Inligting

Prednisoon vir honde met kanker


Adrienne is 'n gesertifiseerde honde-afrigter, gedragskonsultant, voormalige veeartsassistent en skrywer van 'Brain Training for Dogs'.

Hoe werk prednison vir honde

Prednisoon is 'n kortikosteroïedmiddel (net soos prednisolon, kortisoon en hidrokortisoon) wat gereeld in veeartsenykundige medisyne gebruik word om verskeie mediese toestande by honde te behandel, soos allergieë, inflammasie, outo-immuun siektes en sekere soorte kankers.

Prednisoon is 'n sintetiese middel (vervaardig in 'n laboratorium in 'n vorm wat nie natuurlik deur die liggaam geproduseer word nie) wat werk deur die effek van natuurlike steroïedhormone (kortikosteroïede) wat deur die hond se liggaam geproduseer word, na te boots. Sulke hormone word spesifiek vervaardig deur die bynierskorte van die hond wat in die byniere voorkom, wat bo-op die niere van die hond sit. Die belangrikste steroïedhormoon wat deur die bynierkorte van die hond vervaardig word, is kortisol, wat bekend staan ​​as die "streshormoon."

Kortisol speel 'n hoofrol in die metabolisme en immuunstelsel van die hond, veral wanneer die hond emosionele of fisiese spanning ondergaan. Dit is bekend dat hierdie hormoon die gevegs- of vlugreaksie oproep wat gesien word by honde as hulle onder spanning verkeer of wanneer honde bedreig voel. Met vergunning van kortisol, kry honde wat onder spanning is, 'n hupstoot van energie wat hulle tot aksie aanspoor, wat hulle veilig hou as hulle in gevaar voel of deur iets bedreig word.

Kortisol help ook om outo-immuun reaksies te beheer. Outo-immuunafwykings vind plaas wanneer witbloedselle dele van die liggaam begin aanval asof dit vreemde indringers is.

Dit is die rede waarom kortikosteroïede soos prednisoon, prednisoloon, ens. Baie werk om inflammatoriese prosesse en outo-immuun siektes te onderdruk. Sodra dit in die liggaam is, boots prednisoon die werking van kortisol na, wat die simptome van inflammatoriese toestande verminder en die immuunstelsel onderdruk as dit oorreaktief is.

Prednisoon as palliatiewe sorg vir honde met kanker

Dit is jammer dat kanker een van die belangrikste oorsake van sterftes by honde bly. Nie alle kankers word dieselfde geskep nie. Daar is 'n paar vorme van kankers waar aggressiewe behandeling met chirurgie en chemo-middels die moeite werd is om toegepas te word, terwyl daar ander is waar hierdie behandelings nie is nie. Boonop kan sommige honde in so 'n gevorderde toestand verkeer dat hulle onbruikbaar is, en die beste opsie is om palliatiewe sorg in te stel.

Palliatiewe sorg moet nie geïnterpreteer word as 'tou opgooi' nie, maar eerder as 'n poging om 'n goeie lewensgehalte so lank as moontlik te handhaaf. In sommige gevalle waar gevorderde kanker is, kan palliatiewe sorg oorlewingstye bied wat soortgelyk is aan dié wat met aggressiewe behandeling verkry is.

Palliatiewe sorg moet ook nie geïnterpreteer word as verlenging van die onvermydelike nie. Dit is verkeerd om palliatiewe sorg te beskou as 'n manier om die hond meer dae of weke te sleep as die hond in suboptimale gesondheidstoestande met 'n slegte lewenskwaliteit leef. Op 'n sekere punt, wanneer die lewensgehalte van die hond afneem, moet menslike genadedood gekies word om die lyding van die hond nie onnodig te verleng nie.

Palliatiewe sorg by honde met kanker behels voedingsondersteuning om te voorkom dat honde voedingstekorte ontwikkel, terwyl hulle 'n goeie eetlus behou. Ander palliatiewe sorg sluit in pynbeheer en ander nodige stappe om goeie fisiese en emosionele welstand te handhaaf. Prednisoon vir hondekanker kan 'n belangrike rol speel in die verskaffing van palliatiewe sorg.

Prednisoon om eetlus te verhoog by kankerhonde

Honde met kanker het die neiging om te ontwikkel wat bekend staan ​​as kanker kakeksie. Kankeksie is 'n sekondêre toestand wat voorkom by honde met kanker wat gekenmerk word deur gewigsverlies, eetlus, swakheid, spiervermorsing en bloedarmoede. Die verlies aan eetlus by honde met kanker kan toegeskryf word aan 'n verskeidenheid faktore, insluitend meganiese afwykings en iatrogene gevolge.

Meganiese afwykings is as gevolg van die direkte effek van kanker self. By honde met 'n mond- of keelgewas kan eet byvoorbeeld 'n pynlike beproewing wees. Gou begin die hond die pyn met kos assosieer, en die verlies aan eetlus kom dikwels daarna. Honde met 'n baie vergrote milt kan eerder versadig voel omdat die milt op die maag kan druk en 'n vals gevoel van volheid kan veroorsaak. Honde met gewasse wat die spysverteringskanaal beïnvloed, kan huiwerig wees om te eet as gevolg van meganiese obstruksie, naarheid of pyn. Gevorderde stadium kanker by honde, ongeag die liggaamsdeel wat geraak word, sal ook lei tot gedeeltelike of volledige verlies aan eetlus.

Iatrogene gevolge is gevolge wat voortspruit uit die behandeling self. Byvoorbeeld, honde kan 'n verlies aan eetlus ontwikkel as 'n newe-effek van sekere middels wat gebruik word om kanker te behandel, of as gevolg van chemoterapie of bestraling wat deel uitmaak van die behandelingsplan vir kanker.

Die verlies aan eetlus by honde met kanker begin dikwels op 'n subtiele manier. Die hond kan 'kieskeurig' begin optree. Hy of sy kan die maaltyd nie so vinnig afhandel as voorheen nie, anders kan hy of sy 'n bietjie lok. Soms kan dit aanvanklik toegeskryf word aan die hond wat "net oud word" en 'n bietjie reuksintuig verloor.

Namate die kanker vorder, kan die hond op een of ander tyd begin voedsel weier, alhoewel hy verskillende kosse probeer lok. Hierdie verlies aan eetlus sal lei tot gewigsverlies en spiervermorsing met verloop van tyd.

Die gebruik van prednisoon op hierdie stadium kan help om 'n verskil te maak, aangesien 'n toename in eetlus een van die mees algemene newe-effekte van hierdie middel is. Hierdie toename in eetlus is te danke aan die kortikosteroïed-geïnduseerde euforie van hierdie middel wat eetlus bevorder.

Daar is verskeie ander opsies om eetlus by kankerhonde te verhoog. Hierdie opsies sluit in Maropitant sitraat (Cerenia-Zoetis), wat boonop honde wat opgooi, ook kan help met naarheid, en mirtazapine. Albei kan veilig saam gebruik word, wys dr. Sue Ettinger, 'n raadgesertifiseerde veearts wat spesialiseer in onkologie.

Glukokortikoïede is moontlik die mees gebruikte enkelgeneesmiddelklas in veeartsenykunde. Die feit dat dit nuttig is in 'n wye verskeidenheid toestande, goedkoop, veelsydig, relatief veilig en dat dit sterk en dramatiese effekte kan hê as dit op die regte manier gebruik word, verseker dat dit steeds gewild sal wees onder veeartse. Dit is miskien hierdie gewildheid wat gelei het tot die stelling "geen dier mag sterf sonder die voordeel van steroïede nie."

- Alan Chicoine, DVM

Prednisoon om honde met kanker te help

Wanneer prednisoon toegedien word in dosisse wat die normale vlakke in die hond se liggaam oorskry, verminder dit inflammasie en onderdruk dit die immuunstelsel, wat kan help om inflammatoriese toestande en outo-immuun siektes te beheer, waar die immuunstelsel verkeerdelik sy eie aanval. weefsels.

Vir honde met kanker kan prednisoon voordelig wees as gevolg van die ligte pynverligting van hierdie middel, veral as daar inflammasie voorkom. Steroïede soos prednisoon moet nie saam met NSAID's gebruik word nie (nie-steroïed-anti-inflammatoriese middels.) Hondeienaars moet met 'n veearts konsulteer as dit oorweeg word om na 'n NSAID-middel oor te skakel, aangesien 'n uitwasperiode nodig is.

Buiten die verskaffing van ligte pynbeheer, kan prednison help om die verspreiding van kanker te vertraag. Kwaadaardige kanker versprei gewoonlik van een liggaamsdeel na 'n ander, 'n proses wat bekend staan ​​as metastase. Die proses word geaktiveer deur 'n opvlam van die immuunstelsel waarheen nuwe selle vertrek om verafgeleë terreine te bereik en op 'n onbeheerde manier te herhaal. Wanneer prednison gebruik word, voorkom dit dat die immuunstelsel behoorlik werk, wat die verspreiding en voortplanting van kankerselle vertraag.

Sekere soorte kanker kan met prednison beheer word. In sulke gevalle kan prednison gebruik word as 'n chemoterapeutiese middel, of dit kan gekombineer word met ander sterker chemo-middels om gewasse te laat krimp.

In die geval van miltkanker help prednison om die produksie van rooibloedselle te stimuleer. As die milt egter steeds nuwe rooibloedselle vernietig, sal die aangetaste hond bloedarm bly, verduidelik die veearts, dr. Scott.

In die geval van limfoom is prednison nuttig omdat dit limfoomselle kan doodmaak. Honde-eienaars wat nie chemo wil gebruik nie, kan prednisoon as 'n losstaande behandeling vir limfoom gebruik.

Die belangrikste ding om op te let, is dat prednison eers begin moet word as 'n diagnose gemaak is, aangesien die medisyne die diagnose bemoeilik en dat dit boonop chemo minder effektief kan maak, wys die veeartsenykundige onkoloog Susan Ettinger in 'n artikel oor die Hondekanker-blog.

Ander vorme van kanker wat baat vind by prednisoon, is mastseltumore, breingewasse en neustumore.

Honde-eienaars is dikwels bekommerd oor die newe-effekte van prednisoon by honde. Korttermyn newe-effekte sluit in verhoogde drink en urinering, verhoogde honger, hyg, verlies aan energie, die aanvang van infeksies of erger infeksies, naarheid of braking, en maagsere.

Wanneer prednison langtermyn gebruik word, soos langer as drie tot vier maande by hoë, immuunonderdrukkende dosisse, is daar verdere risiko's vir newe-effekte soos urienweginfeksies (roetine-urinale ondersoek word aanbeveel), vetsug, geneigdheid tot diabetes, swak vel en pels toestand, verlaagde immuniteit teen infeksies, en wondgenesing.

As u hond newe-effekte het as gevolg van die gebruik van prednison, meld dit aan u veearts. U veearts kan probeer om die dosering aan te pas, of kan 'n ander tipe steroïede voorskryf in die hoop om dit teë te werk.

Prednisoon is 'n behandeling vir limfoom. Alleen is dit nie 'n ideale behandeling nie, maar dit kan die kwaliteit van u hond se lewe op kort termyn verbeter. Steroïede soos prednisoon het giftige effekte op die selle wat onvanpas vermeerder in u hond. Hierdie effek maak nie alle kankerselle dood nie en dit sal nie vir altyd werk nie, maar dit kan u hond beter laat voel.

- Dr. Shadwick, veearts

Verwysings

  • DVM360: Behandeling van kankerpyn by honde en katte
  • DVM360: Uitbreiding van lewensgehalte by kankerpasiënte
  • Hondekanker-blog: algemene kankerfout: begin u hond te vroeg met limfoom op prednison
  • VCA Dierehospitaal: Steroïedbehandeling - langtermyn-effekte by honde

Vrae en antwoorde

Vraag: Is prednisoon skadelik vir honde met nierversaking?

Antwoord: Prednisoon is 'n steroïed en kan as sodanig die nierversaking van 'n hond vererger. Ek sou aanvaar dat 'n veearts sou huiwer om 'n hond in nierversaking op 'n middel soos prednisoon te plaas.

Vraag: Kan honde ernstige diarree van prednison kry?

Antwoord: Ja, dit is moontlik as in ag geneem word dat prednison streng kan wees op die SVK van die hond, en dit kan boonop moontlik maak dat sekondêre aansteeklike middels oorneem, aangesien dit die immuunstelsel kan demp. Raadpleeg u veearts vir instruksies.

Vraag: My hond is op prednisoon en hy wil meer eet as gewoonlik. Moet ek bekommerd wees oor die oorvoeding van my hond terwyl hy prednison gebruik?

Antwoord: Verhoogde honger by prednison is nie ongewoon nie. Inderdaad, honde met terminale kanker kan prednison voorgeskryf word as hulle nie meer wil eet nie, en dit kan hulle soms nog 'n paar weke gee. Ek dink u moet dit ook met u veearts bespreek, want verhoogde eetlus is 'n newe-effek en as dit oormatig is, kan veeartse soms besluit om die dosis aan te pas. Oorvoeding kan op die langtermyn lei tot vetsug wat druk op gewrigte kan plaas, sekere toestande kan vererger en ander negatiewe gevolge kan hê.

© 2018 Adrienne Farricelli

Bobbie Clark op 24 Junie 2020:

My 4-jarige Giant Schnoodle is gediagnoseer met limfoom. Ons veearts het hom op 'n 20 dae voorraad prednisoon geplaas en hy het wonderlik gereageer. Noudat hy sy laaste dosis geneem het, is ek bang wanneer sy knoppe / knoppe weer sal kom :-(

Adrienne Farricelli (skrywer) op 8 Mei 2020:

Hallo Bernard, ek is bly om te hoor die prednisoon help. Ek sou voorstel dat u met 'n veeartsenykundige onkoloog konsulteer. As daar honde is, moet ons altyd interaksies oorweeg as ons ander medisyne / aanvullings wil probeer.

Bernard Prevuznak op 4 Mei 2020:

My pragtige seuntjie Beau is met leukemie gediagnoseer en het 2 weke tot 2 maande tyd gehad om te lewe ... Ek het die prednison begin en dit gaan goed met hom. Beau is maar 4 jaar oud en dit was hartverskeurend ... ek is so lief vir hom! ... enige ander voorstelle ... ons bid vir 'n wonderwerk ... en verwag dit! Dankie Jesus!

Adrienne Farricelli (skrywer) op 20 Oktober 2019:

Hallo Karen, bedoel u SSK-olie? Dit is iets waaraan u u veearts regtig moet vra, want wanneer u medisyne en aanvullings meng, is daar altyd risiko's vir interaksies.

Karen Beal op 20 Oktober 2019:

Ek wil graag weet of die PDB-olie goed is om met presdnison te gee. My brak het limfoom gehad. Sy 13 jaar oud. Hy is altyd honger. Hy het 3 kg verloor. Ek hoop dat hy nou 'n bietjie gewig sal aansit. Hy het wel van sy kos af gegaan, maar het dit nou liefgehad. Moet ek hom hierdie olie gee. Groete Karen

Kay op 02 Oktober 2019:

Hallo Jasmine,

Is jou hond nog gelukkig? My hond het ook kanker, pas gediagnoseer.

Sy lê die grootste deel van die dag rond, ek sal haar graag meer aktief wil sien! Sy is net nie haarself nie!

Groete Kay

Jasmyn op 29 Augustus 2019:

Hallo Adrienne,

Is dit veilig om presdnisoon- en cbd-olie te gebruik? Ek het gelees van 'n paar ongelooflike verhale van honde met kanker op CBD olie. My hond is gediagnoseer met limfoom en is op prednison. Ek was nie seker of CBD olie goed sou wees met die steroïde nie?

Dankie!

Adrienne Farricelli (skrywer) op 19 April 2019:

Lucy, dit is iets wat net u veearts kan voorstel. Prednison is 'n middel waar u die veearts se instruksies moet volg volgens 'n T, met inagneming van die risiko's vir newe-effekte en komplikasies.

Lucy Jones op 13 April 2019:

My laboratorium is 6 maande gelede met limfoom gediagnoseer en het 1-2 maande gekry. Sy het een keer per dag 20 mg prednison gebruik. Haar gewasse in haar mond en rektum is weg. Sy voel wonderlik, maar onlangs is haar eetlus wat met die prednisoon toegeneem het, buite beheer geraak. Sy is gek na iets om te eet, selfs leë blikkies. Lees inligting ... haar veearts moes haar dosis lankal teruggesny het. Wat stel jy voor. Sy is ook op die middestad om haar te help versag. Dankie!

Kelli op 21 Februarie 2019:

Waar kan ek CBD-olie vir my ouers se hond kry?

Karen op 17 Februarie 2019:

Kan my hond vir 9 maande prednisoon aanbring, want die buik word uitgesprei, die eetlus veroorsaak bloedige stoelgang en braking. Hy het limfoom. Ek het die prednisoon gestop en dit gaan beter met hom

Jude op 7 Desember 2018:

My hond is dood toe hy te veel prednisoon geneem het. Die veearts het 4xday gesê. Ek het vir hom gesê dat dit te sterk was, hy het niks gesê as hy moes getoets het voordat hy die pille gegee het nie.

Adrienne Farricelli (skrywer) op 27 Julie 2018:

Debbie, so jammer vir die diagnose van u hond. My hond is nou al meer as 2 maande op prednisoon. Dit werk goed vir haar. Sy drink meer en urineer meer en het soms aflewerende episodes, maar hierdie newe-effekte is gering in vergelyking met die feit dat sy nie eet nie. Ek kontak nou en dan my veearts om seker te maak dat alles reg is. Pas 'n urinemonster ingedien, aangesien honde op prednison soms UTI's kan kry sonder om tipiese simptome te toon, aangesien prednison ontsteking verwyder. Ek wou ook diabetes uitsluit, aangesien prednison soms diabetes by oorsaaklike honde kan veroorsaak.

Debbie Kogan op 22 Julie 2018:

Hallo Adrienne, so jammer oor jou geliefde hond. Ons geliefde goldendoodle is pas met limfoom in haar derm gediagnoseer. Sy het verlede week 'n noodoperasie ondergaan om 'n siek gedeelte van haar derm waar die limfoom ontdek is, te verwyder. Sy is amper 13 en was tot op hierdie stadium uiters gesond en aktief. Ons het teen chemoterapie besluit omdat dit net 'n paar maande sou duur. Ons is verslae en hartseer oor hierdie diagnose, maar ons hoofdoel is om ons meisie die beste lewenskwaliteit te gee. Sy eet al amper 3 dae nie. Ons het haar gister by ons veearts geneem en hulle het vloeistowwe en 'n eetlusstimulant gegee. Sy is ook op Pepcid vir slegte spysvertering. Ek het haar met CBD olie begin. Ek speen die tramadol van haar af vir pyn. Sy begin more met prednisoon as sy nie begin eet nie. Dankie dat u u storie gedeel het, aangesien ek baie bekommerd was om haar die prednison te gee, maar nou voel ek dat dit die regte keuse is. Ek is hoopvol dat haar eetlus sal terugkeer en ek kan haar 'n ketogene dieet gee.

Adrienne Farricelli (skrywer) op 01 Junie 2018:

Hallo Heidi, ek het nooit gemaklik gevoel om my honde steroïede te gee nie, so ek het probeer om dit soveel as moontlik te vermy. Maar met my hond se kanker, sien ek hoe nuttig hierdie middel kan wees. My hond eet nou lekker en geniet 'n goeie lewensgehalte.

Rottweilers is ongelukkig geneig tot kanker, en nou toon statistieke ongelukkig dat 1 uit 3 honde aan kanker sterf. Kanker bly die grootste oorsaak van sterftes by honde ouer as 10 jaar.

Terwyl my Rottweiler amper 11 was, dink ek sy het 'n tydbom getik, meer 'n kwessie van wanneer sy kanker sou kry eerder as om.

Ek het altyd gedink ons ​​sal kanker aggressief behandel en chirurgie en chemo doen as sy kanker kry, maar dit is blykbaar nie 'n opsie met hierdie soort kanker nie. Dit is heeltemal te aggressief en as sy 'n operasie sou ondergaan (en dit sou oorleef), sou die meeste van haar tyd aan 'n operasie spandeer word.

Gelukkig was my onkoloog baie ondersteunend en het hy saamgestem dat dit met 'n swak voorspelling en oorlewingstye van waarskynlik minder as 'n maand nie die moeite werd is om haar daaraan te steek nie.

Adrienne Farricelli (skrywer) op 01 Junie 2018:

Hallo Leah, baie dankie vir jou vriendelike woorde. Ons geniet tyd saam en elke dag is 'n geskenk. Sy eet gelukkig nou en geniet dit om bederf te word, so dit is goed. Prednison en 'n paar aanvullings was vir ons 'n wonderwerk.

Heidi Thorne vanaf Chicago Area op 29 Mei 2018:

Was al meer kere op die hondekankerpad as wat ek wou onthou. Ek is so jammer om van jou hondjie te hoor! My hart gaan uit na albei van u gedurende hierdie tyd.

Ja, prednisoon was nuttig in die versorging van ons s'n deur die kanker- en chemo-proses. Ons veearts het dit ook deur die jare aanbeveel vir ander nie-kanker, maar inflammatoriese toestande. Ek probeer egter die gebruik daarvan tot die minimum beperk as gevolg van die newe-effekte.

Dankie dat u, soos altyd, u rykdom aan kennis van hondeversorging met ons gedeel het! Kyk mooi na jouself!

Leah Lefler vanaf Wes-New York op 29 Mei 2018:

Ek is jammer dat u hond kanker het, Adrienne! Hierdie artikel is baie nuttig om die voordele van prednisoon te verstaan. Palliatiewe sorg is so belangrik om honde te help om die beste lewensgehalte te geniet vir die tyd wat hulle oor het. Ek het nie besef dat die steroïde ook die verspreiding van metastatiese kanker kan vertraag nie - dit is 'n groot voordeel. Stuur u baie liefde en hoop vir soveel goeie dae as moontlik saam met u hond.

Adrienne Farricelli (skrywer) op 27 Mei 2018:

Dankie Peggy. U woorde beteken vir my baie in hierdie moeilike tyd. Ek probeer my bes om die oomblik te koester. Ek het vir eers opgehou om instap- en opleidingskliënte te neem om my hele dae aan haar toe te wy. Sy is my hartsdog en ek is lief vir haar. Dit is baie moeilik om haar te verloor.

Peggy Woods vanaf Houston, Texas op 27 Mei 2018:

So jammer om te hoor dat u hond kanker het. Geniet elke dag met u kosbare troeteldier. Ek weet jy doen presies dit.

Adrienne Farricelli (skrywer) op 27 Mei 2018:

Peggy, so jammer om te hoor van jou ma se hond. Ek dink dat nie alle kankers voordeel kan trek uit palliatiewe sorg nie. My hond het 'n baie seldsame vorm van kanker gehad. Oorlewingstye met chirurgie en chemo is net minder as 'n maand. My onkoloog het prednison voorgeskryf en tot dusver goed. Haar eetlus is terug en sy tree op soos haar normale self. Ek bederf haar vrot. Elke dag is nou 'n geskenk.

Peggy Woods van Houston, Texas op 26 Mei 2018:

My ma het eens 'n hond gehad wat jonk was en met 'n aggressiewe vorm van kanker gediagnoseer is. Die veearts het genadedood aanbeveel, wat sy ongelukkig gedoen het. Hy het geen vorm van behandeling voorgestel nie omdat dit vrugteloos sou wees en die onvermydelike sou verleng het. Goed om te weet dat die gebruik van prednison in sommige gevalle van hulp kan wees in sommige vorme van kanker.


Prednison vir honde - gebruike, voordele en newe-effekte Dr. Tammy Powell Deep Dive

Opsomming

Prednison vir honde: wondermiddel, of newe-effek nagmerrie? Dit word gebruik vir tientalle probleme, waaronder verskeie kankers. En daar is baie om te weet om dit verstandig en goed te gebruik. Kom ons doen 'n diep duik.

Episode Notas

Pred: wondermiddel, of newe-effek nagmerrie? Dit word gebruik vir tientalle probleme, waaronder verskeie kankers. En daar is baie om te weet om dit verstandig en goed te gebruik. Kom ons doen 'n diep duik en vind uit oor wanneer en hoe dit gebruik word, wat die algemene en langtermyn newe-effekte is, en hoe u u keuse deeglik kan maak.

Dr Tammy Powell is 'n volledige spektrum veearts en dra by tot DogCancerBlog.com, die tuiste van ons podcast-borg, die boek The Dog Cancer Survival Guide: Full Spectrum Treatments to Optimize Your Dog's Life Quality and Longevity.

Skakels wat in die program van vandag genoem word:

As u veearts voorbeveel vir pyn, kan u ook hierdie artikel oor pynbestuur deur Dr. Dressler lees: https://www.dogcancerblog.com/articles/managing-pain/pain-management-update-plus-natural- pynverligting-vir-honde /

Gaan na https://www.facebook.com/groups/dogcancersupport/ om deel te neem aan die private Facebook-groep vir lesers van Dr. Dressler se boek "The Dog Cancer Survival Guide".

Oor die gas van vandag, dr. Tammy Powell:

Dr Tammy Powell is 'n gegradueerde van die Universiteit van Suid-Carolina en die Universiteit van Georgia College of Veterinary Medicine, en is 'n veearts met klein diere met 7 jaar kliniese praktykervaring, verdeel tussen die Gulf Coast van Florida en Abu Dhabi (Verenigde Arabiese Emirate) in Middel ooste. Dr Tammy is passievol oor beide diere en skryf, en is 'n voltydse vryskutskrywer wat spesialiseer in troeteldier- en veeartsenykundige onderwerpe. Sy skryf ook oor diere in 'n fiktiewe formaat en werk aan 'n kinderboek oor katte met supermoondhede. Dr Tammy woon in die West Valley of Phoenix, Arizona met haar man, twee stiefkinders, en 'n pragtige geredde Himalaja-kat met die naam Luna. In haar vrye tyd hou dr. Tammy van lees, reis, nuwe koffiewinkels probeer en dans in die balsaal.

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Hierdie episode word geborg deur die topverkoper boek vir dieregesondheid The Dog Cancer Survival Guide: Full Spectrum Treatments to Optimize Your Dog's Life Quality and Longevity deur Dr. Demian Dressler en Dr. Susan Ettinger. Oral beskikbaar boeke word verkoop.

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Transkripsie

>> Dr. Tammy Powell: Prednisoon doen eintlik iets baie goed vir u hond. U weet of u hond nie kandidaat is vir 'n ander behandeling nie en of daar 'n ander faktor is.

>> Omroeper: Welkom by Dog Cancer Answers waar ons u help om u hond met kanker te help. Hier is jou gasheer, James Jacobson.

>> James Jacobson: Dankie dat u op daardie speelknoppie gedruk het, ek is bly dat u hier is, want die episode van vandag handel oor 'n baie belangrike onderwerp: prednison — wat dikwels bloot verwys word as pred.

Prednisoon is 'n 'go-to' middel vir baie probleme in veeartsenykundige medisyne, insluitend limfoom en ander kankers. Ons praat dus vandag met ons Full Spectrum-veeartsvriend, dr. Tammy Powell, wat haar superomvattende artikel soos 'n term-papierlengte op DogCancerblog.com oor prednison saamvat: dit gebruik, die voordele daarvan, en dit is newe-effekte .

>> James Jacobson: Tammy Powell, baie dankie dat jy by ons was. U is 'n gegradueerde aan die Universiteit van Suid-Carolina en u het na die veeartsskool gegaan aan die Universiteit van Georgia en u is al sewe jaar in die praktyk of in die kliniese praktyk.

Heerlik om jou vandag by die program te hê, dankie dat jy hier was.

>> Dr. Tammy Powell: Ja, absoluut. Dit is goed om hier te wees.

>> James Jacobson: U het 'n opspraakwekkende artikel geskryf. Eintlik dink ek dit is soos die mega-artikel oor prednisoon. Dit is alles wat enigiemand wat 'n hondliefhebber is, oor prednison op dogcancerblog moet weet, en ons sal daarna skakel uit die aantekeninge van die episode van vandag. Maar ek dink ons ​​begin met die mees basiese vraag.

>> Dr. Tammy Powell: Prednisoon is waarskynlik een van die mees gebruikte middels in veeartsenykundige medisyne, omdat dit kan help met 'n wye verskeidenheid siektes vir troeteldiere, vir honde en katte. Dit is eintlik 'n tipe steroïde, maar dit is nie waaraan jy kan dink nie - baie mense, toe ek sê dat hulle dink dat ek testosteroon bedoel

>> James Jacobson: Ja, ek bedoel, is dit iets om te vergroot, en sodat u hond meer drukwerk kan doen?

>> Dr. Tammy Powell: Waar ek in Florida geoefen het, het ons eintlik baie pitbulls gehad wat baie spieragtig, baie energiek is, en soms sal mense my vra, is u seker dat u hierdie hond 'n steroïed wil gee? ? Hierdie tipe hormone is ook steroïede, maar hierdie spesifieke soort wat deur die byniere geproduseer word, word 'n kortikosteroïed genoem, wat beteken dat dit afkomstig is van die korteks van die byniere.

En binne daardie kategorie spesifiek, nog 'n lang woord hier, is dit 'n glukokortikoïed. Dit is dus een wat betrokke is by die bekamping van inflammasie, dit is ook 'n deel van die liggaam se stryd of vlugstresreaksie. As u dus die reaksie in u liggaam het, gee u liggaam kortisol vry, wat u help om suikers, energiewinkels te mobiliseer, en sekere nie-noodsaaklike prosesse te sluit, sodat u heeltemal op daardie stryd of vlug kan fokus. En dit word gebruik om te help met alles wat verband hou met inflammasie.

>> James Jacobson: Waarom word prednison so gereeld voorgeskryf? Jy het gesê so algemeen gebruik hoekom?

>> Dr. Tammy Powell: Net as gevolg van die verskeidenheid dinge wat binne die liggaam kan help, is um - inflammasie redelik algemeen - wat soveel verskillende dele van die liggaam by troeteldiere en mense kan beïnvloed. En u weet, ek sal waarskynlik 'n hele podcast-episode hê wat al die verskillende toestande waarmee dit kan help, gaan, maar sommige van die mees algemene toestande waarvoor ek dit sou gebruik, is allergieë. En weer, in 'n warmer klimaat oefen, was dit iets wat ons die hele tyd gesien het, of dit nou stuifmeel- en omgewingsallergieë was, of vlooi-allergieë, 'n ander baie algemene een. En sommige van hierdie honde het dag en nag net baie ongemaklik gejeuk, jeuk totdat hulle brandpunte gemaak het en hul vel besmet geraak het. Hulle het dus nodig gehad: prednisoon was vir sommige van hulle baie belangrik. Daar is ook ander opsies, maar sommige honde het prednison nodig gehad.

'N Paar ander algemene voorbeelde is alles wat outo-immuun is, wat geïrriteerde dermprobleme kan wees, of lupus.

>> James Jacobson: Kom ons praat spesifiek daaroor as dit verband hou met kanker, want dit word baie gebruik in die behandeling van kanker. Hoekom?

>> Dr. Tammy Powell: Dit is waar. Limfoom is een van die algemeenste, maar daar is 'n paar verskillende maniere waarop dit kan help. Dit kan eintlik direk deel uitmaak van die chemoterapie-protokol. Dit het eintlik 'n paar antikanker-eienskappe in dinge soos limfoom of mastseltumore. Limfoom beïnvloed limfosiete en mastseltumore beïnvloed mastselle. Dit is albei deel van die immuunstelsel en kan bydra tot inflammasie tydens die bestryding van siektes. En as u kanker van hierdie selle het, kan prednisoon direk relevant vir hulle wees, maar prednisoon kan ook gebruik word vir 'n verskeidenheid kankers, net om te help met ontsteking wat teenwoordig is.

>> James Jacobson: Ek weet dat pred dikwels in verskillende chemoterapie-regimes gebruik word, soos die CHOP-protokol vir limfoom.

>> Dr. Tammy Powell: CHOP is vier verskillende middels. Drie van hulle is wat u kan dink as meer tradisionele chemoterapie-middels. En dan is die P in CHOP vir prednison.

>> James Jacobson: Ek sal jou nie eers vasvra nie. Ek dink dr. Ettinger het vir my gesê: wil u selfs doen wat al die ander vier letters is, want ek weet dit is moeilik, maar die P is maklik. Veroorsaak dat dit prednisoon is.

>> Dr. Tammy Powell: Dit is 'n bietjie vreemd, want hulle begin nie noodwendig met die letter wat u dink nie, of die handelsnaam word gebruik in plaas van die generiese naam om die CHOP-akroniem te maak.

Maar ja, prednisoon is 'n belangrike deel daarvan, maar die skedule is baie spesifiek en dus, die meeste onkoloë beveel aan dat u nie limfoom begin voor chemoterapie nie.

Die rede hiervoor is dat prednison weerstand teen medisyne kan veroorsaak, sodat chemoterapie minder effektief sal wees. En daar is ook ander redes: dit kan moeiliker wees om die spesifieke tipe limfoom te diagnoseer, maar dat die weerstand teen medisyne 'n groot probleem is. Onthou dus om eers eers by 'n onkoloog te gaan soek om al u opsies vir limfoom te sien.

>> James Jacobson: Vir watter soort ander kankers kan dit gebruik word?

>> Dr. Tammy Powell: Een wat ek sou sien gebeur meer dikwels as met neurologiese kankers, breingewasse, veral - en 'n deel van die rede is as u 'n massa het wat groei in 'n beperkte ruimte in die skedel, binne die ruggraat. koord, daar is regtig geen ruimte vir 'n mis nie.

As u dus een groei, kan dit daardie baie belangrike organe saamdruk. Dus is chirurgie 'n opsie vir sommige, maar ongeag die operasie of nie, moet u soms nog steeds die massa krimp en daar is ook ander middels wat u daarvoor kan gebruik, maar prednison is baie algemeen.

'N Ander een kan 'n massa aan die buitekant van die liggaam wees. As dit aangesteek is en vinnig groei, kan prednison dit 'n bietjie verminder om die operasie 'n bietjie makliker te maak sodat daar nie soveel weggesny hoef te word nie. Weereens, dit hang af van die tipe massa. Dit gaan nie met alles help nie, maar wanneer dit wel gebeur, kan dit regtig voordelig wees.

>> James Jacobson: Nou weet ek dat die eetlus vroeër stimuleer,

>> James Jacobson: Wat ek dink belangrik sal wees as u hond nie eet nie.

>> Dr. Tammy Powell: Dit is baie waar. Soms het honde wat ons kankerkakeksie noem. En daardie term beteken basies dat hulle nie baie eet nie. En as gevolg van die spanning op hul liggaam van kanker, verloor hulle vinniger gewig. Hulle kan so te sê 'n bietjie verspil, verlies aan spiere, verlies aan liggaamsmassa en hulle moet kalorieë inneem, maar soms voel hulle net nie goed nie, of dit nou van kanker of chemoterapie is, albei kan veroorsaak dat die hond nie goed voel nie. Miskien 'n bietjie naar wees, nie honger nie, en prednisoon kan dit ook doen, en laat hulle ook 'n bietjie beter voel deur die ontsteking wat die eetlus kan verhoog, te verminder. Dit is eintlik een van die mees algemene newe-effekte wat ons sien, maar in hierdie geval is dit 'n voordelige newe-effek, sodat dit daardie hond regtig kan help.

>> James Jacobson: Nou weet ek dat daar hierdie konsep is van wat dit genoem word? Pred en bid? Ek bedoel, basies word dit net soms slegs vir palliatiewe sorg gebruik.

>> Dr Tammy Powell: Palliatiewe sorg beteken basies dat ons die siekte nie genees nie, maar dat ons die hond help om beter te voel. So this can be considered a little bit like hospice care, although many dogs are actually very active during palliative care. So whether they’re resting a lot or active, that can still be palliative care.

And some people look at this as giving up, especially if it’s taken over a more standard option such as a full chemotherapy protocol, but that’s actually not true. It’s actually doing something pretty great for your dog. You know, whether your dog is not a candidate for another treatment or whether there’s another factor, like maybe someone in your house is pregnant and you can’t do chemotherapy, or the cost is prohibitive. It’s absolutely still an okay option to do something like palliative care and that can make your dog feel much better. Really, it’s more about quality of life and that’s one of the best things you can do for your dog.

>> James Jacobson: And this is a good place to pause to hear from our sponsor, and when we come back we’ll talk about side effects to watch for with prednisone.

Today’s episode of Dog Cancer Answers is brought to you by the best-selling animal health book, The Dog Cancer Survival Guide: Full Spectrum Treatments to Optimize Your Dog’s Life Quality and Longevity by Dr. Demian Dressler and Dr. Susan Ettinger (an oncologist in New York). And in a minute I will tell you how to get their book at a discount.

Whether you are looking to use every treatment possible or just focusing on palliative care – or something in between, like I do with my dog – you’ll find actionable information in this book. You’ll get behind the scenes information on everything from chemotherapy to surgery to supplements to diet, plus tons of supportive information about how cancer works and how to handle the emotional overwhelm that comes with a diagnosis.

The Dog Cancer Survival Guide is available wherever fine books are sold– both online and in physical bookstores. And you can support this podcast by using a coupon code and getting The Dog Cancer Survival Guide right away direct from the publisher. Its available either in paperback (and there is free shipping to any US address). OR as an e-book edition that is under ten dollars.
The website to get either the paperback or the ebook is: DogCancerBook.com.

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Welcome back. What about the side effects from pred. Is there a balancing situation between that and the cancer itself?

>> Dr. Tammy Powell: There are some side effects that almost always happen, and that would be the increased appetite, in addition to that, classic side effect that we see in almost every single dog is going to be increased urination and increased thirst, and that’s something they can’t control. The prednisone causes that. So you do have to keep water around for your dog. They can’t control the amount of urination. So if you don’t keep water, they can get dehydrated. And they may need walks more often.

Even well-trained dogs may have accidents if they’re trying to hold it in for too long,

>> James Jacobson: Because it just makes them want to urinate more than normal and that they can’t control it. Let’s talk about the pain control components of prednisone. It’s effective for that?

>> Dr. Tammy Powell: It can be, but one important caveat to note here is that it’s not actually a pain medication. So by itself, it’s a poor pain control usually, but it can be used in combination with other pain control medications. And the reason that it’s used in combination is because it addresses the inflammation component.

So for example, if you have a dog with arthritis, it’s not going to make that arthritis pain go away, but it can stop some of that inflammatory process, especially if it’s a newly diagnosed condition. And then it’s combined with other pain control medicines to address the pain directly.

>> James Jacobson: Now I know that you’ve practiced veterinary medicine all over the world. Have you seen people use pred in novel ways?

>> Dr. Tammy Powell: In novel ways, that’s a good question. In some countries where maybe there’s less access to certain medications, I have seen prednisone used as a post-operative medicine, which is something given for pain control. And I believe that used to be done here. I have heard of some veterinarians doing that in the U.S., too, but it’s a little bit outdated because we know more about it now.

So while it helps with inflammation, you do need something for the actual pain of the surgery too.

>> James Jacobson: Is pred ever considered dangerous for dogs?

>> Dr. Tammy Powell: It can be. Some of the things we’ll see short term, there’s very little risk, even if they eat extra doses, that’s unlikely to be toxic, you know — still good to check with your vet if your dog gets into the bottle and eats more than they should.

>> James Jacobson: They’re not treats.

>> Dr. Tammy Powell: Exactly. Fortunately the risk of toxicity is low and used short term, prednisone is usually pretty safe.
It’s really the longterm side effects we worry about. Some things that can happen or problems with the liver, risk of diabetes, because it elevates the blood sugar levels. And we also see effects on the adrenal function.

If the adrenal glands are used to getting this external supply, they can actually really ramp down their own natural production of cortisol. And there’s a condition called Addison’s disease, which is the reduction in these corticosteroids produced by the adrenal glands.

Addison’s disease, it can be quite dangerous. It happens naturally in a lot of breeds standard poodles are a common example, but what happens, since they don’t have that cortisol for the fight or flight response, actually their body doesn’t respond well to stress. So stressful events, whether that’s another illness or even something as mundane as boarding, if they don’t like being away from home, the dogs can actually die during those times.

>> James Jacobson: I had a dog that was on pred for a long time, for a really unusual eye injury or an eye thing where it’s SARS or something like, SARS, this was basically where

>> Dr. Tammy Powell: The retinal problem?

>> James Jacobson: It was a really weird thing. And the ophthalmologist said, well, basically, we’re going to put your dog on pred for the rest of her life.

And she was a senior dog and I was like, Whoa, I heard that’s really bad. But she said, well, basically it’s an equation that you just have to sort of figure out. You either do it or you don’t. But, I really think it’s something that you should do and talk about that discussion that a veterinarian will have with the client.

>> Dr. Tammy Powell: The thing about prednisone is it helps with a lot of things, but it shouldn’t necessarily be a knee jerk reaction to use it. You have to kind of look at every pet, every dog as an individual, and a few things would go into that consideration. That one would be any underlying medical conditions they might have.

If your dog was diabetic, they may have needed something else, cause that could have thrown their diabetes out of control. They’re taking another medication that’s not compatible, you may need to switch to something else, either something not prednisone or change the other medication. One good example is nonsteroidal antiinflammatories. And these are kind of the doggy equivalents of ibuprofen, you know, safer alternatives for them,

>> James Jacobson: But don’t give your dog over the counter human ibuprofen.

>> Dr. Tammy Powell: Thank you for pointing that out. We have formulations for dogs but you should not give human medications like that without checking with your vet, they can be very toxic for pets. So always check first.

The one other reason you can’t combine that one — and it’s one that we always remember not to mix — is that they both cause stomach ulcers in some dogs. And if you combine both of them, the risk of stomach ulcers really goes up. And some other factors to consider are the condition your dog actually has.

Is there something else to treat it available, sometimes there’s not. Also have you determined for sure that that’s what your dog has? So for example, if your dog, if you thought they had allergies, but they actually had the skin mite called demodex, which can have a similar type of symptom.

>> James Jacobson: Say that again?

>> Dr. Tammy Powell: It’s called demodex. It’s a microscopic mite. It lives on the skin normally, but when it overgrows, it can cause itching, hair loss, and look a little bit like allergies. But if you assume it’s allergies without testing and you give your dog prednisone that demodex is going to get much worse really quickly. So it’s important to determine that your dog actually has a condition that needs prednisone and not something that would respond badly to it.

>> James Jacobson: So when my dog was on pred, I noticed that after a while her stomach became sort of distended. Do dogs get fat on prednisone?

>> Dr. Tammy Powell: They can. In the short term, that’s usually due to that increase in appetite. They just are hungry all the time. In the longterm there can be some effects on metabolism, it can affect their thyroid hormone and also kind of create what we call iatrogenic, which means it’s caused by the medication or treatment. Cushing’s disease and natural Cushing’s disease is the opposite of Addison’s, it’s too much cortisol in the body. So you kind of get that weight gain in the belly. They’re feeling a little bit sluggish, they’re more prone to things like urinary tract infections, maybe a little bit of hair loss, things like that.

So that’s possible with long-term use. But I’d say for a lot of dogs, especially if it’s in the short term use that main, the main reason is going to be cause they’re hungry and they just want to eat all the time.

And even dogs. I’ve seen them gain weight in a couple of weeks of use. Very short-term use.

>> James Jacobson: And it’s not just hunger. I mean, we talked about the urination part, but they actually drink more. Right.

>> Dr. Tammy Powell: That’s true. They do. Cause they’re stimulated to urinate more. If they need to drink more, to keep up with that and they feel thirstier, too.

And that can be amplified if it’s hot outside.

>> James Jacobson: Now, it’s been a long time since I used pred with the dog I was talking about. But as I recall, I think I used a little bit of Pepcid AC every time I gave the pred, would that make sense? Is there a reason to do that?

>> Dr. Tammy Powell: That reduces the risk of stomach ulcers, cause prednisone can increase stomach acids. This is common if you’re giving it with dogs with certain cancers, such as mast cell tumors, which increase stomach acid too.

So check with your vet for their specific recommendation, and of course the dose. Not every single dog will need it, especially in the short term, but if your dog’s got a sensitive stomach, it’s probably a good idea to check.

>> James Jacobson: Tell me a little bit more about what it could do to the liver.

>> Dr. Tammy Powell: Given over the long-term, it can cause liver problems, liver disease, you know, cause any drug you give depending on the organ that processes, it, it can be a lot of work on that organ. But, and the interesting thing about prednisone, we monitor the blood chemistry values just to check these sorts of things.

Be sure the liver is okay, that kidneys are okay too, but it can actually cause a false positive, a false increase in one of the liver values, what we call ALP or alkaline phosphatase

>> James Jacobson: ALP, say that again, ALP is what?

>> Dr. Tammy Powell: Alkaline phosphatase, and this enzyme, as opposed to direct damage to the liver, which we usually rely on another liver enzyme to tell us, ALP is usually more an indication of backup, like for a gallbladder problem. For example, if you have bile in the liver, that would increase it too.

So sometimes this can indicate a problem, but sometimes it’s actually a false positive because the prednisone produces something similar that falsely increases the value — actually can be elevated in older, younger dogs, too, specifically seniors, it goes up. We don’t know all the reasons why, and growing puppies, there’s an enzyme produced by the bones that’s very similar and can again produce a false positive. So one way to tell the difference is monitoring over the long term and looking at your dog’s overall health.

>> James Jacobson: How frequently should you be monitoring? How frequently should you get the blood test for the liver?

>> Dr. Tammy Powell: It depends a little bit on the dog. I’d say every six months is average for a longterm user. Some dogs are doing really well and may go up to a year and some dogs that are a bit older, or may have other underlying conditions that we want to monitor, it may be bumped up to every two or three months.

>> James Jacobson: Now is it an expensive test?

>> Dr. Tammy Powell: That is a good question. I guess it

>> James Jacobson: It depends on your vet.

>> Dr. Tammy Powell: Depends what you consider expensive.

>> James Jacobson: But I mean, is it a complicated test? Is it basically just a little blood test? Do they have to send it off to a lab or do they do it in the clinic?

>> Dr. Tammy Powell: It depends on the clinic. Some have in house labs available and some send it out. But I will say this is one of the most common blood tests we do. Usually if you want to just screen a dog’s overall health, it’s part of what we call a blood chemistry, which can be bigger or smaller, but even the smallest panels usually check their liver values, their kidney values, electrolytes, key electrolytes and blood glucose or blood sugar.

>> James Jacobson: Okay. So let’s sort of review in terms of the factors to consider when determining if a dog is a good candidate for prednisone.

>> Dr. Tammy Powell: What the underlying medical condition is. What medicines they’re on. And if they have another health problem that would contraindicate it, some other factors would be individual, you know, with any drug you give, there are some individuals that just don’t process it well.

And even without an allergy, sometimes a body just reacts poorly to it. And it may be some genetic factor that we don’t know all the reasons behind, but fortunately, that sort of thing is pretty rare with prednisone.

But I have had a few patients I prescribed it to that just felt the side effects a lot more than other dogs did, and they weren’t good candidates. Like some got stomach ulcers.

>> James Jacobson: Would that be a function of size or breed or are just totally just luck of the draw?

>> Dr. Tammy Powell: I think it’s luck of the draw. Nevertheless I think, dogs I saw with severe stomach upset or even stomach ulcers for whatever reason, tended to be larger dogs, such as Labrador, golden retriever. So we ended up really reducing the dose and then looking into more alternatives for them.

>> James Jacobson: Cause that is something that you can do. The dose can be tweaked. Pretty significantly to have — to minimize some of the side effects, right?

>> Dr. Tammy Powell: That’s true. One of the things that’s interesting about prednisone is we’ve got a couple of different dose ranges: we have an anti inflammatory dose, which is a bit on the lower side.

And then we have an immunosuppressive dose and this would be given to pets with autoimmune diseases, especially for autoimmune diseases that are considered emergencies. One example would be, IMHA that stands for immune mediated hemolytic anemia. And that basically means the body is destroying its own red blood cells.

That can be life threatening and it can happen pretty quickly. So we have to give a very strong dose of immunosuppressive drugs.

>> James Jacobson: So there’s a lot of variety in terms of dosing, how much you want to use, how little you want to use, what’s the right amount. How is that figured out?

>> Dr. Tammy Powell: That will vary from dog to dog. It’s based on weight and whether they just need a little bit of anti-inflammatory or they need that immunosuppressive dose.

But the nice thing is we try to find what we call the lowest effective dose. So even if you have a starting point your veterinarian will usually work with you to find the lowest dose that’s going to be still effective for your dog, but will reduce the amount of side effects, especially for the long-term.

And usually a lot of dogs can get to taking it just every other day and that minimizes side effects.

>> James Jacobson: So when I saw those side effects with my dog, I wanted to stop pred, but Dr. Dressler freaked out a little and was really clear with me that I should never stop cold turkey, right? Can you talk about the reason that you should only stop when your veterinarian tells you to? Isn’t it important to taper off?

>> Dr. Tammy Powell: The reason is because that Addison’s disease – If your dog’s been taking it quite a long time, their body may not be producing as much cortisol as it used to because it’s so used to getting this external supply and if you stop that cortisol supply, suddenly it could be life threatening. They can have even just things that cause stress be fatal just because their body’s not able to handle that stress response.

>> James Jacobson: So, there’s just so much pred, and it’s just one of these drugs that is used with so many different things, but it’s often used with cancer. Dr. Tammy Powell, thank you. This is, as I said, it is the motherload of information and you did an amazing job. I think it’s wonderful. And if you ever are wondering, anything about prednisone and your dog, please check out her blog post on dogcancerblog. We will put a link to it in the show notes. Dr. Tammy Powell, thanks for being with us today.

>> Dr. Tammy Powell: Thank you.

>> James Jacobson: So, there you have it, there it is: our Deep Dive discussion on prednisone with Dr. Tammy Powell. I’ve never really understood before why it’s used for so many problems, but I guess it makes sense. It makes a very clear, immediate difference to a lot of dogs, and even though there are some side effects — like hunger, and thirst, and increased urination — those are manageable. And I can personally attest to the long-term benefits with my dog, who was on it for about five years before she died. It really did keep her kicking and feeling good for much longer than she would have otherwise.

Like most dog lovers, I didn’t like the side effects, though. But now I get why Dr. Dressler was so, let’s call it “stern,” when I told him that I wanted to stop cold turkey. He didn’t want her to go into shock over something small and die.

If you are looking at using pred with your dog, definitely read Dr. Powell’s article on dogcancerblog, which will be updated as time goes on if things change. It really does tell you even more than we were able to cover today. I think this is a must-read if you’re thinking of using this drug with your dog.

Links to that are in the show notes, which are in your podcast app or at DogCancerAnswers.com.

If you’re appreciating what we do here at Dog Cancer Answers, the best way you can support this free podcast for dog lovers facing dog cancer is to subscribe in the app of your choice and tell a friend or even your own veterinarian about the show. The more ratings, and reviews, and listens, and subscriptions we get, the easier it is for to be found by other dog lovers who really need this information.

And hey, if your personal veterinarian is like our other veterinary guests, maybe they should be on our show. Next time you see them, maybe plant the idea that they could be destined for greatness – or at least for a guest slot on our show. All they have to do is contact our producers via our website: DogCancerAnswers.com.

And those touch tones remind me to remind you that our veterinarians are “on-call” at our Listener Line. If you have a question for a dog cancer vet, please call our listener line and record your question. We will pose it to one of our veterinary experts (and as an experiment for just a limited time– we’ll email you the vet’s answer to your question as soon as we get it). After that, your question and the answer will appear on a future episode of Dog Cancer Answers. The telephone number Is 808-868-3200 or visit our website at DogCancerAnswers.com.

Let me take a moment to thank our sponsor: The Dog Cancer Survival Guide book by Demian Dressler and Sue Ettinger. The book is available wherever fine books are sold both online and in physical bookstores. And remember, if you would like to help support this podcast, get the book today– direct from the publisher, Maui Media. The website again: DogCancerBook.com and use the promo code “podcast” for 10% off. That is www.DogCancerBook.com.

Stay tuned to our podcast feed for the next episode of Dog Cancer Answers. And remember the best way to make sure you get it as soon as it is released is to subscribe in Apple Podcasts or on your favorite podcast app. We are also on Spotify and YouTube.
I would like to thank Dr. Tammy Powell for being our guest today.

Until next time, I am James Jacobson. From all of us here at Dog Cancer Answers, & Dog Podcast Network–I wish you and your dog a warm Aloha.

>> Announcer: Thank you for listening to Dog Cancer Answers. If you’d like to connect, please visit our website at DogCancerAnswers.com or call our Listener Line at 808-868-3200.

And here’s a friendly reminder that you probably already know: this podcast is provided for informational and educational purposes only. It’s not meant to take the place of the advice you receive from your dog’s veterinarian. Only veterinarians who examine your dog can give you veterinary advice or diagnose your dog’s medical condition. Your reliance on the information you hear on this podcast is solely at your own risk. If your dog has a specific health problem, contact your veterinarian.

Also, please keep in mind that veterinary information can change rapidly. Therefore, some information may be out of date.

Dog Cancer Answers is a presentation of Maui Media in association with Dog Podcast Network.


Library Archive

Dr. Gail Mason, DVM, MA, DACVIMKathi L. Smith, RVT

Mast cell tumors (MCTs) are fairly common tumors in dogs. They are most frequently found in the superficial layers of the skin, on any part of the body. Frequently, there will be ulceration over the area of the tumor, and the dog may scratch or bite at the affected area. The appearance of the tumor does not reveal its potential for spread or recurrence with any certainty. The tumors are usually singular, but dogs may present with multiple nodules, or recurrent ones. Some nodules occasionally enlarge and then regress in size on their own, due to swelling within the tumor itself. This should always raise the suspicion of the presence of an MCT.

Diagnosis of Mast Cell Tumors

Mast cell tumors do not have a specific appearance. However, they are fairly easily detected by a "needle aspirate and cytology." Insertion of a small needle into the tumor (virtually painless) area is followed by examination of the cells under a microscope. Mast cells are large, round cells that usually have dark granules in them. The granules contain substances which, when released, cause swelling, itching, and redness. Infrequently, when a large number of granules spontaneously discharge their chemical contents into the bloodstream, vomiting, stomach ulcers, shock and even death may result.

Mast Cell Tumor Staging

Mast cell tumors can be somewhat unpredictable in their behavior, relative to other types of tumors in dogs. Because of this, care is taken to "grade" the tumors that are discovered. The grade reflects the degree to which the malignant mast cells differ from normal, non-malignant mast cells. The stage can generally be correlated with tumor behavior, tumor recurrence, and survival of the patient. Mast cell tumors affecting the limbs, head, or neck tend to correlate with a more favorable prognosis than those found on the trunk or groin. Multiple mast cell tumors or those exhibiting rapid growth tend to have a more guarded prognosis. A pathologist determines the tissue grade of the tumor after the tumor is biopsied or removed.

*Grade I: well-differentiated-25% recurrence rate post-surgery

*Grade II: moderately differentiated-44% recurrence rate post-surgery

*Grade III: poorly differentiated-76% recurrence rate post-surgery

Treatment for Mast Cell Tumors

Treatment for mast cell tumors may involve surgery (the mainstay), chemotherapy, and/or radiation therapy. Recommendations for treatment are based on the type and grade of the tumor, surgical feasibility, and the presence or absence of spread (dissemination) of malignant mast cells throughout the body. Your veterinarian will usually submit blood tests and request abdominal ultrasound or radiographs (x-rays) to determine the likelihood of malignant mast cells elsewhere in the dog's body. Bone marrow biopsies are no longer routinely done, as they have not shown to have high predictive value for tumor staging.

Surgery
For single mast cell tumors, a surgical procedure known as a "wide resection" by an experienced surgeon is performed. This means aggressively excavating the tumor and surrounding tissues so that at least 2-3 cm of normal tissue in all directions is removed. This must include a "deep margin" which involves removing tissue below the tumor. The margins of the removed tissue are marked and examined by a pathologist to determine the presence of any lingering malignant cells. If negative, we refer to it as "clean margins". If the pathologist suspects the presence of mast cells in the remaining tissues of the surgery site, we refer to it as "dirty margins". If the remaining, malignant cells are less than 2 cm from the edge of the biopsy specimen, it is referred to as "close margins".

An aggressive surgery early in the course of mast cell tumor disease is associated with the best overall prognosis. A grade I or II tumor that has been completely removed usually requires no other immediate therapy. A grade III tumor, multiple tumors, recurrent tumors, or tumors with dirty margins (those which for anatomical reasons could not be subjected to further surgery) often require follow-up or "adjunct" therapy.

Radiation Therapy
Radiation therapy is an option for dogs whose mast cells tumors are localized, but too large for a clean resection or in an area difficult to resect such as tissues of the facial region, or as follow-up therapy for tumors with dirty margins. Dogs tolerate radiation therapy well, and it can offer long-term control for these tumors. Radiation therapy would not be appropriate for dogs with multiple tumors or those with evidence of disease throughout the body since the radiation beam treats only a single focus of disease. Radiation treatment can be accessed at New England Veterinary Oncology Group (NEVOG) in Waltham MA., Angell Memorial Animal Hospital in Boston, MA. and Tufts University School of Veterinary Medicine in Grafton, MA. This is a highly specialized form of therapy and we are pleased to refer your pet to these centers if need arises.

Chemoterapie
Chemotherapy denotes the administration of certain anti-cancer drugs in order to delay/prevent tumor growth or spread. It may be used before or after surgery, or alone.

Prednisone (a cortisone) is the most commonly used drug for therapy of mast cell tumors. It is well tolerated by dogs and is usually employed for a minimum of six months. If no new tumors appear within that time, your doctor may wean your dog off the prednisone completely. The side effects of prednisone include weight gain, increased appetite and thirst, bladder or skin infections, and panting. Occasionally, stomach irritation or ulcers can occur, or inflammation of the pancreas. Most of the time, the drug dose can be titrated to the patient to minimize any overt symptoms. If the tumor type is determined to be aggressive, additional drugs such as stomach protectants may be prescribed to guard against untoward tumor effects. By itself, prednisone is considered to have only mild anti-cancer effects on MCTS.

Chlorambucil Protocol
If your pet is deemed to have an increased risk of tumor recurrence, we may recommend combination oral therapy with prednisone and chlorambucil (Leukeran¨). Chlorambucil is a chemotherapy drug that is extremely well tolerated in most patients and yet offers more tumor protection than prednisone alone. This drug is usually administered twice weekly and requires that your pet be monitored at least every 6-8 weeks. The minimum treatment period is 6 months.

Vinblastine Protocol
For recurrent or multiple tumors, and for those tumors that cannot be surgically removed, combination chemotherapy can be effective in controlling tumor growth and spread for weeks to months or more. A cure per se is generally not realistic, but many dogs tolerate therapy extremely well. The six-month protocol involves:

Prednisone: high dose at first, then taper over 4 months
Vinblastine: an outpatient injection, given once every 21 days
Cyclophosphamide (Cytoxan¨): an oral chemotherapy drug, given by the owners on days 8,9,10, and 11 of a 21-day cycle.

This protocol has produced a 1 and 2 year survival rate for grade 2 tumors of 91%. For patients with grade 3 tumors, the 1-year survival rate is 66%.

Newe-effekte
The side effects of prednisone are discussed above. Vinblastine and Cytoxan have the ability to cause nausea and or vomiting, though this is not usual. The most important possible side effects are lowering the body's defenses so that infections occurs, or (rarely) causing many mast cells to release their contents at once. Both situations can be life threatening. However, these are NOT common, and the risk of these is significantly lower than the risk of untreated mast cell disease. You will be given instructions on what to do if any side effects occur, so do not hesitate to contact us.

Lomustine (CeeNu¨)
CeeNu is a potent oral chemotherapy drug that can be used once every three weeks in patients who MCTs have become resistant to other treatments. It is very well tolerated in general. However, because it can increase the risk of infection (especially seven days after it is given), any noted fever, depression, weakness, or refusal to eat should be reported to us or your veterinarian, or an emergency hospital immediately. Infection is almost always completely reversible. This drug is more potent than Cytoxan¨ and maybe substituted for it if indicated. Occasionally, this drug may decrease patient blood cell counts, which requires a dose reduction or discontinuance.

Prognosis
The factors that are known to influence patient outcome are grade of tumor (I is best, III is most dangerous), completeness of surgical removal (clean margins), and tumor location. Dogs with high-grade tumors, multiple or recurrent tumors, or evidence of spread to the bloodstream or other organs have a much more guarded prognosis for a lengthy survival.

Patient Monitoring
Close patient monitoring is essential in dogs with a history of mast cell tumors. As with many tumors, early detection and treatment increases the chances of successful treatment. You may be asked to have your dog examined and monitored every 6-8 weeks following surgery, or every 21 days during chemotherapy. Blood tests and/or needle aspirates are often requested to assess tumor control. Any time you suspect a new or recurrent tumor, or that your dog is physically ill, contact us immediately. We welcome the opportunity to help you and your dog in any manner we can.

Reference: Mast cell tumors in dogs In: Managing The Veterinary Cancer Patient Ogilvie, OK and Moore, As. © 1995 Veterinary Learning Systems. Trenton, NJ. *Based on protocol published by Elmslie, Robin published in the Veterinary Cancer Newsletter.


Prednisolone

Prednisolone can be used in any sick pet from cancer. Low doses can be used to reduce the inflammation associated with cancer and make sick pets feel clinically better within one to two days. Therefore, prednisolone can be used to decrease inflammation, swelling and discomfort associated with many cancers in pets (such as brain cancer).

For some cancers (such as lymphoma, leukaemia, mast cell tumours and multiple myeloma), high doses of prednisolone can potentially kill cancer cells (i.e. shrink the cancer). However, even if it works, the duration of response is often short-lived.

After a diagnosis, prednisolone can also be used to treat high blood calcium, which is a cancer-associated condition that can be life-threatening if left untreated.

Prednisolone can be used alone or in combination with many other anti-cancer treatments. However, it should not be administered concurrently with NSAIDs (such as piroxicam, firocoxib, carprofen, meloxicam), and it should not be administered on the same days as Palladia® (toceranib). Giving them together can cause life-threatening gastrointestinal ulceration.


Dog Lymphoma Management with Prednisone

Dog lymphoma is a cancer that may affect any area of the dog's body, and the disease has a rapid development. In some cases, the dog will have to undergo surgery, but sometimes surgery is not an option. Lymphoma may be managed with chemotherapy, radiation therapy and in some cases with prednisone. Prednisone is prescribed if the dog doesn't respond well to chemo or if the owner can't afford the costs of chemo. Prednisone cannot cure dog lymphoma and won't help the dog live a longer life with cancer, but it will improve the dog's life quality.


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