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Pick your poison: Modern pet healthcare or pink juice Kool-Aid (May 15, 2008)

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My dane was dx w/oral melanoma in April '07, we tried the vaccine, unfortunately it didnt work for him. We started using Neoplasene in July '07 (mentioned in the June '07 of WDJ) and he is doing great

Just another option...

Lori and Diesel

# Posted By Lori | 7/16/08 11:47 AM

Neoplasene...is that like Temodar? These owners are incredibly resistant to any form of oral or injectable chemo--can't says I blame them in this case.

# Posted By Dr. Patty Khuly | 7/16/08 3:01 PM

Scottish Terriers are pre-disposed to melanomas (behind#1 bladder cancer& lymphomas). I also know one Scottie owner that tried the melanoma vaccine without success.

This post prompts more interest in: the pathology itself and why it has been written that mitotic<2 indicates non-malignant, yet it "can" be precursor to malignancy. And curiously, did this pet have any abnormal bloodwork: such as high alk phos or other liver enzymes.

And has the use of "piroxicam" ever been suggested and/or tried with this particular cancer? I noted a recent DVM360 article that had piroxicam listed for use with mammary tumors and I'm going to ask to try it with my older Scot diagnosed with adenocarcinoma recently.

Have to say, "piroxicam" has been hugely successful with abating symptoms and slowing progression of Transitional Cell Carcinoma, if the dog can tolerate it.

# Posted By Barbara A. Albright/New Hampshire | 7/16/08 5:43 PM

Neoplasene is made from bloodroot

http://www.holvet.net/neoplasene.html

Lori and Diesel

# Posted By Lori | 7/17/08 6:40 AM

Barbara: Good question on the bloodwork. Yes, this dog has had chronic >3 yrs elevations in his Alk Phos, in particular. He had been thoroughly worked up once a year for three years--including by the internist the last time when all the basics came back negative. Insidious, this cancer. Until it shows itself (in this case very suddenly) there's nothing much that can be done. True of humans, too, as you may know.

# Posted By Dr. Patty Khuly | 7/17/08 8:01 AM

Dr. Patty, My 9 yr old Collie X has HAS (Hyperplastic Adrenal Syndrome, a.k.a. Atypical Cushings) with an elevation in Alk Phos (around 1000 now). I'm curious as to the connection of the Alk Phos to the melanoma. Is there liver involvement in the cancer spread as well as lung and mouth?

# Posted By Bonnie | 7/17/08 10:49 AM

dr. patty:

what are the signs/symptoms of malignant melanoma? since it was in the back of the dog's throat, i don't think it's visible. did owners just observe him not eating for several days and figured something was wrong with him? i want to be observant so if it's something that can be caught, removed and treated, it will keep my dog with me as long as possible.

thanks, leslie

# Posted By leslie | 7/17/08 3:33 PM

leslie: (I'll get to the other q's later, I promise): On a routine dental--that's how it became obvious. btw, this is NOT a dog that lets you look in his mouth on a regular basis.

# Posted By Dr. Patty Khuly | 7/17/08 4:32 PM

QUOTE: It’s a tough choice, knowing that several paychecks will need to go to your dog’s last few months. The time bomb factor. The worry if you do. The guilt if you don’t. UNQUOTE

One way to look at this conundrum is to accept that the animal has a life-threatening disease. So, anything that is done to prolong its life is just that: the prolonging of its life. If the disease were to run its normal course -- say, out in the wild -- the animal would die. The actions we humans take may give an animal extra time. If I let the animal die on nature's schedule instead of trying to squeeze out extra time, I feel sad for the loss, but not guilty.

I know this is not a popular way of looking at things, but I’m sure I’m not the only one who feels this way. (And, yes, I feel the same about my own life/death.)

# Posted By Marcella | 7/18/08 2:26 AM

Marcella: As far as I'm concerned, life is a terminal disease. So should we not treat severe bite wounds or debilitating upper respiratory infections? These, too, would likely yield death in the wild. Cancer, if it's treatable, deserves no less just because it's expensive (as long as the resources are available) or its outcome uncertain. (IMHO)

# Posted By Dr. Patty Khuly | 7/18/08 7:45 AM

Dr K, yes that is a valid view also (as are all mentioned here). I guess for me the main issue is the level of outcome certainty -- the less certain the extension of good quality life, the less I would want to try the treatment. Also, if the animal is older, I might be less willing to pursue potentially life-prolonging procedures.

Just thinking this all through as I read your post and the comments. Although it's never clear until it's one's own pet and money involved. And heartbreak.

# Posted By Marcella | 7/19/08 1:30 AM

Didn't mean that to sound snotty, like I'm the one in charge of what's valid. :-}

# Posted By Marcella | 7/19/08 1:32 AM

Marcella: Nor is "my way" to be misconstrued as dogma just because I'm technically "in charge" around here. Thanks for your comments.

# Posted By Dr. Patty Khuly | 7/19/08 7:26 AM

One of the reasons to treat terminal disease in animals or humans is to give the rest of us time to say goodbye.

# Posted By Magdalena Plewinska | 7/19/08 10:12 AM

http://jvdi.org/cgi/reprint/18/4/422.pdf , good resource of melanomas study

leslie, according to the above link, you would want to be vigilant checking your dog for any type of melanoma. It is thought that eye, toe, and oral cavity are the worst areas, but have discovered that melanomas arising from "haired areas" can be malignant also. Also, to answer "my" question, mitotic rate or histology is not a guarantee of non-malignancy.

I was so curious of this topic, because both my dear Pocket (linked to my name) and her dam , both sprouted an eye rim melanoma (same eye, same location) & surgically removed w/ margins, two years prior to their death(s). In addition, one of Pocket's littermates had a toe melanoma (digit removed--but never healed) one year prior to death.Coincidence-maybe? Scotties & mini-schnauzers are known to have this come up. And curiously, there was a rise in alk phos to a peak well beyond 1000, followed by decline.

Marcella: I echo your sentiments, I would be less likely to treat terminal illness agressively in an elderly animal (or myself, or loved-human) and opt for comfort and supportive measures.

# Posted By Barbara A. Albright/New Hampshire | 7/22/08 10:48 PM

<Barbara wrote: "And curiously, there was a rise in alk phos to a peak well beyond 1000, followed by decline.">

When my guy developed (atypical) Cushings, I did quite a bit of research on alkaline phosphatase, but never came up with any info on the melanoma connection. Most of the info said when alk phos increases in an adult dog (w/out other liver enzyme increases and no evidence of liver disease) to look at Cushings, hepatic nodular hyperplasia (benign), and bile duct obstruction. I've heard of some Cush dogs having an alk phos at 15,000.

It is curious. Does anyone know of the reason of the increase and then the sudden decline in alk phos in cancer/melanoma cases? Does the ALT also increase in cancer cases where the alk phos increases?

# Posted By Bonnie | 7/23/08 11:31 AM

Bonnie, I am sorry to have misled you a bit. ALL my Scotties with diagnosed cancer (except Pocket, of course, who supposedly did NOT have cancer) had a rise in alk phos, with or without rise in ALT, then a decline (why? maybe as the liver failed??)----regardless of the cancer. I had one with lung, bone, TCC, liver, Pocket??---suspicious spleen? and now my girl with adenomacarcinoma. The highs were 1600, 1800, 1800, 1200----my current has 600+ and "holding".

I have read a few times, that cancer cells are "water-loving" cells. Everything I've read on true Cushing's indicate 2-21/2 times normal water consumption--
I find atypical Cushing's a fascinating subject and wish their was more published about it. Wonderful that U of Tenn. has the panel for diagnosis!

# Posted By Barbara A. Albright/New Hampshire | 7/23/08 5:55 PM

Bonnie, My poor grammar did not explain well. Pocket's dam also had bile duct obstruction, liver tumor, and calcified gall bladder. Her high alk phos was 1200, then declined. Pocket reached a peak of 1800, then declined to the levels you see on her blood panels (posted on my web site). Unfortunately, no bile acids were ever suggested, nor was liver failure ever mentioned as per her u/s diagnosis.

Do I feel the need to know the source or metastasis of my 11 yr. 5mo. half-sister to Pocket's adenomacarcinoma? Nope! Nor did I need to know Dottie Sealyham's, who's groin lymphnodes swelled to rock hard limes.

# Posted By Barbara A. Albright/New Hampshire | 7/24/08 12:44 AM

<Barbara wrote: "I find atypical Cushing's a fascinating subject and wish their was more published about it. Wonderful that U of Tenn. has the panel for diagnosis!">

I agree--Thank goodness for the U of T! And especially Jack Oliver! What a wonderful gentleman and doctor he is.

# Posted By Bonnie | 7/27/08 11:03 AM

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