Mirtazapine for Dog Cancer
By · CommentsDear Dog Lovers,
A newer drug is being used frequently lately, and I would like to make sure everyone dealing with a canine cancer diagnosis has heard of it. This medication may help some dogs out there, so let’s keep everyone up to date.
The drug is mirtazapine, also called Remeron.
The medication is a very effective appetite stimulant. This is particularly useful in cases of canine cancer, especially if either chemotherapy or the cancer itself is causing a loss of appetite.
On top of this, it helps with nausea and vomiting, and helps block spasm of the muscular wall of the stomach and intestine. This is useful as it not only improves nutrition by keeping food down, but on top of that, alleviation of vomiting is a major life quality positive.
But there’s more. Mirtazapine has a neat little antihistamine effect. Dogs with mast cell tumor cells in the body often have histamine excess, since the tumor cells secrete histamine. Too much histamine is not good for the body, causing swelling, redness, discomfort, nausea, vomiting, loss of appetite, and even low blood pressure. This makes mirtazapine very well suited for some dogs with mast cell tumors.
Finally, this medication is an antidepressant. Although there is little talk of canine depression’s link to cancer, there are some documented links in human medicine. In my opinion, the same reasoning may be applied to dogs, being sentient beings with happiness and sorrows like ours.
Mirtazapine was originally designed and intended for use in people for its antidepressant effect. However, in veterinary cancer care, we take advantage of mirtazapine’s effects on fighting nausea and helping with appetite. The effects on mood and anxiety are a bonus!
Mirtazapine works by increasing two chemicals in the body, serotonin and norepinephrine. A few other drugs also increase the levels of serotonin in the body. If these effects add up, a reaction can occur. Some other drugs that may significantly increase serotinin levels are Prozac (fluoxetine), Anipryl (selegeline), and Elavil (amitriptyline). You should double check with your veterinarian if your dog is on these drugs already, and you have a prescription for mirtazapine.
For more information on topics like this, check out The Dog Cancer Survival Guide.
Best,
Dr D
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.
Dog Cancer Tests: Blood, Urine and More?
By · CommentsHealthy dogs should have early detection cancer screens. The reason for this is that veterinarians often fail to eradicate cancer in a given dog. The fact that cancer is the single number one cause of dog death should make this clear.
If you have a dog of about 10 years of age or more, statistics show that this dog will have a 40-50% chance of dying of cancer. This is scary data!!
The problem is that we (veterinarians like myself) are lagging behind in our recommendations. By the time a dog develops cancer to the point where there are visible signs, we are often too late to do anything of benefit using conventional veterinary care.
Certain breeds are more at risk for cancers than others. Common examples that come to mind are the Golden Retriever, Rottweiler, Scottish Terrier, Boxer, Mastiff, Burnese Mountain Dog, Cocker, Labrador Retriever, Pug, Sharpei, Greyhound, Flat Coated Retriever, Chow, Collie, Irish Wolfhound, and American Bulldog, just to name a few.
Mixed breed dogs, as well as other breeds, get cancer too.
We really need to get involved doing early cancer screening. Sadly, blood testing for dog cancers is way behind that of human medicine. There is, however, a lymphoma test put out by Pet Screen which is a good quality test that would be worth considering in older dogs prone to lymphoma like the Golden, Cocker, Lab, or Boxer. Veterinarians and dog lovers need to team up to make sure the test results are interpreted accurately. Talk to your vet about getting new information on this new technology.
Scotties are 18 times prone to transitional cell carcinoma than other breeds. Senior Scotties could benefit from a urine test called the Veterinary Bladder Tumor Antigen (v-TBA). Although this test is a bit tricky to interpret if positive, a negative test result is usually accurate and reliable. That means a negative v-TBA is usually real, but a positive v-TBA may be false.
We really should be using the ultrasound to check the abdomen of these at-risk dogs on a regular basis. This is a harmless tool that emits sound waves to produce an image. Most have seen ultrasound images of a developing child during pregnancy.
This tool can look at the liver, spleen, kidneys, bladder, prostate (in males), lymph nodes, and more. It is a great way to scan the inner world of a dog, giving information that neither a physical exam or an X-ray could.
General blood work and urine testing is a good idea in senior dogs to screen for overall health.
The Dog Cancer Survival Guide discusses these topics in more detail.
At this point in the development of our profession, it is high time we vets start pushing for early cancer detection. Don’t be afraid to bring this topic up to your veterinarian, and be your dog’s number one health advocate!
Best to all,
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.
Dog Prostate Cancer: Intraoperative Radiation
By · CommentsProstate cancer in the dog is very different from that in people. Not because the cancers themselves are that different, but because treatment success is different.
This has not been good news for our dogs. The success rates (due to surgical techniques, mainly) for dealing with human prostate cancer are much better than for dogs.
However those of you who are close to a veterinary school or referral center may be able to take advantage of radiation therapy for prostate cancers of different kinds. This can help, so read on.
One specific kind of radiation therapy is during an operation, where the prostate cancer is exposed surgically. This allows the beam to really contact the tumor. This treatment is called intraoperative radiation.
A study was done looking at this procedure and its success rates. Here is the abstract if you are interested.
What are the facts? As usual, we need these as a critical part of our treatment plan analysis.
Analyzing a treatment plan before starting, or upon re-assessment, is a major part of being your dog’s primary health advocate. This is a big topic in The Dog Cancer Survival Guide. Since there is no cure (yet) for cancer, there is no “correct” way to treat many cancers in dogs. Thus, we must gather and weigh information, including our own values and judgments.
About half the dogs receiving intraoperative radiation for the prostate cancer enjoyed a complete remission, which lasted about 6 months. In the world of Hard-To-Cure cancers, as tough as it is to accept, this is not that bad.
The complications of radiation in this area included inflammation of the colon (colitis), which occurs in a little over half the dogs. Roughly one fifth of the dogs that received pelvic radiation ended up with a hole in the colon (perforation). These numbers were taken from another study looking at radiation in the pelvic area (which is where the prostate gland lives).
This is pretty nasty, but the majority (about four out of five) dogs did not develop a hole in their colon. So the odds are still decent. You should also realize that many of the dogs in the safety study had a radiation potentiator (a special sponge with cisplatin in it) implanted at the surgery site, so these stats are not just for strict radiation only. This sponge usually helps increase survival times.
However, I will point out that a perforation of the colon would require a second surgery, and for many dog lovers dealing with this particular case that might be too much for their loved dogs. This should be considered.
Here is the study on these complications.
Since prostate cancer is a tough one, I hope that this information may help as a part of a Full Spectrum Approach to dog cancer.
Best,
Dr D
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.
Escaping Dog Cancer Days, part 2
By · CommentsIn the last post we looked at a challenging topic:
being happy and at the same time time coping with canine cancer.
Since so much of humanity’s attention is on the pursuit of this commodity (happiness), let’s spend a little more time on it. One of the previous points made was that it can seem like a betrayal to a loyal dog to allow ourselves the luxury of being happy during this life or death fight. However, after doing what you need to to experience what comes up, everyone wins if you can release ongoing sadness.
You will be a more effective advocate for your dog’s health. You competence will increase. You will change the mood and the environment in which your dog lives to make it a more healing one. You will help your dog, yourself, and others by letting go of chronic sadness.
The age-old saying, “Fake it until you make it,” although it is tired and worn out, is still good wisdom. In our context, this means using our own backbones (willpower) to literally create some happiness out of thin air.
An interesting article showed that smiling after a distressing experience is a positive coping mechanism. Sound corny? Well, I agree. However, I will say that if one deliberately smiles in the mornings using will power, and allow the feelings naturally arise from the expression, some very interesting positive effects are produced. If a person makes this a practice using willed repetition, the changes can be long lasting.
Simply smiling, for no apparent reason, can be a little salve for life’s abrasions. Try it for yourself if you are skeptical. But give it a real try. Fake smiles don’t work on others or on ourselves.
Having a hard time with that? Try making a deliberate effort to be around other people. Laughter is 36 times more likely to occur in the presence of someone else.
Don’t believe it? Well, for what it is worth, the same phenomenon occurs in a favorite of scientists, the rat.
Rats product a very high chirping noise that occurs during behaviors that appear to be playful, and not during times when they are showing more fear. They make these noises much more commonly in the presence of other rats than they do by themselves.
It has been found that there is a lot of overlap in brain circuitry when someone is experiencing happiness or sadness. That is, a lot of the brain’s activity is the same. So it makes sense to say, on a nuts and bolts level anyway, that happiness and sadness are not really opposites at all.
More importantly, the take home message is that you can feel happy while you are also feeling sad. Not only are you allowed to do it, it is wired into your hardware.
If you are intrigued by the possibilities this raises, you may want to read the first couple of chapters in The Dog Cancer Survival Guide.
Best to all,
Dr D
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.
Escaping Dog Cancer Days
By · CommentsMost, if not all of the readers of the Dog Cancer Blog have an interest in being happy.
Why not? Dealing with a dog cancer diagnosis can be the most challenging and daunting task faced in some one’s life. During this time it can be quite a struggle to be happy. The sadness, frustration and sinking feelings can overwhelm anyone.
On a basic level, you are reading this post because you would like to be more happy. Whether looking for data to help your dog or for any other reason, the bottom line is goal is happiness accrual. I could write about hemangiosarcoma, lymphosarcoma, or mast cell tumors.
But on a much deeper level, really the currency we are most interested in is happiness.
So let’s look at this subject in more detail, since it is, for all of us, centrally important. And for someone in the trenches of dog cancer, it is a topic that can be overshadowed by medication, prognosis, and quality of life considerations.
Many of us feel that happiness during the time we are helping a canine family member during cancer is not appropriate. It can feel like a betrayal to our loved dog. Be happy when our four legged companion is in a fight for life? Are you kidding?
No, it really seems like it is in poor taste to be laughing and smiling when your most loyal, trusted companion is struggling with a killing disease. How dare I suggest this? What is wrong with me? Am I totally insensitive and devoid of respect for the bond between beings?
Well, hang on a minute. Let’s back up and contemplate this. It is really wrong? How much does your ongoing sadness actually help your dog? How much does chronic sadness help you?
Dale Carnegie pointed out that some people will cling to emotions for prolonged periods, in some cases incapacitating themselves and those around them for years.
When is an acceptance and release of the sadness allowed?
Nobody is saying that one should not experience the trauma and sadness that is a natural reaction to one of life’s most overwhelming experiences. But, once the anguish has been experienced, how long are we to carry it around? That is the key point.
How long are we to hang on to the sadness?
Can we let it go even while our dear one is still in the fight for life?
I would like to reiterate a question: how much does your ongoing sadness help your dog?
Does it make you more competent? Does it make you more resourceful? Does it create an effect in your dog that is healing, restoring, calming, and reassuring?
I think after considering this question deliberately, the answer will surface. The answer is, of course, no.
Again, experience what is there in whatever way is natural for you. But will you allow chronic sadness to be a second disease that you and your dog must face together?
Perhaps allowing ourselves to more quickly experience happiness again, even while on the path of canine cancer, could help everyone involved, especially our dogs.
For more on techniques to increase feelings of happiness even while enduring canine cancer, you may be interested in The Dog Cancer Survival Guide.
Best to all,
Dr D
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.
