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Faced with slim choices on med treatments

So I have been inquiring through my Vet clinic (VSC) and the U of I, regarding what our options are regarding Neka’s continued treatment. Id say this is my slowest decision since all this began.(very unlike me as I am a fix it person) The problem is, I am not offered a fix it solution..

Assuming her liver enzyme levels are back to normal( im sure they are, we just havnt had the final recheck, and they probably have been normal for a couple weeks now) I have inquired about my options in treatment for stunting the lung mets(that are still not visible on xray, just CT scan)

The questions I asked started out regarding the palladia as I have read many situations and the both vets mentioned in the beginning of the consultation that sometimes we have to lower the dose if the dog does not tolerate it well, or give the dog a break and resume treatment.

So what I found interesting is that -that option was not offered to me (not that I was even sure I wanted to continue it) but its my curse, I want to know the reasons why or why not?.. So I asked –what red flags/symptoms/physiological signs do distinguish between a dog definitely not being able to handle palladia vs a dog that could be reintroduced to back to it?

Also from what we know of Neka, how do you feel she does or does not fit into this.?

The responses I received were.. no one really answered the first question… I am not giving up on that one.

and the second question I was offered by her her reg oncologist to try palladia again and lower the dose as well as have her on it for 2 weeks then off for 1 week and recheck panel. He said he doesn’t do that often but the original vet that supervised the study for FDA approval(dr Cheryl London) actually recommended it in her report for dogs who have increased intolerance. (hmmm… ok but still scarey).

option 2: Of course I was offered metromnomic but I found out from U of I that alone it hasnt had great results in treating lung mets alone and I found out it takes a couple of months to build up in the system…ugg.

option 3: I can do the U of I trial for rapamycin(oral form), but its first phase and its to test the safety and the time the body takes to process it. (shes already been accepted in as a candidate, I just am unsure and have not given my answer)  its only 26days long but if her mets stay stable, then they can offer it to me to continue out of my pocket.But not alot of data on how it will actually work on the mets themselves. I would have to stay there for 2 days, well I dont have to but they do blood draws every couple of hours and would want to keep her, but Id rather stay with her and chill there then they can take the blood over the 2 days.

Option 4: Ifosfamide which is what is used in children with OSA. However in dogs there is an increased side effect of hemorrhagic cystitis (bladder bleed/hemorrhage) so to counter act it they give an injection with it to protect bladder tissue and give her 8hrs of fluids the same day as the chemo…oh its IV treatment… it hasnt shown cure in dogs, but has shown to stablilize the disease while my vet worked with it when he was in vet school..They dont carry it but he said he would order it specific for Neka if I chose to go that route.

So needless to say I am at a bit of a loss and back to lots of stress. I mean I clearly have a few more questions to ask . Ie palladia. Since I know what to look for now, maybe at the slightest bit of oddity in her I can catch it and reverse side effect quicker, on the other hand I fear it could be worse, though they said they isnt necessarily the case.

The trial is an option, but somewhat of a shot in the dark, I guess if I tried palladia another time and it just didnt work then I could do the trial. If they had more data on results, I think Id jump on it. But I am calling the U of I again and see how its been going but its too early to tell if it will work on the mets, but I can get info on side effects (they did say it would mostly be GI issues if any) But it is a trail.

 

 

~ by neka03 on October 26, 2014 .



4 Responses to “Faced with slim choices on med treatments”

  1.   jerry Says:

    Hey guys kudos to you for doing your homework. As much as mets suck I’m glad to hear there are more choices available when treating them. When it was our time to decide, Palladia wasn’t around yet so our only choice was metronomics. Well, that gave Jerry 8 more great months, it actually shrank & stabilized his two large lung tumors, so we think it’s a promising option in most cases. You can read a lot about metronomics here:

    http://tripawds.com/forums/tips-and-resources/metronomic-therapy-for-canine-osteosarcoma-metastasis-jerrys-experience/

    Whatever you decide, just remember that whatever you do can possibly make a difference and you can always stop if you don’t like the side effects. Also, many dogs have lived a long time with mets, there are no expiration dates stamped on our dog’s butts 😉

    {{{hugs}}} to all of you

  2.   neka03 Says:

    @ Jerry.. Thanks. I think the hardest part is I feel so responsible for every decision I make for her. Though I know I can only do what I can, I take it so personal. I even ask the vets that I am not trying to just “give” her something for the sake of saying I did for my satisfaction, but actually would like to hear about data and successes. Though i know she is not curable, as you mentioned just stabilizing and containing it would be wonderful, while not screwing up the rest of her body…uug.. time to take on extra jobs to pay for whatever my choice is…

  3.   benny55 Says:

    Well written, welk thought out and just one more way you and Neka are making a positive for anyone facing this journey.

    It IS very difficult trying to make the “right” decison. Your love for Neka is so evident. You will make the “right” decision because it will be one based onnyour unshakable love for her…and she fornyou.

    Thank you for sharing your thought process snd this valuable information.

    Neka is not going anywhere anytime soon! She’s enjoying the loving and spoiling way too much and wants ton0 hang around for more!!

    Love and hugs!

    ®
    Sally and Alumni Happy Hannah and Merry Myrtle too!

    •   neka03 Says:

      Sally,
      Thank you!! I’m working on it. This step has delayed me some, I don’t know why, I’m usually so ontop of it. I think the scare of her being out of it threw me off some and gave me some hesitation. Its the balance of “but shes acting fine” to the reality of knowing there’s something growing inside of her, so I have to do something to keep her as healthy as i can within my God given ability.
      Its been a full month of her doing well, so back to get the blood draw to recheck liver, though I’m sure its all back to normal as she hasn’t missed a step.. no punt intended.lol. A little delay with a sore knee..uug the obstacles we encounter.

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