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Oral Chemo Palladia and Chlorambucil
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The Rainbow Bridge



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8 January 2021 - 10:54 am
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This is a super helpful thread, I hope more folks give their experiences with Palladia, it’s been a while. Thank you!

And thank you for the reminder about chlorambucil on an empty stomach.

It's better to hop on three legs than to limp on four.™
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8 January 2021 - 2:20 pm
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Hi.  After reading the post from Razbeg’s mom, I checked with my oncologist about how to administer Chlorambucil as I was not given specific directions when the prescription was filled.  Dr. Camps said: In people, it may be better to give chlorambucil on an empty stomach but it can also exacerbate nausea. In dogs I usually recommend it to give it with food and it doesn’t seem to alter its efficacy.  However, if you want to maximize absorption,  you could give it on an empty stomach and if Griffin gets nauseated, you can switch to giving it with food.  We recommend that you use gloves and make sure you follow the instructions regarding keeping the drug refrigerated.

Griffin started Chlorambucil yesterday, and I administered it in the morning with food both days.  I will switch to administering it on an empty stomach (likely at night before bed) starting tomorrow and keep my fingers crossed that he does not experience any nausea.  Thanks to all for the good information!

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8 January 2021 - 3:04 pm
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Excellent, thank you for asking, Stacy! Makes total sense. Paws crossed your amazing boy handles it without issue on an empty stomach.

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8 January 2021 - 10:04 pm
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Makes perfect sense that in dogs chlorambucil can also be given with food to prevent nausea & because with many dogs it is easier to give pills with food. 

I’m a bit neurotic maybe, but I do worry about the efficacy suffering if I don’t give it to an empty stomach. But actually I didn’t get any specific directions about how to administer chlorambucil either when we switched to it, I just read the package leaflet & looked for information on Internet.

Luckily Razbeg hasn’t suffered from nausea or had any other side effects, so I can keep giving it to him before meal as I have done.

Razbeg the rescue borzoi (born in 11.06.2009) became a tripawd in 20.09.2018.

He and his adopted "brother" Myrsky have their own facebook page:Razbeg & Myrsky

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14 January 2021 - 10:05 am
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I did not know about “empty stomach” administration either and I did not subscribe to my own question so I did not see some of the posts until now.

The vet did not tell us anything other than to alternate between the two drugs. Zeus is starting to refuse food and it is a game of wits to get him to eat and since he is on two drugs it is hard to tell which one is causing his nausea, or it could be both, or it could be something else. This is such a stressful journey. I feel like I am experimenting on him and I feel guilty every time he does not feel well. For the most part he sleeps and is not very active when we go out for walks.

I don’t know anymore…

We have a follow up appointment on Monday and we will decide then how to move forward.

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14 January 2021 - 11:37 am
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So sorry to hear Zeus has suffered from nausea, and that he hasn’t been very active lately. Sometimes these medicines can also cause tiredness, I’ve heard, so hopefully your vet can help you with this and adjust the medication if necessary.

I thought I could tell how I give Razbeg his pills, if it’s of any help. I gently put the pills in the back of his mouth, lightly hold his muzzle and then spray just a little bit of water with a syringe so that he must swallow. Then instantly I give him some cheese as a reward. It probably sounds unpleasant, but when done gently and quickly it really isn’t. I used to have real problems with giving pills to Razbeg and this has been by far the easiest technique, and Razbeg doesn’t mind at all!

Best wishes again!

Razbeg the rescue borzoi (born in 11.06.2009) became a tripawd in 20.09.2018.

He and his adopted "brother" Myrsky have their own facebook page:Razbeg & Myrsky

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14 January 2021 - 12:04 pm
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((((hugs))))

Try not to look at the situation as failing or experimenting, or blaming yourself in any way. This is a learn-as-we-go situation and Zeus would never ever hold anything against you when he feels badly. That is the magic of animals, they teach us about forgiving others and also ourselves. 

The way Razbeg gets pills is spot-on and does the job. I think we as pet parents try to do things as pleasantly and easily as possible and that’s always the goal, but sometimes we have to practice tough love and it’s hard as heck. But it can get the job done and help our furkids feel better.

Be sure to check out the appetite tips link I shared earlier OK? There are many ideas in there that can hopefully help. Keep us posted OK? We are thinking of you.

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14 January 2021 - 4:11 pm
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I’m so sorry to hear that Zeus is struggling with his appetite.  Palladia was the only chemo drug (out of 5 total) that caused Griffin to lose his appetite.  He started taking Chlorambucil a week ago.  I tried administering it at night so his stomach would be empty, but after 2 middle of the night vomiting episodes, I’ve started giving it to him in the early afternoon, 3 hours after his breakfast and at least 1 hour before his lunch (he eats 3 small meals a day to help with acid reflux).  That time slot seems to be working and his appetite has remained strong since he began taking Chlorambucil.  I’m sending you and Zeus big hugs and lots of love! sp_hearticon2 Stacy

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