Question Details
Mast Cell Tumors In A Dog
by drakedoc - October 25, 2017    View Case Report
I am SO SORRY to bug you but when I got back to my practice from the AHVMA meeting (I live in San Diego) one of my favorite patients, 5 1/2 year 100 pound mastiff named Moose (best dog ever), sprouted new mast cell tumors. One month ago she had 3 small masses pop up suddenly on her pinna, 1 SQ on her lateral thorax 1.5cm and one cutaneous ulcerated mass on her right hock 1.5cm that had been present for a month but suddenly got bigger. All the masses were removed and came back high grade II. The one on the side was incompletely rescected. It subsequently dehisced and is not healing well (no shock there). Anyway she was sent to an oncologist who was going to recut but then her popliteal node blew up and was positive for MCT. Her abdominal ultrasound was clean but before she could get in to see the surgeon 2 weeks later four new masses were found near her stifle. Now the plan is to start an alternating course of CCNU and vinblastine. I want to make sure that nothing I do is going to interfere with his plan. I already started her on a home cooked diet from JustFoodforDogs and a tumeric supplement (Curost Total Support by Tom Shell, has a few other things in it too). I usually do the typical modified XFZYT but I'm not sure that is her ideal choice as prior to seeing MCT she did have Damp signs (otitis, pyoderma). I have not felt her pulses recently but Moose is a huge wet super friendly, not timid at all dog. Blood deficiency/ stasis may be a component but not the whole story. Anyway, I was considering Xian Fang Huo Ming Yin because of the Dampness (although her tumors did pop up during our dry season). I just want to make sure this will not interfere with the oncologists CCNU/ Vinblastine plan. I left a message on his voicemail asking about prognosis and when does Palladia come in.
BTW Erin,you totally rock. (you too Steve) Thank you for staying true to yourself and your efforts to bridge the gap between western and eastern medicine with kindness and listening and science. Critical if we ever want to accomplish anything, Kathy Boehme
Replies
by naturevet
October 30, 2017
Hi Kathy,

For a case like this, I usually stay away from Blood movers, and use Hoxsey and Si Miao San together.

They are fine with chemo in principle, and may enhance its efficacy. For that reason, I use them even on chemo days, although I know Erin likes to skip giving herbs on injection days. So your choice there. If you can get the situation cooled off, and there are still tumors on the periphery, I'd recommend removing them at some point.

If chemo takes the dog very low, you can use Six Gentlemen (Liu Jun Zi Tang) to pick her back up, and temporarily halt the Hoxsey and SMS. Otherwise, though, I'd use them as long as there is a suggestion of Damp Heat

Hope that helps!

Steve
by drakedoc
October 30, 2017
Thank you Steve. I'll update Moose's case as we progress, Kathy
by bannink
January 3, 2018
Hi Kathy and Steve,

Just now getting a minute to catch up on the forum. I wonder how Moose fared with treatments?
I wanted to make a clarifying comment about herbs with chemo, just since it is such a common question. In my personal patients who are already on herbs and are planning to get chemo, I don't actually skip the herbs on chemo days. That is an advisable approach when working with an oncologist who is uncomfortable with the idea of giving the herbs concurrent with the chemotherapy. So, out of respect for everyone that is a good compromise. I do, however, try to avoid starting a bunch of new therapies at once. So if the patient is new to both chemo and herbs, my approach is (gernerally) to start chemo. Then after the patient has received one dose of each drug in the protocol then we start antineoplastic herbs. The reason for that is just because chemo can affect appetite and GI (vomiting and diarrhea) and if we start everything at once it isn't possible to determine what is causing the problem. So it's a management preference. So, not that it's relevant to Moose at this point, but if people are browsing the forum wanted to just add these two cents.
Erin
Reply to this question.
You must be logged in to reply