PPT explain genral introduction Regarding chemotheraphy in animals, there scope, advantage & disadvantages.

1. COLLEGE OF VETERINARY AND ANIMAL
SCINCES, PARBHANI
Submitted by
Balaji. M. Jogdand
M.Vsc Scholar,
Dept. of Vet Pathology

2. Introduction
 Chemotherapy for animals is much different from that for human cancer patients.
 For animals receiving chemotherapy, quality-of-life and the basic goal of extension
of life span for the patient is the primary concern
 In many cases, doctor are unable to cure veterinary cancer patients. The goal, once
again, is therefore to improve a pet’s quality of life. To this end, chemotherapy can be
used to minimize the discomfort caused by a tumor or to slow down the progression
of the disease.
 Doses of drugs and treatment schedules are calculated to minimize discomfort to the
patient, while providing the most effective defense against the disease.

3.  Most people are pleasantly surprised at how well their pets feel while
undergoing chemotherapy.
 For most (but not all) types of tumors, the oncologist will provide information
on average life expectancy with and without treatments
 Although the word chemotherapy can mean the use of any drug to treat any
disease, to most animals/peoples
chemotherapy refers to drugs used for cancer treatment.
Introduction cont..

4. Mechanisms of Chemotherapy
 The goal of chemotherapy is to inhibit the growth of cancer cells with minimum
effect on normal cells
Most chemotherapeutic agents either bind directly to genetic material in the cell
nucleus, or affect a cell's ability to synthesize protein, which may damage growth
and reproduction of normal cells as well cancerous cell.
 Chemotherapeutic agents are classified according to their pharmacologic action,
and the point in the cell cycle at which they interfere with cellular reproduction.

5. I. Cycle phase-specific: Drugs that are active only during a specific phase of the cell
cycle.
II. Cycle phase-nonspecific: Drugs that are active regardless of the cell cycle phase
Mechanisms of Chemotherapy cont..

6. Following cell death, resting cells are 'awakened' into the reproduction cycle and are
then more susceptible to chemotherapeutic agents.
Regardless of the specific mechanism of the intracellular disruption, the cell will die as
it attempts cell division if it is not capable of repairing itself.
 The cell kill rate of various drugs is related to the concentration of the drug and to the
degree of tumor cell exposure over time.
 Combining cytotoxic drugs is an important, effective strategy in chemotherapy,
because when drugs are used in combination, they often enhance the activities of each
other.
Mechanisms of Chemotherapy cont..

7. Administration
 Treatment dose and schedule depends on the type of cancer and chemotherapy
method.
 In many cases periodic chemotherapy will be necessary to control the cancer for
the rest of the pet's life.
 For maximum therapeutic effect, a drug should be used with a dose that causes
minimal toxicity with maximal effectiveness.
The most effective dose of chemotherapeutic agents is often very close to the
toxic dose.

8. Doses of chemotherapeutic agents are often calculated on the basis of body surface area
in square meters, rather than by a patient's weight.
 The following charts give some common dosages for many drugs and the conversion
chart used for dogs and cats
 The duration of chemotherapy depends on the type of cancer and the extent of disease
I. Some animals need to receive chemotherapy for the rest of their lives.
II. In others, treatments may be spread out or discontinued after a period of weeks to
months provided that the cancer is in remission.
Administration cont..

9. Administration cont..

10. Administration cont..

11. Treatment Of Specific Neoplasms In Animals
Lymphosarcoma is the most common hemolymphatic neoplasm
in the dog. Untreated, the disease is rapidly progressive resulting
in death in one to three months for the majority of dogs.
Most regimes have an aggressive induction schedule where
drugs are given more frequently or at a higher dose followed by
a maintenance program. Varying combinations of
cyclophosphamide, vincristine, methotrexate, L-asparaginase,
prednisone, cytosine arabinoside and adriamycin have been used
with success.

12. Monoclonal Gammopathies-Monoclonal elevations of protein result from the increased synthesis of
immunoglobulin (Ig) by a clone of B lymphocytes. The cause of the monoclonal gammopathy may be
idiopathic or benign, but more commonly they are the result of a malignant neoplasm.
 The type of immunoglobulin produced and cell type identified on biospy together forms the basis of
categorizing the neoplasms as multiple myeloma, macroglobulinemia or a lymphoproliferative disease.
 A standard regime for the treatment of multiple myeloma includes the use of cyclophosphamide,
melphalan and prednisone. The response to therapy is good with a 77% remission rate and average
survival of greater than nine months.
 Macroglobulinemia is a neoplasm of B cells that produces IgM. The large size of IgM results in serum
hyper-viscosity and can cause a variety of clinical signs . The treatment for macroglobulinemia consists
of chlorambucil.
Treatment Of Specific Neoplasms In Animals cont..

13.  Mast Cell Tumors- Chemotherapy has been
recommended for the treatment of mast cell tumors if
there are multiple dermal tumors, incomplete excision,
large infiltrating tumors or metastases.
Treatment for this is Combinations of prednisone,
vinblastine and cyclophosphamide.
Despite these reports, there have been no controlled
clinical trials using combination chemotherapy in which
the tumors were histologically graded or clinically
staged.
Treatment Of Specific Neoplasms In Animals cont..

14. Transmissible Venereal Granuloma(TVT)-
A combination of vincristine, cyclophosphamide and
methotrexate
A more recent report indicates that treatment with
vincristine (0.025 mg/kg, I.V.; up to a I mg maximum)
is as effective as combination chemotherapy
Treatment Of Specific Neoplasms In Animals cont..

15. Osteosarcoma(osteogenic sarcoma/primary
bone tumors):
Osteosarcoma is the most common primary
bone tumor diagnosed in dogs. In fact, when a
tumor is found in the bone, it is ultimately
diagnosed as OSA more than 90% of the time.
 This cancer is characterized by a high rate of
spread to other parts of the body, especially the
lungs and other bones
Treatment Of Specific Neoplasms In Animals cont..
Radiograph of a patient with osteosarcoma.
The lesion is seen in the distal radius and ulna of the forelimb
and is characterized by lysis and production of bone .

16. In cats, amputation alone is often curative(OSA tends to
remain localized, therefore chemotherapy is not advised.).
In dogs, surgery and chemotherapy are the treatments of
choice.
cisplatin or carboplatin alone or in combination with
doxorubicin.
 The first chemotherapy is ideally administered immediately
following surgery, and then further treatments are given at
21 day intervals for a total of 5-6 treatments.
Treatment Of Specific Neoplasms In Animals cont..
Cells obtained from a bone
aspirate of a dog with OSA.

17. Anal gland adenocarcinoma (AGA) (apocrine gland
anal sac carcinoma adenocarcinoma or anal sac
adenocarcinoma)
 uncommon cancer that arises from the apocrine glands
in the walls of the anal sacs.
middle aged - older dogs.
 High calcium levels (paraneoplastic hypercalcemia) are
seen in approximately 25% of patients with AGA.
Treatment Of Specific Neoplasms In Animals cont..

18.  The recommended treatment for anal gland tumors is complete
surgical excision followed by chemotherapy (e.g. carboplatin or
mitoxantrone) in order to prevent or slow the onset of metastasis.
 For cases in which complete surgical excision cannot be
obtained, follow-up radiation therapy is recommended to control
local disease.
 Because sublumbar lympadenopathy occurs in more than 50% of
patients, it is recommended that sublumbar lymphadenectomy
(removal of sublumbar nodes) be performed.
Treatment Of Specific Neoplasms In Animals cont..
Cytology from fine needle aspirate of
an anal sac adenocarcinoma. Typical
epithelial cell clustering is noted.

20. Twinkie is getting vinblastine for her metastatic mast
cell tumors(MCT).

21. Side Effects
Practically all anticancer drugs have side effects. However, their potential effect
against the cancer generally outweighs the possible side effects.
Compared to people who receive chemotherapy, pet animals experience fewer
and less severe side effects because lower doses of drugs are used and are not
combined as many drugs in human medicine are.
Below are listed some potential side effects of many chemotherapeutic agents:

22. 1. Hair Loss (Alopecia)-Animals rarely lose their hair, but if they do, they are not
bothered by it as much as people are. In most pet animals, hair does not grow
continually throughout their lives like it does in people. Therefore, hair loss in
pets is rare.
2. Loss of White Blood Cells (Neutropenia)-Many chemotherapeutic agents
impair the bone marrow's ability to produce cells. As a result, neutropenia may
occur seven to ten days after chemotherapy. Neutropenia, alone, is not a danger
to a patient. However, a patient's ability to fight off infection is impaired by
neutropenia.
Side Effects cont..

23. 3. Stomach or Intestinal (Gastrointestinal) Discomfort-Many patients experience some form
of stomach or intestinal discomfort two to seven days after a chemotherapy treatment.
4. Tissue Damage-if some chemotherapy agents are accidentally given outside the vein,
severe tissue reactions can result.
5. Allergic Reactions-Allergic reaction to chemotherapeutic agents is rare, and if there is a
reaction it develops upon initial administration and is treated quickly
6. Heart Damage-Some chemotherapeutic agents, in some rare cases, can irreversibly
damage the heart muscle. The dose of these agents prescribed for is below the dose that
usually causes heart disease.
Side Effects cont..

24. References
 Morrison, W.B. 2010. Cancer Chemotherapy: An Annotated History. Journal of
Veterinary Internal Medicine. Vol. 24 Issue 6: 1249-1262
Crump, Kenneth. 2012. Veterinary Oncology: Cancer and Chemotherapy.
Veterinary Support Personnel
 Networkhttp://www.vspn.org/Library/Misc/VSPN M02045.htm. Retrieved April
2012
Withrow SJ, MacEwen, EG: Small Animal Clinical Oncology, Second Edition.
WB Saunders Company.

25.  Goodman, MS: Cancer: Chemotherapy and Care. 1986, Bristol-Myers Oncology
Division.
 McCurnin DM: Clinical Textbook for Veterinary Technicians, Fourth Edition. WB
Saunders Company.
O'Brien, MG: Cancer pain management: a review of recent considerations and
advancements. Veterinary Cancer Society Newsletter, Vol 22. No.2,Summer 1998.
Chemotherapy and cytotoxic drug safety plan. Veterinary Support Personnel Network,
(URL): http://www.vspn.org/Library/Misc/VSPN_M01282.htm
References cont..

26. Thank you..