Maggie had her left rear leg amputated on September 7, 2006 due to a large mast cell tumor in her knee. The tumor could not be surgically removed from the leg. She was sent home the next day on the following medications (she weighed 17 lbs at time of discharge):
Fentanyl patch, 25 ug to remain in place on right rear leg for 3 days. Pain med.
Tramadol, 50 mg tabs. Give .25 tab every 8 to 12 hours (2 to 3 times a day) as needed for pain. I think we used 2 per day for a week and a half, then stared to taper down. She took at least one dose a day for 14 days. Pain med.
Clavamox, 250 mg tabs. Give 1 tab twice a day for six days. Antibiotic.
She had also been on the following for a week prior to surgery, and continued on until suture removal (14 days post amp):
Benadryl, 25 mg caps. Give 2 caps twice a day. Standard supplemental med when dealing with mast cell cancer.
Pepcid AC, 10 mg tabs. Give 1 tab once a day. Standard supplemental med when dealing with mast cell cancer.
At this time the prognosis was good pending biopsy results, I was not expecting further treatment.
When the biopsy results came back her prognosis was down graded to fair, with a 6 to 9 month average survival time WITH chemo treatments. The official diagnosis reads “Mast cell cancer with regional lymph node metastasis”. Cancerous mast cells were found in the lymph node removed with the leg.
Maggie’s chemo treatments started on September 21st, two weeks after her amputation. Her last chemo treatment was on March 1st 2007.
The mast cell tumor protocol used by our vet was a combination of two drugs, with a scheduled treatment every two weeks, the drugs were alternated each treatment. There was a total of 14 treatments, 7 of each drug. The two drugs used were CCNU or Lomustine, an oral drug, and Vinblastine, an IV drug.
Mag spent the day at the oncology vet for each treatment. Prior to the CCNU treatment blood work completed was a CBC and comprehensive chemistry. Prior to the Vinblastine treatments blood work completed was a CBC. If she seemed nauseous between treatments or off in any way we completed blood work at our local vet during the ‘off’ week. Treatment had to be postponed once due to a low WBC.
The treatment stradegy was to start with low doses of each drug, and increase the dose with each subsequent treatment until she had a negative reaction. Then the dose was dropped back to the last value that did not cause a negative reaction, and that dose was continued for the remainder of the treatments. The negative reaction in each case was nausea. We never had vomiting or diarrhea. There was some tiredness or fatigue noticed about 7 days after each treatment.
In addition to chemo drugs Maggie was also perscribed:
Benadryl, 25 mg caps. Give one cap twice a day.
Pepcid AC, 10 mg tabs. Give one tab once a day.
Prednisolone, 5 mg tabs. Give one and one-half tabs once a day for two weeks, then one and one-half tabs once every other day throughout chemo treatment. Chemo was completed on March 1st. On March 29th we began to taper off of the pred. Her last dose was May 13th, a taper of about seven weeks.
We also had metoclopramide, 5 mg tabs. We were to give one-half tab every 8 hours as needed for vomiting or nausea. We only needed it a couple of times after the Vinblastine treatments.
During chemo treatment I kept a log of all meds given, her mood and energy level, her appetite, etc. I also had to monitor her temperature which I recorded in the log. This helped me keep track of which meds to give when, and gave me an overall view of her condition during treatment.