Chemotherapy toxicity in dog cancer: Acetyl-L-Carnitine (ALC)
ByChemotherapy agents are used to help slow the growth of tumors, improve life quality, and decrease tumor spread in dogs. Although the doses used are less than in humans, toxicity of chemo drugs is still a concern.
The big problem is that things that decrease toxicity of the chemo drugs often will decrease the effectiveness of those drugs as well. So we end up with an overall neutralization of the chemo drug effects, both good and bad.
One contender I’ve come across to help with chemo toxicity, and possibly with no reduction in chemo effect, is Acetyl-L-Carnitine.
This amino acid derivative was shown to reduce the nerve toxicity effects seen with platinum compounds. The platinum compounds used in dogs are cisplatin and carboplatin, usually for osteosarcoma (bone tumors), transmissible venereal tumor, and mast cell tumors.
The nice thing was that, at least in rats receiving cisplatin, the Acetyl-L-Carnitine did not interfere with the effectiveness of the cisplatin. Read more here. And here.
Doxorubicin (Adriamycin) can cause irreversible injury to the heart. This drug is used often with lymphosarcoma, hemangiosarcoma, other sarcomas, and carcinomas. There is some new evidence that ALC is able to block this effect. Here is the paper for your reference.
According to the University of Maryland, this effect may occur without decreasing the effectiveness of the doxorubicin (scroll down to the bottom of this link). Another study showed that there was a reversal of heart toxicity due to doxorubicin in rats without decreasing its effectiveness using ALC.
Side effects are minimal in dogs. Some develop digestive upset (nausea, vomiting, diarrhea).
The lowest published dose is 1 gram twice daily.
As always, make sure you are in touch with your veterinarian and/or oncologist regarding any treatment plan in dog cancer, as the info here is not a recommendation for any individual, specific dog. Each animal needs to have its own case evaluation….
Hope this helps!!
Best,
Dr Dressler
About the Author
Dr. Demian Dressler, DVM is known as the "dog cancer vet" and is author of Dog Cancer Survival Guide: Beyond Surgery, Chemotherapy & Radiation. Visit his blog and sign up free to get the latest information about canine cancer. Go to http://DogCancerBlog.com.
11 Comments
December 17th, 2008 at 2:58 am
My 12 yr old dog started cancer treatment last March for lymphoma. Yesterday after being in remission for 4 months his cancer has come back. My husband and I want to do the right thing for him; which would be to retreat him, what are the chances of the lymphoma coming back again and are we making the right decision to retreat him. His health is good with the exception of the cancer returning.
Please help us make the right choice for our beloved pet.
Thanking you in advance,
Kathleen
P.S. we have to make the decision today (this a.m.)
December 18th, 2008 at 4:40 pm
Kathleen, I must be honest here and let you know that usually the “recapture” period is shorter than the first remission. Translation: it will most often come back faster the second time.
Please read the blog on life quality as well.
Regards,
D
January 13th, 2009 at 9:52 pm
Dr. Dressler-
Our dog Griffy was diagnosed with Lymphoma this past December. He has had four treatments on the Madison protocol and is up for Doxorubicin this coming Thursday. I am very concerned about the potential side effects of this drug, especially possible heart damage, and want to do everything I can to try prevent and/or alleviate them. Coenzyme Q10 has been recommended, but my wife has read about never using any antioxidants while a dog is being treated with chemo. Do you have any suggestions regarding this issue?
Patrick
January 19th, 2009 at 1:18 pm
My 12.5 year old Westie-Poo was diagnosed with a tumor growing over the bladder and actually has penetrated the wall of the bladder. The vet wanted to do a tissue biopsy and even try to remove the tumor. After the information of the treatment options, chemo to follow and of course the cost involved, I declined the surgery. Instead, the vet took a “fluid” biopsy with a scope and sent it to a lab. The report came back “inconclusive” likely because they didn’t have a tissue sample. This tumor/mass was detected three weeks after the first ultrasound was done due to a bladder infection. This tumor grew in just a span of three weeks! I love my dog, she is my baby. However, I am on a fixed income and the cost was way beyond my means.
The vet put my dog on Previcox 57mg and Amoxicillin 150mg. After a two week period, she recommended Piroxicam 2mg instead of Previcox. However, Abby cannot tolerate it and throws up on it. Tomorrow she has another ultrasound to view the bladder and determine if it has grown or (hopefully) not grown or metastasized. I printed out your report on the Doxycyline and will show this to my vet tomorrow. I have downloaded your coping guide DVDs as well as ordering the print out. Abby shows no signs of sickness, except the constant licking of the vulva area. Any suggestion Dr. Dressler that I may discuss with my vet?
I am not sure if you are familiar with Andrew Jones, DVM out of British Columbia, CANADA. I have been feeding Abby Dr. Jones’ Ultimate All In One Nutrition. This supplement powder has made such a difference in Abby’s digestion problems. I used to feed her Iams Low Residue until I found it contained Ethoxiquin, a known carcinogenic. I spoke to my vet and she didn’t know that Iams foods contained this preservative. Interestingly enough, when speaking with an Iams’ representative, they told me that they only use this preservative in the foods that are sold by vets, not over the counter. Andrew Jones, DVM says to “NEVER give your dog food that contains Ethoxyquin, or its two equally dangerous companion chemicals – BHA and BHT.” Abby is now on Royal Canin, HE. It has absolutely no preservatives in it. In my opinion, I believe that these preservatives are a leading cause of cancer in dogs.
January 19th, 2009 at 6:08 pm
Judith, sounds like a tough time for all. Discuss EGCG with your vet. There is a study that supports the idea that EGCG, from green tea, can lessen the amount of peroxicam needed and boost the blood levels of it.
Good luck!
D
February 12th, 2009 at 6:22 am
I’ve lost since 2004 two leos due to cancer, one mammary ca., mam.glands removed, she was fine for 18 months, than recidives and the cancer metastated (finally squameous cell ca.) – the other one died from liver-ca. and he was fine till the very last day; we tried to so an operation as we were not sure about the symptoms (could have as well been a ruptured spleen) – finally we found cancerous noddles on both liver parts – and so we had to let him go……… I am now mainly interested to AVOID – if any possible – cancer in my Leos and as well to be prepared for “alternative” methods in case it should happen to us. The breed is on medium risk for haemangiosarcoma, osteosarcom and females for mammary ca.
I did work in the medical field for several years and I am also a holistic animal therapeut (homeopathy, Bach Flower remedies, phytotherapy etc.), got the chance to do volunteer work on animal hospitals and I am always eager to learn more as cancer seems to be the #1 problem for humans and animals.
Thanks !
August 8th, 2009 at 6:34 pm
Greetings Dr. Dessler- What is the recommended dosage of acetyl-L-carntine? I haven’t been able to find the information on-line. Sorry, this note will be long, but my (million dollar!) dog’s medical history is pretty complicated. I have a 12 year old neutered male Weimaraner that has survived mast cell cancer for ~8 years. When he was 4 years old, he initially had 9 mast cell tumors pop at once (grade 3) and surgery to remove those, followed by cis-platin chemo. Another set of mast cell tumors cropped up soon thereafter and he had surgery and chemo again. He seemed to be getting more sensitive to the cis-platin and we stopped treatment because of his quality of life. A full year after his last cis-platin chemo treatment, he developed a bunch of necrotic tissue in his abdominal area, exactly in the area of the chemo injections. He had to have surgery to remove all the dead tissue. Over the years, he’s had some abdominal ultrasounds (he likes to eat random objects!) and other tests and, despite having the occasional mast cell tumors on his skin, he had no signs of organ involvement. We would get the mast cell tumors cut off as they showed up, but we eventually gave up on that as it didn’t make sense to make him go through more surgery. He even returned to work as a search and rescue dog and was seemingly healthy. (Well, and he also ended up needing a hip replacement, but he recovered well from that and again returned to work.) About 2 years ago (6 years post-treatment), we took him to the veterinary neurologist because of rear leg weakness. After extensive testing, they were unable to identify the problem and labeled it as “degenerative neuropathy”. (He’s even been tested for a genetic marker for degenerative myelopathy through a research program.) They didn’t think his neuropathy was due to the cis-platin. They did recommend that we supplement with CoQ10 and L-carnitine. (He’s also been on a quality food/high protein diet and taken fish oil.) We have been doing that everyday for the last few years. His leg weakness (and muscle atrophy) have, unfortunately, gotten progressively worse. I’m wondering if he’s getting enough L-carnitine and if there is any evidence it can help a long time after chemo treatment. (Wish we would have known of the potential problem during treatment.) Is there any evidence that the neuropathy problems can start many years after chemo treatment?
He seemed under the weather a few weekends ago. I took him in for a check-up (thinking maybe his thryoid med was off- his thyroid stopped working when he was 1 years old) and, sadly, it turns out he has lymphoma. He was staged a few weeks ago and he’s Stage IV. (Wow, it must move fast because he had barely palpable lymph nodes and then all external lymph nodes were clearly visible within 4 days.) His bone marrow came back clean. We started the vet oncologists chemo protocol for lymphoma (so far, one treatment of vincristine and Cytoxan and prednisone). Not sure how much more we want this brave guy to endure but, so far, he seems to not be as adversely affected by these chemo drugs as he was by the cis-platin. He’s been a great dog (saved over 10 people in his work) and we want to do the best for him. Of course, we’d love more time with him, but we do not want to cause him any more discomfort. Our plan is to see if he responds and if his quality of life declines, we will stop treatment. Any advice is greatly appreciated. Thank you!
August 11th, 2009 at 11:59 am
My little 10 yr. old westie also has bladder cancer (tcc). On July 31st. 2009 she had her first chemo (mitoxantrone) and they also dropped her piroxicam to.6ml from 1.0 its only been two weeks but she seems like she is losing ground with alot of blood in her urine. How do I decide to give her another treatment or to just make her comfortable until the end? Will this chemo cure her or just extend her life for a short time? I cant decide what to do, please help.
Margie and Sophie ( she was diagnosed in may)
September 24th, 2009 at 12:37 pm
I have a 12 yr. old bloodhound diagnosed with Lymphoma. We started chemo yesterday and she was throwing up today. We got an injection for her and will be giving her pills for her upset stomach. We were told that she has a 50/50 chance of making it one more year and 25% for 2 more years but no guarantees. The pricetag is approx. $8000. My question is this. Is it sensible to put her through therapy at this cost? She is our 3rd bloodhound, the other two only lived to age 8 so we are very please with Opal. She has been healthy her whole life which is another reason the vet said to go for it. Thank you for helping us with this decision and our beloved Opal. Oh and by the way, I lost my 10 year old corgi in June to Lymphoma and DM.
September 27th, 2009 at 7:36 am
Virginia,
this is a tough question. You really need to ask yourself what your personal feelings are to clarify it. Are you someone who really would rather not have your loved dog experience any side effects from treatment? How about some mild to moderate side effects? If you are comfortable with mild to moderate (some) side effects, you should give the chemo another try, perhaps with a modified chemo plan. If not, then perhaps life quality oriented treatments with minimal to no side effects would be best. I will talk about this question more in this month’s webinar if you want to tune in. It will be recorded so you can listen later (www.mydogvet.com).
Best
Dr D
January 30th, 2010 at 5:03 am
Hi Dr. Dressler,
I have a 12 yr old Blue Tick Coonhound “Bleu” that has been diagnosed with Transitional Cell Carcinoma (Bladder). He is otherwise very healthy and playful, and this is the first health issue in his 12 yrs.
We started him on Chemotherapy “Mitoxantrone” combined with Deramaxx. I also started him on K9 Immunity and Transfer Factor, and also wanted to start him on Omega 3,6,9 Fish Oil. Do you see any issues with giving him the Omega supplement along with the Chemo. Will it have any adverse reactions, or negative benefits?
Also, if you know of any other supplements, or treatments for this type of cancer, please let me know.
Thanks so much for the service you provide.
Have a great day!
~Mark