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Note: these dosages are for a dog of approximately 60 pounds
- Prednisone 40 mgm by mouth each day
- for 7 days. Later Prednisone 20 mgm by mouth every other day as long as tolerated by the dog.
- CEENU 80 mgm by mouth every three weeks (CEENU is also known as CCNU).
Click here for info on CCNU (Lomustine)
The Prednisone was started on 8-12-02, and the first dose of CEENU was given on 8-13-02.
Note: CEENU is a compound and we had trouble finding a pharmacy capable of preparing it. Dr. Kyle used the same pharmacy that compounds chemo for humans in Columbus.
This drug was studied in canines by the "Tufts University School of Veterinary Medicine. The study shows antitumor activity of CCNU against canine malignant lymphoma".
Wear gloves and a dust mask when opening the capsules for the dog. We gave the medicine to Cassie in a McDonald's hamburger and she ate it without blinking.
The vet must do a complete blood count and platelet count one week after the CCNU is given to determine whether the dose can be given the next time. Too much suppression requires that the dosage be held until counts come back up.
Note: This is not curative, but rather palliative. It does give the dog a fairly good quality of life. Decreased appetitie, diarrhea and fever are the side effects and from mild to severe degrees Cassie had all of them. We were able to control all the side effects with diet and medication though. She used a high nutrition, low fiber Science Diet prescription food. We used bananas, rice and applesauce plus a medication to decrease intestinal motility for the diarrhea.
Cassie was feeling surprisingly well after her first chemo round and the tumor in her groin shrunk about 75% allowing her a bit more freedom of movement. She seemed to be comfortable and was loving all the extra attention. She was still able to jump onto our bed so we could snuggle cuddle and she could rest in "luxury".
A month later she was still doing very well. We never really thought she would make it that long when she was first diagnosed. She didn't mind taking the chemo. Of course, we gave it to her in a McDonald's cheeseburger!!! She also continued on a hefty maintenance dose of Prednisone every other day. She was acting like a puppy again. The tumor in her groin that was the size of a baseball shrunk to a marble size within about 1-2 weeks of the first dose of chemo and she was able to once again jump and run without discomfort (which is important when you are Queen of the king size bed!!!). At that point we couldn't feel the tumor at all. She did have a difficult period of explosive diarrhea for about 2 weeks and had urinary accidents in the house twice due to the effects of the Prednisone, which we treated with yogurt and believe it or not, Metamucil and bananas. Why argue with success?
Cassie had a pretty frightening episode in October. She presented with severe malaise and abdominal cramping. We ended up in the vet on an emergency basis. She was infected with Clostridium. The Prednisone made her so susceptible to infection and it just overwhelmed her poor little body. She responded well to antibiotics and was hydrated well enough that they did not need to start I.V. fluids. She did lose l.5 pounds which she couldn't really afford. But she ate the puppy's food on the sly a couple of times so we hoped she would put on a little weight.
She experienced good and bad days, but on the whole, more good. She had so many good days, that I kept struggling to resign myself to the fact that she was going away soon. That pesky denial phase!
The Prednisone and an occasional Rimadyl seemed to control her pain adequately. She only needed the Rimadyl about once a week if that often. The CCNU made those tumors that restricted her movement shrink and that helped as well. She was, however developing the small nodules that are so common to the disease. They were on her skin but didn't seem to cause discomfort at that time.
Cassie's bloodwork always made me nervous and sometimes with good reason. In January bloodwork showed that her bone marrow was no longer producing lymphocytes and she has a value of "0" in her blood at that time. Apparently that was one potential side effect of the CCNU, the chemotherapy, she was on. My husband and I talked about quality of life issues and how we needed to try and make sure that we were not making the decision to euthanize at the wrong time. We needed to try to stay focused on what Cassie was feeling, not what we were feeling. I had a deep fear that our own love for her and the fear of letting go would cause her to suffer even a moment longer than necessary. As my husband summarized; we cannot make the right decision ... at the wrong time ...for the wrong reasons.......
On January 29,2003, I wrote the following: "Cassie is doing VERY well. She has not had bloodwork yet. I can't seem to bring myself to take her to the vet. She was due last Thursday. I suppose I will do it before the end of this week. She has been so active and happy. Very cuddly. We have had snow on the ground continually for the last two weeks or so. That is very unusual in this part of Ohio. We generally have ice storms which melt in a day or so. But the snow is Cassie's joy! She spent Saturday afternoon with Ron and Matthew playing the day away in her element. She literally rolled in the snow until she was soaking wet. But the smile never left her face. She is even eating much better. She has only had three episodes of vomiting and they were easily treated with an over the counter preparation. She has had only one half a pain pill in the last month. Perhaps it is the calm before the storm. If so, that is fine."
Only two days later Cassie had to be euthanized. She suddenly became quite ill. She was unable to eat or drink and developed numerous tumors overnight. She didn't appear to be in pain...the vet said that dehydration is a body's way of making us quite comfortable in the very last hours of life.
We spent our last minutes together. Loving and hugging, petting and kissing..........
Cassie was loved by: Maryanne, Ron, Missy and Matthew