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An Urban Experience
From the study the recommended dose for MCT is 3.25 mg/kg EOD. It is recommend to give with or without food (I recommend with food), give in evening, and adjust dose based on biweekly assessments for 1st 6 weeks, then every 4 to 6 weeks. Dose reductions of 0.5 m/kg are recommended with a minimum dose of 2.2 mg/kg EOD. If AE occur, drug holidays for up to 2 weeks. It is important to not be complacent in monitoring. Clients must be educated if any side effects are noted, STOP medication, start just in case medications, and contact
a veterinarian. Early recognition if side effects are critical when using Palladia!
TKI combination protocols are starting to be evaluated. Palladia given with vinblastine caused myelosuppression, and the dose of vinblastine was reduced significantly. The ORR of 71% is encouraging.
Intralesional therapy: Intralesional therapies such
as deionized water or corticosteroids may provide temporary shrinkage but unfortunately are rarely effective for long term tumor control.
Supportive medications: Any dog that has grossly detectable tumor should have supportive medications, including H1 blocker (diphenhydramine) and a proton pump blocker (omeprazole) or H2 blocker (famotidine).
Additional Resources
1. London CA, Thamm DH. Mast Cell Tumors. In: Small Animal Clin- ical Oncology. 5th ed. St. Louis Missouri: Elsevier Saunders; 2013: 335--355
2. Geiger T. Mast Cell Tumors, Dog. In Clinical Veterinary Advisor Dogs and Cats. 3rd edition. St. Louis Missouri: Elsevier Mosby; 2015: 646-648.
3. McCaw DL. Mast Cell Tumors. In Cancer Management in Small Animal Practice. Saunders 2010. 317-321

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