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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….

4 Responses to “Dog Blog: Living with canine cancer (5)”

  1. Bev said

    I am so please that its not cancer. I would urge your vet to check the ulcer is not an Eosinophilic granuloma, a type of auto immune disease.
    I had two cavalier king charles spaniels that got this, unfortunatly because it is so rare in dogs vets just do not think about it as a diagnosis or to check for it, so my first dog we had to have put to sleep after a year as by then he was really suffering. he was only 4 years old.
    A year later my other one went down with it, and finally after 8 months they took a biopsey of it and it came back that is what it was. There are treatments out there, (not cures) that can help. Part of that treatment can to be to hit it hard with steroids along with some other drugs. Unfortunatly it had spread to far for my second dog and 4 months into the treatment we lost her too age 7 years.
    This type of autoimmune disease attacks the soft tissue and does slowly or sometimes rapidly spread.
    Can you tell me exactly what symptoms Lou had that led you to find the ulcer please as my two seemed to get tired quickly, and do an awful lot of reverse sneezing daily, when it got really bad they were having trouble even eating soft food.
    Unfortunatly vets are not recording the problem in dogs, I think there are only a handful of recorded cases. I done a lot of research afterwards and found it could be more common than is thought, its just not being recognised by vets because its not being recorded.
    Its common in cats and is often called (Rodent Ulcer) but seems to affect them differently and they can cope with it better.

  2. indigodream said

    Hi Bev

    Thanks for your detailed comment – which I have published so that other readers may benefit from the information – I’m sorry to hear about your dog trouble – auto-immune diseases are very tricky things to manage and heartbreaking to lose them so young.

    Lou’s ulcer is 99.999% caused by the side-effects of radiotherapy and chemotherapy – she’s been having intensive treatment for lymphoma in her throat/neck which has left her with inflammation which I hope we’ll be able to control with antibiotics and steroids (which she’s on as part of her chemotherapy). Lou’s story is a long one one, but we have no reason to suspect an auto-immune problem at the moment – though I will keep it in mind…

    Thanks again

    Sue

  3. Amy said

    Glad to hear that there’s a bit of good news for Lou.

    Regarding academic papers on the medical issues you described which are behind paywalls, I’d be happy to use my university ID to access and download them for you, if you send me the links. 🙂

  4. indigodream said

    Hi Amy

    Thanks for the offer of downloading articles – I may be in touch!

    In all fairness, I can get hold of most things via the Royal Pharmaceutical Society for myself, but I can’t always get the links to the blog to work so that I can share with others.

    Regards

    Sue

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