Hi,

What a stunning girl Morgana is! Great to hear she's doing fine and no signs of lung mets!

My boy Razbeg has been on metronomics for about a year now, so I thought I might share our experiences on subject. Razbeg already had one small lung met before chemo, although at the time we didn't know for sure what it was, because it didn't grow at first. After 4 rounds of carboplatin Razbeg switched to cyclophosphamide last June. Razbeg is about 26kg and he got a capsule of 12,5mg each day. You probably have heard about the side effects of cyclophosphamide, one being haemorrhagic cystitis. To prevent this, Razbeg had diuretics as well. Everything went well for about nine months, but this March, despite of all precautions, Razbeg got the cystitis, and we are still struggling with it, although now the symptoms are almost gone. Usually cystitis heals more easily, though, once giving cyclophosphamide has been stopped. Besides, statistically the risk of getting it is quite small. When we started using cyclophosphamide, the small met in Razbeg's lung started to grow for the first time (before that there was hope it wouldn't be anything serious), and then another small spot appeared. His lung mets have been growing really slowly, however, and they don't cause any symptoms.

Now Razbeg's having chlorambucil (Leukeran). He gets 4mg daily, except only 2mg every third day. Leukeran is quite new thing to us, so I can't yet say if it's been beneficial or not. We haven't been able to check his lungs for 4 months now, because we have been concentrating on curing his cystitis, and also corona virus has messed thing up, because Razbeg finds taking x-rays stressful and at the moment I can't accompany him to the procedure. He's doing well, though, no visible signs of having anything wrong with his lungs. Generally speaking chlorambucil seems to have fewer side effects than cyclophosphamide, but cyclophosphamide has more scientific data behind it. And of course, leukeran is not entirely without side effects, either, for it can cause bone marrow suppression.

As others have said, there's no right or wrong, and different things work for different dogs. Some onclogists indeed seem to think that metronomics aren't that useful that they once were hoped to be, and I don't know whether cyclophosphamide and chlorambucil have helped Razbeg, but I want to know I have done everything possible to help him, and now, after a year of being on metronomics , he's still doing fine. At the moment, metronomics are the only option we have after chemo. We are fellow Europeans (living in Finland), and unfortunately immunotherapy vaccines are not available here. I don't think they're available anywhere in Europe, although I cannot be entirely sure.

These were some of my thoughts. To sum up, I think metronomics are worth trying, although they might have side effects and their effectiveness is disputed. I hope you all the best whatever you choose to do, and have a lovely vacation in Sardinia