From:
Stacia DeBaun
Date: 2006-02-16 05:35:44 UTC
Subject: [ferrethealth] Palliative treatment for lung disease?
To: ferrethealth@smartgroups.com
Hello all,
I have a 7-year-old male with multiple medical problems including renal failure, recurrent prostate/bladder infections, adrenal disease, insulinoma, and now what we believe to be lung cancer due to numerous pulmonary infiltrates on chest films. Obviously with his renal failure, surgery is not really an option so further workup to determine if these infiltrates are in fact malignant and to find out if they are primary or secondary has not/will not be done and instead we are going for comfort measures only.
He is currently being managed on subQ fluids on a prn basis for kidneys, melatonin 1 mg daily and finasteride 1 mg daily for adrenal. He also has been on Clavamox twice daily for a significant amount of time (about two months) due to the prostate/bladder but we have just stopped this and will be switching to Baytril should he have recurrent symptoms. He is also on 1 mg of prednisolone twice daily for both the insulinoma as well as a cough associated with the pulmonary infiltrates.
Of note, the pred did initially get rid of his cough completely and he did very well for a couple of months but now it has started to return, although not nearly as severe as it when it first showed up. He is still eating his soup very well, still begs for treats at least a few times a day if not more, and seems pretty content in general, but in the last couple of days his breathing seems to be becoming more labored and he is beginning to appear somewhat cachexic.
So, now my question - any other treatments that might help him out a little more with the cough/breathing issue other than just bumping up the pred dose even further? Has anyone used any type of nebulizer or inhaler treatments for cases like this with any luck? How about a bronchodilator such as theophylline? Just looking for possible alternatives other than just pred or adding in an oral narcotic like Torb for cough suppression.
I will be taking him back in tomorrow for a repeat chest film to make sure he hasn't developed a pleural effusion and to also recheck the size/number of the nodules and repeat his blood work. I know no matter what we do at this point his time is limited, but given his excellent appetite and overall demeanor I just don't think he's quite ready to go yet so I have to try something.
Thanks!
Stacia
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