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Be More DogWhat does it mean to Be More Dog?

Find out in Be More Dog: Learning to Live in the Now by Tripawds founders Rene and Jim. Learn life lessons learned from their Chief Fun Officer Jerry G. Dawg! Get the book and find fun gifts in the Be More Dog Bookstore.

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Tazzie's results: haircut by haircut
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Winnipeg
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13 July 2009
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30 September 2009 - 8:56 am
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Tazzie 2 update by his getting-to-be-anxious mum:

Today would have been the day we would have done the 4th chemo treatment if it were not for that darn lump I found the night before his last chemo, three weeks ago. So far our course of sail is not clear. At present we are not doing any form of treatment.

The vet who has diligently been looking after Tazzie since our return to Winnipeg is away this week. I just spoke to the other vet, who was the person who removed the lump. Of course, he would have had no idea of the myriad of options we were considering when he took my call, the poor vet (metronomics , artemisinin , palladia, etc).

He did read the pathology report for the subQ lump to me: it is consistent with OSA with neoplastic cells in the blood vessels so consistent with a high likelihood of mets in other visceral places.

As you know, we did not find visible mets in other places (apart from two candidate nodes in the spleen) when searching two weeks ago. It seems time to act (a bit late, but still appropriate), while Tazzie still feels good and mets have not taken over visibly. But are we too late for something like metronomics to have an effect? Does it take time for its effects to kick in?

I am thinking of contacting an oncologist recommended by Maximutt, who oversees Max's metronomics protocol, but definitely want my vet's blessing before doing this. We do have an oncologist in Calgary, but I'm not sure she would oversee a metronomics protocol herself, even though she seems to think it is reasonable.

We will need to decide: continue same old chemo; switch chemo (is there a point in chemo - there are probably lesions present that are just too small to see by ultrasound or x-ray); switch to metronomics , or palladia (I don't like the idea of possible side effects of the latter but have not read much on the topic). I am leaning to metronomics , modified to avoid kidney issues, and artemisinin , but I'd love to have an oncologist review the case and advise. One of the artemisinin packages arrived in the mail this morning.

If Pam has suggestions now (e.g., a different chemo, metronomics or palladia?), that would be terrific. I put quality of life first. At this stage, I don't want him down and out for a few days or a week following rounds of chemo or other drugs (okay, if Palladia might cure it, that is different, but I assume that is out of the question.)

Tazzie 2

Member Since:
20 May 2009
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30 September 2009 - 9:43 am
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I am so sorry that the pathology report did not come back as we all hoped it would.  Sorry I can not add any wisdom but I do send my prayers.

Debra

Debra & Emily, a five year old doberman mix, who was diagnosed with an osteosaecoma. She had a right rear leg amputation on May 19, 2009. On November 10, 2009 she earned her wings and regained her fourth leg.

Montréal , Canada
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31 July 2009
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30 September 2009 - 9:56 am
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Susan, I really feel for you and I am sorry about the pathology results.  From what I understood of metronomics , it can be started anytime (at all stage)   

On the bright side, it is of great comfort to hear Tazzie is feeling good.  We all want him to have fun as long as possible.  Best wishes to both of you.

Suzanne and Oslo


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30 September 2009 - 11:56 am
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I would try metronomics first.  It is the safest and has the best track record.  Your oncologist might want to try a different injectable chemo but odds of success there would be low.  There is no point to continuing the carbo/ adriamycin. I would save Palladia for later.

I would also continue the artemisinin !

Pam and Tazzie

Winnipeg
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13 July 2009
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30 September 2009 - 12:23 pm
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Pam

Thanks for responding so quickly. Metronomics seems the most attractive option from the little bit I know at this point, well, unless Palladia could actually have a curative effect. My vet called and she was still considering mytoxatrone, but is comfortable with metronomics . Hopefully I can talk to an oncologist this week to make a decision.

So far, two oncologists (one second hand for a different tripawd, Maximutt) have not responded well to the idea of Artemisinin . (I just got it in the mail, so we have not begun using it). The material from the Seattle labs seems promising, with no apparent downsides, and there does seem to be a decent logic behind it, even if its effects are not proven. I wonder why there are not more studies of its effects.

Susan

macsmom
66
30 September 2009 - 12:25 pm
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Ugh!  I'm so sorry!!  When do you anticipate talking with the oncologist?  I'm sending you big hugs now!

Winnipeg
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13 July 2009
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30 September 2009 - 1:28 pm
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We are kind of stuck here with no oncologist in the city. However, the one in Calgary that saw Tazzie this summer in Alberta sent a reference that my vet dug up (bless her heart!) with a metronomics protocol. The dose in this protocol is 10 mg/m2 for the Cytoxan in case that means anything to anyone. The oncologist indicated it was a reduced dose that has pretty good outcome with fewer side effects.

However, I just this minute sent an email to a Michigan oncologist from Maximutt's fleet of specialists (thanks Maximutt!). She advised on Max's protocol, and it is a bit different (includes something named Actis  although I do not have Maxi's post right in front of me to give you the correct drug name) that is usually prescribed for diabetes. So my vet is wondering why that drug - to control the sugar craved by OSA? The Michigan oncologist also seems to be using a higher dose than the dose recommended in the paper read by my vet. But, the Michigan person seems to be someone who regularly uses metronomics in her work.

Anyway, I HOPE she can act as a consultant although she must be incredibly busy. 

I know McGwire is not at this point, but mention these specifics in case they mean anything to anyone. It would be nice to get Tazzie on something by the start of next week. 

Susan

Oregon
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19 September 2009
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30 September 2009 - 1:31 pm
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I wish I could offer you more... HUGS from us to you!!!

Shilo diagnosed with osteosarcoma 9/4/2009, amputation 9/9/2009. ShiloAnne lost her battle 11/23/2009 where she regained her fourth leg and is patiently waiting for her parents to join her. We will always love you baby girl.

On The Road


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24 September 2009
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30 September 2009 - 1:34 pm
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Tazzie said:

... a metronomics protocol. The dose in this protocol is 10 mg/m2 for the Cytoxan in case that means anything to anyone.


Similar to Jerry's metronomic protocol for dog cancer therapy ...

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

Winnipeg
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13 July 2009
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30 September 2009 - 2:22 pm
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Hi Jerry-Admin

Thanks for sending your metronomics link. I was amazed how many people who left comments to your metronomics blog post had dogs with abdominal tumors, spleen, liver, kidney (and not very happy outcomes, sigh). I thought visceral tumors were uncommon for OSA dogs so this is really confusing. I don't expect a response - I was just surprised. I also noticed how you were fielding their questions left and right.

Madison, WI
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14 June 2009
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30 September 2009 - 2:37 pm
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Hey Susan,

As far as Palladia, I'm sure the vets you're talking to will know better than I, but what I understood from Yoda's oncologist was that Palladia would not have a curative effect, it could only help slow the lung mets.  And in Yoda's case, his oncologist only gave it a 15% of doing that.  But Tazzie's OSA is working on him in different ways than Yoda's so maybe that makes a difference in how Palladia may be able to help?

You're doing amazing, I think, juggling all this info and reaching out for more answers on treatments.  I don't know how you manage it while working.  We do what we have to, I guess.  You rock!

Sounds like Yoda and Tazzie are like two peas in a pod these days - both getting scary-serious results from the vet, but still astoundingly hoppy and care-free! 

I think I may have to give in and take Yoda to the dog park tomorrow morning.  Few dogs will be there, so he won't be as likely to overexert himself.

Yoda&Mom united: 9/5/06 …….… Yoda&Leg separated: 6/5/09……… Yoda&Leg reunited: 10/14/09 ……… ……………….………….………….……. Yoda&Mom NEVER separated! …………………….….……....….…… Though Spirit Yoda currently free-lances as a rabbit hunting instructor for tripawds nationwide

Winnipeg
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13 July 2009
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30 September 2009 - 3:30 pm
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I was SOO looking forward to an off-leash romp at the park chasing dogs this weekend, but the vet kind of quashed that idea. She didn't like the idea of him possibly pulling his stitches. She probably wouldn't like the way he charged downstairs when the doorbell rang today! We are still going to the park, and we do run, but it is not high speed dog-chasing playing running. Being a tripawd, he hops and I jog for about 100 yards, then he stops and stands (and stands and stands and stands . . .) Eventually he starts again.

Well, we pretty much knew it would be a met, but it sure would be nice to get another treatment plan underway. My vet said the oncologist told her something like 60% of dogs taking Palladia were cured (how can that be?!?). Who knows, Tazzie might be a good candidate with his soft-tissue mets, although the possible side-effect of "hind limb lameness" kind of kills the deal for that treatment option with our 3-legged dogs.

If it weren't for all of you, who knows how we'd handle this. I am really glad that Yoda is hanging in there.

On The Road


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24 September 2009
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30 September 2009 - 3:48 pm
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Doctor knows best. FYI: We kept Jerry from any serious activity until his stitches were out. While he did start to feel cooped up, and wanted to run and play, not worrying about his incision was well worth the wait.

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

Winnipeg
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13 July 2009
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30 September 2009 - 5:01 pm
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does that apply to ANY incision? Amputation is one thing. I thought a SubQ lump would be quite another. But maybe the risk of busting stitches applies equally.


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22 August 2008
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30 September 2009 - 5:05 pm
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Susan,

The normal dose of Cytoxan for metronomics is 10 mg/M2 once daily or 25 mg/M2 every other day. I would not worry about that affecting Tazzie's kidneys, although it can cause bladder irritation or infection.  I do not know anything about Actis so you would have to ask the oncologist about that.  My question would be what they would substitute for the NSAID (normally Piroxicam or Metacam is used) because that drug could definitely flare-up his kidney issues.

I asked my oncologist about artemisinin before I started it and she said it was very safe but unproven.  There is an ongoing study at Ohio State by Dr Cuoto but no results have been published yet.  Artemisinin has been proven to kill OSA cells in a petri dish but unproven in the body.  I would only buy artemisinin from a reputable company to make sure that it is pure and not contaminated (Holley Pharmaceuticals has an online safety certificate that you can view).  My holistic vet has used it for years and also assured me that it was safe.

The studies on Palladia (60% success) only apply to mast cell tumors but this drug does seem promising for other tumors but side effects on the GI tract are common.

I think that the other chemo drug your oncologist is talking about using is mitaxantrone.  I have not used it myself but it is safer than Adriamycin.

Unfortunately there is no established regimen for OSA mets so none of these choices would be wrong.  I started both metronomics and artemisinin for prevention so your case may be different since your Tazzie already has one met.  Maybe Palladia would be a better choice since it seems to be a stronger drug.  From what I have read most oncologists will not use Palladia along with an NSAID because of the increased risk for GI upset or ulceration.

Pam

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