Why use stomach medication for mast cell tumors?
ByMany dog lovers are coping with a diagnosis of canine mast cell tumor. Just yesterday afternoon I was removing a very large one from the body wall of Big, a 10 year old, 105 pound, much-loved mixed breed.
The day before his surgery, Big started to throw up. He became quite sick, and would not eat. His tumor, which was about 5 inches in diameter, had started getting very painful, red and inflamed.
Luckily, tumor is now out and Big is on his way to happier days.
One of our strategies is to help Big with his nausea. I was explaining to his owner last night that the mast cells in the tumor secrete a substance called histamine, which is the same stuff that causes a bee sting to become red, swollen and painful.
These high histamine levels now in Big’s bloodstream cause the lining of the stomach to produce excess acid. When you have a belly full of acid, it feels awful and you may start vomiting.
So in dogs with any signs of decreased appetite, nausea (licking lips a lot, salivation), vomiting, or loss of energy with mast cell tumors, we always want to address this acid issue.
There are several approaches. We definitely want an antacid. Cimetidine (Tagamet) is a good choice, as this drug has not only antacid effects but also some nice, documented anti-cancer effects. Tagamet is available over the counter at most locations where non-prescription human medications are sold. Like many drugs we use in veterinary medicine, it is labeled for human use.
Fresh ginger is always a nice supplement to use in dogs with nausea, and has been shown in papers to help in human medicine with both anti-cancer effects and helping nausea. Many big-box grocery stores will carry ginger root, and some health food stores do as well.
Many clinicians advise famotidine (Pepcid), which has a good antacid effect, but no anticancer effects. You can get Pepcid AC over the counter at most places where non-prescription medications for people are sold.
In cases where there is no other option and the vomiting is very severe, a drug called Zofran (odansetron) can be used. It is rather expensive, and its use is on the new side. It does help though for cases where the stomach upset is really bad. It is a prescription medication.
If there is diarrhea, which reflects inflammation of the intestine (lower down the digestive tract than the stomach), misoprostel (Cytotec) should be considered. This drug stimulates the protective lining of the intestine and decreases inflammation of the intestinal wall. This is a prescription medication.
Slippery elm, which is from bark of the slippery elm tree, is a good supplement that can be added for diarrhea as well. It acts as a natural bandage, coating the lining of the intestine and helping soothe and heal. Slippery elm is available on-line and at health food stores.
Branched chain amino acids can also be added as a part of the arsenal. These supplement the other approaches by providing the building blocks to rebuild the lining of the intestine. Branched chain amino acids are available in health food stores and supplement outlets.
Probiotics can always be added to help a bit with diarrhea. A probiotic is a bacteria which helps restore the normal amounts of healthy bacteria in the intestine. We need these bacteria, and so do our dogs. These can be purchased at supplement outlets and health food stores.
Lastly, plain old liquid Pepto Bismol helps a lot with diarrhea as well, and is available over the counter too.
For more information and specifics on these items, you can find more details on dosage and use in The Dog Cancer Survival Guide and through discussions with your vet or oncologist.
All my 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.
27 Comments
September 22nd, 2009 at 4:45 pm
Hello Dr. D,
Thanks for all the useful information. I didn’t know that fresh ginger can be a nice supplement that can be used to ease dogs in nausea.
September 24th, 2009 at 4:34 am
Hello Dr. Dressler,
We have a boxer the we have been giving our dog Pepcid for awhile now because he will occasionally vomit when he drink a lot of water at once and he seems to get an upset stomach easily. He has had four mast cell tumors all which have been removed. They were all send off to Michigan State for c-kit testing. Three came back with a Kit staining pattern 1 and one came back as a Kit pattern 2. All were PCR negative. Now we are being told he needs to have chemo which I am fine with if it is necessary but he is only 4 years old and we can’t seem to get a really good reason as to why we should do the chemo. He is healthy now that the mast cell tumors are gone. I was just wondering what your thoughts would be. We give him krill oil and feed him Orijen 6 fresh fish with sea vegetables which seems like a good food. Do you have any syggestions for us that might help?
September 24th, 2009 at 7:06 am
Dear Dr. Dressler,
Thank you for this very informative and helpful information. I was treating my Boxer with an antiangiogenesis protocol that was very upsetting to his stomach. At the time, I used a generic form of Pepcid AC but am very thankful to know that cimetadine has anti-cancer benefits. Since Boxers seem to have sensitve stomachs from time to time, I will defiantely use this instead when needed.
Thanks again!
September 24th, 2009 at 2:12 pm
Since my dog is raw fed he dosent seem to be affected with the over production of acid when histamine releases with mass cell. Since Dannon is eating Raw foods I believe this helps to disperse the excess amounts of HCL that may be produced and the body uses it for digestion the way dogs are supposed. There food is digested in the stomach instead of the small intestine like canned and kibles are not the way nature intended it to be. Even with Neoplasene. NO vomitng no diarrhea no loss of appetite. So far so good. Next is angiostop, myomine and revivin for cancer apoptosis. This is the next rotation for treatment as well as DMSO mixed with sodium bicabonate as a poltis to rid the body of the external tumors. And yes it really works. Or it can be injected directly into the tumor especially if the sodium bicarb mixture is injected corectly. The tumor shrinks and disapears completly, typically in 6-9 days. These are alternative therapies that can help and rid the body of cancers.
September 24th, 2009 at 2:18 pm
Hello Dr. Dressler,
Our doggie had squammous cell carcinoma of the nasal septum. Dr Alice Villalobos, Oncologist, prescribed Reglan before each intra lessional treatment. Do you use this medication in your practice?
September 25th, 2009 at 8:06 am
I asked for this information several months ago when I had a Bichon with stomach cancer and didn’t get a reply. Thanks for nothing. My dog is dead and your information is 4 months to late. If you caught on fire I wouldn’t piss on you to put the fire out. Now you know how I really feel.
September 25th, 2009 at 9:46 am
Ron, I’m sorry for your loss, but I can’t imagine that it’s Dr. Dressler actually deserves the treatment you describe. Do you really think it’s his fault that your Bichon passed? I have read his book, implemented his recommendations, and while my Sweetie is not out of the woods, I can see that she is really helped. I also attend Dr. Dressler’s monthly teleseminar and get all of my questions asked. I don’t think it’s fair for you to assume that if you post on a blog where hundreds of others post, too, that Dr. Dressler can answer every question personally. Again, I’m sorry for your loss, because I know exactly how it feels (my Dusty passed last year from Mast Cell), but I think you’re letting your anger get in the way. I for one am thankful that Dr. Dressler’s information is here, now, to help my dog. The fact that I didn’t know about him last year doesn’t mean that he’s to blame for Dusty dying. I hope that eventually you find comfort, because I know how hard it is to lose a great dog.
September 27th, 2009 at 7:27 am
Kevin,
Reglan (metaclopramide) is a common medication used to control vomiting. Yes, I have used it. I will talk more about the treatments for nausea on the webinar this week (www.mydogvet.com), which will be recorded if you want to listen later. Thanks,
Dr D
September 27th, 2009 at 7:39 am
Thanks Carmen. Best of luck to you and your Boxer. You may be interested in this month’s webinar on mast cell tumors (www.mydogvet.com), which will be recorded.
Warm regards,
Dr D
September 27th, 2009 at 12:44 pm
thank you Dr Dressler for such a fine book. I purchased it while my Italian greyhound, Donny, was going through radiation treatment…boy I wish I could have read it BEFORE I decided so lightly to go through with the radiation! Your book explains everything so easily…my top oncologist did not
http://www.flickr.com/photos/louies/sets/72157616287244159/
my poor donny took over 4 months to heal from the horrible burns he received from the radiation. He had a delayed reaction to the treatment. Went through 17 rounds with no issues, no pain, no hairloss…………THEN bam! he was basically writhing in pain with burned skin UNDER his coat! the photos are horrific. The radiation doctors told me that what he had was a very rare reaction.
September 27th, 2009 at 12:45 pm
http://www.flickr.com/photos/louies/3917643720/in/set-72157616287244159/
my beautiful Donny today!
September 27th, 2009 at 1:04 pm
Yay!!!!!
Thanks for the useful input Christina. Good for Donny boy!
Best
Dr D
September 28th, 2009 at 1:52 am
Dear Dr dressler,
) it came back that the reocurrence of the mast cell was very low (sorry, don’t remember the terminology or #s) Based on the kit, the lab gave marcelino about 70 months before we would have to worry about cancer. No radiation was given and no chemo. NOW marcey has a second growth about 3 inches from the center of the first. It was so tiny, you could hardly see it but then it would grow to the size of a golf ball within an hour and then after a dose of benadryl, it would shrink again. This has been going on for 2 weeks and his surgery to remove it is set for tomorrow. We have not had it aspirated and now it is so tiny. I am opting for radical surgery and do not want to put marcey through 2 surgeries again because I know it has to be a mast cell again. Am i wrong? Should I just have it popped out, tested and THEN do the radical surgery given his history??? The last surgery was only a few months ago. i know my vet is aware of doeing with the benadryl during mast cell removal….but maybe some cells slipped by, causing this second tumor so quickly???
unfortunately I have a second Italian greyhound with mast cell cancer. While Donny was going through radiation, I found a tiny lump on marcelino’s side (under the shoulder) We had it taken out (it was too tiny to aspirate) My vet was concerned about the chance for it to ba a mast cell cancer because the lump rose and fell over and over for about a week.He told me about the Histamine they give off. He removed it and it turned out to be a mast cell grade 2. He got good clean margins but wanted to go back in a few days later and make even more of cleaned area because of what my other IG went through with him
needing radiation. We did the stain kit (he was the one who took it upon himself to send out for the stain
This dog also had oral resorptive lesions that took away ALL but one tooth before he was 3 years old. He is now 5 and only has one upper canine left. He is a rescued dog so i do not know his breeding history. He is a strong and healthy dog and is fed Dr Harvey diet since he was 5 months old. His teeth (when he had them) were brushed every day– that is why i noticed his teeth turning pink and caught the mouth disease so early. (I am teeth obsessed) He had 4 surgeries in 2 years as the teeth succumbed to the lesions.
I am petrified that my IG is full of cancer cells due to his immune issues…I do not vaccinate either.
http://www.flickr.com/photos/louies/3879092024/
this was his last tooth surgery——and his mast cell tumor is also on this same site.
christina
September 28th, 2009 at 7:40 am
I couldn’t attend the Webinar but I just finished listing to it. You addressed my question (Leslie Parker for some reason you got my first name and town name). Clear margins were not obtained because of the location. His tumor was in the axillary region and there were so many vital structures in that area. There is no evidence of spread at this time. My gut feeling was the same as yours, use everything, but I think that the holistic vet is concerned about long term effects of the Cytoxin. Do you think we should try again with surgery even though the location is risky. The original surgery was not done by the oncologist but in a large, progressive hospital. I just don’t know if the were conservative because they did not know what the tumor was or if the structures were truly the issue. The fine needle aspirate done presurgically was mostly blood with no definative diagnosis. The surgeon actually expected the tumor to be a different type. My dog currently shows no evidence of disease. He had had xray, ultrasounds, bloodwork and physical (palpation of area) exams.
October 6th, 2009 at 7:30 am
I have heard that mast cell tumors typically can spread to other areas of the body. My golden had a mast cell and it was surgerically removed and we were led to believe she would be ok because the vet said he got the entire cancer. The cancer spread to other areas of her body and she died of the disease. Should we always do surgery and hope for the best or are we just kidding ourselves?
October 9th, 2009 at 12:44 pm
Reading through all the information, I didn’t see anything about using an antihistamine on the mast turmors. Your article said the tumors produce histamine and that’s what causes them to become so large. Is it likely that an antihistmine will help? I am giving my Pepto Bismol right now and will start her on Pepcid in the morning, but wanted to know if we could use the antihistimine. I’m hoping to shrink the tumors enough that she can start eating again and have surgery to remove them.
October 15th, 2009 at 7:53 am
Has anybody had this experience? My 11-year old dalmation has been battling mast cell disease since last winter. She’s had surgery, chemo and even Palladia, but it still spread. A month ago, her white count was way down, the disease showed up in her liver, and they told me it was time to let her go. Three days later, she rebounded so well that I began to doubt the test results. Now it’s just a roller coaster. She crashes, she bounces back. She’s curled up in a ball shivering, she’s bouncing around like a puppy. She’s on all these stomach medications, plus antibiotics, Benadryl, herbal supplements and Metro-something for a nasty bout of diarrhea that hit a few days ago. She recovered in less than 24 hours. The oncologist doesn’t seem to know what to do with a dog that’s past her expiration date, and her holistic vet is stumped too. Is this this just the way the disease progresses? I am beyond grateful for any extra time with my girl, but I could really use some advice on stabilizing her. I appreciate any feedback. Also wondering the same thing as Lu Ann re: anti-histimines. Thanks!
October 17th, 2009 at 9:54 pm
Lu Ann, the treatment for mast cell tumors involves a lot more than this single post about digestive upset and mast cell tumors. Yes, benadryl is commonly used to deal with histamine secreted by mast cell tumors. Interestingly,the cimetidine in this post is a specific type of antihistamine, but works on a different receptor type than does benadryl..and deals with stomach acid, unlike benadryl.
Best, D
October 17th, 2009 at 9:58 pm
Anne, I would bet the cycles are related to cyclic histamine secretion and gastric (stomach acid) secretion. Definitely talk to your vet folks about increasing the antihistamines and cimetidine/famotidine, and possibly some pain medication for those episodes. Consider luteolin too, which in humans has been shown to stabilize mast cells and inhibit histamine secretion.
d
October 19th, 2009 at 6:33 am
Thanks Dr. D,
I appreciate your reply, and hope you can clarify about the antacid component. She was on Pepcid, but was switched to Prilosec by the oncologist. How does that fit with the Tagamet? Does it act with Benadryl? Does it make sense to mix and match antacids, or should we pick one? She also has Ondansetron for nausea, a drug (Sulfa-something)for ulcers, a small dose of Prednisone and Cipro. She is on Hesperiden, which I think gives her the luteolin you recommend, Milk Thistle for her liver, and now Benadryl. Tramadol and Gas-X as needed.
October 19th, 2009 at 11:14 pm
Anne, I would discuss doxepin with your oncologist. This is the real deal for histamine receptor (very potent H1 and H2) blockade. If they don’t know about it have them research it. Known a little in behavioral circles as an “anti-depressant” but there is way more to it..
D
October 20th, 2009 at 3:39 am
Thanks again Dr. D,
We are seeing the vet tomorrow, and I will ask. She crashed again last night, exactly a week after her last crash, so your cyclic histamine theory must be right on the mark. I appreciate your input. Even with two excellent vets in the mix, you’re still offering new ideas when they seem to be running out of them.
October 23rd, 2009 at 5:30 pm
I have a precious 10 year black cocker spaniel who was diagnosed w/ Melanoma in January. After complete amputation of her toe, she was put on the Melanoma vaccine. In August, Dollface developed a lump on her lymph glan & I took her to Texas A&M Vet School. They gave her 1-2 months to live & suggested I take her home & make her comfortable. I did put her on several homeopathic meds, she seems very happy, eats great but the tumor is HUGE. Any thoughts?
December 3rd, 2009 at 3:30 pm
I just took my 9 yr old 90 pound dog to the vet to have a bump checked out. After doing an aspiration, the vet suspects he has a mass cell tumor.
The tumor is pretty large, over 3 inches for sure, sonogram x-rays showed no evidence of tumors anywhere else in his body. The vet also did blood work – results pending. We may also do one more cell aspiration to check his spleen and liver – I think?
We are planning to surgically remove his tumor next week; I suspect the surgery will be a bit complicated given the position of the mass. The vet also mentioned the possibility of needing chemo.
In reading several sources of info, it seems like chemo can be debilitating and expensive depending on treatment type. So as a pet owner I’m now worried about making the right decisions. I don’t want my dog to spend his last year suffering, I also don’t want to spend thousand of dollars and then see my dog die in a couple of months.
Should I proceed with the surgery and evaluate chemo options once biopsy results return? Or is there something else we should check before moving forward with the surgery to make sure is worth proceeding with it? Is chemo a good option for dogs? Is it successful? Right now, I want to make sure I’m objective and make the best decision for my dog; I just don’t know what that is?
December 6th, 2009 at 2:54 pm
Dear Moby,
I think you really need to get information to help you make your own personal decisions. There is no right or wrong way to deal with severe malignancies. Having said that, your vet is on the right track. Surgical removal of tumors is the first way and the central way to get them out in most cases of localized cancer. You would be well advised to spend some time reading the Dog Cancer Survival Guide to help you with questions such as dog cancer treatment plan analysis, which includes life quality assessment and your own personal ethics. The time spend integrating the information is well worth it.
Best,
Dr D
December 7th, 2009 at 2:39 pm
Thanks Dr Dressler. I have one last question, I visited today an oncologist at a pretty well know animal center in NYC. I wanted to gather info before the surgery. This doctor mentioned that she only treats dogs with mass cell tumors with chemo or RT. She told me that Palladia was not a good drug for mass cell tumors and she was not trained to use other medications .i.e Neoplasene, Kinavet, Mitotic, et,etc. I walked out feeling like I wasn’t given options? I’m now searching for 2nd and 3rd oncologist to consult with after the surgery/biopsy is completed. Is this type of experience normal? Am I fooling myself by searching for other options?
December 28th, 2009 at 5:25 pm
I was beyond ecstatic to see you reference Slippery Elm Bark powder which I’ve been using not only for diarrhea but for irritable bowel, colitis and just stomach issues for years. It used to be use as a milk substitute for human infants who were allergic to even goat’s milk and is very nutritious — so I’ve used it for extra nutrition as well. I’m so glad I found this site!