Working that Palladia
Posted on | April 8, 2009 |
About 8 months ago, Vodka’s pressing needs seemed to be ball-time, walks, hanging out with pals and yummy treats. And some of mine involved making sure he got all that 
Things are somewhat different now. Weelllll, his needs are the same … mine, however, are a bit more heavyweight - exploring every option possible to keep him healthy and happy!
Which was why we chose to explore Palladia. We approached this with plenty of misgivings - a Phase III clinical trial drug … an unknown entity, no support group to work with, very little information about contraindications … not a great place to be in. We really hoped that surgery to debulk the tumor, followed by Neoplasene would be the protocol of choice. But we couldn’t really find a vet who supported this and was comfortable trying the Neo salve or injectable. So, we gave in and went with Palladia instead.
Most of you must be aware of our Palladia roller-coaster ride - great response but strong side-effects. Very frustrating. Today, I saw a comment from a pooch-parent whose dog also has MCTs - systemic, in the lymphatics and he is on Palladia. I’m going to attempt to address several questions that Billie Sue had about our experience with Palladia:
Dosage & Frequency
Vodka weighs about 86 lbs and was initially on 130 mg of Palladia every alternate day. This worked great for about 2 weeks, then the side effects showed up - nausea, general inappetance and GI unhappiness. So, we pulled Vodka off Palladia and let his stomach heal. Then, we restarted at 115 mg thrice a week - we went through 2 doses of this before it hit him again. So, we pulled off for another week to let him recover.
As we were rethinking this whole Palladia strategy, we found that the tumor was growing again. Bummer. So, we decided to try it again. This time, we chose to dose at 115 mg, but once every three days. I’ve read a few papers that talk about cancer cells being more active around midnight-2 am. Based on that, we’ve chosen to give him the Palladia in the evening after his PM meal.
Also, he gets one Metoclopramide (Reglan) pill about 30 minutes before the Palladia dose, and gets 2 more over the next 24 hours, spaced 8 hours apart. The goal is to “pretreat” the GI system and prep it for dealing with nausea and inappetance. Vodka got his third dose of the current round of Palladia earlier this evening.
Side effects:
- Nausea/Inappetance - The Metoclopramide dose is expected to help with this. We’ve seen that the Palladia side effects hit hardest 12-36 hours after the dose - we’re hoping that prepping the GI system will alleviate some of this. Vodka is also on Seacure - a predigested (and super stinky!) protein supplement - comes in capsule form. This was recommended by an acquaintance on a cancer group who is a RN - she’s seen this help chemo patients deal with inappetance issues.
- Diarrhea - Vodka had a few instances of bad poop over the last few days. We chose to treat this with Imodium. Metronidazole instead of (or in addition to) Imodium is another option.
- Digestion issues - We’ve been giving Vodka a digestive soother (slippery elm + L-glutamine + fructo-oligo saccharides). We also have this homeopathic remedy Nux vomica on hand to deal with nausea/vomiting. We’re hoping to restart him on Essiac tea and have Bentonite clay detox on hand. He’ll probably start getting the Bentonite on the 2nd off-day (the day before Palladia dosing) so as not to minimize the impact of Palladia.
- Pickiness about food - This is a tough one. I feel like Palladia totally messes with Vodka’s sense of smell and taste! With the current dosing strategy, he seems to like his Orijen kibbles quite a bit, especially with an egg cracked atop. He sometimes eats his meat, other times, he walks away. To work around this, I’ve started baking his meat and veggies into treats - he really seems to enjoy these baked goodies! I just mix a can of food or wonk of meat (ground beef or turkey or chicken) with an egg, a little oil, some herbs like parsley, alfalfa, licorice, ginger and some spelt flour (since we’re trying to stay away from wheat) and drop spoons of these into a muffin pan and bake at 350 F for 20+ minutes. We’ve been able to use these as “pill-pockets” to get those gazillion meds into Vodka!
- Tachypnea (rapid breathing) - We’ve seen some of this, it existed even pre-Palladia because of prednisone.
- Tiredness/Hind limb weakness - The Palladia Phase II trial mentioned instances of this. Vodka has not been tired, but I’ve noticed that when he poops, he’s a bit slowly recovering his ass from the hunched position. He’s on Tramadol for dealing with arthritis and general pain and that seems like a decent solution.
Supplements:
- K-9 Immunity, Transfer Factor - Vodka used to wolf these down, but lately it has been hard getting them into him. Until I stretched my baking skills to start making him treats! We now stick the pills into treats - seems to work. So, can these be given alongside Palladia? No one really knows. But, we’re thinking about staying away from diluting the Palladia dose with any other supplements - so the plan is to start dosing these on the Palladia off-days.
- Curcumin - These go in every day - twice or thrice a day. Dr. Dressler suggested that these be mixed in with soy lecithin for better absorption - so, I’m going to start doing that. And maybe mixing it in with some virgin coconut oil - that has got to be tasty!
- Glutamine - This is a must. Everyday. It is supposed to help protect the GI system, plays a major role in protein synthesis and assists in immune function.
- Green Tea extract, NAC, Medicinal mushrooms - Hoping to dose these on Palladia off-days.
- Chinese herbs - We’re currently using Xue Fu Zhu Yu and Stasis Breaker. It has been hard to get these into Vodka giving his eating finickiness. But we try to get in one dose of these a day if possible.
Unfortunately (like with most other chemo drugs), there is little evidence of contraindications when using alternate treatments in conjunction with Palladia. Our attempt to stagger some doses is to potentially offset this. So, we continue our dosage dance hoping we can work this Palladia the right way.
These treats double as pill pockets!
Good wishes to Han, the black lab who also has MCTs - hope the Palladia works its mojo!
Tags: digestion > MCTs > Palladia > side effects > Supplements > treatment
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3 Responses to “Working that Palladia”
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April 11th, 2009 @ 12:52 pm
Thank you for answering my previous comments. On Vodka’s trips to his oncologist, does he get his bloodwork checked? This past Tuesday, we took Han in and his red blood count had dropped to 26%. He was also a little dehydrated. Has Vodka experienced this and do you know whether or not it is a side effect of the Palladia? His oncologist did another chest x-ray to see if the Palladia had had any effect on the enlarged lymphnodes there and she thought they had enlarged slightly, but wasn’t sure if it was the Palladia working - she said that sometimes the lymphnodes become inflammed meaning that it is working or that the mast cells were spreading. Han had six radiation treatments on his abdomen in February and March, and the mast cells in the lymphnode in that area healed and his original tumor went away. So on Tuesday Han’s oncologist decided to give him six more radiation treatments on his chest area starting on Thursday. On Thursday Han has his first treatment but they checked his bloodwork beforehand. It had dropped to 24%. They did the treatment and he did just fine as before. They also gave him an IV. Han has acted extremely tired since Thursday. He vomited a few times and also had diarrhea. He didn’t want to eat either but managed to keep down a few bites of ham. His oncologist gave him Carafate to soothe his stomach. Yesterday, he acted tired again but ate a pancake and some more ham, and later in the evening had a can of chicken broth. He took his Palladia on Thursday and he is supposed to take it today. He takes three 50 mg tablets one day, skips a day, and then takes two 50 mg tablets. Did Vodka’s appetite improve when you spaced the Palladia out more? Has Vodka had radiation treatments and if so how did they affect him? In February and March, Han’s treatments did not affect him this way. It breaks our hearts to see him refuse to eat anything but a few bites of something. It wasn’t until he began the Palladia on March 19 that his appetite began to wane. It really wasn’t apparent until around March 31-April 1, after he had taken the Palladia a few times.
July 23rd, 2009 @ 2:59 pm
Where can I get Palladia? My golden lab has large Mast Cell tumors. I’ve read good things about Palladia. I know there are tough side effects. It’s worth a try though. My poor dog has a lot of histamines in her blood, and we are giving her anti-histamines, but not curing her.
Where can I get it?
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