[PyrNet-L] HEALTH: Clondike the Chemo Star

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

Clondike, the 11 1/2 year-old Pyr bitch who has been undergoing
chemotherapy for lymphoma for almost a year now continues to surprise the
vets.  After one treatment of the DMAC protocol she is well on the way to
her third remission.  DMAC uses two combinations of drugs, alternating on
a one or two week schedule for up to 16 weeks (8 cycles).  Clondike
achieved a full remission after only 3 treatments (1 1/2 cycles) in
February and was able to hold it for 12 weeks without any chemo.

By using injectable Centrine for nausea and diarrhea control she got
through this first treatment with only some soft stools and a little
queeziness that caused her to reject 1 meal and only eat half of another.

24 hours after the treatment our regular vet thought her nodes were back
within normal limits, but her spleen was still slightly enlarged--common
with lymphoma, the spleen acts like a big lymph node.

Thursday night, 8 days after the treatment, our vet checked her again and
found her nodes down about 1/3 from the previous week, spleen unpalpable
(which is as it should be), and her color and heart rate very
satisfactory.  Unfortunately her white count was down to 2,400 (6,000 is
low normal), but this is an expected side effect of this particular drug
combination.  She is on antibiotics and today the oncologist gave her a
shot of neupogen, a very expensive and exotic drug that stimulates the
bone marrow to produce white cells.  Clondike responds very rapidly to
this drug.

On a positive note, after some lethargy Sunday and Monday, Clondike was
very perky on Tuesday, and visited the groomers for a bath which removed
most of her undercoat (not sure if the chemo hastened this blow or if it
was normal seasonal shedding).  Standing for 2 hours for a bath and comb
out usually tires her out, but she was still pretty perky Tues. night and
she was a monster on Wed.  By Tues. she was having perfect poop and by
Thursday she was back on dog food along with meat (round steak,
actually--she's spoiled) and a rice gruel.

Based on notes our vet made and my memory, we think Clondike is responding
to the DMAC protocol almost identically to the way she responded the first
time.  This is much more encouraging that the results we got when we tried
to re-induce a remission with the traditional first-line drugs.

Today I asked the oncologist for some sense of how well Clondike is doing
and she basically said we are in totally unknown territory.  She
reiterated that DMAC is a rescue remission protocol intended for dogs
refractory (non-responsive) for the first-line drugs.  She said that for
some dogs it "doesn't do squat" (I love this technical talk), and for
others she is seeing positive results.  The research clearly shows shorter
remissions with DMAC than with traditional protocols, but how many times
you can reinduce remission is just not known yet.  We feel very lucky to
have achieved a 2nd remission with DMAC 75% as long as the first remission
when the conventional wisdom is that each successive remission is only
about half as long.   

Clondike will be re-evaluated next Friday and will probably be ready for
DMAC 2, a treatment that gave her moderately severe vomiting and diarrhea
last time around.  It also made her lymph nodes all but disappear!  We
hope that using injectable Centrine before the symptoms occur will greatly
reduce the severity of her reaction.  Keep your fingers crossed.

I know some people who have experienced dogs with lymphoma are especially
curious about the DMAC protocol that seems to be doing so much for
Clondike.  I asked if the research has been published yet and the
oncologist doesn't think so.  I would guess that the Ohio State Vet School
could probably answer specific questions that vets or oncologists might
have.  Just keep in mind that apparently Clondike's success is "not
typical."

Thanks again for all the good thoughts and prayers.  Clondike continues to
enjoy life and to teach us to live "in the moment."  I'll keep you posted.

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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