PDA

View Full Version : Chemotherapy-Carboplatin/ Cisplatin



spotnnotfarm
Dec. 27, 2010, 11:51 AM
I have a horse that will be receiving Carbolatin injections for a pesky Sarcoid. Has anyone had a horse injected with this? What are the side effects and is there anything I should watch for?

spotnnotfarm
Dec. 27, 2010, 08:56 PM
Bumping this up for information on Cisplatin since they are similar medications. Also, how much did the treatment cost.

SquishTheBunny
Dec. 27, 2010, 09:19 PM
Never used it on horses...but on Dogs we use it as a chemo agent for (usually) osteosarcomas. It is drawn up under a fumehood, with a safe closed system as to prevent any leakage. When given IV in dogs, it is given through an IV catheter, the techs are gowned, gloved and wear masks. Never heard of it being used any other way. You need to be extremely careful when handelling chemo drugs. In dogs, we watch for neutropenia, leukopenia, vomiting and diarrhea. If their wbcs drop they are not given another injection and put in isolation for a few days.

But, I bet with horses, your vet will inject, pat your horse, and say have a nice day ;)

Bluey
Dec. 27, 2010, 10:26 PM
Our then 29 year horse had a very aggressive and fast growing penile tumor, squamous cell carcinoma.
The vet took off 95% and injected the site with Cisplatin right then and two more times at two weeks intervals.
The tumor came back twice more, so he had surgery three times and was injected nine times total, over several months.
After the third time, he was in complete remission, you could not even see where the tumor had been, there was clean, white normal skin there.

We lost him this summer at 30 from a bad knee.:cry:

Grataan
Dec. 28, 2010, 12:11 AM
I've had pretty good luck using the Cisplatin beads around melanomas in grey horses (my n is pretty low though, under 30)

spotnnotfarm
Dec. 28, 2010, 12:14 PM
Thanks everyone! Were the any side effects? How much did the treatment cost? I have to take him to Auburn University tomorrow and just wondered what to expect.

horsepoor
Dec. 28, 2010, 02:01 PM
It has been years...maybe 10?... since I had a sarcoid treated with cisplatin injections. I'm really foggy on the details, it has been so long and we treated that sarcoid with everything under the sun, including lasers and surgical removal.

I had to have a local vet get the cisplatin from the non-local vet that prescribed it, then the local guy came and injected the sarcoid periodically -- once a week? I don't remember! It wasn't terribly expensive, as I recall, for the cisplatin itself - maybe a few hundred bucks. But the call out for the local vet added up ($25 farm call + $40 or whatever he charged to inject, over multiple times).

In the end, the only thing that removed the sarcoid completely and made it stay away was xterra. After 10 years, or whatever it has been, the sarcoid has finally stayed gone.

Oh- and no side effects that I noticed, and don't recall being concerned about any.

Grataan
Dec. 28, 2010, 06:09 PM
Oh I think the beads were around $100 each our cost (or it was $100 our cost for the pack of three, it's been a while since I've done one) I surgically remove the melanoma and leave the beads behind if there is any doubt about margins or if the melanoma was large.

As an owner with a melanoma horse it makes me feel better to be "doing something" but as a doc ehhh...I just haven't seen/used enough to be "OOOH we need to do this every time, this is the best method ever" Because of this, we are only charging cost+handling of the beads (no markup) and then the client pays for sedation and surgery etc.

fivehorses
Dec. 28, 2010, 08:08 PM
I had a horse treated this summer for sarcoid on her muzzle with cisplatin beads..no side effects that I noticed.
sarcoid was treated twice with implants.

I think the cost was almost 5,000.

spotnnotfarm
Dec. 28, 2010, 08:28 PM
I had a horse treated this summer for sarcoid on her muzzle with cisplatin beads..no side effects that I noticed.
sarcoid was treated twice with implants.

I think the cost was almost 5,000.

Yikes! I wa told the gas to the University would be more than the treatment! He is just getting an injection not an implant. What did the implants do/look like etc... Did your horse have to stay at the hospital?

I am somewhat worried because Grover has a fair amount of allergies and is sensitive to a lot! I am hoping it goes smooth tomorrow and does not have a $5000.00 price tag!

fivehorses
Dec. 28, 2010, 08:53 PM
beads were 150 each, mare had to go two times, general anesthesia for 15 minutes to implant, 3 day hospital stay x2.
cost was 4,300.
no, this place isn't cheap, but they are good. But, I do think on the high end of costs.

rockfordbuckeye
Dec. 28, 2010, 09:37 PM
Dunno about horses but in humans the main side effects of cisplatin/carboplatin: 1. nausea/vomiting - they are the worst offenders of all chemo agents for this 2. drop in platelet counts (like all chemo drugs) 3. drop in white blood cell count (expected - desired - you're attacking their immune system - the biggest drop is about 10-14 days after treatment) 4. damage to kidneys - make sure horse is well hydrated 5. damage to liver 6. hearing loss/ringing of the ears 7. fever (more common with cisplatin than carboplatin).

Granted - these are for humans getting high doses for aggressive chemotherapy but it's what I have to offer :)

Bogey2
Dec. 29, 2010, 09:34 AM
two horses here were treated only once with the injection of chemo and both had no side effects and the sarcoids nevr came back. Both were done over 4 years ago. The cost was around 200.00 or less at Tufts. No hospital stay, just out patient.

jcotton
Dec. 29, 2010, 10:37 AM
Crest toothpaste is very affective and cheap for most sarcoids.

Rider61
Dec. 29, 2010, 10:57 AM
Hi, all! I haven't been around here for a while, so I was amazed to find this topic that I just emailed my vet about. I've got a mare with a squamous cell carcinoma that I've had standard surgery, laser surgery, and 5-FU chemo on but persists nonetheless. This popped into my mailbox a couple of days ago, and I immediately sent it on to my vet. I had cisplatin treatment myself for cancer, so I know that there are some side effects when it's given IV but nothing to write home about as long as supportive meds are given, and not getting it intravenously has to be better. There was an article about five years ago about cisplatin beads for sarcoids, so the treatment has been around for quite a while. Granted, this article isn't about sarcoids, but the info on the treatment is interesting, and this is the identical tumor that I'm dealing with. I don't have a price estimate yet, but hope to soon. Check this out:

http://horseandman.com/medical/cisplatin-beads-to-cure-squamous-cell-carcinoma-in-horses-a-happy-ending-for-aponi/?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+Horseandmancom+%28horseandman .com%29

The side effects of the topical 5-FU were bad enough for me to be unable to finish the 14 days of treatment the first time around, so if this is better, I'm all for it! A single tube of 5-FU was over $300, and that's after the "family discount" at Rite Aid when I made my horse a dependent on their discount program. :cool:

Grataan
Dec. 29, 2010, 06:04 PM
Yikes! I wa told the gas to the University would be more than the treatment! He is just getting an injection not an implant. What did the implants do/look like etc... Did your horse have to stay at the hospital?

I am somewhat worried because Grover has a fair amount of allergies and is sensitive to a lot! I am hoping it goes smooth tomorrow and does not have a $5000.00 price tag!

The beads we get look like those little plastic cat litter beads, or those little white nonpareils that one puts on cakes or cookies.

I would guess the major cost of that $5k bill was anesthesia or surgery charge related.

Grataan
Dec. 29, 2010, 06:06 PM
Dunno about horses but in humans the main side effects of cisplatin/carboplatin: 1. nausea/vomiting - they are the worst offenders of all chemo agents for this 2. drop in platelet counts (like all chemo drugs) 3. drop in white blood cell count (expected - desired - you're attacking their immune system - the biggest drop is about 10-14 days after treatment) 4. damage to kidneys - make sure horse is well hydrated 5. damage to liver 6. hearing loss/ringing of the ears 7. fever (more common with cisplatin than carboplatin).

Granted - these are for humans getting high doses for aggressive chemotherapy but it's what I have to offer :)

Do you have any data about the method of administration? I'm guessing this was IV, but I wonder if they use other methods in people, I'm going to call Dr Mr G and ask if he has a good hospital pharmacist friend with a brain I could pick....oooh I can raid his textbook stash in the den too

Bluey
Dec. 29, 2010, 06:47 PM
For his penile tumor, our horse was at the vet hospital, either for surgery or for treatments after that, two weeks apart.
Best I remember, each cisplatin injection was around $80 and it was injected directly on the site.
When we hauled him there to be injected, he was lightly tranquilized only, no heavy sedation.

There were no side effects at all locally, no swelling, discomfort or even itching and he never acted sore, slow or quit eating.

rockfordbuckeye
Dec. 29, 2010, 09:42 PM
So, I am a hospital pharmacist with a decent brain ;)

The side effects I stated are (I think I said?) really more for people on IV higher dose for systemic treatment of cancer. So they would be worse case scenario.

I have never seen a human given Sub-Q or IM cisplatin or carboplatin. I looked and there are no papers on it in pubmed. I'm sure someone's tried it but probably for skin tumors and what not and I would likely not see those in the hospital - they would be in outpatient clinics :( So sorry - no experience!

There are a few regimens that we use other chemo agents in by that route (cytarabine or Ara-C is the most common). In my patients that have had sub-Q cytarabine it is much better tolerated sub-Q vs. IV in higher doses. Which kinda makes sense right? The stuff is basically cell poison and has a very strong dose response curve. Low dose sub-Q isn't going to nearly knock out your immune system like high dose IV would. So I really saw little side effects in patient son sub-q cytarabine, I would totally believe that carboplatin and cisplatin might be as well tolerated.

spotnnotfarm
Dec. 30, 2010, 02:15 PM
Thanks everyone! We went to Auburn yesterday for his first injection. It was very quick appointment and was not expensive. I asked for banamine since he is sensitive and today there is just a small amount of swelling around the sarcoid. He goes a few more times and hopefully, imporvement will be seen soon!

rockfordbuckeye
Dec. 30, 2010, 02:50 PM
'cause I'm curious - how often will vet inject for sarcoid and how do they monitor? will he get blood counts weekly?

i figure i know enough about human stuff - time to learn what the vets are up too!

spotnnotfarm
Dec. 30, 2010, 05:35 PM
They are injecting him every 3-4 weeks. It is a lot easier than Chemo in humans. They are not conducting any blood counts or monitoring his levels at all. In fact the only side effect is swelling. I was worried because of how badly Chemo affects people. Apparently, using Chemo in horses for a sarcoid is not that big of a deal.

SquishTheBunny
Dec. 31, 2010, 12:00 AM
Apparently, using Chemo in horses for a sarcoid is not that big of a deal.

You are probably right, but the person HANDELING the chemo is the one at risk.

Just gave an injection on the tounge of a cat today, carbo directly into the Squamous cell carcinoma lesion. Vet was gowned up in a spill resistent gown, face mask and chemo gloves.

Chemo causes cell death, cancerous and heathy. Cisplatin is also carcinogenic to humans:

Cisplatin
Toxic? Yes. “Cumulative renal toxicity associated with [Cisplatin] is severe…Ototoxicity which may be more pronounced in children, and is manifested by tinnitus, and/or loss of high frequency hearing and occasionally deafness, is significant.”

Carcinogenic? Yes. Cisplatin was listed as “Reasonably Anticipated to be a Human Carcinogen” in the Eighth Report on Carcinogens published by the U.S. Department of Health and Human Services.

FDA approved only for metastatic testicular cancer, metastatic ovarian cancer and transitional cell bladder cancer.


Carboplatin
Toxic? Yes. “Loss of vision…has been reported…”

Carcinogenic? Unknown. “The carcinogenic potential of carboplatin has not been studied… Carboplatin has been shown to be mutagenic both invitro and invivo.”


Just because its not given IV doesnt mean there are no risks....especially for the handeler of the chemo, not necessarily the reipient! Dont forget there is also biohazard disposal for the waste, cant just chuck it in the garbage! Biohazard pickup can run up to $1500 per month! This is why at any "good" practice that dispose of hazards properly and provide safety measures for their staff, the costs are going to be high for that "one tiny injection".

spotnnotfarm
Dec. 31, 2010, 08:02 AM
You are probably right, but the person HANDELING the chemo is the one at risk.

Just because its not given IV doesnt mean there are no risks....especially for the handeler of the chemo, not necessarily the reipient! Dont forget there is also biohazard disposal for the waste, cant just chuck it in the garbage! Biohazard pickup can run up to $1500 per month! This is why at any "good" practice that dispose of hazards properly and provide safety measures for their staff, the costs are going to be high for that "one tiny injection".

You are 100% correct! The vet and techs had on protective clothing, gloves, etc... Everything used on him was put into a Hazmat bag. I had to take him to the University because my vet does not have the license and facility to handle the medication. The shot itself was $28.00 but the "extras" made my bill $100.00 (still not bad at all). Also, I have to wear gloves for the next week when I clean the area and cannot ride him for 4 days in case of leakage.

I did not mean to demean the process, but it was not as severe as a person who is undergoing chemo for the horse. The vet stressed that I was more at risk than he was. Thanks for the information!

Grataan
Dec. 31, 2010, 01:12 PM
FWIW, when we use the stuff it is completely separate from biohazard waste. It is a whole nother level of Chemotherapeutic waste and the charge and handling is much much much more expensive than biohazard.