TCC -- Piroxicam & Mitoxantrone, & link to animal cancer center

Hi to everyone.  For those of you with a TCC bladder cancer dog looking for info on treatment options, here's on update on how my 11 yr old scotty JJ is doing with chemo.  After his TCC diagnosis in February (positive VBAT bladder cancer screening test), I took him to the Colorado State University Animal Cancer Center & they confirmed diagnosis of tcc in the urethra, trigone, & down the front bottom part of his bladder.  They did not do a biopsy & recommended against any surgery in his case due to the involvement of the trigone & urethra.  Instead the oncologist started JJ on the standard treatment of Mitoxantrone chemo intravenously, in combination with the oral Piroxicam he was already taking, & the first chemo session was Feb 19.  He also had a baseline ultrasound done the same day.  He had already been on Piroxicam for 2 weeks, as my vet advised me that I should make sure JJ could do ok on the Piroxicam before proceeding with any other kind of treatment.

Our 3rd chemo treatment with the Mitoxantrone was April 10, & JJ has handled the chemo with no problems.  He has also continued the Piroxicam (3.5 mg once daily for 28 lb dog.)  The good news is that the ultrasound done on Apr 10, when compared with the baseline ultrasound from Feb 19, shows that the cancer has not grown or spread to any lymphs or to the prostate.  The chemo has succeeded in keeping the tcc from progressing, but it has not made it go away.  His treatment schedule was 3 chemo treatments with Mitoxantrone 3 weeks apart.  The chemo session takes about 20 minutes with an iv taped to his leg.  He is sleepy the first night afterwards, but otherwise seems fine & hasn't gotten sick at all.  He had significant improvement in his ability to pee within a couple of days after the first chemo (went from just a drip drip to steady dribble without as much straining).  The oncologist said the median survival rate with mitoxantrone & piroxicam treatment is 305 days. Since the chemo is helping JJ, he recommended one more chemo in 3 weeks & maybe one more 3 weeks after that, then we will stop the chemo & just do an ultrasound every 2 months.  I will post updates as we go ahead with this treatment plan & I hope it helps someone else in making their decisions.  If you decide on chemo, I highly recommend going to a veterinary oncology center that does chemo on a regular basis so you know that they know what they're doing.  My local vet offered to order in the medication & do it in his office, but it's not something he does very often, so we've been going to the animal cancer center for every chemo session and ultrasound. 

Here's the website link for CSU-they have useful info on canine cancer with FAQs, nutrition, when to say goodbye, & grief counseling links with phone numbers.  The grief counseling links appear to be staffed mostly by vet students at university veterinary schools & if you're looking for a veterinary oncology specialist, I would start with that list of vet schools & see if one is near you.   

http://www.csuanimalcancercenter.org/

Good Luck to all of you.

Joy & JJ

On 4/16/2008 JJsMom wrote:

Hi to everyone.  For those of you with a TCC bladder cancer dog looking for info on treatment options, here's on update on how my 11 yr old scotty JJ is doing with chemo.  After his TCC diagnosis in February (positive VBAT bladder cancer screening test), I took him to the Colorado State University Animal Cancer Center & they confirmed diagnosis of tcc in the urethra, trigone, & down the front bottom part of his bladder.  They did not do a biopsy & recommended against any surgery in his case due to the involvement of the trigone & urethra.  Instead the oncologist started JJ on the standard treatment of Mitoxantrone chemo intravenously, in combination with the oral Piroxicam he was already taking, & the first chemo session was Feb 19.  He also had a baseline ultrasound done the same day.  He had already been on Piroxicam for 2 weeks, as my vet advised me that I should make sure JJ could do ok on the Piroxicam before proceeding with any other kind of treatment.

Our 3rd chemo treatment with the Mitoxantrone was April 10, & JJ has handled the chemo with no problems.  He has also continued the Piroxicam (3.5 mg once daily for 28 lb dog.)  The good news is that the ultrasound done on Apr 10, when compared with the baseline ultrasound from Feb 19, shows that the cancer has not grown or spread to any lymphs or to the prostate.  The chemo has succeeded in keeping the tcc from progressing, but it has not made it go away.  His treatment schedule was 3 chemo treatments with Mitoxantrone 3 weeks apart.  The chemo session takes about 20 minutes with an iv taped to his leg.  He is sleepy the first night afterwards, but otherwise seems fine & hasn't gotten sick at all.  He had significant improvement in his ability to pee within a couple of days after the first chemo (went from just a drip drip to steady dribble without as much straining).  The oncologist said the median survival rate with mitoxantrone & piroxicam treatment is 305 days. Since the chemo is helping JJ, he recommended one more chemo in 3 weeks & maybe one more 3 weeks after that, then we will stop the chemo & just do an ultrasound every 2 months.  I will post updates as we go ahead with this treatment plan & I hope it helps someone else in making their decisions.  If you decide on chemo, I highly recommend going to a veterinary oncology center that does chemo on a regular basis so you know that they know what they're doing.  My local vet offered to order in the medication & do it in his office, but it's not something he does very often, so we've been going to the animal cancer center for every chemo session and ultrasound. 

Here's the website link for CSU-they have useful info on canine cancer with FAQs, nutrition, when to say goodbye, & grief counseling links with phone numbers.  The grief counseling links appear to be staffed mostly by vet students at university veterinary schools & if you're looking for a veterinary oncology specialist, I would start with that list of vet schools & see if one is near you.   

http://www.csuanimalcancercenter.org/

Good Luck to all of you.

Joy & JJ

Dear Joy and JJ;

Thank you for sharing all your information with us!

My Spike, a 13 yr. old Westie, was diagnosed around Christmas last year but was being treated for a UTI since November. He's been on 3 mg of peroxicam and after initial problems (due to the glucosamine we found out and removed from his therapy) he's doing ok. Recent Ultrasound shows the mass (inoperable due to it being located near the trigone) has increased in density but not grown significantly or spread. He is not on any other treatment except his tummy meds. He is on Hill's i/d diet (wet and kibble) which he likes. He loves his walks and still  acts and walks around like a pup. Has anyone else seen their dog's tumor get more dense and not spread? Still concerned but we take each day at a time. Sometimes except for the straining I try to imagine that Spikey doesn't have cancer and he will live out his biological life, we can only dream and hope!

I have just been on the web-site and have read your story about your Scottie JJ.

Last week, Toto my eldest scottie girl at 10yr 3mths, was diagnosed with TCC. We will be starting treatment to-morrow (Friday 27.6.08) which will be Mitoxantrone and Piroxicam.  We will keep you up-dated with progress.

How is JJ.

On 6/26/2008 Elaine and many paws wrote:

I have just been on the web-site and have read your story about your Scottie JJ.

Last week, Toto my eldest scottie girl at 10yr 3mths, was diagnosed with TCC. We will be starting treatment to-morrow (Friday 27.6.08) which will be Mitoxantrone and Piroxicam.  We will keep you up-dated with progress.

How is JJ.

Hi.  I just now checked back on this post--I hope the treatments are helping Toto.  My JJ is doing well after a setback.  The mitoxantrone & piroxicam did wonders for him.  However, after his 4th chemo session the weather was so nice I let him spend a lot more time outside, instead of keeping him inside with a diaper on like we'd done before.  I didn't notice he was licking himself, & the mitoxantrone comes out in the pee for a day or two after treatment & his stomach was irritated by the chemo drug in his urine that he ingested.  By the time my husband noticed it & pointed it out to me, the damage was done.  Because of the stomach irritation, I had to stop giving him piroxicam & then slowly start it at a lower dosage only every other day.  On the next ultrasound 4 weeks later, the cancer had grown 20% & spread to his prostate.  So when your Toto has the chemo, make sure she's not able to lick at herself for at least a couple days afterward.  It seems to me that the mitoxantrone worked miracles as long as it was in combination with the piroxicam....as soon as I had to back off on the piroxicam, the cancer started growing again.  June 3rd JJ became blocked & couldn't pee, & my local vet put in a catheter & I took JJ to CSU.  That's when they did the ultrasound that showed the cancer started growing again & spread to the prostate.  However, it had not spread to the lymphs or anywhere else outside the urinary tract.  So I made the decision to have them put in a urethral stent.  There was no surgery;just a catheter guided procedure.  Immediately JJ was able to pee normally & he's been having no trouble at all peeing since then.  We switched to doxorubicin for chemo & had the chemo done the day after the stent placement.  While the stent was an easy procedure that helped him greatly, the chemo with the doxorubicin made JJ completely stop eating for 3 days & after that he acted like his stomach hurt when he did eat (for about another 4 days.)  It was very rough on him, but he was completely over it after about a week.  Now his bladder is emptying normally & his kidney levels are back down to acceptable levels. JJ's ureters were becoming partially blocked with tcc which caused elevated kidney levels of bun & creatinine. The doxorubicin chemo cleared the cancer from the ureters & the kidneys are working ok now.  He is back on the full dose of piroxicam with daily pepcid, & we're just staying with that for now with occasional course of antibiotics when there's infection.  I doubt that we'll do doxorubicin again because it was so rough on him, but it did appear to work against the cancer.  They said they could do a lower dose & give anti-nausea medication if we do chemo again, but if we did chemo again I think I'd go back to the mitoxantrone because he had no side effects from it.  CSU has one female dog with tcc that's been on mitoxantrone & piroxicam intermittently for over 2 years now.  So, I think your decision to go with the mitoxantrone & piroxicam makes sense.  If CSU had been doing stent placements sooner, that's one thing I would have done a lot earlier.  I can't believe how much it helped him & he doesn't go around straining all the time (only strains when he has a uti.)  Otherwise, he's acting normally & playing with toys & chasing squirrels & eating OK (with an occasional cheeseburger).  I know it's still terminal cancer & the prostate involvement has probably shortened his time, but I'm glad I didn't euthanize him when he got blocked over a month ago. 

Let me know how things are going with Toto.

Joy & JJ.

thank you so much for your reply, I shall copy this and let my vet read your reply. Toto has had her first chemo, no problems so far, she is now on Piroxcam daily, and seeing this can irritate the stomach, I am feeding her 3 small meals a day of Salmon & Potato kibble, which will not leave her stomach empty for acid to build up.  She has her second chemo on the 18th July.  I am finding that Toto is back to her old self, her confidence has come back, she was the Alpha female in the pack of 17 dogs, but when we noticed she had water works trouble she seemed to not want to be top dog.  She did have a secondary infection of ecoli, which has now cleared up and she is more cheerful.  She does not want to pass urine so much as well, also she takes less time to empty her bladder,especially when it is raining. Glad to read that JJ is respondin again to treatment also good to read about the other little female still having a quality of life after 2 years, I can only hope that for Toto.  I will keep you posted.

On 4/16/2008 JJsMom wrote:

Hi to everyone.  For those of you with a TCC bladder cancer dog looking for info on treatment options, here's on update on how my 11 yr old scotty JJ is doing with chemo.  After his TCC diagnosis in February (positive VBAT bladder cancer screening test), I took him to the Colorado State University Animal Cancer Center & they confirmed diagnosis of tcc in the urethra, trigone, & down the front bottom part of his bladder.  They did not do a biopsy & recommended against any surgery in his case due to the involvement of the trigone & urethra.  Instead the oncologist started JJ on the standard treatment of Mitoxantrone chemo intravenously, in combination with the oral Piroxicam he was already taking, & the first chemo session was Feb 19.  He also had a baseline ultrasound done the same day.  He had already been on Piroxicam for 2 weeks, as my vet advised me that I should make sure JJ could do ok on the Piroxicam before proceeding with any other kind of treatment.

Our 3rd chemo treatment with the Mitoxantrone was April 10, & JJ has handled the chemo with no problems.  He has also continued the Piroxicam (3.5 mg once daily for 28 lb dog.)  The good news is that the ultrasound done on Apr 10, when compared with the baseline ultrasound from Feb 19, shows that the cancer has not grown or spread to any lymphs or to the prostate.  The chemo has succeeded in keeping the tcc from progressing, but it has not made it go away.  His treatment schedule was 3 chemo treatments with Mitoxantrone 3 weeks apart.  The chemo session takes about 20 minutes with an iv taped to his leg.  He is sleepy the first night afterwards, but otherwise seems fine & hasn't gotten sick at all.  He had significant improvement in his ability to pee within a couple of days after the first chemo (went from just a drip drip to steady dribble without as much straining).  The oncologist said the median survival rate with mitoxantrone & piroxicam treatment is 305 days. Since the chemo is helping JJ, he recommended one more chemo in 3 weeks & maybe one more 3 weeks after that, then we will stop the chemo & just do an ultrasound every 2 months.  I will post updates as we go ahead with this treatment plan & I hope it helps someone else in making their decisions.  If you decide on chemo, I highly recommend going to a veterinary oncology center that does chemo on a regular basis so you know that they know what they're doing.  My local vet offered to order in the medication & do it in his office, but it's not something he does very often, so we've been going to the animal cancer center for every chemo session and ultrasound. 

Here's the website link for CSU-they have useful info on canine cancer with FAQs, nutrition, when to say goodbye, & grief counseling links with phone numbers.  The grief counseling links appear to be staffed mostly by vet students at university veterinary schools & if you're looking for a veterinary oncology specialist, I would start with that list of vet schools & see if one is near you.   

http://www.csuanimalcancercenter.org/

Good Luck to all of you.

Joy & JJ

My dog, an 8 year old bull mastiff - is being treated with the same medications and chemo

in addition to the piroxicam - she takes mistoprostol twice a day

the side effect of the prixicam is stomach ulcers due to a decrease in the a stomach lining protective enzyme from taking the piroxicam. the mistoprostol replaces the emzyme not produced

I also have her on a  high special diet -- hills n/d for specificially for cancer

it is a high protien and fat and low carb diet ( carbs are thought to feed the cancer) and has other nutritional needs

I also feed her raw brocccoli , shitaki mushrooms , maitake extract and green tea extract , cod liver oil

her recent ultasound showed that the growths have not grown ( same size) 

do now know what is working but I know her immune system ( with all I am giving her) is in good shape and I beleive is needed to fight the her immmune system strong to be able to fight the cancer

My 9 year old Westie Todo just had her first treatment of mitroanitrone (chemo) and is on piroxicam 2.5 each day. I have cheanged her to filtered or distilled water and have changed her diet to high protein low carb diet, I asked by vet if licking herself after her chemo treatment was a problem and she said no.  What did you feed your dog during chemo?  Hope all is well.