Palladia info? side effects?

[EAO76]

I haven't seen this cancer drug discussed here lately. My vet has suggested we try it for Trucker's very aggressive spindle cell tumor. I'm thinking of trying it but I'm very concerned about side effects. Right now he is happy and full of life. We already decided against amputating his leg because we did not want to affect the quality of his life. Initially I thought we could try the palladia for a couple weeks and stop it if it seems to bother him but I have read about dogs that get so sick that they cannot recover even after discontinuing the drug. I'm not sure what to do. I feel like doing nothing (we tried surgery but the tumor grew back before his stitches were even out) is giving up on him but I don't want to load him full of poison that will make him sick either. I see him happy right now and don't want to take that from him but in a few weeks or months when the cancer really starts to take over will I regret not trying the treatment? And then it will be too late. If anyone can share their experience with this drug please let me know.

 

[Cami]

One of my clients with a Golden Retriever used Palladia for a grade 3 MCT which had metastasized. Prior to seeing an oncologist the tumor had been removed surgically and she was told that life expectancy was pretty short (if I remember correctly, it was a few months). I did post about it in a Palladia/MCT thread here on BW but can't find it.
She also had radiation and it was deemed not an appropriate treatment used in combination with the Palladia as there were complications as a direct result which required additional surgeries.
At any rate IMO (the owners too) felt the Palladia was a Godsend. It gave them MANY months, in fact I believe they got a year + and something makes me think it was closer to 18 months (I wish I could find that post).
She took Pepcid daily to ward off stomach upset (it worked) and they also gave her an OTC anti-diarrhea med daily (it also worked). A few months into treatment her hair coloring, especially around her face changed. She was a pretty deep red Golden to start and she lost some of the intensity of the red almost giving her a pink-ish color. I would never have thought pink myself but this is what the owner always referred to her color as.
She literally NEVER slowed down from her original energy level, ate well and personality remained the same. Even with all of the additional issues she fought which happened from the radiation being added she was a trooper.
The Palladia did require many trips back to the oncologist for check-ups and blood work and I know it was expensive.
The oncologist she went to was the same one Cami was treated by and I asked about using it for Cami (prior to the Golden) and she refused to give it to her. I don't know if it was because it would be considered overkill for grades 1 & 2 or if it was because she knew something I didn't (she was involved in the development of the drug). It was also still in trials at the time but she was doing the trials and had easy access to it.

I know how it feels to think we are not doing everything in our power to help them when they continue to fight such gallant battles and I also understand all too well how it feels to not know the right answer to make.

I just remembered that there was a point during treatment that the Palladia was discontinued for a short while (less than a month and it may have been just a week or so). No symptoms from stopping nor when restarting.
This isn't 2nd hand knowledge but my actual experience with her. I cared for her almost on a daily basis to administer the drugs while the owner was working or out of town.

 

[Independence]

We used Palladia in 2009 when it was still in the trial phase. Looks like most if my original thread is missing.

This is a thread from another forum I use, i hope it works.

My Indy-Bug - Southern Maryland Community Forums

There are side effects from the drug. They vary depending on the dog and dosage. I know they gave my boy a couple of weeks to live (MCT Grade 3 with lymphnode involvement, prognosis GRAVE). Indy did amazingly well on the Palladia. I honestly think if we could have gotten the medication when he was initally diagosed he would have lived even longer. We went proactive and got mediciation for nausea and diarrhea. We also gave benadryl for the MCT. Indy was tested once a week for the white blood cell count. The dosage of the Palladia was adjusted depending on the results.

That being said, Indy was happy and other than a large tumor in his face, looked healthy right up to the end.

I am sorry you are going thru this. Cancer just SUCKS!!

If you have any questions, I'll help if I can.

 

[Sansal]

Can your vet provide you with information about studies that have been done with this drug on dogs in a situation similar to Truckers? I just did a quick search on google scholar and did find some articles about palladia use but none that dealt with spindle cell tumors specifically (I only scanned the entries quickly, though).
Sometimes when we make those decisions I think we also have to trust our intuition. I am glad to hear that Trucker is doing well so far

 

[EAO76]

Thanks for the responses. I'd love to know why the oncologist would not give it to Cami. I read through that entire thread about Indy. So heartbreaking. I still don't know what to do. I called the vet today to order two weeks worth of Palladia and I got disconnected. I wonder if that was a "sign"? I know thats silly but??? Trucker's tumor is huge and literally grows daily. I just don't see how anything will be able to stop that monster. Its about the size of my fist or an apple. It started out shaped like a football but beginning last week he started getting these weird irregular edges around it like there are MM's or frozen peas in there. He has been on Piroxicam (an NSAID that is used to treat some cancers in dogs ) and he already has loose stools because of that. I can only imagine what adding the Palladia would do. The vet wants to alternate Piroxicam one day then Palladia the next. Lisa do you remember what dose Indy was on? In regards to Santina's post his tumor can also be called a soft tissue sarcoma, fibrosarcoma, or a nerve sheath tumor. But your right I have not seen too much info on Palladia's effect on this type of tumor. My vet is not an oncologist but she is consulting with one who is directing the treatment. According to the oncologist they are finding that Padillia is helpful for treating all sorts of tumors besides MCT's (what it was originally developed for).

 

[EAO76]

I have another question...do you think I tried it for two weeks that would be long enough to know if it was working/ see results?

 

[Independence]

I would have to go back and look at Indy's paperwork for the dosages. The dosage changed weekly depending on his white blood cell count. At the time Indy was taking the Palladia it was only being used on MCT's. I can only tell you my experience and that we saw an immediate response to the medication. I would hope it would be the same for Trucker's tumor. On top of the Palladia we gave Indy benadryl twice a day, a pepcid/zantac once a day, flagyl and metrodiazonal as perscribed. (I got the last 2 at the pharmacy not from the vet). That cocktail of meds helped with stomach upset, nausea and the runs. I actually think Indy ate better while he was taking all those meds. We also used prednisone and baytril to help with the lymphode/tumor swelling and infection from the tumor on his face. Gosh, looking back now, I'm not sure how he took all those pills everyday. The pill pockets were a lifesaver. He thought the were just treats.

Also, I'ms sure they will tell you but make sure you do not have skin cotact with the Palladia. Use glove to administer.

Know whatever decision you make it is yours and you know what is best for Trucker. We can help however you need.

 

[Sansal]

I looked some more on google. The best document I could find summarizes some of the studies that have been done.... (cancer article starts p 29, p 32 to read about palladia and MCT, palladia and non-MCT patients starts p 38)
http://www.avsg.net/documents/WWTSClean.pdf
Not sure if it will be helpful at all to make a decision for Trucker but at least it gives you some numbers in terms of outcomes and adverse effects experienced. It's from 2010, so I'm sure there is some new evidence out there that is not mentioned in this article.
Also, and you might know this already, you have to be very careful when handling the drug/excretions (gloves, hand washing, never crush the tablets, dispose poop in sealed plastic bags), especially because you are pregnant.
Even if you don't see a lot of results after 2 weeks I think you might at least be able to tell how well Trucker is doing in terms of side effects/adverse effects. Not an easy decision that's for sure.
Sending you lots of (((positive vibes))).

 

[Cami]

Found additional info for you. It is a lot to digest. I quoted a snippet from the first link concerning other types of cancers/tumors in which Palladia showed promise. It doesn't look like the link is allowed here on BW so I am including things from the article that seem important as well.

Other types of tumors which have demonstrated response to Palladia include anal sac adenocarcinomas, metastatic osteosarcomas, thyroid carcinomas, nasal carcinomas, melanomas, squamous cell carcinomas, multiple myeloma and transitional cell carcinomas.

All dogs should have a baseline CBC, chemistry profile, urinalysis and fecal occult blood prior to starting Palladia. Owners must observe carefully for loose stools, anorexia or lethargy. For dogs that develop diarrhea, loperamide is used SID/BID and continued during therapy. For dogs with decreased appetite, add canned food to the diet and use metoclopramide, ondansetron or Cerenia.

Dogs are rechecked weekly with CBC and hemoccults for the first 2-4 weeks and body weight should be monitored very closely. It is then recommended to monitor at least monthly with hemoccult, CBC and chemistry panels. Neutropenia can occur but is tolerable as long as neutrophils stay above 1500. If they are lower than 1500, a drug holiday is recommended until the neutrophil count is normal, then the dose is modified. The same holds true for muscle cramping and lameness, an occasionally reported side effect of the drug. Newly reported side effects are elevations in ALT and ALP, protein-losing nephropathy, hypertension and pancreatitis.

It is usually recommended to give Palladia for 30 days to see the full response but some responses are dramatic and seen in the first 7 days. It is unknown how long to treat dogs who are having a good response but many will have their disease recur if Palladia is discontinued. If they are tolerating the drug well, it is currently recommended to keep them on the drug on a M/W/F basis indefinitely.

http://www.palladia-pi.com/Palladia_PI.pdf

I see Palladia being talked about quite often on the yahoo cancer group. It might not hurt to join the list at least to read the previous posts about its use?

 

[EAO76]

Thanks for the links. They both worked and were helpful. There still is very little mention of Padillia & Trucker's specific type of cancer. Ironically I have found much more mention of Padillia's affect on Anal Gland Carcinoma which is the type of cancer that our other dog Fluffy currently has. But I assume because Fluffy's tumor had already spread and because she also has liver disease & cushings disease she is not a good candidate. Anyhow I just keep coming across more & more horror stories not only about all the usual stuff (stomach upset, stops eating, etc) but also abut it causing high blood pressure, kidney failure, major infections, etc. My head tells me to just let him be...let him be happy and enjoy whatever time he has (especially since there is not a lot of evidence that the treatment will even work). But the guilt associated with that decision is HUGE. How can I look at him and do nothing?

I did find this one anecdotal piece of evidence as a comment on a vet blog that gave me hope...

I read with interest your post on Palladia; having had a dog who was on it, it peaked my interest. I realize that the numbers are not overwhelming for Palladia’s life-saving abilities, but I do not believe that this – or any chemotherapy – is necessarily intended to be a cure. If looking at the potential for extension of quality life, Palladia can be a worthwhile endeavor – especially if given at slightly under recommended dosage to limit side effects (I think that the doses are not refined yet, especially since it is still relatively new to the canine market). I have an elderly Irish Setter, diagnosed with sarcoma (for which radical surgery was advised, but his CHF and IVC obstruction from a carcinoma prevented that). So, we tried Palladia for a 2.5 weeks at a dose somewhat lower than recommended. We stopped because he was having some GI issues, and our promise is that we would not do anything to worsen his quality of life…so we stopped it. But, in the second week of treatment, the tumor had shrunk by about 5%, upon entering the 3rd week it had shrunk more, and – even after stopping the therapy – the tumor continued to steadily shrink. It finally nearly resolved – and has been that way for about 3 months. Now, it may recur, but in the meantime, he has lived another 3 months of high quality, happy life, unencumbered by what would have been surely a horrible cancer (it was growing so quickly and already interfering with comfort and ambulation!). I know he is but one dog, and the studies bespeak statistics involving hundreds (and only for mast cell tumors). But, I have was extremely impressed by the response and, thus, the potential of what it can offer in terms of extension of quality of life (ever mindful that one must cease the therapy if major side effects occur, as the whole quality of life thing can go out the window if one doesn’t; and, I realize the side effects can be pretty nasty with Palladia, like with any antineoplastic). All these antineoplastic are a horror, when you think about it – but Palladia might give some dogs a few more happy comfortable days (and not just for mast cell tumors).