[PyrNet-L] HEALTH: What is acute pain response in Pyrs?

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

Clondike continues to confound the vets, but this time it is NOT a good
thing.  She had a reaction to neupogen, a protein-derived drug that is
used to stimulate the bone marrow to increase white blood cell production.

She has had this drug 4 times previously, and I think she had a little
stomach upset one time, but nothing you would describe as a reaction.
This time she refused food about 7 hours after administration, and by
about 10 hours after administration she was one very sick dog.  The
symptoms included: rapid, shallow and uneven breathing--at least 4 times
normal rate; involuntary muscle spasms involving twitching of the head,
neck and chest; the "chasing rabbits" type flailing of the hind legs;
extreme weakness; eyes droopy.

By 18 hours post-administration, which was 8 am Monday when we could get
the oncologist, Clondike was much calmer and looked more alert.  At the
vet's instruction, we took her temperature which was 102.2.  The vet was
stumped but wanted to see her, so off to West Chester Nancy went (had to
go to graduation ceremonies where I teach).  A CBC showed Clondike's white
count had increased from 2,400 to 7,600 in some 20 hours.  A physical exam
didn't show much out of the ordinary by that time.

The only significant side effect of neupogen noted in the PDR is bone pain
experienced in 22% of human patients.  This is usually relieved by NSAIDs,
but in some cases is severe enough to require narcotics.  Before Nancy
even had a chance to ask about this the oncologist mentioned it, but said
she has NEVER seen it in a canine patient.

Clondike seems relatively normal now, but we are very worried because
neupogen is very effective to help counter the white count lowering
properties of the chemo she is on.  We want to know if we should pre-treat
her for pain.

So... here are my questions:

1.  Do the symptoms sound like a reaction to sudden, acute bone pain?

2.  What are the options available to treat for this prophylactically in a
dog on chemo with a sensitive gastrointestinal system?

3.  Does anyone know what human oncologists use in this situation (no
specifics were given in the PDR)?

Any help would be MOST appreciated.

David
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