[PyrNet-L] Lymphoma/Clondike Update

[David P Kintsfather Jr <kintsfat@kutztown.edu>]

I'm sorry to have kept people in suspense for so long as to how Clondike
is progressing with chemotherapy, but the news has not been good and I
was hoping for something more positive to report.  Today has been an
upbeat day, so it is probably just as well I waited to file this report.

To recap, Clondike is a 10 1/2 year old spayed bitch who was diagnosed
with lymphosarcoma (also called canine lymphoma) in early summer.  She is
undergoing 2 cycles of 4 chemotherapeutic agents (supposedly one per
week), and if she can hold a remission for 3 weeks after this protocol,
she will get 5 days of monoclonal antibody therapy which in many cases can
yield a fairly long remission.

She tolerated the first 2 drugs (L-asparaginase and vincristine) well and
was evaluated in almost full remission after the 2nd treatment.  The third
drug (cytoxan) caused a bad reaction with 3 days of vomiting followed by
diarrhea.  Injectable anti-nausea drugs and 3 hours on IV fluids
stabilized her and the oncologist pronounced her in full remission.

The 4th drug (doxorubicin, also called adriamycin), however, nearly killed
her.  She vomited for several hours and then started violent diarrhea.
She spent 8 days in the veterinary hospital on an IV drip, required a
special bone marrow stimulating drug called neupogen when her white count
fell to 900, and probably had pneumonia, as her temperature hit 106 and
there is fluid in her chest.  Our local vet also was concerned that she
might have congestive heart failure, a known problem with doxorubicin,
however a cardiac ultrasound has ruled this out.

This whole situation was very distressing, especially since Clondike had
no symptoms from the disease, but the treatment had left her weak,
coughing, and with a severe loss of muscle tone in her hind end.  We were
feeling very guilty, and the vets at our local hospital were very emphatic
that she can not survive another reaction like the one to the doxorubicin.

A few days on Lasix (a diuretic) and an antibiotic cleared up her chest
congestion, but the muscle tone in the rear will take much longer to
regain.  The holistic vet that we are using for nutritional counseling
also showed me some accupressure points to massage and this seems to be
helping, along with aspirin prescribed by the oncologist.

We had a serious heart-to-heart discussion with the oncologist and she
admitted she doesn't treat many Pyrs.  She said this is good for the
breed, but bad news for Clondike, who had essentially become an
experimental subject during the first cycle of chemo.  The oncologist's
feeling was that the reactions were caused by the low white count, and
that the normal bowel bacteria attacked the tissue, becoming toxic.

Very reluctantly we began a 2nd cycle of chemo agents, with the plan to
monitor Clondike's white count closely, reduce dosages, and space out the
treatments.  Last week she received the 2nd drug in the protocol
(vincristine) and today we did a white count.  It was low, and this is
very unusual with vincristine.  The oncologist said this confirms her
theory that the reactions were caused by a cascade effect with each drug
lowering the white count more and making the next drug more toxic.

This is good news in that we should be able to totally eliminate the
reactions by spacing the doses and monitoring the white count.  We are
also switching to Darbazine as an anti-nausea drug, as it is more
effective than Centrine in some dogs.  Unfortunately Darbazine is no
longer manufactured because it wasn't financially successful, but the
oncologist has found a lab that can formulate it for her.

To supplement this, the holistic vet has come up with a Chinese herbal
regimen which is supposed to strengthen the immune system and GI tract to
help the animal tolerate chemo treatments better.  We started this today,
so I'll have to report on how that works later.

Meanwhile, all 3 vets most closely involved in Clondike's care say the
cancer is in total remission.  So we go forward, still scared, but
cautiously optimistic.  In the last week I have met 2 dogs who have
survived with lymphoma for more than 18 months and both looked to be in
good health and spirits.  I have also read that 3-6% of dogs with lymphoma
are actually cured (in that they die of something else).  We figure that
since Clondike is among the 5% of dogs that have a problem with
chemotherapy, she SHOULD also be in the 3-6% that find a cure (OK--wishful
thinking!).

I want to thank everyone for their kind thoughts, prayers and support.  It
has been a great help during a very difficult time.

Hug your dogs tonight,

David


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 David Kintsfather              | PHONE:       (610) 683-4497
 Dept. of Telecommunications    | FAX:         (610) 683-4659
 Kutztown University            | INTERNET:    kintsfat@kutztown.edu
 PO Box 730                     |   "We need not think alike to love alike."
 Kutztown, PA  19530-0730       |                Francis David
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