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Protocol for Carboplatin Chemotherapy...how to know.. 4, 5, 6 treatments?
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Member Since:
21 December 2015
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26 April 2016 - 1:08 am
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My 7 year old black lab/dane X, Bloo, had his rear left amputated in December, he is doing very well 4 months post op and just completed his 5th treatment of carboplatin.

He has had minimal side effects, we have not even used one of his antinauseants.

He gets an ideal homemade diet loaded with local grass fed meat, a variety of veggies, lentils, with fresh ginger, turmeric, garlic, sardines, nutritional yeast, flax seed, olive oil, blueberries, and CBD coconut oil ( we call this his 'magic medicine' and we think it has played a large role in keeping chemo side effects at bay and Bloo feeling good).

All in all, the chemo has not been too rough, but as we keep going it seems to affect him more and more, emotionally and physically. We can tell he doesn't feel himself after a treatment and he may be a bit drooly for a couple of days which means he feels a bit nauseous. When this happens we give him a dose of his 'magic medicine' and he seems to improve within an hour or so. He has had full appetite (even gained muscle and weight!), and full energy most of the time, with a bit of a lull in that first week or so after chemo. His carbo treatments have been at full strength and we have spaced to 4 weeks apart after finding his had a second white blood cell nadir at around the 3 week mark. His WBC have been consistently around the 2-3000 mark at treatment times and his full CBC shows no effects to the liver or other organs. Basically, he's been doing amazingly. The worst part is when they have to get the IV in him and his veins are all so scar tissued up that they have to keep trying different spots, last time we had to go into his femoral artery. He has caught onto it when we go to the vet and although he is the most complient dog you could get, he looks at me and I know he hates it and he is fed up with it. We have been trudging along with treatments and staying positive, but after this last treatment (his 5th) the next day he was curled up in a ball and I could just tell he wasn't feeling himself. I cried because I felt bad about knocking him back down again just as he starts feeling awesome.

We also wonder...why is the vet saying his protocol is 6 treatments? We have done a ton of research and we know that it can vary usually being 4 or 6. Why is it 6 for him? How do we know this isn't overkill? At this point are we just knocking down his immune system and causing unnecessary discomfort? This time I felt like he kinda has had it. I don't want to make him do any more. That morning I hugged him and cried and told him Mommy doesn't want to make him do any more. I told my husband how I felt. I know he was wincing at the vet the day before as they poked and poked trying to get the damn IV into him and as he looked up at us in pain I know my husband was feeling the same way I was. I called my vet and told her we were thinking about stopping before his last treatment. We are after all doing a lot of other holistic methods...ones that we truly believe can make a huge impact...though not what vets would recommend or have much information on mind you...so of course she gave the expected schpeil. I just don't get it...why some 4? Why some 6? How do you know when you are done? Am I sacrificing the effectiveness of the other 5 treatments (which cost a ton of money that we don't have) by cutting him off before the 6th? So far the vet hears no oddities in his lungs as she listens each time and he shows no symptoms of mets at this point. When he was xrayed prior to amputation he had no visible mets on his lungs. We wonder if maybe we got it all? Or if we got everything that the carbo will get?

So hard to know if stopping is the right thing at this point. Wondering if anyone can shed some light on this and share their experiences and results.

Thanks in advance for any feedback, Bloo's Mommy (Kristen)

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26 April 2016 - 4:54 am
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I am not a vet, so this is just my experience.  Our oncologist said 4, and our last treatment is today.  We have some of the same symptoms as you do, so I will be glad to get this over and let him live his life.  There seem to be 2 schools of thought among the oncologists on 4 v. 6.  I worry that perhaps 6 would be better, but I also think about quality of life in his time remaining.  I would hate for him to be one of the unlucky ones and to have spent his time not feeling well.  I would talk to your oncologist, especially about whether opting not to do #6 would make any real difference.

Otis - 106 pound lab/Dane mix, lost his right front leg to osteosarcoma on Febuary 9, 2016.  Four rounds of carboplatin completed in April, 2016.  Lung mets August 25, 2016.  Said goodbye too soon on September 4, 2016.   Lost his adopted sister, Tess, suddenly on October 9, 2016. likely due to hemangiosarcoma.  

Wherever they are, they are together.

Maryland
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26 April 2016 - 6:06 am
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Hi Kristen & Bloo and Family!

From everything I've read here, the number of treatments w/ carbo ranges between 4 and 6. I personally (not a vet of course) do not think there is strong evidence as to the best number of treatments. 6 may be better than 4, but I don't think in any way you are "throwing away" the first 5 if you stop now. Many many folks do 4 treatments. From what I know, 4 treatments were the standard for a long time but then our oncologist said the price came way way down so people were able to try to do more rounds. 

If Bloo has reached his limit and you are seeing changes in behaviour then I think that is something that should not be minimized. Quality of life is what it is all about in my book. Your onc is probably a caring and professional vet, but you are Bloo's family and you should be the ones deciding what the next steps are. 

Our Ellie also had vein trouble, and did not like car rides and was a general nervous Nellie. We did 6 rounds, but each and every time we did chemo, we went through a "is this still good?" question. When we finished chemo, it was a relief because we could go back to "normal" life. I think that is important. 

Denise, Bill and Angel Ellie

Active 10+ Pyr mix suddenly came up lame with ACL tear in left rear leg. Scheduled for a TPLO but final pre-op x-rays indicated a small suspicious area, possibly OSA, which could have caused the ACL tear. Surgeon opened the knee for TPLO but found soft bone. Biopsy came back positive for OSA. Became a Tripawd 9/18/14. Carbo6 with Cerenia and Fluids. Pain free and living in the moment. Crossed the Bridge on 7/12/15 after probable spread of cancer to her cervical spine. A whole lifetime of memories squeezed into 10 months. Here's her story: Eloise

On The Road


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26 April 2016 - 8:15 am
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Glad to hear Bloo is doing so well otherwise!

Chemo is a very personal decision and only you know what's best for him. If you are uncomfortable with more treatments, there's no law saying you have to do it. You have to make a decision you can all live with. Follow your heart, it sounds like it's talking to you now.

As for why 4 vs. 6... there is little evidence across the board that 6 is better than 4, but it comes down to what the vet has experienced in their own patients. Oncologists can't agree 100% on 4 vs 6, so they go with their best experiences. They are kind of like chefs, cooking up chemo recipes that they have seen work for their clients, but the same one may not work as well for another vet's. It's critical to have a vet you see eye to eye with on things like this.

More info:

News from #AAHA2016: Learn About Canine Osteosarcoma Breakthroughs

How Many Chemotherapy Sessions are Best for Osteosarcoma in Dogs?

Bone Cancer Treatment News for Dogs and Cats

Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet

Virginia




Member Since:
22 February 2013
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26 April 2016 - 9:31 am
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BLOO! Love your name! A d you sound like such a sweet gentle boy! Can't wait to hea more about you and see pictures.

My Happy Hannah had FOUR rounds of Carboplatin as suggested by her Onco. At the time she was a recent graduate (can't remember...Cornell maybe?) andshe said that's what she was being taught. Her exact quote was "more isn't necessarily better these days". I had no regrets.

Now, as you have already seen, some do four, some five, some six. If it appears your Onco is pushing for another treatment,you can almost be guaranteed that there are plenty others out there who will tell you four or five is absolutely enough! I'm not a vet and I'm not giving you vet advise. This is your decision AND Bloo's decision!

Okay, all that aside. I read your post three times and each time it was more and more clear to me BLOO has given you his answer. He's not interested in anymore chemo!! It's also clear to me your "inner voice" is in complete agreement!

As others have already mentioned, it's about QUALITY, not days on a calender. It sounds like Bloo's quality is starting to be compromised, and increasingly so based on the last treatment.

You are doing a splendid job with Bloo's supplemental program and it causes NO side effects!!clap All his previous tests have been great! It sou ds like Bloo is telling yo u it's time to be Vet free and test free! It is such a freeing experience ro be do e with all that stuff. Your conversation with Bloo and your husband, and your heart...spot on!

You are Bloo's advocate! You know Bloo best! You've already tried to express your wishes to his Onco and it didn't appear to be well received. Okay, I shouldn't say this, a d Imq trying not to.....but no further calls are necessary! You a d Bloo didn't aplear to be heard! We hear you!!

Please stay connected and update when you can. Give that sweet boy a hug and give hi a treat! Ow go live life ro the fullest and savor the moment!!

Love a d hugs!

Sally and Alumni Happy Hannah and Merry Myrtle and Frankie too!

Happy Hannah had a glorious additional bonus time of over one yr & two months after amp for osteo! She made me laugh everyday! Joined April's Angels after send off meal of steak, ice cream, M&Ms & deer poop!

Los Angeles, CA
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26 April 2016 - 9:32 am
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We did 7 - but we were fighting a different cancer and had to try a couple different chemos once lung mets showed up. I think it's an oncologist preference or how aggressive your cancer might be. As far as all with the same chemo, I cannot answer that since Shelby had to switch chemos mid-treatment since we developed the lung mets. My goal was to be as aggressive as I could to fight this with all that I could. And I was fortunate to have some resources to manage.

But Jerry gave you some good links!

Wishing you all the best and lots of love and healing your way!!! 

alison with spirit shelby in her heart 

Shelby Lynne; Jack Russell/Shiba Inu mix. Proud member of the April Angels of 2014.

October 15, 2000 to April 8, 2014

Our story: Broke rear leg in June 2013 - non-conclusive results for cancer so leg was plated and pinned. Enlarged spleen in September 2013 and had it removed and was diagnosed with Hemangiosarcoma and started chemotherapy. Became a Tripawd January 8th, 2014 and definitive Hemangiosarcoma diagnosis. Three major surgeries in 7 months and Shelby took them all like a champ only to lose her battle to cancer in her brain. We had 8 amazing extra months together and no regrets. #shelbystrong #loveofmylife

Livermore, CA




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26 April 2016 - 10:05 am
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What I'm hearing in your post is that you want to stop- and I think that is valid.

I've had 3 cancer journeys in two pugs.  Once I chose to do chemo, twice I declined.  A big part of why I declined twice was life quality.

Quad pug Tani had recurring mast cell cancer- I chose to treat holistically and it worked out well.  She lived a long time and did not pass from mast cell. 

Maggie lost her leg to mast cell cancer and we did do chemo. I went into the amp thinking it was curative- but after the amp her prognosis was very poor.  We did the recommended protocol, which lasted 6 months, and Maggie was one of the lucky ones that beat her cancer. 

Then Mag developed a second cancer.  Factoring everything in, her health, age, how she did at the vet, etc I chose not to treat it at all.  Maggie passed just 3 months later.

The point I want to make is that you need to be comfortable with your decision, now and later.  In my first two examples I had no doubt I had made the right decision.  But after Maggie passed those 'what if' thoughts did enter my mind. I was able to walk through my decision making process and reassure myself that I had done the right thing. 

Make the best decision for you and Bloo.  The truth is we will never know what would have happened if we made a different decision.

Karen and the Spirit Pug Girls

Tri-pug Maggie survived a 4.5 year mast cell cancer battle only to be lost to oral melanoma.

1999 to 2010

 

              Maggie's Story                  Amputation and Chemo

New Jersey
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27 December 2011
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26 April 2016 - 5:53 pm
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Hi Kristen,

I just had to respond because what is happening with your Bloo is so similar to what happened to my Lily (not the IV issue). We did 5 treatments of Carbo, and Lily looked just the way your Bloo did. She was exhausted and not herself at all; we stopped. Since each treatment affected her more and more, I didn't want to see what the 6th treatment would do. I never looked back. I talked to my vet and Dr. Couto at Ohio State, a renowned bone cancer expert (works with greyhounds) and they both agreed. Lily always ate healthy food and drank filtered water-she had chest xrays every 4-5 months-always clear, thankfully. We just lost her due to back issues at age 13. She lived 4 years, 3 months, and 15 days after her amputation. Everyone is different, and every dog is different. It is such a personal decision. I just wanted to let you know that I understand, and 5 for us worked really well. 

Sending hugs,

Joan and her angel, Lily

Our beautiful Lily was diagnosed with osteosarcoma in her front leg on 12/14/11 at age 8 and had amp on 12/16/11. She completed 5 rounds of carbo. She was so brave and kicked cancer's butt daily! She lived life fully for 4 years, 3 months, and 15 days after her amp. My angel is a warrior princess. I miss her so much.

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16 March 2016
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26 April 2016 - 9:19 pm
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Bloo! I feel your pain. My Bentley is most likely starting chemo next week. It's been two weeks since his amputation, and found out the cancer isn't gone like they thought. Our oncologist is recommending 6-8 sessions of chemo with the hope of doing 8. After reading this whole thread I realize 8 is double everyone else. He has histiocystic sarcoma so maybe that's different. But I have to agree with others- no more for Bloo. I hope I can have your courage and intuition to listen to Bentley like you can to Bloo. Right now I know of Bent had to start chemo tomorrow he wouldn't be able to because he is still so tired. Hang in there! You're a blessing like everyone else on here and giving me hope!

bentley and mama

Virginia




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22 February 2013
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26 April 2016 - 9:36 pm
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A quick hijack of Bloo's thread ....Bentley's mom! My Happy Hannah had osteosarcoma (four rounds Carboplatin) so can't address the 6-8 chemos suggested for Bentley. I can suggest that you not start the chemo until you see Bentley feeling better! Happy Hannah was "supposed" to start hers at the two week mark. She was still dealing with a rough recovery and I put it off for another week, making it a little past the third week until her first. I needed to see her feeling better before she started.

Sorry for the interruption!

Sally and Alumni Happy Hannah and Merry Myrtle and Frankie too!

Happy Hannah had a glorious additional bonus time of over one yr & two months after amp for osteo! She made me laugh everyday! Joined April's Angels after send off meal of steak, ice cream, M&Ms & deer poop!

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21 December 2015
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26 April 2016 - 11:09 pm
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You guys! I am so glad I posted. I have been a Tripawds member since Bloo's amputation and have found a lot of solace and wisdom in this site and others experiences and stories, as well as a great deal of inspiration. 

Tonight as I read your responses, I am literally in tears. Not because of the exact responses but mostly because of the amount of HEART I can hear in your words and thoughts. It means so much to have people who truly understand what we are going through reach out to offer advice, support, and a listening ear. You have no idea. Each one of your replies...just amazing. I think sometimes you need to hear someone tell you "yes, you have the answer to the question you are asking!" and you guys all gave a piece of wisdom to help me out. What an amazing online community. I have to say, through this experience with Bloo, though it has been a nightmare and perhaps the hardest thing my husband and I have gone through in our lives (yes...I say that with all seriousness....we are not having children and our furbabies truly are our family and we love them more than anything), we have learned so much and found inspiration and hope in between all the stress and sadness and worry. So many hard decisions have to be made....in such a short time. It has taught us a lot. You like to think you know what you would do in this type of situation...but until it happens...you have no real idea. We have changed our minds a million times...first with the amputation, then with chemo...now with when to say we are done with it all and ready to just enjoy life and let Bloo be free of being a 'cancer patient'.

He really is such a special boy...a gem of a dog. I am a dog walker as well and although I love all animals, but this guy is something else. One of those "once in a lifetime" dogs that I'm sure many of you have had. Tripawds tend to be special dogs...I have noticed that. They also tend to have the best families and honestly that is what it is all about.  It fills me with joy to hear your experiences and your babies too....my heart goes out to all of you for being so brave and strong and for reaching out to others like me who would be so lost and alone if it weren't for this community. If there is one thing in my life I am proud of, at age 31, it is my family of pets. They are so amazing and good and full of love...I like to think that is partly from me and they are the best thing about me. Having to deal with Bloo's diagnosis was perhaps the most soul shattering thing I have endured...both me and my husband were destroyed at the news and seeing a military man break down and sob is enough to crumble even the strongest of heart. But you know what? It has been worth it. Every day I see Bloo hopping around parading his favorite toys with his tail doing the 'helicopter' and his ears pulled back in a smile...it's worth it. 

What I'm trying to say to you all is THANK YOU! I am writing this all through tears and you can bet I will be re-reading all of your responses a hundred times; it will be staying up on my computer screen so I can read it every day. You have given me so much hope and comfort and through your strength I can find my own. You and your Tripawds, whether here or in Angel form...are helping me and Bloo and so many others.

Please check out my youtube channel 

https://www.you.....9WV1F5-Rbw

We have been making short videos documenting Bloo's journey and recovery. Please check out my channel I have not posted photos or videos yet on Tripawds but I am going to make an effort to get more active on this site, it has been a godsend. 

Love and Tail wags to you all!!!!!

Kristen, Blake, Bloo, Nakiska, Indra, Ollie, and Cleo! 

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27 April 2016 - 2:00 am
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This is a video I took after Bloo's 4th treatment, he is a special guy. Forgive my doggy talk voice. (don't act like you don't do it!)

Anyone else have a Tripawd with a kitty buddy that seems to sense when they are not feeling well? Our cat Cleo is all over him when he isn't feeling the best. Sometimes she will go up and lick his face and ears and rub all over him, then lay down next to him purring. I think it's adorable they are such good buddies. 

Sidenote....anyone else cry like a baby when watching videos of their Tripawds? Every. Damn. Time. If I watch the video we make when we first brought him home from surgery I just bawl! Glad it's all in the past.

On The Road


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27 April 2016 - 10:22 am
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Kristen, thank you so much for the kind words, you made our day. AND for sharing your videos, we've added them to our playlist. Bloo is a total inspawration and so are you! Thanks for helping others by documenting your journey and being a part of this community.

Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet

On The Road


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27 April 2016 - 10:23 am
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And yep, we cry hoppy tears when we see videos of Jer. Even now we have to stop what we're doing when one comes up. Can't even watch the PBS documentary with Jerry without a box of tissues!

Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet

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27 April 2016 - 9:31 pm
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jerry said
And yep, we cry hoppy tears when we see videos of Jer. Even now we have to stop what we're doing when one comes up. Can't even watch the PBS documentary with Jerry without a box of tissues!

Just watched the clip with Jerry......def got me tearing up. Nice to see others that truly love their dogs..I can see how amazing Jerry was and that you guys gave him the best you could right up til the end. We feel the same way about ongoing xrays etc....now that we are done with treatment we just want to live life with him and enjoy every moment. If he gets a few months or a few years we will be grateful for whatever time we have, every day is worth it. Thank you for showing the world that life on 3 legs can be every bit as good...and for our Tripawds, they know it can even be better!

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