substitute for Vincristine?

Re: substitute for Vincristine?

Martin Atkinson — Thu, 16 Oct 2014 13:52:39 GMT

[quote user="Martin Atkinson"]I wrote it up as a case in VT and got a bollocking from some pedant who accused me of risking the dog's life with an undocumented treatment protocol - heck it may even been one of you lot on here![/quote]Given this post has gone from an instant 5 gold stars to 3.5 means that this supposition was probably correct and my detractor is a red star man amongst us.

Re: substitute for Vincristine?

Francisco Gomez — Thu, 16 Oct 2014 12:24:42 GMT

[quote user="Bob Russell"]

www.munroveterinarysupplies.com have it listed as in stock (also pretty good price!). Give them a ring to check!

[/quote]

Thank you Bob! Got some vials from them. Problem solved!!! (for now...)

Re: substitute for Vincristine?

Laurence Webb — Wed, 15 Oct 2014 20:45:55 GMT

I had vincristine and cyclophosphamide delivered today from NVS. No problems with ordering for me.

Re: substitute for Vincristine?

Virginia Campbell — Wed, 15 Oct 2014 16:17:57 GMT

[quote user="Martin Atkinson"]I wrote it up as a case in VT and got a bollocking from some pedant who accused me of risking the dog's life with an undocumented treatment protocol -[/quote]

Well it's documented now - by you. Job's a good 'un.

Re: substitute for Vincristine?

Martin Atkinson — Wed, 15 Oct 2014 15:04:38 GMT

I used vinblastine once for a dog with life threatening auto-immune thrombocytopaenia because we hadn't got any vincristine and had no access to packed blood cells or a transfusion. It seems it's platelet releasing properties are even greater as the dog went from a PLT count of single figures to hundreds and the petechaie and echymoses disappeared, overnight.

I wrote it up as a case in VT and got a bollocking from some pedant who accused me of risking the dog's life with an undocumented treatment protocol - heck it may even been one of you lot on here!

Re: substitute for Vincristine?

Bob Russell — Wed, 15 Oct 2014 14:56:57 GMT

www.munroveterinarysupplies.com have it listed as in stock (also pretty good price!). Give them a ring to check!

Re: substitute for Vincristine?

Francisco Gomez — Wed, 15 Oct 2014 14:30:34 GMT

Thanks to all of you for your responses!!! I can't thank you guys enough!

We have already tried local pharmacists but will keep looking since it looks like I'm the only one with this problem. If not, I will be following Garry's advice and try vinblastine with the recommended precautions.

Re: substitute for Vincristine?

Robin Grimmer — Wed, 15 Oct 2014 13:38:13 GMT

Has anyone had problems getting hold of cyclophosphamide?

Re: substitute for Vincristine?

Gerry Polton — Wed, 15 Oct 2014 13:30:28 GMT

I agree with Martin in that if you can't get hold of vincristine, vinblastine would be your best substitute. The dose is 2mg/sqm, approximately three times the volume of injection that you would give with vincristine. The adverse effect profile is similar but vinblastine is more likely to induce myelosuppression so make sure you check a CBC 7 days after the dose is given.

I would be really surprised if you were unable to obtain vincristine from anywhere. As mentioned in another post, you might find you can obtain it from a local pharmacy. We regularly hear of reported drug shortages but almost never find ourselves really unable to obtain drugs. I am fortunate that I have a staff member who has been sourcing these products for me for a long time and knows which local pharmacies are good for which products but when we started working together it did take a while to figure out who to go to for what when NVS and Centaur couldn't deliver.

Best of luck

And by the way, I virtually never 'fully stage' cases. Money for old rope most of the time in my humble opinion so good on you for conserving your owner's resources for something useful instead

Gerry

Re: substitute for Vincristine?

Andrew Mellor — Wed, 15 Oct 2014 10:22:05 GMT

I suppose you have rung round your local pharmacies we had a n issue just over a month ago but then get 5 vials from a local pharmacy no problem and much cheaper than from our wholesaler.

If that angle has been tried have you considered moving onto metronomic chemo dropping the vincristine altogether and continuing with cyclophos and steroid or nsaid ( I usually use meloxicam ) on a daily basis to hit the blood supply rather than the tumour, 12.5-15mg /m2 cyclophos daily ( novalabs) and normal maintenance dose metacam.

Re: substitute for Vincristine?

Martin Atkinson — Wed, 15 Oct 2014 10:00:57 GMT

That's a bit of a worry if we get a new case.

I've used Vinblastine instead, supposed to be useful for vincristine resistant tumours, don't know if that is any more available. I would also suggest l-Asparaginase but it is very expensive. Gerry is away I think at the moment but he will know better.