests before chemo
tazziedog : For Buster: Tazzie's sore is healing with the bootie. I think it is taking time because of the chemo
tazziedog : For Titan: A chest xray is recommended after chemo #3 in case the cancer has already metastasized. As you can see from this site, it does happen sometimes.
admin : There's a nasty picture of the sore in our Procedure Picks gallery ...
OKim1 : how are tazzie's pressure sores healing?
Titan : Pam I am having Titan's 4th chemo tomorrow do you think I should have them do a chest xray. I am a little freaked out(but trying not to be) about Butch's situation?
OKim1 : ok...thank u
tazziedog : I wouldn't worry. Tazzie eats between 6-8 cups daily and I note that she actually eats better since her surgery!
OKim1 : no alot of energy lately
tazziedog : A sudden increase in appetite might just be due to higher caloric needs. If the pressure sores are new you should have his liver values checked, as sometimes those things go together. Is he acting sick?
admin : Let's all try to remember to give Pam time to answer questions, keeping them to one at a time. Thanks!
jerry : Hi Pam, thanks for being here. Hi everyone!
Genie : Hi Pam!
OKim1 : Hi Dr Pam... what would cause my dog to have a sudden increase in appetite?Should i be concerned? it seems he is hungry all the time & worry about his weight & pressure sores..
Titan : Hey Pam
tazziedog : Hi everyone!
Titan : I know I am sure we will have lots of owners and dogs
admin : Keep that tail waggin' ... Pam will be joining us soon I'm sure.
Titan : I am so excited
jerry : Dr. Pam Wiltzius graduated in 1992 from University of Wisconsin-Madison. In 2003, she and her husband moved to Puyallup, WA where she currently works at River Road Animal Hospital. They have 3 dogs, 3 birds, and 1 lizard.
jerry : Stay tuned for our first Ask A Vet live tripawds chat tonight at 6:00 p.m. PST ...
Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet
Tripawds.com “Ask a Vet” Chat Session Transcript
Dr. Pam Vilksius (Tazziedog)
November 18,2008
(reverse chronological order)
admin bye y'all ... we'll post the transcript in the forums.
jakethesnake Good night everyone! Goodnight Johnboy!
OKim1 Bye.. [smiley]
jerry Bye bye!
admin thanks again!
tazziedog Okay I am going to feed my dogs now. Chat with you later!
OKim1 give Tazzie a( hug )
jakethesnake thank YOU!!!
admin ➡ FYI to all ... Voting should begin for the 2 Dogs 2000 Miles cancer research calendar by this Thursday. The new 2009 Tripawd Tribute calendar is available at http://www.tripawds.com/2008/11/14/new-tripawds-merchandise-available/
jerry Many many thanks Pam, we love you!
jerry Yeah, thanks guys. This is all new to us so we're always looking to make it better!
admin There is a chat link in the banner on every page ... suppose we could make it more obvious in places. thank
OKim1 not a sat or fri night...
Titan Thanks Pam
tazziedog We can do a weekend next time unless you think that would be worse
jakethesnake not sure... maybe put it up on top when people log in... as a reminder kind of thing???
OKim1 no games.. how about a header on forum page
admin I'd like to see people publish a time they can promise to be available in the chat room for anyone who might just pop in ... there is a topic for this in the Shout Outs forum.
tazziedog I would only give milk thistle if he has an issue. Are they checking a liver enzyme with the cbc blood test? It is rare but some chemo can affect the liver. Tazzie's has stayed okay after 3 doses carboplatin.
jerry Hey guys, quick question: do you have any ideas about how we can let more people know about the chat? We've had a lot of new people at Tripawds, but we're wondering where they are tonight. Is there a game on or something?
Titan k now I get so one more. Should I give titan the milk thistle or only he has an issue
jakethesnake Thanks Jerry! Thanks Rene and Jim! [smiley]
OKim1 Yes, very informative.
tazziedog No milk thistle is different, and only needed for liver support. SAM-E is an anti-inflammator y that can reverse liver damage and may help with arthritis, too
Titan is SAME the same as that milk thistle I am so confused
jakethesnake Thanks sooooo... much Dr. Pam!!! As usual I've learned A lOT!!!
Titan I have one more
admin Time flies when having fun ... hour is about up. Any more pressing questions out there?
OKim1 thank you... [smiley]
tazziedog Doses of milk thistle are 75 mg per50-100 pound dog. Tazzie takes 125 mg. SAM-E is 400 mg per 50 pounds. Tazzie takes 1200 mg
jerry Who knew?
admin When Jerry stopped eating he developed dark orange urine from bile buildup in his system. [smiley]
tazziedog Yes jaundice is yellow skin, eyes, dark yellow or orange urine
admin challenges ... never problems.
jerry Do dogs turn yellow when they're jaundiced?
OKim1 how much per body weight? supplements..
tazziedog Usually the dogs are not sick until the values get so high that the dog becomes jaundiced and stops eating or starts vomiting. This is liver failure and harder to treat
tazziedog Only bloodwork will let you know if there is a problem. This is a very common problem in our dogs because the liver is the filter for the whole body. I caught Tazzie's on routine bloodwork when she was 2 or 3 years old. I watched it for a while, but put her on the supplements when her values kept going up.
tazziedog Titan, only start SAM-E if there is a joint problem. Dasuquin is okay for pups
OKim1 good q
jerry How do you know when a dog's liver is flaring up?
tazziedog Tazzie eats Innova Large Breed Senior due to her liver. She used to be on Evo but the high protein content would flare up her liver.
Titan so start both then
tazziedog Titan 6 to 9 months would be a good place to start.
Titan like 6 months or earlier
tazziedog Sorry not SAM-E
OKim1 what do you feed Tazzie?
tazziedog Titan, yes I would start Dasuquin for a large or giant breed as a pup. ot SAM-E unless there is inflammation
jerry Thanks!
tazziedog I know that Dasuquin has its own website http://www.dasuquin.com
Titan would u start dasuquin and SAME when they are pups?
jerry Thank you for that explanation.
tazziedog Avocado oil is supposed to be high in anti-inflammator y properties. It is okay for humans to take but I don't know of any glucosamine/chon droiten supplements for people that also have that oil in it.
jerry Cool, we'll look that up and post some info about it at some point, unless you want to do a guest blog post about it [smiley]
tazziedog No Nutramax (only 1 "R" I checked the bottle!)is a supplement company that specializes in veterinary supplements
jerry How come no avocado oil for humans?
jerry Oh wait, I got that backwards
jerry Right, no avocados for dogs!
tazziedog Dasequin has avocado oil in it so it is not a human drug at this time
jerry Thanks! Hmmmm...is Nutramaxx the dog food company?
OKim1 maybe we can share supplements!! Buster & I LOL
admin Looks like sam-e is often used for treating depression in humans as a seratonin enhancer ... no wonder Tazzie is a Happy Dog!
tazziedog Jerry I have learned this stuff at vet conferences. A good company that does lots of research is Nutramaxx and they have a new drug for "oxidative stress" that I have not tried yet but would probably be good prior to surgery or chemo.
jerry Is Dasequin available in human form?
Titan would u start dasuquin and SAMe when they are pups
OKim1 yes but for dogs... maybe cheaper for humans [smiley]
tazziedog I'll bet that hepato -support has some sort of zinc, vitamin E and milk thistle in it.
Titan I am slow today but got it
jerry Pam, where did you find this info? It's all new to us, we'd love to learn more.
tazziedog that's why I just call it SAM-E!
OKim1 Buster takes Hepato Support
admin darn gremlins!
admin I can't seem to type either: s-adenylmethioni ne ...
tazziedog Dasequin is glucosamine. Tazzie takes that too! They can all be given together but SAM-E has to be on empty stomach.
admin s-adenylmethioni ne ...
Titan What is that
jerry Titan, it's artemisinin
admin oh ... typo
admin Is ne for Neon?
tazziedog Milk thistle is also called silymarin and is used to treat mushroom toxicity and protect the liver from insult. Dog brand name is Marin but also can use human grade
Titan Jerry what is that art....drug rocco takes
Titan Is that the same as dasuquin? Can u take both dasuquin and SAME
jerry Pam, can you send us links to any info about this? What led you to try it?
tazziedog S-adenylmethioni ne. It is a natural liver detoxifier and also an anti-inflammator y that can help joints. Spelling might be off but the brand name is denamarin . You can also get it at human health food stores. SAM-E ight be more accurate way to abbreviate.
jakethesnake my brother told me about it... gives it to his big doberman babies
OKim1 humane grade milk thistle or canine?
admin Sams Club maybe ... [smiley]
jakethesnake Can you purchase the Sam E at Walmart?
admin what a survivor!
admin what is SAME?
tazziedog Chronic hepatitis. It is inflammatory not infectious but some NSAIDS and other drugs flare it up. She takes SAME and milk thistle daily and now her liver values are ok. She got jaundiced after her surgery and was sick for 4 days!
jerry Which hep type?
tazziedog Okay. I have seen some studies that look promising but Tazzie has hepatitis so I have to really be careful what she takes.
Titan I didn't notice the difference [smiley]
admin we plan to write about that too ...
jerry Oh what a tough word to spell!
admin Artemisinin ..
Titan What is arteminism
jerry My friend Rocco is on arteminisin. I can get you that contact info if you'd like.
tazziedog That would be great! And the doctor that started using artemisinin (sp?) is here in Seattle so I am trying to contact him directly. My concern is effect on the liver.
Titan carbo and adrio
jerry Titan, what NSAID are you using?
jerry Pam, Dr. Mullins graduated from there. She can hook you up with the right people!
tazziedog Theoretically it should help any sarcoma because it starves the blood supply by inhibiting new blood vessels.
admin but as a preventative, we no nothing...
Titan I think the combo Titan is using 20% can live up to 2 yrs
admin 2 months after being on my metronomics protocol follow up x-rays showed reduction in tumor size of about 10%
OKim1 i never even heard of metronomic till here, is it 4 certain types of cancer??
tazziedog I have not used this protocol yet. I might try to contact the Colorado Vet School.
admin wish we knew ...
OKim1 yes, what are the percentages?
jakethesnake We'll definitely be here!
tazziedog Yes! I want to know about the Metronomic protocol as a preventative prior to lung mets.
admin be there .... here!
jerry Sounds like a good question for my oncologist, Dr. Mullins, on 12/2.
jakethesnake sure!
tazziedog I would have to ask since I don't know if that combo is okay. Cisplatin and adriamycin or Carboplatin and adriamycin are okay but I'm not sure if you can change around platinum drugs. All of these work by cumulative effect and build up in the body
admin we give our hearts to all tripawds...
OKim1 wow what pawrent! what about the heart?
jerry Awwwwwwww
jakethesnake I'll give my kidney to Jake!
jakethesnake ugh
jerry So Pam, did you say that you aren't sure if you can switch chemo drugs, say if you don't like the reaction your Tripawd is having to one kind?
tazziedog Yes, at least with that drug. Once the kidneys are damaged they can't be repaired which is why so many people need transplants.
OKim1 is that the only way to protect the kidneys?
jakethesnake [smiley]
admin thanks dog
tazziedog Usually during the procedure they walk them
jakethesnake thank God!
jerry Oh good thing!
jakethesnake he gets to urinate
jerry When this is getting done, do patients get to urinate throughout the process, or all at once when it's over?
tazziedog Cisplatin used to be cheaper but if you add in the diuresis I'll bet it is more than carboplatin.
jakethesnake Jake was there ALL day long!
jakethesnake wow, I didn't realize that the actual chemo took 10-15 minutes and the rest was all flushing!!
tazziedog Yes, Jake the diuresis causes water retention. The carboplatin is given straight IV over 10-15 minutes and you are done
jerry Got it. Thank you for the clarification.
admin Artemisinin ... we'll be writing about that after a bit more research.
tazziedog Diuresis is flushing large amounts of fluid through an IV over several hours to flush and support the kidneys.
jakethesnake is Cisplatin considered a hassle because of him being essentially a water balloon when I pick him up?
OKim1 Just looking for progress..
tazziedog Kim, there is nothing new chemo-wise except for the trials. There is always the hope of holistic help! I am interested in the artemensin.
jerry Doc, what is "diuresis"?
jerry We just learned about Bella today, thanks to Lalla.
Titan Bella is a neopolitan who needs to be adopted. She is a tripawd from a tractor accident. I was seeing if I may know someone who would like to adopt her.
jakethesnake the Cisplatin treatments are about 450 per visit
jerry I think she is from Maryland, they aren't very clear about it on the site. «link»
tazziedog I do not know Bella
Titan I looked on Bella the neopolitans site do u know where she is from Jerry
tazziedog As long as he gets the diuresis his kidneys should be fine. It is just such a hassle to use that drug. And now carboplatin is cheap! I don't know if you can switch now.
jerry What do you think Pam?
jakethesnake my vet said that his research shows better results with Osteosarcoma with the Cisplatin... I didn't want to tell him that my tripawd friends begged to differ [smiley]
OKim1 Is there anything new for treating cancer? besides the trials
jerry Oh yeay!
jakethesnake I decided to go ahead Jerry since he bounced back
tazziedog I am glad Jake is tolerating the Cisplatin. Did they say why they didn't like carboplatin?
jakethesnake every 3 weeks
Titan We have Titan's 5th Thurs
jerry Are you still thinking of discontinuing the chemo for Jake?
jakethesnake I think 4???
Titan Jake will do fine how many chemos is he getting
jakethesnake Jake just had his first chemo a week and a half ago... Cisplatin with the diuresis... hard on the belly and appetite but after a few days he felt fine. Went in for his first round of bloodwork yesterday... no results just yet.
tazziedog It is actually almost healed. I had to put her on antibiotics again and use the boot!
Titan I hope the english mastiff mom gets another opinion
OKim1 how is Tazzies paw?
jerry Well, now Tazzie is one more amazing tripawd that is inspiring others. How cool is that?
Titan I am so happy we went for the amputation. Giant breeds have the stereotype since they are big that it will be too hard on them. I think just like people it depends on the dognd their livilhood.
tazziedog How is Jake doing?
jakethesnake tripawds rule!
tazziedog I had to talk to my surgeon and oncologist and see pictures of Finnegan and Titan to convince myself.
jerry You are so brave.
jerry Wow, now THAT's crazy!
tazziedog Yes I saw that! I will after this chat. I had many other vets tell me I was crazy or selfish for considering amputation.
Titan Where is Bella the neopolitan mastiff from?
admin Tazzie may need to respond to this recent post that just came in from another English Mastiff ... «link»
OKim1 ok..
tazziedog I would consider the bloodwork then if you can afford it. Especially thyroid!
jerry My pawrents were afraid to get lung rads too. But afterward, they were glad they did.
OKim1 thanks 4 advice... we have to make an appt
OKim1 no coughing, it think he is just getting older 10yrs
admin ... You must log in to participate.
admin FYI: To any guests that may be seeing this chat but no post entry box ...
tazziedog Of course lung rads are a good idea. His tumor type doesn't often met to the lungs but he could also have asthma or bronchitis. Is he coughing? How did his heart sound?
OKim1 im afraid to go 2 the vet...
OKim1 we had x rays in aug
OKim1 once in a blue moon , like he can't catch his breath
jerry Like what?
OKim1 he has been have a breathing prob
jerry Is it the twitching that's making you worry or other stuff?
OKim1 on my to do list
tazziedog Did 7you every get the full blood panel we talked aout last time? It isn't a bad idea to check a cbc, chem screen, and maybve thyroid every 6 months.
admin no worries!
OKim1 thank u..
OKim1 i am worried about him lately...
tazziedog I would do a thyroid panel because the winter breeds and some others are more prone to that as they get older. It can cause hair loss, muscle weakness, and lethargy.
jerry What kind of blood test?
tazziedog If only few twitches then don't worry but if happening more frequently I would have a blood test.
OKim1 thanks [smiley]
admin all pawsitive vibes here
tazziedog Is he on his third round of chemo? He will do fine!
OKim1 only had a few episodes
admin do these "ticks" dissipate over time
Titan Titan has been dong good. e have his chest xray thurs wish pawsitive thought
tazziedog It could be a nervous "tick" which is involuntary, but I wouldn't worry if it appens on his side or legs, just if it happens a lot with his face.
admin or a Possum!
jerry Jake!
Titan Good to see or read you all
jakethesnake Hello everyone!
admin Just rabbits in Busters sleep ...
jerry Howdy!
Titan Hi all
OKim1 could it just be nerves?
tazziedog Twitching is probably a muscle spasm. If it happens a lot in the face that would be odd.. Sometimes low thyroid can cause that.
admin Yup! #1 How are you and Tazzie?
OKim1 Hello Dr Pam; what would cause twitching on Busters side? or is it a muscle spasm?.. even when I pet or massage him I notice it happens once in awhile..his face even flinches involuntarily. he doesn't seem to be in pain [smiley]
tazziedog Hi everyone! Is everyone ready with questions?
jerry Dr. Pam is a frequent contributor in the Tripawd Discussion Forums on behalf of her 175 lb. English Mastiff Tazzie.
jerry Stay tuned for tonight's Live Ask A Vet Chat Sesion, 9pm Eastern, 6 pm Pacific time. Dr Pam Wilksius will be our guest.
Tripawds Founders Jim and Rene
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