Caring for a Three Legged Dog or Cat
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Hi,
My boy Brodie became a Tripawd on 9/26/11 and had his first dose of Carboplatin on 10/24/11. I've been lucky as he had NO observable adverse reactions at all; he was able to play, eat, poop, etc that day and every day since.
He is scheduled for second of six doses of Carboplatin tomorrow. At least I think it's his second dose; he has an appointment scheduled for tomorrow, but I recently heard that Carboplatin should be administered every 3 weeks, not every 2 weeks, and that his blood should be checked every week until the nadir point is discovered. He did not have his blood checked last week; the last time it was taken was on the day he had chemo.
Does this sound correct? For those of you who elected to try Carboplatin, how often was it administered, every 2 or 3 weeks? Also was blood taken from your tripawd every week, or every 2 weeks?
Finally, for those of you who did elect to try Carboplatin, how many doses did your tripawd get? Most studies that I have read mention the standard of care being 4 doses of Carboplatin, not 6. Has anybody here tried 6 doses of Carboplatin, and if so, how did your tripawd respond to the treatment?
I had originally decided that I would try any/all available treatments for Brodie, regardless of cost, provided that the treatments did not harm him or his quality of life. Since his diagnosis in September, including all of the diagnostic tests, surgery, rehab, meds, etc, I have spent over $12,000. I do not regret spending this amount, and I can't argue with the results; Brodie acts exactly like he did previous to his OSA diagnoses, minus a leg. I could not have asked for a better outcome!
That said, I am not the 1%, and in order to continue financing Brodie's long term care, I need to find ways in which I can keep his veterinary costs down. One possible way to do that is to try 4 doses of Carboplatin instead of 6. But I am afraid that by doing so I could be jeopardizing his chance for a better prognosis.
That's why I am looking for any information from other Tripawd parents who elected to try Carboplatin if they used 6 or 4 doses, how they arrived at that amount, and how their tripawd responded to the treatments.
Thanks,
Bruno
brodie said:
Most studies that I have read mention the standard of care being 4 doses of Carboplatin, not 6...
Please see our video interview with board certified veterinary oncologist Dr. Mona Rosenburg reporting on recommended carboplatin treatments for dogs with osteosarcoma back in early 2010. The effectiveness of six treatments over the previously recommended four was discussed at a conference the doctor attended just prior to us shooting this video.
Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet
Hi Bruno and Brodie - glad to hear Brodie is doing well so far. He's such a handsome boy!
We did 6 rounds of carbo, every 2 weeks. I know I've heard most people say they went every 3 weeks for their chemo, but our onc said we were going to give Abby the max dose at the max interval (2 weeks). He wanted to "hit her hard" with it to try to really knock the heck outta the cancer. It's been a while now, so I don't totally remember everything he said, but I seem to recall him explaining that a lot of dogs need 3 weeks to recover and get their CBC totally back to normal, but if we could get away with every 2 weeks, that would be more aggressive and the better way to go. We had her blood checked each time when we went in for the chemo treatment. They would check it right before and make sure everything was fine before proceeding. (It always was.)
As for 4-6, our onc. works in the same office group as Dr. Rosenburg (mentioned above), so he recommended 6 as, again, being more aggressive. Unfortunately, Abby did develop a lung met, even with 'hitting her hard' but she is still going strong today, 11 months after spotting that first little met.
Sometimes you DO have to consider the financial side of all this - even if you want to try to do everything possible. I can't really give advice as to 4 v. 6 other than to say we went with 6. As to how she responded, the treatments seemed to hit her a little harder toward the last 2. Her onc. said that is normal as there is a cumulative effect. However, having said that, she still did really well - she was just a lot more tired. (But we were also having work done on our house at the time, which was quite stressful for her, so that was also a contributing factor.)
Are you going to do an xray part way through the chemo treatments or after the 4th? Of course, that adds another expense, but it might help inform your decision of whether to do 4 or go with 6??
All the best with your decision. PM me if you have any more specific ??s about what we've done w/ Abby.
Jackie, Abby's mom
Abby: Aug 1, 2009 – Jan 10, 2012. Our beautiful rescue pup lived LARGE with osteosarcoma for 15 months – half her way-too-short life. I think our "halflistic" approach (mixing traditional meds + supplements) helped her thrive. (PM me for details. I'm happy to help.) She had lung mets for over a year. They took her from us in the end, but they cannot take her spirit! She will live forever in our hearts. She loved the beach and giving kisses and going to In-N-Out for a Flying Dutchman. Tripawds blog, and a more detailed blog here. Please also check out my novel, What the Dog Ate. Now also in paperback! Purchase it at Amazon via Tripawds and help support Tripawds!
4-6 is what I was told for Nova, but for financial reasons, I went with 4. Her oncologist told me at the time (2008) that the outcomes were pretty much the same, so 4 was her recommendation. That said, if I could have afforded 6 I probably would have done it. Nova had her doses every 2 weeks. It is now 3 years later, and she remains in remission with no evidence of metastasis. I really don't know what to attribute her success to, perhaps it was the Carboplatin, perhaps we caught her Osteosarcoma early, perhaps it's just luck. I guess I will never know. I guess what I am trying to say is that there is a pup here that did only 4 rounds and remains cancer-free. I wish you all the best with your Brodie. I was where you are at now 3 years ago, and my girl is still healthy and happy. I hope that gives you hope and reassurance that is it possible to beat this horrible disease.
Dane Mom Sue and Queen Nova
Dane Mom Sue at nova.tripawds.com and Mom to Beautiful Great Dane Queen Nova, a Blind Tripawd, who kicked cancer's butt from 11/08-03/13. The Queen is Spirit Nova now, but her legacy lives on here at Tripawds!
Hi Bruno & Brodie. Max had 6 rounds of carboplatin, that was our onc's recommendation. The infusions were given every 3 weeks. Max would have a CBC blood test right before the infusion; then I would take him back one week after the infusion for another blood check. Max handled the treatments well, he only had some side effects on # 5 and 6. He was a little more tired, and had a little diarrhea, some loss of appetite for a day or so. Other than that, he handled the carbo very well. Please keep us updated on your boy's progress, and be sure to come back here with any questions. Like Nova's Mom said, we've all been where you are now.
Hi Bruno and Brodi, Hi! Our Oncologist recommended and we decided to do the Chemo (Carboplatin) every three weeks and the full 6 treatments for Cadence. She is handling the chemo really good. The only thing that happens is she tends to lose interest in food the first day or so after, but bounces back and eats like normal. We will be doing chemo #5 next week and we have one more to go after that. We get her blood checked as well as other stuff regularly (At each chemo appointment as well as a couple random bloodworks for other reasons) and all her counts have been normal every time. At her 3 month check up, the X-rays and check of lymph nodes was clean. We have been very lucky. We started her chemo two or 3 weeks after the amputation and so far, so good. I have not yet read the data on the difference between 4 and 6 treatments, but after having been on here a while, and seeing both sides like Nova that has been in remission for three years even after having had ostesarcoma, and then some who get the mets during chemo, I think a lot depends on the cancer, the age of dog, the immune system, the diet, etc. I really don't see a magic bullet. You do the best you can as far as treatments, what you can afford, put your dog on a good cancer fighting diet and supplements, and the rest is up to God.
Dane's Mom, could you give me a little more information on Nova's condition? How far along was she with the cancer, what was the grade, what is her diet and supplements, etc? Thanks!
Cadence Faye: Born 10/30/04, stepped into our hearts 12/23/2004. Rear leg tumor found 7/24/11 by mom and dad, Xray on 7/25/11, Osteosarcoma suspected 7/26/11, amputation 7/29/11, Carboplatin started 8/23. Met free so far!
trifod2004 said:
could you give me a little more information on Nova's condition?
If you don't hear from Sue, be sure to check out Nova's blog. The Queen is now three years cancer free!
Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet
Thanks to everyone for their reply! I will check out that video now, thanks admin!
AbbysMom, thanks for sharing your experience with the 6 doses of Carboplatin. I had heard that waiting only 2 weeks instead of 3 weeks between doses could be harmful because the white blood cell count could be at their lowest for up to 21 days after treatment, and by giving the next dose too soon, you could potentially be lowering the white blood cell count even more my overlapping treatments, if that makes sense. Anyway, it seems that this was not the case for your girl, and I appreciate the info. To be honest, I have no idea why I am second guessing the Dr.'s; rationally, I know that every dog is different, data in any study can be interpreted differently by different experts, and that different Oncologist will have different opinions based on what they have studied/been trained on, and none is really "better" than any other. It all comes down to trusting yourself to trust your Dr. Anyway, I do appreciate the info and hope the best for your girl!
Danes Mom, you have no idea how relieved I am to read your post; thanks so much for sharing! I tend to be hard on myself to begin with, but I am even more so when it comes to my boys. Initially, I had considered taking part in an OSU study that would provide Carboplatin and Palladia at no cost; however that study dictated that 4 doses of Carbolpatin would be administered 3 weeks apart, followed by Palladia afterwards. At the time I agonized whether Brodie should participate in the study or not because although it would have been considerably less expensive, it would have given Brodie "only" 4 doses of Carboplatin instead 6, and I was afraid that I would be killing him by "cheaping out" so to speak and depriving him of the two extra doses of Carboplatin. Brodie ended up being ineligible for the study anyway; he couldn't start his chemo treatments within the 14 days that the study dictated due to a heart infection. But I had decided that I would participate in the study had he not gotten the heart infection, which is why I am now having second thoughts on the 6 vs 4 doses of Carboplatin. In any case, I know that every dog is different, but it is great to hear of Nova's success!
Maximut and trifod2004, thanks for the info! I'm glad to hear that both of your pups are doing well!
I do know that every dog is different, and I really do appreciate everyone's input.
As for Brodie, his pathology report came back pretty good, I think. Danes mom, do you remember what Nova's pathology report was like? From what I was able to decipher from the report, Brodie's diagnosis was as good as one could expect for OSA; the Ulna had minimally productive osteosarcoma with no mitoses seen in 10 HPF examined and overt metastatic disease was not seen. Lymph nodes were also clear.
Thanks again for everyone's input,
Bruno
Bruno - we did 6 rounds of carbo every 3 weeks (starting on day 9 after surgery). We had Sam's blood checked on day 10 following the first round of chemo and it was fine so they just checked his blood at each subsequent chemo appointment. We also debated about the study and thought the same thing - if he was tolerating the chemo well, we would do 6 rounds so we opted out. We had thought we would do the same treatment though (with the Palladia following the carboplatin) after the 6 rounds. Sammy didn't tolerate the chemo real well -- it was managable, but still a struggle. He presented with mets after round 6 so we decided against pushing forward with the Palladia and opted for metronomic which he tolerated fine (although didn't stop his mets). Hang in there - this stuff is confusing and there are no right/wrong answers so try not to beat yourself up too much! Sounds like Brodie is in great hands! xoxo Sue and Sammy
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