It has been about a month since Cody's surgery. He is doing well. The incision is healed and his hair is almost totally grown back in. No more evidence of grey in the muzzle! I'm not sure what I saw before.
I've slowly been gathering information about what types of things I can do to help prevent this cancer from coming back. I'm speaking to 3 veterinary oncologists and you might be able to guess how that is going! Three opinions!! Well not that differing actually. They all recommend metronomic chemotherapy. This web site has a very good explanation of the process and the theory behind metronomic therapy http://www.veterinarycancer.com/metronomic_chemotherapy.html
Basically it is low doses of chemotherapy given over an extended period of time. This therapy is thought to reduce the toxicity of the chemotherapeutic drug and also to inhibit angiogenesis. What the heck is angiogenesis??? Just like it sounds folks, production of new blood vessels. Cancer needs blood to grow. Shut down that pathway - no cancer. There's a great talk by William Li on angiogenesis: http://www.ted.com/talks/william_li.html. Check it out.
The recommended protocol for metronomic therapy is typically a non-steroidal anti-inflammatory (NSAID) plus a chemotherapeutic agent. Two of the three oncologists I've spoken to have recommended I keep Cody on Previcox (that is the NSAID I'm giving him for his arthritis) and add in Cytoxan (also known as cyclophosphamide). If a dog is not already on a NSAID the drug of choice is piroxicam which has been studied extensively for its benefits in treating transitional cell carcinomas in dogs. I am assuming (I haven't asked the oncologist yet) that they have found that all NSAIDs seem to have similar effects on cancer and that is why it doesn't make a difference which NSAID you use.
Now Cytoxan can be a little scary. The drug can cause a hemorrhagic sterile cystitis and/or bone marrow suppression. To prevent the cystitis you basically need to get your dog to drink a lot of water and urinate a lot. Not usually an issue with Labradors, thank goodness! To monitor for bone marrow suppression it is wise to have a CBC (complete blood count) performed every 1-2 weeks. Humans taking this drug are likely to lose their hair. This can happen in dogs, especially those that have continuous hair growth (Poodles).
I'm going to dig around a bit more and I'll let you know what I decide. I guess my biggest fear as a pet owner is that if I don't do the metronomic chemotherapy and the cancer comes back will I be kicking myself and wishing I'd done it. If the cancer doesn't come back well then I'll be singing the praises of all the holistic therapies I've chosen. If the cancer comes back even with doing all of the above well then I guess at that point you just have to let nature take its course.
