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Archive for August 10th, 2012

Dog Blog: Living with canine cancer (5)

Posted by indigodream on 10 August, 2012

Friday 10th August 2012

I got the results of Lou’s latest tests this morning – there is some VERY GOOD news – the big patch of inflammation at the back of her throat is NOT cancer – despite the vets telling me that it couldn’t possibly be malignant, I confess that I didn’t quite believe them.

The vet says that the test confirm that Lou, basically, had the equivalent of a huge mouth ulcer at the back of her throat – he feels that it is manageable but the question is “how”….

They did culture some MRSA – not a huge bacterial load, but it may just be enough to prevent healing. The other factor co consider is the dose of her steroids – she’s been on quite a high dose to reduce inflammation, but now we may need to reduce the dose in case the steroid is contributing to the ulceration and poor healing. But it may not be possible to withdraw the steroid completely – it is a VITAL part of her chemotherapy.

It is a bit confusing, the MRSA in her throat is, in vitro (lit. ‘in glass’ i.e. in the laboratory), resistant to everything apart from a group of antibiotics called Tetracyclines; but the vets, generally, don’t rate them as antibiotic because they are bacteristatic (slow/prevent bacterial growth) as opposed to bactericidal (kill bacteria).

So our vet has decided to stick with an antibiotic called Veraflox (pradofloxacin) – the MRSA is resistant to this in vitro, but he thinks that it will work in vivo (i.e. in life) because its one of the antibiotics that worked before. But it’s not – the antibiotic that finally knocked the last bout of MRSA on the head was Duphatrim (to which the MRSA in her foot was sensitive in vitro). I took this up with Lou’s vet (I bet he’s glad he’s going on holiday!) but he came back with the backwards argument that as the current MRSA was also resistant to Duphatrim in vitro he’s prefer to stick with the Veraflox. To be honest, I’m a more than a bit sceptical about his reasoning but I’ll go with it for now – even though Veraflox costs an eye-watering amount of money….

It’s very strange, but I’m not whooping with joy, yet I should be – good news has been hard to come by recently. But I think I’ve got so used to bad news that I don’t know quite how to ‘lift’ myself – I will have to practice!

I’m not a fan of complementary therapies – I think that there is not enough proper scientific evidence of their efficacy/safety and I believe that the anecdotal evidence tends to over-report the benefits and under-estimate the harms. However I do respect the people who have suggested carious remedies – I know that you’re trying to help us through a difficult time. I take suggestions seriously but I am a pharmacist so I use my access to medical databases (though not necessarily veterinary medicine) to investigate the available evidence base for complementary therapies – particularly herbal remedies, that can interact significantly with conventional therapies.

So, here are  my brief findings on  two remedies that have been suggested:

Manuka Honey to ease Lou’s throat and help to fight infection – interesting to note that the NHS does not recommend using honey bought over-the-counter for home wound healing – it needs to be medical grade, which has been highly purified. Nonetheless I will use my home-made honey linctus as it will at least be soothing and won’t be in contact with Lou’s throat for a very long time – unlike honey applied to open wounds: http://www.nhs.uk/news/2011/04April/Pages/manuka-honey-mrsa-superbug-bacteria.aspx4

Devil’s Claw to ease Lou’s arthritis/muscle pain: I have looked this up, but most of the articles that I found were member/subscriber only so I can’t link to them – though there is this letter to the BMJ. However I will not be using Devil’s Claw for Lou – there is some evidence to show that it affects liver enzymes so might interact with other drugs that are metabolised by the liver. Devil’s claw may als0 exacerbate gastrointestinal bleeding if taken with non-steroidal or steroidal drugs (they increase the risk of gastrointestinal bleeding just by themselves). Lou is on such a cocktail for her chemotherapy I daren’t risk an interaction on top of all her other problems….

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