From:
Soren Tabnitz
Date: 2011-08-15 19:03:52 UTC
Subject: Waiting Lymph Biopsy
To: fhl <ferrethealth@yahoogroups.com>
----- Forwarded Message -----
From: Soren Tabnitz <sorentabnitz@yahoo.com>
To: Susan Jones <pickledferret@gmail.com>
Sent: Monday, August 15, 2011 3:02 PM
Hi Susan and list,
I was procrastinating posting an update on GinGin but saw your email and here's the latest: At her 4th chemo visit, we decided to abandon the Tufts protocol and try vincristine--which Dr. Antinoff has had good results with. Gin's lymph nodes are continuing to grow and ones that had been normal are now enlarged--so I felt like we had to get more "aggressive."
The vinc meant IV catheter and brief anesthesia which I hated the thought of, but something more needed to be done. Her lymph nodes remained enlarged, so at her 5th chemo, her oncologist gave her the full dose (he had started at a slightly reduced dose out of caution). At this point, 5 days after, GinGin's lymph nodes are still big. She eats well hand fed, and her poops are good. She sleeps alot--but she has always slept more than the other ferrets. When she wants to, she seems to have no problem going upstairs to the catbed I keep in the bathroom. She looks bright-eyed and alert.
My choice now is to just keep going with the pred and stop the "real" chemo and just let her wind down. OR, the next step as far as chemo would be to use doxorubicin. They have started using this drug in very small doses to try to treat insulinoma (1mg/kg). The usual dose is much higher (20mg/kg). It is used as a "rescue" drug, when pets come out of remission and the previously used drugs don't work. The drawback is, it has much stronger side effects. Not just vomiting/diarrhea but possible heart/liver/kidney as well.
I have no experience caring for pets who have received this drug (it's also called adriamycin) but when I spoke with vet tech friends/colleagues it sounded very scary. A very sick/debilitated pet could wind up being pushed over the edge by this drug.
On the other hand, GinGin has handled the treatment so far extremely well. The pred has caused some muscle wasting and her belly (including her giant spleen) is even bigger. But, as I noted, her appetite is good and she gets around and does her little ferretty things. She is a good candidate, as they say.
My hard choice, and I invite comment from *especially* anyone who has experience with adriamycin/doxorubicin is: do I whomp her with this drug that might save her (at least for a bit) or might kill her? I would feel so awful if I put her through the side effects and then the drug didn't actually help her disease.
>From what I understand, anecdotally the Tufts Protocol has a 50% success rate. Antinoff claims 85% success rate. But each ferret is an individual and basically there's no way to predict how he or she will respond to a particular protocol--it's really only in hindsight that you can say whether she's part of the 85% or the other 15%.
Right now, I am trying to research adriamycin in ferrets and I am also looking into just doing some palliative alternative treatments like acupuncture, TCM, homeopathy. Of course, the big problem I'm finding with that is that most vets offering these modalities only do dogs and cats.
Susan, whichever plan you choose, I can't stress enough doing GI protectants--pepcid, sucralfate/carafate. Especially with using pred, and the stress of chemo and vet trips. We do 1ml sucralfate 3 times a day on empty stomach, them wait at *least* 20 minutes before feeding/meds.
--Skyla and GinGin
________________________________
From: Susan Jones <pickledferret@gmail.com>
To: sorentabnitz <sorentabnitz@yahoo.com>
Sent: Monday, August 15, 2011 1:13 AM
Hiya, I wanted an update on the chemo treatment. I have a five year old with enlarged nodes and we are waiting on biopsy results they took Wednesday. She is having trouble eating AND he glocose was 34 pre-op so we've got to work on insulinoma too. I've ordered the pet dopilous as she is on antibiotics now and poops look good but could go sour at any time. I'm feeding her small frequent meals of duck soup/turkey babyfood and A/D with pumpkin (probably why poops looking good. Please let me know as while I have heard of TUFTS - I hadn't heard of the new protocol you are trying...will need to get my Rhodes on something soon BUT will probably be starting pred next week to control the insulinoma.
Thanks! Susan Jones
--
All Fur Thuh Luv of Ferts!
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