Advice with a high dose COP for B cell Lymphoma

RE: Advice with a high dose COP for B cell Lymphoma

Martin Atkinson — Fri, 09 Oct 2015 09:47:43 GMT

[quote user="SER"] Owner has decided not to persue acupuncture at the moment.[/quote]At least common sense has prevailed. Who or what put up for acupuncture in the first place? If it was a para-professional they are guilty of exploiting the vulnerable and desperate and should be talked to at least.

RE: Advice with a high dose COP for B cell Lymphoma

Sara Ramsey — Fri, 09 Oct 2015 01:02:22 GMT

Thank you Dalya, very helpful. Owner has decided not to persue acupuncture at the moment.

RE: Advice with a high dose COP for B cell Lymphoma

Dalya Livy — Thu, 08 Oct 2015 22:02:01 GMT

Acupuncture use in cancer patients is generally contraindicated, for 2 main reasons:

- if they are on chemotherapy, there is a risk of infection, as already stated above

- acupuncture increases blood flow locally, and activates the inflammatory cascade both locally and systemically - not ideal if your needles are anywhere near the tumour

My AP training was with IVAS which teaches both Western and Eastern methods, and both agree in this respect. I would only use acupuncture if I needed extra help with nausea or appetite stimulation, provided I could keep my needles well away from the tumour site(s).

I hope that helps, and good luck with the dog!

Dalya

RE: Advice with a high dose COP for B cell Lymphoma

Anthony Dennison — Thu, 08 Oct 2015 09:06:08 GMT

I recently read a meta-analysis on acupuncture - there seems to be no difference for chronic pain, but does seem to help diarrhoea for some reason?!

RE: Advice with a high dose COP for B cell Lymphoma

Sara Ramsey — Wed, 07 Oct 2015 21:54:52 GMT

Thank you, Lucy that is helpful advice.

RE: Advice with a high dose COP for B cell Lymphoma

Lucy Fleming — Wed, 07 Oct 2015 16:14:05 GMT

[quote user="SER"]also, the owner wants to do acupuncture as well, is there any clinical reason not to do this?[/quote]

I would tend to agree that needling an immune-compromised animal isn't a good idea. Based on the western theory of acupuncture for pain relief I can't see how it could be helpful in this case. BSAVA rehab, supportive and palliative care manual has some interesting bits of info about acupuncture in each of their case studies and the lymphoma one doesn't really support it (and they are generally relatively pro its use where appropriate)

RE: Advice with a high dose COP for B cell Lymphoma

Martin Atkinson — Wed, 07 Oct 2015 15:28:02 GMT

[quote user="SER"]the owner wants to do acupuncture as well, is there any clinical reason not to do this?[/quote]You may be better asking if there's any clinical reason to do it! They might like to get some snake oil from Animal healings solutions while they're at it as well. I would head this off my emphasising the risk of an infection from the acupuncture needles in an immuno-suppressed individual.

[quote user="SER"]

5mg/m2 would be around 2.35mg for this dog, so most a likely a 2mg leukeran tablet.

How long do we do this every other day dosing...is it continuous for life or just the induction (first 4 weeks) phase? and would I start it immediately or wait until 21 days after my last cyclophosphamide dose?

also, the owner wants to do acupuncture as well, is there any clinical reason not to do this?

Thanks again for any replies

[/quote]Gerry is the best man again for this but to get the dose nearer the target of 5mg/msq you could give a total of 8mg in a week so that would mean one day double dose or two days in succession. Some protocols suggest up to 10mg/msq so you should be OK.

You give chlorambucil every week until when you go alternate weeks with preds then go alternate weeks with that as well normally 8 weeks from induction.

RE: Advice with a high dose COP for B cell Lymphoma

Sara Ramsey — Wed, 07 Oct 2015 10:42:55 GMT

5mg/m2 would be around 2.35mg for this dog, so most a likely a 2mg leukeran tablet.

also, the owner wants to do acupuncture as well, is there any clinical reason not to do this?

Thanks again for any replies

RE: Advice with a high dose COP for B cell Lymphoma

Gerry Polton — Wed, 07 Oct 2015 08:32:39 GMT

I use option four every time

Gerry

RE: Advice with a high dose COP for B cell Lymphoma

Sara Ramsey — Tue, 06 Oct 2015 23:01:43 GMT

I have edited it now. Many thanks for spotting that.

RE: Advice with a high dose COP for B cell Lymphoma

scatty — Tue, 06 Oct 2015 22:48:57 GMT

I was reading through your history and I was a bit confused - is it meant to read ' This is my main query - how to dose the chlorambucil' ?