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Nova's Chemo is Done - Now What?
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Linden, MI
Forum Posts: 458
Member Since:
11 November 2008
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6 February 2009 - 2:16 pm
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Today Nova had her 4th and last round of chemo. So I am trying to decide what my next steps are. I talked with the oncologist during her treatment this morning and she said she felt stopping at 4 rounds would be okay, studies have shown that 4 rounds is just as effective as 6. So I was relieved, the chemo has been such a drain on me financially. She also said that it was customary to do chest x-rays one month after completion of the chemo. So I will probably follow that recommendation, although I hadn't planned on doing them until April.

I asked about K-9 Immunity and other supplements, but of course I hadn't gone prepared with some of the recommendations I've seen on here. She said that I should not start Nova on anything for 1 month, she didn't want anything conflicting with her chemo. So I figure I have about 30 days to get a plan in place for that. I know there is all sorts of information on the site about metronomics , supplements, etc. But it's all so confusing and I am trying to organize it all into a good plan for Nova. Financially I am drained, so I can't continue to spend at the same level I was during the chemo months. But I do want to come up with an effective, affordable plan to boost Nova's immunity and try to keep this monster at bay. I tend to throw money in too many directions at once, what I am looking for is some recommendations that include kind of the “whole package”, like what would be a good mix of products/meds/supplements, etc. that will not be as expensive as chemo.

Whaddaya'll think?

Sue and 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!

Here and Now


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6 February 2009 - 2:24 pm
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We totally understand the financial concerns. My only recommendation is to pick a diet and treatment plan that works for you and stick with it. If everyone does that, and documents the results here in the forums, the more informed future tripawds and their people will be.

Stay tuned to the blog where we will soon be posting Jerry’s updated diet and supplements info from his various treatment phases.


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6 February 2009 - 6:42 pm
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Sue,

There is no right answer on what to do next.  My original plan for Tazzie was to stop after 4 Carboplatin treatments and then do nothing.  I ended up doing 5 because she tolerated them so well.  As I researched Artemisinin I thought it looked promising and safe so I started that.  I can't remember how much Nova weighs but I know she is smaller than Tazzie.  Tazzie is on 2 forms of Artemisinin from 2 different companies.  She gets 2 capsules once daily for 8 weeks and then she will be reduced to every other day.  This is the prevention dose; those with lung mets can take a higher dose.  I buy the Artemather from Hepalin.com and it costs $60 for 60 caps (a 30 day supply for Tazzie).  The Artemisinin comes from Holley Pharmaceuticals and I got a “buy 2 get 1 free” deal so 3 bottles of 60 caps each cost $85 (90 days).

She also gets 3 tsp “Bone Stasis” powder twice daily which might help prevent bone mets. A 100 day supply of that costs about $60.

I decided to try metronomic therapy because Tazzie's oncologist felt that this was the most promising way to prevent/delay mets and that is pretty cheap because she can use human meds due to her large size.  I get the generic Metacam (meloxicam) for $4 a month from Fred Meyer pharmacy (you can also use Walmart or Target) and her Cytoxan was about $125 for 100 days.  I decided not to do doxycyline because most oncologists do not think it is all that beneficial.

I looked into K9 Immunity and Tazzie would have needed 18 capsules a day.  I decided that this was too many pills on top of everything else and it was the least likely to help her.  It is a good product to boost immune function but she already takes several antioxidants for her liver and seems to have a pretty strong immune system.  I might change my mind if she gets lung mets!

So the above treatments cost me $5 per day.  I do get a slight vet discount on the Bone Stasis powder and Cytoxan but the other meds are not discounted.  I haven't added up the cost of her liver supplements or food but I really don't want to know!!  Even with all of the things I can do at low cost like bloodwork and xrays I still estimate that we have spent about $5000 to $6000 on Tazzie since August.  Well worth it for a happy pain-free dog but we are feeling the pinch!  No vacations and less dinners out this year, but I will gladly keep it up if we can keep our girl with us as long as possible.

It may be that none of the above even helps since OSA is so aggressive.  On the other hand, there have been dogs that have lived over 2 years with amputation alone, and the amp plus carboplatin can also lead to long-term survivors so you have already done the 2 most important things.

Pam and Tazzie

Forum Posts: 930
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7 February 2009 - 11:17 am
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Cherry's dad here,

I have read these postings with great interest. When we finished our last (fourth) chemotherapy treatment seventeen days ago, the only discussion was to do follow-up x-rays approximately every three months. Cherry did not take to the chemotherapy treatments too well. The first was literally hours after the amputation. After that one, her appetite went to zero quickly and she stopped accepting any fluids. Her tolerance for the next three were slightly better each time, but with that record no one considered additional treatments. However, we did not reduce any of the doses but rather went to “force” feeding, which actually sounds worse that reality. Cherry also had many other complications.

You all have our total sympathy for the drain this journey places on everyone. For us, it has been both finanically and emotionaly draining. The running vet expense total from first diagnosis to the present is approaching $11,000. If the treatments that Pam & Tazzie are employing can help and be used safely in our case, then they definately are worth using. Eventhough I have been retired for nearly eight years and on a fixed imcome, there really never was a choice in the treatment. Only this path could allow the sparkle to return to Cherry's eyes and the zeal for life that had defined her eleven years. If the treatments you describe can extend her quality life, then I will start to employ them.

Thanks Sue for stimulating this conversation, and thanks Pam for your eye opening input.

All our prayers and positive thoughts

Bob, Emily, Cherry & Coal

Linden, MI
Forum Posts: 458
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7 February 2009 - 3:07 pm
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Thank you, Pam, for the incredible amount of detail you provided. That was just what I was looking for!  You are such an asset to this community! We are so lucky to all have our “resident vet”/Tripawd parent.

Right now Nova weighs 112 lbs.

What is the difference between Artemisinin and Arthmather? What does it do, and why do you take both? Are these products that I can order? Or do I need to get a prescription?

Same with the BoneStasis, Metacam and Cytoxan? Is a prescription needed?

What is metronomic anyway? Is it oral chemo? Are there any negative side effects to it? What does Metacam and Cytoxan do? I know there have been postings on it, but I am still not clear on if it is a drug like Carboplatin.

The oncologist suggested Fish Oil capsules, but again, she does not want me to start anything until the end of the month.

Bob and Cherry and family, hang in there. I wish chemo would have been easier for Cherry, hopefully things are looking up now!

Sue and 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!

Zaks mom
6
7 February 2009 - 3:42 pm
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Pam.. I found your post to be very helpful. Thank you for taking the time to clearly explain what you have done with Tazzie's treatments. I've saved them into my files for future reference.

Bob & Emily.. I agree wholeheartly with your post so much so that I could've typed it myself. The financial portion is brutal & emotional equally difficult. That said.. Now that I know the amputation was the best thing for him.. I, too, would like to continue treating him to keep the cancer at bay for as long as possible. 

Best of luck in all our fights!

Jenna


Forum Posts: 2000
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7 February 2009 - 6:19 pm
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Sue,

If you look back in the old postings in “Treatment and Recovery” I did a post on Tazzie's complete protocol (I think it must have been the beginning of January). Everything is the same except I recently added the Bone Stasis powder on the advice of the holistic vet that I use for one of my other dogs (Kona). The website for this is http://www.tcvmherbal.com but you need to be a vet to actually order.  I found my holistic vet through word of mouth but they might have a “search” function on this site to find one in your area.  So yes, for this you will need a vet or at least a prescription but the company can ship direct to you.

There are several postings elsewhere on artemisinin and Kim (Buster's mom) found a good article on this herb from the BoneCancerDog website. Basically, when researchers mixed this herb in a petri dish with cancer cells (including osteosarcoma cells) all of the cancer cells were killed!  It works by restricting the iron that the cancer cells need to grow, but does not hurt normal cells. It is unknown if this will work when a dog takes the meds orally.  There are 3 forms of the herb; artemisinin , artemather, and artenusate.  The first 2 are the most potent.  If you go to http://www.Hepalin.com you can order all 3, plus they have a product called Artemix that has all 3 combined.  The reason I did not go this route is strictly cost!  I found that the artemisinin was cheapest on the Holley Pharmaceuticals site since they had a “2 for 1″ deal but they did not sell the other forms.  It was cheaper for me to buy the artemather separately and since artenusate is not that potent I just skipped it.  The artemather is the only one that can be harmful in high amounts so do not exceed 0.5 mg/pound bodyweight/day (Tazzie is slightly underdosed here at 80 mg daily).  They are testing artemisinin at OSU vet school and the Dr there recommended 200-300 mg daily for Tazzie's weight.  You do not need a prescription for any of these and if you can only afford one I would just do the artemisinin or Artemix product.  If you go to the Holley Pharmaceuticals website they have some good articles and also offer a drug called butyrate that is very cheap ($12 for 100 caps) which may help the artemisinin be absorbed better.  Tazzie takes 2 of these per day.

Metronomic protocol refers to periodic low dosing of drug.  Some docs do daily, some every other day, and some weekly.  The current info I found is to give cyclophosphamide (Cytoxan) at 10mg/m2 every day or 25 mg/m2 every other day.  These doses need to be calculated by your vet and you will need a prescription.  It will have to be compounded for Nova's size.  Jerry could give you an idea on cost per month because he was on it (I think from RoadRunner pharmacy).  Your vet/oncologist probably already knows a local pharmacist that does this.  Side effects are rare and involve the bladder (infections or minor bleeding) so urine should be checked every 3-6 months.  No problems with bone marrow or platelets due to the low dose ๐Ÿ™‚  The other part of this protocol is a daily NSAID.  I chose Metacam for Tazzie because it is one of the safest on the liver and GI tract plus it is only $4 (generic is meloxicam). You will need a script for this but due to Nova's smaller size she would only need 1/2 of the 7.5 mg tablet.  Your vet might think that she would do better with a different drug like piroxicam or Deramaxx. Side effects with these drugs usually involve the GI tract so watch for vomiting or dark, tarry stools (due to bleeding).  Some dogs can have side effects that involve the liver or kidneys so periodic bloodwork (1 month after starting then every 6 months) is prudent.  Tazzie has a form of liver disease called chronic hepatitis and her values are still normal after 4 weeks of Metacam.  The whole point of metronomic protocol is to prevent cancer cells from “taking hold” in a new spot so this protocol starves their blood supply (anti-angiogenic).  Some vets used to also add doxycycline (an antibiotic) and this would not be wrong but many oncologists have stopped this since there does not appear to be an anti-angiogenic effect.  I decided not to do it in the interest of less pills/money but if your oncologist still uses it then it would not hurt.

So this is a long, technical post but I hope it answered your questions.

Pam and Tazzie

My heart lives at Rainbow Bridge
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8 February 2009 - 1:44 pm
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Pam, I think I can speak for all of us in being so very thankful you are willing to share your knowledge so freely.  We, too, are nearing the end of chemo and are starting to contemplate what if anything we should do next.  I haven't had this conversation with our vet yet, he is kind of an in the moment kind of guy. ๐Ÿ™‚  He believes in taking on step at a time and not trying to second guess what is coming next, which really has been a godsend at keeping me calm and focused.  If he isn't worried, then I'm not either.

Thanks again for giving us the info we need to begin weighing our choices.  You and Tazzie are the greatest.

Shanna & Spirit Trouble ~ Trouble gained her wings 3/16/2011, a 27 1/2 month cancer survivor, tail wagging. RIP sweetheart, you are my heart and soul.ย  Run free at Rainbow Bridge.
The November Five - Spirits Max, Cherry, Tika, Trouble & Nova. 11/2008 - 3/2013 An era ends as Queen Nova crossed the Bridge.

Northern CA
Forum Posts: 314
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23 December 2008
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8 February 2009 - 3:39 pm
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Yes, we agree with Shanna and Trouble- you and Tazzie are the greatest. Your knowledge and willingness to share it is so greatly appreciated.  Thank you  Thank you Thank you !

We have only had 2 rounds, but have been thinking what do you do after the chemo rounds so this post was very helpful.

Seanne and Wrigley

Seanne and Angel Wrigley

Linden, MI
Forum Posts: 458
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8 February 2009 - 4:39 pm
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Again, thank you Pam and Tazzie. This was exactly the type of information I was looking for. It was so wonderful for you to spell it all out for us, and I'm sure many people on the site will benefit immensely.

I am going to discuss some of these things with Nova's oncologist and see what she recommends.

A big Great Dane hug to you for being so willing to share!

Sue and 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!

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