Confused and Overwhelmed-Diagnosed Anal Sac Carcinoma (Woody has passed)

[goldengirl88]

Tracy:
I cannot believe they have not called you yet. There seems to be something going on there. I am sorry you have no power. That is tough when everything is powered with electricity. I am praying for you to get a phone call soon. Is your niece looking after your mom while you are home? It is ok here today, but more storms are coming in the next few days. Blessings
Patti

[Woodydog]

Well Ian has finally called. He has apologised profusely for taking his time in getting back to me, but assured me that he had been doing lots of research both human and animal into woody,s condition. We spoke in detail about his colitis and his collapsing episode, and he is like me shocked that Woody still has colitis. He will look into different meds that he can take and also agreed with me in changing his protein for his diet. He then discussed his findings from his research, both human and animal but Woody is not a candidate for any of the treatments he found, surgery is an option, but as we can,t find the tumour then it pretty much rules that option out. He says Woody displays a lot of classic symptoms of cushings, pu/pd, the hungar, the pot belly, the increased cortisol in his urine but all tests were negative several times over. But he said he is sure that it is all coming from the adrenal mass, but he still can,t believe that the affected lymph node on the left side, has affected an organ on the right as this is soooo rare, but then so is Woody lol

He knows of one treatment that Woody maybe able to take, which will help him and that's a drug call Pallidia, which in the UK is a new drug for cancer, it originated in the US so anyone over there heard of it.? Its main side effect is diarr. The vet hospital have never used it on any of their patients yet so Woody would be the first animal that they would treat with this. Ian has all the literature on this from the US, but he wants to speak with me face to face to go over all of Woodys case notes and hopefully formulate a plan going forward, he is asking Emma the IMS we saw and Craig my own vet to attend the meeting with us, so we are all together and on the same page sort of speak. He will call me in the next few days for an appointment.

Thoughts please : Would you let your dog be treated with a new drug ?

[goldengirl88]

Tracy:
That is a million dollar question you are asking. If I knew for sure 100% that there was cancer in the adrenal mass and that all the side effects of this drug have been thoroughly studied and had independent clinical trials supporting its efficacy I may go for it, dependent on how much time they feel it would give Woody. There are also the considerations of Woody being a good candidate or not, with his heart issues etc. If I truly knew my dog was going to die soon if I did not do something, and that this drug would extend a good quality of life for him, and he was a good candidate, and having a really qualified person to look after him while on the drug I may go for it. I would have to know the clinical trial stats as to how many became ill and it accelerated their death, and how many were helped and living a good quality of life after taking the drug. My biggest fear would be how a dog would react to this when it has only been tried in humans. Are you saying they have never tried this in any animals? That could be the deal breaker for me as then you could be put in a situation of either curing, or killing them, sorry there is no other way to put it. Are they 100% sure this adrenal mass is going to affect Woody and in how long of a period before it would? Do they feel this drug is safer than removing the adrenal gland? What side effects will he suffer, and how long must her take it? This is really a hard decision that I probably could not make. You will have to get a bunch of questions for the meeting and then think on it a while before doing anything so you know you made a decision you can live with. I do not envy you, having to decide this is terrible. We all need support when we get to a cross road such as this, as this is truly very hard decision to make. God Bless You Both.
Patti

[Woodydog]

Patti - This drug is for Animals only not humans. Sorry I think I put it wrong this is the first time the pet hospital would use it on an animal, as its a relatively new animal drug to the UK and they,ve not had any canditates for it. I have research it a little and its used for MCT (Mast Cell Tumour) or skin cancer in dogs, from what I can see the most side effect is GI upset, hence the reason he wants Woody,s colitis under control before we consider it.

Ian has been back on the phone just now, he has discussed Woody,s case with Emma IMS, Jo Ward (head of oncology), Laura and Mike who are both IMS, and with the symtoms woody has, they have said sounds like adrenal cushings, but with all bloods being negative what can they do. They want to run another LDDS test on Woody to see if it has changed as its 2 months since his last one. So we have an appointment on Thursday at 0930 hours to see all of them, including my vet, bit nervous to be dealing with 6 vets all at once, but Ian says he is confident that I will give them a run for their money, as I sound a very clued up owner. (thanks to all you lol)

Ian also mentioned in this phone call that when discussing Woody with the others he didn,t tell them about him collapsing, when they said cushings he then told them about Woody collapsing and 3 out of the 5 said it maybe a Pheo there dealing with. So on Thursday woody will be having a LDDS and a full check up, bloods and BP etc, we will discuss his case in detail, discussing the possible Cushings and the Pheo, and the Pallidia will be discussed. I,m wibbling muchly lol

[Roxee's Dad]

Geez Tracy, this is always a very difficult decision. I have been doing some reading on this drug and it seems to have about a 40ish % success rate which is considered pretty good.

It only seems applicable to certain types of of Grade II and III, cutaneous mast cell tumors. Here is a link to a pretty good information sheet on it and I hope it will help you form some questions that you can discuss with your vet.

http://www.nevog.com/uploads/news/do...s/palladia.pdf

Ideally your vet could give you a long or short term prognosis and along with your thoughts on Woody's quality vs quantity of life. You really know woody best, so after your discussion with the vet, and gathering all the information, go with what your gut tells you.

[frijole]

I went back in your thread but could not find the description of the collapsing incident. can you repeat it/describe it for me please?

Are they saying this new drug is their recommendation for treating a pheo? I'd need to ask them a boat load of questions - seems like there are alot of nasty side effects.

Thanks!
Kim

[molly muffin]

Kim, here is where Tracy described Woody's collapse.

I'm back but little Woody dog is being kept in for a few hours. By the time I got to the vets 30 mins away Woody had come round and looked a bit better. My vet examined him, his temp was fine and his colour was good my vet thinks that Woody had a smpgo (sp) it when the blood pumping from the heart doesn't get pumped quick enough the the dog faints it's common in Boxers apparently so he reckons it's been Woodys heart murmour has caused the problem one thing after another. It didn't want to poke and prod Woody or take bloods he just wanted him to relax and get back to normal but does want to keep an eye on him for the next few hours so I will pick Woody up at 8pm tonight. I can't stop shaking as one minute he was having a drink of water and the next he had collapsed out cold with head in water dish I had to grab him flip him onto his side and take his head from the water dish he was out for ages. I'm scared that I'm running out of time with him (cry)

Sharlene and Molly Muffin

[Trish]

[QUOTE=Trish;129743]OMG what a shock for you and Woody. Like Sharlene I hope they did check his BP, that adrenal mass could cause BP spike if it was a pheo /[QUOTE].

Tracy said obs were OK, but not 100% sure if BP was checked. But the vet thought it was due to low BP. But it sounded like it affected him for a while as she commented he was still walking around like a little drunk person when they got home a few hours later.

The surgeon who did Flynn's adrenalectomy a year ago discussed using Palladia. Again last month in Auckland, this IMS also mentioned this for Flynn after the liver resection. "Metronomic chemotherapy +/- palladia are possible medical treatment options for Flynn. These are unlikely to be all that helpful though" He told me that it is more useful when the tumour is microscopic and only starting to form and the use of Palladia will disrupt the formation of the blood supply (angiogenesis) that would feed the potential regrowth of the tumour therefore slowing it down or preventing new growth. Most of the research I read was with mast cell tumours but apparently it is being used with other tumours. His thinking with Flynn's liver tumours (either adenoma or low grade tumour) is that they are already formed so its not so useful in that case. Plus GI side effects can be troublesome and with Flynn's IBD that could be a deal breaker but I do indeed on discussing it with him again when I see him for our next checkup early February.

I am pleased you have this team discussion coming up Tracy, and further investigations. It sure does seem a coincidence with his known adrenal mass and the collapse, they could be related and I hope we can get to the bottom of it. xxxxxx

[Woodydog]

I went back in your thread but could not find the description of the collapsing incident. can you repeat it/describe it for me please?

Are they saying this new drug is their recommendation for treating a pheo? I'd need to ask them a boat load of questions - seems like there are alot of nasty side effects.

Thanks!
Kim

Kim

Woody,s collapse was about 10 days ago, he was resting on the sofa got up to get a drink and I noticed he was walking with what looked like stiff legs, at first I thought he had hurt his leg (he has a luxating patella) he then went to get a drink and as I was watching him he just collapased in front of me, his head fell into his water dish and he fell against the side of the sofa, when he came round he was very disorientated and was staggering, he was a bit unstable on his legs for 2 days and very subdued afterwards. His BP wasn,t checked at my own vets as he doesn,t have the facilities to check, his last BP check was at the hospital a few weeks ago and it was I think 163/83 which was borderline hypertension.

The hospital aren,t saying he defo has a pheo, just some of his syptoms fit for it, but they also fit for other things too, he said we can,t rule it out as a possiblility. He didn,t say if the Palladia would help if it was a pheo, which is why I have to go in on Thursday for a full discussion on this drug, and he will show me the statics, studies etc.

Tracy

[Woodydog]

Trish - I hope we get to the bottom of this once and for all as well. I am a bit nervous facing all the professionals, but the more heads involved the better the chance of coming up with a plan I think, its like fresh eyes looking over him and his notes. I am wary of Palladia for the same reason as you the GI upset, but all I can do is go on Thursday and listen to them and see the studies for myself. The good thing is that Ian isn,t doing any treatment to woody whilst he still has the Colitis, he said its a priority to get this fixed out. He kept apologising to me, that Woody still had it, and how sorry he was that such a cheeky chappie had got sick, I was almost in tears.

This is Ian, Dr McDreamy eh no so sure lol

http://www.gla.ac.uk/schools/vet/sma.../iain%20grant/