Dog Cancer and the Malaria Drug Artemisinin
Dr. Demian Dressler is internationally recognized as “the dog cancer vet” because of his innovations in the field of dog cancer management, and the popularity of his blog here at Dog Cancer Blog. The owner of South Shore Veterinary Care, a full-service veterinary hospital in Maui, Hawaii, Dr. Dressler studied Animal Physiology and received a Bachelor of Science degree from the University of California at Davis before earning his Doctorate in Veterinary Medicine from Cornell University. After practicing at Killewald Animal Hospital in Amherst, New York, he returned to his home state, Hawaii, to practice at the East Honolulu Pet Hospital before heading home to Maui to open his own hospital. Dr. Dressler consults both dog lovers and veterinary professionals, and is sought after as a speaker on topics ranging from the links between lifestyle choices and disease, nutrition and cancer, and animal ethics. His television appearances include “Ask the Vet” segments on local news programs. He is the author of The Dog Cancer Survival Guide: Full Spectrum Treatments to Optimize Your Dog’s Life Quality and Longevity. He is a member of the American Veterinary Medical Association, the Hawaii Veterinary Medical Association, the American Association of Avian Veterinarians, the National Animal Supplement Council and CORE (Comparative Orthopedic Research Evaluation). He is also an advisory board member for Pacific Primate Sanctuary.
Updated: October 11th, 2021
Summary
Artemisinin for dogs with cancer? Yup. This herb can help make chemo more effective, and may also target cancer directly.
The anti-malarial remedy artemisinin may be beneficial for dogs with osteosarcoma (the most common bone cancer). And more good news: it may also help several other cancers.
Studies have shown this herb can help chemotherapy do its job, and may also target cancer directly!
Let’s take a closer look at using artemisinin for dogs with cancer because there are several things to consider.
From Malaria to Cancer
Artemisinin is most famous for treating malaria infections.
It is derived from sweet wormwood, which has been used for centuries in Traditional Chinese Medicine to treat fevers.
Chinese scientist YouYou Tu even won the Nobel Prize in 2015 for her discovery of the compound and its anti-malarial properties.
Many drugs and remedies originally used for one thing turn out to have additional properties.
And as it turns out, artemisinin is also helpful in the fight against cancer.
How Artemisinin Works
Artemisinin reacts with iron in the body. How could that help with cancer?
Well, cancer cells take up more iron than normal body cells, because of their habit of rapidly dividing.
More Iron Uptake Creates Free Radicals Which Damage Cancer Cells
This iron uptake creates free radicals, which are little unstable atoms that can cause major damage in the body.
Normally, this is not good, because we don’t want healthy cells to encounter free radicals.
But when those free radicals are in cancer cells, it’s actually a good thing.
The free radicals caused by the extra iron in cancer cells react with parts of the cancer cell to cause injury.
Since normal body cells have much less iron, they are less affected by this damage.
For more helpful information and tools, get a copy of the Dog Cancer Survival Guide
Again, when it comes to cancer, more free radicals (inside cancer cells) is desirable.
But that’s not all that artemisinin does!
Other Artemisinin Benefits
Some of the other properties that artemisinin has shown in studies include:
- Sensitizing cells to chemo drugs, making them more effective
- Increasing apoptosis
- Decreasing cancer cell communication
- Decreasing angiogenesis, the creation of new blood vessels that feed the tumor
Problems with Using Artemisinin
One of the challenges of using artemisinin is that it has a short half-life. That means it doesn’t stick around long.
It also has low bioavailability. This means that the digestive system may destroy it before it gets to the cancer cells where it is needed.
To help counteract these factors, some synthetic versions have been created. These forms can be more effective.
Artemisinin for Dogs
In a recent podcast (episode below), my colleague Dr. Nancy Reese, DVM, PhD, says that artemisinin has been shown to be beneficial for these cancers:
- Osteosarcoma (bone cancer)
- Melanoma
- Breast cancer
- Rectal Cancer
- Prostate cancer
- Kidney cancer
For dogs and owners battling osteosarcoma, anything that might help is welcome!
Many of the artemisinin studies have been done in vitro (in the lab). Others have been done using human subjects.
Humans and dogs are very similar when it comes to cancer, so what helps us may help them, and vice versa.
But some artemisinin studies have used or looked at dogs.
And one study even showed increased survival times for dogs who got artemisinin.
How Much Artemisinin to Give to Dogs
We are still learning the best dosage and dosage frequency.
In the past, it has been recommended to give artemisinin for five days or so and then take five days off. This is called “pulse dosing.”
But the current general recommendation is to give a lower dose every day consistently.
This still gets good results, but with fewer side effects.
The possible dose spread is huge, vaguely around 2 to 15 mg per pound one time a day. There is much variation on recommended doses.
It’s best to work with your veterinarian about dosing artemisinin, because there is no “one best dose” and frequency that fits all dogs and all situations.
Note: Keep in mind that if you are using my other “big gun” herbal apoptogen, Apocaps, you shouldn’t use both Apocaps and artemisinin on the same day. They are both potent, and artemisinin can be hard on the stomach (see below). If you want to use both together, rotate their use.
How to Give Artemisinin to Dogs
I recommend giving artemisinin with a small amount of something with fat. This could be fish oil, krill oil, peanut butter, or cream cheese.
This is because fat helps to increase the bioavailability of artemisinin.
NOTE: as always, if your dog has pancreatitis, avoid extra fats!
Some people recommend giving artemisinin with iron-rich foods, such as red meat.
Others are concerned that the artemisinin would react with the iron in the stomach, before it can get to the cancer cells.
Because of this, I recommend giving artemisinin four hours before or after a meal. This helps make sure the artemisinin targets the iron in the cancer cells.
But as always, ask YOUR vet the best plan for your dog. Your dog may have unique needs!
No Antioxidants With Artemisinin
When your dog has cancer, you often use more than one supplement, and sometimes you use an immune booster or antioxidant supplement.
If you do, remember that artemisinin is pro-oxidant and works by creating free radicals in cancer cells.
Antioxidants can counteract artemisinin’s effects.
Antioxidants will destroy those free radicals that are killing the cancer cells.
Because of this, giving artemisinin along with antioxidants can make it less effective.
How to Choose Artemisinin for Your Dog
As with any supplement, choose your product wisely and choose a reliable brand that makes a product to human-grade standards.
The absolute best way to pursue artemisinin with your dog is to see a veterinarian who uses it regularly and can recommend a reliable product.
They’ll also be able to give you the best dose and timing schedule for your dog’s situation.
When NOT to Give Artemisinin
Artemisinin is a powerful compound and can have negative effects as well as positive ones.
- Do not give artemisinin if your dog is getting radiation therapy. The current recommendation is to separate these two therapies by a couple months.
- Dogs with seizure disorders also should not get artemisinin.
Overall, artemisinin is very safe with low toxicity. However, it can cause adverse effects, such as:
- stomach upset
- bone marrow suppression
While we still have a lot to learn about the best dosing for artemisinin, this herbal compound has a lot of promise as an adjunctive treatment for cancer in dogs.
Best to all,
Dr. D
For more details, you can also check out the recent interview with Dr. Nancy Reese on Dog Cancer Answers.
Here is the video version of the podcast:
Have a Great Question for Dog Cancer Answers Veterinarians?
Call the Listener Line at 808-868-3200
Further Reading and References:
Anticancer and Antimalarial Efficacy and Safety of Artemisinin-Derived Trioxane Dimers in Rodents
Retrospective study of small pet tumors treated with Artemisia annua and iron
Dr. Demian Dressler is internationally recognized as “the dog cancer vet” because of his innovations in the field of dog cancer management, and the popularity of his blog here at Dog Cancer Blog. The owner of South Shore Veterinary Care, a full-service veterinary hospital in Maui, Hawaii, Dr. Dressler studied Animal Physiology and received a Bachelor of Science degree from the University of California at Davis before earning his Doctorate in Veterinary Medicine from Cornell University. After practicing at Killewald Animal Hospital in Amherst, New York, he returned to his home state, Hawaii, to practice at the East Honolulu Pet Hospital before heading home to Maui to open his own hospital. Dr. Dressler consults both dog lovers and veterinary professionals, and is sought after as a speaker on topics ranging from the links between lifestyle choices and disease, nutrition and cancer, and animal ethics. His television appearances include “Ask the Vet” segments on local news programs. He is the author of The Dog Cancer Survival Guide: Full Spectrum Treatments to Optimize Your Dog’s Life Quality and Longevity. He is a member of the American Veterinary Medical Association, the Hawaii Veterinary Medical Association, the American Association of Avian Veterinarians, the National Animal Supplement Council and CORE (Comparative Orthopedic Research Evaluation). He is also an advisory board member for Pacific Primate Sanctuary.
Dr Dressler: Purchased your book about 3 months ago when our dog was dx’d w/hemangiosarcoma. It helped a lot and we had a good 2.5 months before having to put him to sleep. Sadly t say, my 14 yr old 60 lb female was dx’d with osteosarcoma. I have her on artemisinin. I am alos giving her piroxicam, and tramedol for pain. I want to start her on K-9 Immunity but am afraid that there may be a poor outcome due to the combination. I was wondering what you may think about this combo. I am considering amputation of her affected right front leg so as to maintain her pain free for as long as possible, but I am concerned about her age.
Her x-rays show no metastisis. I won’t do chemo but will continue artimisinin and k-9 Immunity (if that is a good combo).
Please, any ideas would be helpful.
Thank you.
Jo Anne
Jo Anne,
sounds like you folks are really getting hit hard with dog cancer. I am so sorry. Remember that dogs over 10 have a 50-50 chance of dying from cancer, so you are not alone. Yes, art and K-9 immunity is fine. You also may want to tune in to the webinar on OSA today, which is recorded:
http://www.mydogvet.com
best
Dr D
Dear Dr. Dressler,
PLEASE HELP ME.
My dog Oreo, a 4-year old lab mix, was diagnosed with Osteosarcoma of the ribs on September 9. Back then, she was 56lbs and the tumor was approx. 5,5cm, and there were no visible mets in the lungs on the xrays. Upon a CT scan, mets were found in 5 lung lobes, and because of that, along with the fact that she was not showing any signs of pain, we opted out of the rib resection surgery. Our vet assured us that there would not be much benefit to removing the primary tumor if there are mets already present.
We immediately started her on carboplatin (September 15), along with her regular diet (she is on Hills Z/D food) and cottage cheese and flaxseed oil (we up’ed it slowly to 6 tbps of flaxseed oil a day). But her tumor kept on growing. Since she showed no side effects to the 1st chemo treatment, we did her 2nd treatment 2 weeks and 2 days after the first one (October 1). On that day, her oncologist sais he would probably switch the drug to doxorubicin on her next (3rd) treatment, as the tumor had grown.
On October 2, we also started giving her apricot seeds, along with small chuncks of pineapple. We grinded the seeds and worked her up to 6 a day (adding one a day), which happened last Thursday, October 8. She is now 58 – 60 lbs, and was walking in the neighborhood for 10 – 20 minutes a day. We have also been giving her vitamins (Nutri-Vet Milti-Vite and Health immune), along with liquid Nutri-Vet Probiotics with Wild Alaskan Salmon Oil.
On Friday, October 9, after feeding her the Z/D with 2 grinded apricot seed, walking her for 10 minutes and then giving her cottage cheese and flaxseed oil, she felt a bit restless all day – moving around from spot to spot within a few minutes. We had also been noicing over the last couple of weeks that her energy level had been decreasing gradually.
On Saturday, October 10, her energy seemed to go down considerably. She still ate, but was not as excited about the food as she normally is. Her stomach also felt a little “full” – like there was a small waterballoon in there, versus the normally flabby skin. Since I had walked her the day before within 15-20 minutes of her meal, I was worried about bloating, so I took her to the vet, who said she was not bloated.
On Saturday (October 10), her breathing pattern started to change – she was shallow breathing for most of the day, with not much play or exercise. Upon excitement, sometimes she would whimper – like she wanted to play but couldn’t.
Yesterday, October 11, she had diahrrea in the morning. No vomiting. Her breathing changed even more, like she was having a bit of difficulty. She also would not run or play as usual. I started worring this could be cyanide poisoning because of the apricot seeds, so I took her to the emergency room.
We did chest and belly xrays, and a blood test. Her white blood cell count was actually a bit high (they expected it to be low because of the chemo), so the vet started her on antibiotics. Her belly xray did not seem to show anything wrong, but her chest xrays showed the intensity of the cancer. We could not exacly determine the size, but it looks like her primary tumor (was originally on the 7th rib; now it looks like 7 – 9 ribs) looked like it was approximately 20cm in size (4 times the size of 1 month ago). She also had some fluid on her chest (not in the lungs), but not enough to tap it. She also seemed to have a mass that we could not identify 100%, but looks like it could be a met in the lung. The mass (if this is correct) is very significant now and my best guess is that it is around 5cm in diameter. I believe this may be why her breathing is not normal.
Upon arriving home last night, we also gave her some Tramadol, for possible pain. She slept without moving much, still shallow breathing, and if she lies on her side the breathing gets faster and louder. Standing up is not so bad.
I AM DESPERATE. It has only been one month, and I am not sure what else I can do.
This morning (October 12) I gave her 2 pills of 100mg Artemisinin, and will give one of Artemix at night. Is this the correct dosage, or should we be more aggressive for a 60 lbs dog? I read about doing this for 5 days, then not do it for 2. Is this what you would recommend?
Is Z/D ok with it? What about the antibiotic (she is now taking Metronidazole)? We are also not sure if we should do her next chemo treatment, as doxorubicin has many side effects.
Do you have ANY suggestions or ANYTHING we may try? PLEASE HELP!!!!
Thank you in advance.
Izabel & Oreo
Dear Izabel- this is very grim news. You are looking at referral to a surgeon who can handle en-bloc resection (large removal of body wall) and you should inquire as to the possibility of any oncologist in your area who might be involved or willing to do aerosolized platinum compound chemotherapy (inhaled by your loved pooch). It is dicey stuff for the oncologist involved but there are publications of an apparatus that can be constructed to get high concentration chemo into the lungs. You may also want to check into nebulized methyl jasmonate, also last resort stuff. Do a google search on it. It can be dissolved and used in a Vick’s nebulizer. Very, very experimental with no real veterinary (or human) track record but a good theoretical basis. It may also be time to start doing a life quality analysis, which is detailed in the e-book I wrote.
Best of luck,
D
Dear Izabel,
I am sorry to hear this hard news. This week’s webinar is on OSA, and I thought it might help you since you have a pretty open-ended question that is tough to answer in a concise blog post. The webinar will be recorded:
http://www.mydogvet.com
Best,
Dr D
I have a 12 year-old Hungarian Vizsla with transitional cell carcinoma of the bladder. He was diagnosed two weeks ago and had surgery which managed to de-bulk 80% of the tumour, but the rest was inoperable because of its closeness to the ureter openings. my vet has put him on one capsule of Feldene (Piroxocam) a day with cytotec (stomach liner). I have started him on a capsule of Artimisinin a day. My vet is unsure how this would react with the Feldene. Is anyone able to provide me with this answer? I would be extremely grateful as I want Piccolo to have as much pain-free time as possible.
Thank you.
Dear Patti,
in The Dog Cancer Survival Guide, you will learn that the survival of dogs with TCC of the bladder on Feldene, with or without surgery, is months. The question is, are we worried about losing the itty-bitty beneficial effect of the Feldene? Or are we worried about safety?
I know of now published or anecdotal interactions between the two drugs.
You may want to check out the webinars too, as many questions are answered:
http://www.mydogvet.com
Best of luck.
d
I have a 12 year-ild Hungarian Vizsla with transitional cell carcinoma of the bladder. He was diagnosed two weeks ago and had surgery which managed to de-bulk 80% of the tumour, but the rest was inoperable because of its closeness to the ureter openings. my vet has put him on one capsule of Feldene (Piroxocam) a day with cytotec (stomach liner). I have started him on a capsule of Artimisinin a day. My vet is unsure how this would react with the Feldene. Is anyone able to provide me with this answer? I would be extremely grateful as I want Piccolo to have as much pain-free time as possible.
Thank you.
My dog, a female 12 year old boxer (3/4) has hemangiosarcoma, she weighs about 60 lbs. I have seen different recommended doses for ART ranging from 100 to 600 MG, what do you recommend. Also, she is taking an iron supplement- how long should I wait after giving this to begin giving the treatment or is it just a concern while in the stomach/
My Westie Abby who has bladder cancer was on Artemisinin and at first, the tumor shrank. However, due to constant vomiting, we opted to forego this treatment. Is there something perhaps I could give Abby to contradict the stomach upset in order to continue with Artemisinin. Also, I do feed Abby chicken. Could this iron source have been the reason for the stomach upset? What type of food do you recommend when administering Artemisinin?
I thank you for any response you can give.
Judi Conigliaro
gee_a_puppy@yahoo.com
Judith, consider cimetidine (tagamet) for the stomach upset. I doubt the iron in the chicken is causing the stomach upset, more likely the artemisinin or something else being given by mouth.
I will discuss your question more fully in this weeks webinar:
http://dogcancervet.com
Thanks for the question!
Dr D
FYI the webinar is recorded so you can listen later if you wish,
D
Hi Dr Dressler,
Thank you so much for getting back to me. I am very happy with your book just get a little confused about some of the things.
I printed the info you gave me and will be taking it to the vet.
I have been keeping them informed of everything I am doing for Brandi. I told them if they are not giving me any options on treatments I will do what I have to to help her.
They are not happy with the use of Arte and won’t even talk about the dosage, however they are willing to run periodic blood work and checks on her to check for any other problems associated with it or any other supplement I use. To my surprise, they did prescribe Doxycycline when I ask and agreed with it. With that, I guess they ARE willing to work along with,m e but not comfortable with prescribing some herbal treatments.
They have even told me I am wasting my money using transfer factor and K9 immunity. I ask what they would give her for support and they said nothing.
They also are not happy with the cancer diet for Brandi, they feel that with a dog her age(10) it would be too much for her kidneys. As of now Brandi has no problems associated with kidney problems so I am not sure if they are right.
I should have ask you that question too. What would be the right diet for her given her age and lymphoma? Your cancer diet or the ND version?
Thank you again,
Peg & Brandi
Peggy,
high protein diet does not cause kidney disease. It should not be used though if the kidneys are diseased already though…
Having said that, Greg Oglivie, arguably the most prominent veterinary oncologist in the country, designed ND. So in the conventional realm, he is a top dog. No offense to any other vet out there, but…you get the idea.
Why don’t you use both of the diets…use some ND and some of the home diet??
Can’t say what is better, no data, but this is a nice approach.
I will address your question in more detail in the upcoming webinar:
http://dogcancervet.com
best,
D
Hi Dr Dressler,
My Boxer Brandi has been dianosed with Canine cutaneous epitheliotropic T cell lymphoma(mycosis fungoides)in her mouth. Our vet told me this cancer doesn’t respond to chemo. I know this well as they did try chemo on Brandi’s brother for the same disease in 2005. It was not in his mouth but all over his body and the chemo did not work.
I was told Brandi’s is not as aggressive and to treat palliative, I take this as give up.
At once I started to do reseach on alternative treatments.
I ordered artemisinin and started her on 100mg 2x a day. Then I found your book, I ordered both the ebook and hard book.
Since being off the Arte on the 5 on 5 off schedule I have been alternating it with parsley and I have also bought curcuin but not used it yet.
I am going to be starting the arte again soon and would like to go with the 10mg/lb/day dose as per your book.
My question is do I give it 2 times a day or only once. She is 64.4 pound and 10 years old
So that would be 640mg of Artemin once or 320mg twice a day? I would have to measure out a half a capsule to get the 40mg as I only have 100mg capsules.
Also would the Luteolin be a better rotation supplement, she really doesn’t like the parsley and has been not eating all her dinner since using it.
also any ideas on what I could use on her mouth for the inflammation, it looks so sore.
Thank you
Peg & Brandi
Peg and Brandi,
print this abstract out and take it to your vet. See the blog posts on CLA too…
http://www.ncbi.nlm.nih.gov/pubmed/1596872
There is no evdience to say that the Arte is better or worse once or twice daily. Give the total amount in a 24 hour period, other than that it is your call. You can round up on the Art dose to fit the capsule sizel….whatever is easiest. Please be in touch with your vet about everything you are doing!
Good luck!!
D
Check with Dr. Couto at Ohio State. I believe he is doing an artemisin study with greyhounds.
BTW, a direct injection of aqueous sodium bicarbonate into the tumor site also stops osteo in its tracks because it screws up the pH balance the cancer needs to live
Dear Dr. Dressler,
Thank you for this site; it is comforting to me at this difficult time.
I am torn whether to ampute my dog’s left, front arm and shoulder now or proceed with aggressive Radiation therapy first.
He has aggressive Liposarcoma, low grade, low stage (I asked and these were the terms given). I’ve had to be assertive in inquiry and advocacy to get him into the veterinary oncologists by referral within 2 weeks of the tumor appearing. Thanks to your blog and other web research, I managed it and am grateful I had the courage and fortitude to push through thus far. His CT shows no metastasis beyond his limb at this point.
The tumor arrived Jan. 1, 2009. Today, Jan. 28, 2009 the veterinary surgical oncologist went back in and removed all she could that remained of the cancer. She said without amputation she could not get it all, however. The pathologist from his first biopsy (which went slightly awry because the tumor ‘popped’ out during the procedure unexpectedly, yielding more than the intended circumference of removal than anticipated) indicated unclear margins).
We now await the pathologist’s report from this second surgery, although with the surgeon’s assessment that more cells remain behind without amputation.
I’ve read and carefully considered your posts re. Radiation Therapy and how serious it is and done the life expectancy estimation for my dear dog Milo. He is 10 now, a small terrier, min-pin mix, with an optimistic life expectancy of 15 years had cancer not visited.
Per your recommendation, I am considering the alternatives and options available to me. Both the veterinary surgeon and veterinary oncologist recommend the aggressive, 19 consecutive day Radiation therapy to target the remaining cancer cells. This seems very aggressive to me and I worry for the aftermath of toxic effects and latent consequences of the Radiation for the remainder of his next 5 years should we succeed in a cure.
Per your formula, he is NOT at the end of his life expectancy yet; he has at least 5 years left God willing.
My question is if I should be proactive and choose amputation with radiation (although the surgeon said that with amputation no radiation is necessary although what I’ve read says radiation is still advised…??? Is it?) or…
If I should subject him to this massive amount of radiation for 19 consecutive days and amputate only if/when another tumor/bump/lump appears later on?
Is there an option for amputation now with a lower dosage of radiation?
Is the risk of toxic, latent, residual effects from intense, heavy, radiation over the next 5 years a better bet than amputation now, while the cancer is still contained within the limb, plus a lesser amount of radiation as a ‘just in case’ treatment???
I want him to feel the least amount of ‘sick’ and ‘scared’ for the remainder of his days with the best quality of life and be cancer-free or at least cancer-clueless if possible!
He’s one of those dogs that just WANTS to run and fetch the tennis ball and play tuggie and look at the window and meet other dogs! Milo’s got that joie de vive in buckets, Dr. Dressler! He fits into that ‘type’ of dog you described when trying to make this choice in your post.
So I know he’d bounce back from amputation sooner than later! He’s a super trooper!
And I realize that cancer may reappear somewhere else later, maybe sooner, and then he’d still be one leg shy of a set.
Like the celebrity Christina Applegate who opted for a double masectomy after being tested and due to her familial breast cancer history of onset, I’m willing to be proactive and opt for amputation now because:
1) Both the original pathologist and today’s vet. onco. surgeon admit the cancer cells are still there in the back of his upper arm and due to the location, clean margins of removal cannot be obtained without amputation.
But I don’t want to take his leg off unnecessarily or prematurely either if radiation therapy could work withOUT resulting in likely toxic effects within the next 5 years of his expected life span.
I can’t seem to get a feel for the REAL fall out effect of such aggressive and intense radiation therapy on a little 18 lb. love of my heart dog! ‘They tolerate it so well’ is all I could get from the veterinary oncologist (probably because I wasn’t asking the correct questions I know!) But I’ve bought your book and will work to improve my game. 😉
Radiation is gross. We all know it. I don’t want to radiate my dog if it means that 2 of his 5 years will be spent dealing with likely toxic effects of it in the form of new tumors FROM the radiation and plethora other fallout.
If amputation means ‘a stitch in time…’ or ‘a bird in hand…’ plus either no radiation or lesser radiation will more likely yield Milo 5 FUN, healthy, happy years with less radioactive fallout on his body, then I’m willing to do that.
What do you think? HELP! I’m on information overload.
I just bought your book and will begin the ‘coping’ exercises asap.
Milo’s spending the night at the oncology center tonight, my sweet little man. My love. My heart. I don’t know what to do!
Thank you and God Bless You, Dr. Dressler,
Please let me know…
Sincerely,
Lorene Moore aka Milo’s Mom
Lorene,
this is a yucky one. However, I believe I will help you by acknowledging that you have already answered your own question. I always say this, but I cannot give advice on individual dogs in this blog. Go with your gut on this one. You know what I am saying. My opinion only.
Also, get the next book when it comes. The supplement sections on curcumin/luteolin may help your little Milo.
Give Milo a hug for me,
D