Jake

Are you considering a low-dose chemo pill (e.g., Cytoxan or Leukeran) in addition to metacam (i.e. anti-angiogesis or metronomic therapy)? I don't know what the cost is south of the border, but each 25 mg table here is 70 cents Canadian. That is taken once every day or every other day depending on your oncologist, so comes to $21 or 10.50 per month, plus the cost of the vet writing the script. Just a question . . .

It sounds like the cost of regular high-dose chemo is similar on both sides of the border (not sure why since our human meds are usually far cheaper), so I am guessing that Cytoxan or Leukeran also run for the same cost.

Hah, chilly in Florida, my missing right front foot! I tried to take Tazzie for a swim this morning, but given the 2 degree (34 Deg F) air temperature plus a wind, I did not encourage him and he did not jump in.

Enjoy your big day Jake!

Tazzie 2

Hey Jake

Don't worry too much. Look how well Jerry and many others have done without regular high-dose chemo. Chemo was probably not the best route for my Tazzie, however, we did not know then what we knew 6 weeks later when I found another lump.

First, one qualification. I live in Canada so there might be a big difference in price from the U.S. Others can advise since many of the Yankie  tripawds are using Cytoxan. (Although I know humans ordered from Canadian pharmacies a few years ago - I don't know if you can get Cytoxan from a mail-order pharmacy.) 

Jake is basically the same size as Tazzie and Tika and Max (who range from ~70 to 90 lbs), all of which have used or are using Cytoxan. I would therefore assume (*note: definitely not a vet here*) he would take the same dose, which is either one x 25 mg pill per day or one every other day. That is why I gave you the costs in the previous email. Most oncologists prescribe one every other day, but Max's gave a higher dose and Tazzie followed suit. Tazzie does not have a local oncologist, because such a person does not exist in Winnipeg.

A vet can write the script and they have pills at the regular old clinic. I initially gave my vet information on metronomics . She spoke with an oncologist or two by phone to find out about this type of treatment and then prescribed it for Tazzie. It is kind of nice for Tazzie to be in a vet's hands, because she gives him far more time than an oncologist could ever afford. Having said that, it is definitely reassuring to have the expertise of an oncologist behind these treatment decisions.

Do not expect your general vet to have heard of metronomics or anti-angiogenesis therapy, although it seems to be getting more common with human cancer treatment and with dogs.

But there is another issue, which will raise the costs, so maybe I should not have opened this can of worms. With Cytoxan, there is a risk of crystals/bladder infection, so you need to get the urine and (I think) blood tested frequently, so those vet visits and tests cost money (I think the oncologist said to test the urine after 2 weeks and then 6 weeks). We will copy Max and switch to another drug after 8 weeks. My understanding is that the 2nd drug, Leukeran, does not post a risk of bladder infection.

Jerry did not start metronomics until after they found lung mets, with the idea of slowing the growth of the mets.

I like the idea of a tripawd fund, but it is hard to picture how it would work practically. Any ideas? They do have official funds for cancer dogs - I received a pamphlet when going to an oncologist in a different province this summer and am sure the same thing exists in the states. But sometimes there can be so much hassle in getting those things to work out.

Susan & Tazzie 2