iPet’s Ally Weekly Q&A Round-up 03-15-21: What’s the difference between doxorubicin and vinorelbine?

iPet's Ally Q&A Round-Up 03-15-21

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1. When does B12 deficiency and folate deficiency occur? And what can be done to treat this deficiency?

B12 deficiency and folate deficiency occur when there is an insufficient amount of vitamins being absorbed which is all secondary to the G.I condition, so they don’t cause a problem, but they are a result of an ongoing problem of malabsorption. So, if chronic pancreatitis or pancreatic exocrine insufficiency – the dog’s not making enough pancreatic enzyme, is a potential problem, then this is where the Texas A&M test would be useful because it is going to show you if this a problem because the pancreas is unhappy or your dog’s having diarrhea because there is not enough pancreatic enzyme. It will show you that the B12 is either low or high and the folate is either low or high. I think B12 injections will help your pup feel better, but it still doesn’t address the underlying issue.

Now, if the pancreas is not a problem and your dog is having diarrhea, there might be still a bug in there something like C – diff, campylobacter, E coli, pathogenic species of E. coli and all of these bugs make enterotoxins – the little proteins that make our tummies be very unhappy, wh gich is why it’s important to know if there’s a bug in there not able killed by metronidazole which is what almost every veterinarian tries. However, if your vet is not able to do that, this is where consultation may be very helpful to you as far as I can review the medical records of what’s been done so far and then make some suggestions that your veterinarian may not be familiar with. Again, B12 will probably help your pup feel better but it won’t necessarily fix the G.I issue. I hope that makes sense.

2. How can I help treat my dog’s nasty wound?

If the wound did not heal even after a long time, what I would suggest is to get the skin cultured as soon as possible. Suppose it’s in the shoulder, you probably can do some sort of a wrap where you can pack it with sugar or honey to kind of start killing it. What I would do is clean things with povidone solution, pack it with sugar if you can, and then take your pup to your vet.

What I would ask your vet to do, is to do a culture and sensitivity test and then frankly, do a biopsy because skin stuff can be cancer. Additionally, it can take a long time to get veterinarians to do this, so assuming it has been a long haul for your pup last time, get the answers quickly. I think it’s worth spending the money.

This is something that can be done; your vet may hate me, but you can do this with something that’s called a punch biopsy and a local anesthetic. A punch biopsy looks like a pen except for that at the top, it’s somewhere between 2 mm and 4 to 8 mm. If it’s a good-sized wound, what I would do in practice is clip it up, take the swab to get a culture and sensitivity, put lidocaine under the skin about a quarter sized area, take that punch biopsy, and make sure that part of the normal is gotten in that biopsy and then a good chunk of the abnormal skin. Go all the way down to the fascia. With the lidocaine, your veterinarian can put 1 or 2 sutures in there, close the thing up, bandage it and it will heal reasonably well. That’s going to be your best bet to get this done without anesthesia. Hopefully, that makes sense.

3. Can giving spirulina daily cause the urine pH to be alkaline and cause UTI?

It can cause the urine pH to be alkaline but generally, it should not cause a UTI. Having said that, bacteria often cause the urine to be alkaline. So, if your pup is having problems with this again, this is where making sure your pup’s urine pH stays between 7 and 7½. If you’re seeing it be 8, then I would encourage you to use vitamin C or something else like that to help acidify the urine more and bring it down. Now, if you are concerned about a bacterial infection, that is where using d – mannose on a regular basis can be extremely helpful too. I hope that is helpful.

4. What heartworm medicine is the best?

I think, Heartgard or its generic is the way to go. I would avoid the Tri – heart because it had recall issues. Sentinel has been associated with autoimmune disease. It occurs at a very low percentage of something like 0.1% but let’s just go simple and avoid any type of reactions. Now, if you’re asking specifically for dogs that has cancer, what I would suggest is go every 60 days on heartworm prevention for cancer patients and then definitely clean out with milk thistle to help support the liver because the pup has had some other stuff going on there that its liver will have trouble with.


5. What’s the difference between doxorubicin and vinorelbine?

Now, out of these two drugs – doxorubicin and vinorelbine, doxorubicin has some side effects as far as the heart is related but that is a dose – dependent thing. Now, of course, any animal can respond adversely to any medication at any dose. Vinorelbine is a 2nd generation version of incristine. The way it works is by preventing the microtubular proteins to be locked down so that cancer cannot divide. This was when vincristine was helpful in practice for many type of cancer.

In relation, there’s a paper looking at dogs with lung cancer primarily, and one dog with mast cell tumor. Histiocytic sarcoma was a huge number out of this study of tumors and so what they found was pretty good results. The overall outcome was not bad. One dog had complete response after 3 weeks which is amazing for 160 due 2 days. 11 had a partial response. 19 had a stable disease for 70 days range, but the range is huge 35 to 300 days. So, this is not a bad option. I think out of those two drugs, doxorubicin is the one that I would choose. Doxorubicin is often used when there’s sort of nothing else so I would save that for later.

I hope you all are happy, healthy, and enjoying. Again, we got Patrick’s Day sale coming up. We’re actually starting today, so just let us know how we can be of help. Bettina, thank you so much for doing that video review. And if you have time or inclination to do that, that would be marvelous. Whether it’s about Ipet’s Ally, consultations, CrockPet Diet, Holistic Total Body Support, we would deeply appreciate it because your words as the person who experienced these things with your pets, carry far more weight than anything could ever say. That’s what I’ve got for you this week. Have a wonderful day. Until next week. I’m your pet’s ally. Remember, your pet’s best health starts in the bowl. Thanks!


Links Mentioned:

Vinorelbine: https://bit.ly/3fqgHT2

Clinical effects of vinorelbine administration in the management of various malignant tumor types in dogs: 58 cases (1997–2012): https://bit.ly/3yFRVGa