Chemotherapy AEs

Question 1

Carboplatin/Cisplatin

Answer 1

• can “double nadir” with myelosuppression common at 7 - 21 days post-administration
• cisplatin can be immediately vomit-inducing
• do not use in cats

Question 2

Cyclophosphamide

Answer 2

a metabolite (acrolein) can accumulate in the bladder and cause sterile hemorrhagic cystitis in dogs (more common with oral dosing than with IV)

Question 3

Doxorubicin

Answer 3

• Hypersensitivity reaction can occur if the infusion is delivered too fast (ACCC gives it over 15 minutes)
• Acute and cumulative cardiotoxicity can occur (consider ECG/echo for DCM dog breeds)
• Severe tissue necrosis if extravasated

Question 4

Gemcitabine

Answer 4

the dose limiting toxicity is usually myelosuppresion (neutropenia/ thrombocytopenia)

Question 5

Gilvetmab

Answer 5

• Mild to moderate allergic reactions (facial, eye or ear swelling) has been reported
• Liver enzyme elevations (ALT/AST/ALP) have been reported

Question 6

Imatinib

Answer 6

• Significant diarrhea is the most common GI effect.
• Idiosyncratic hepatotoxicity may necessitate discontinuation of treatment

Question 7

L-Asparginase

Answer 7

–Hypersensitivity reactions (hives, itching, hypotension, vomiting, diarrhea) can occur
–Tumor lysis syndrome can occur with massive cell kill episodes

Question 8

Lomustine

Answer 8

• Cats can have a later nadir especially after successive treatments (1-6 weeks post-treatment)
• ALT abnormalities are common in dogs and can be dramatic

Question 9

Mechlorethamine

Answer 9

Severe tissue necrosis if extravasated

Question 10

Tanovea

Answer 10

• Hotspot-like lesions and ear infections can occur (treat like hotspots)
• Idiosyncratic pulmonary fibrosis in about 4% of patients - presents like respiratory distress that can progress to death over 4-6 weeks. We don’t use Tanovea in West Highland Terriers
• Causes tissue damage if extravasated

Question 11

Palladia

Answer 11

• Most common side effect is diarrhea - stop drug and treat the diarrhea if it is super emergent/explosive
• Depigmentation - eyebrows, nose, lips, usually cosmetic
• A subset of dogs receiving Palladia may develop proteinuria

Question 12

Laverdia

Answer 12

• Polydipsia/polyuria has been observed
• Liver enzyme elevations can occur

Question 13

Vinblastine/Vincristine

Answer 13

• Causes tissue damage if extravasated
• Vincristine can cause peripheral neurotoxicity

Question 14

Vinorelbine

Answer 14

• Peripheral neurotoxic effects are possible
• Significant tissue damage if extravasated
• More myelosuppressive than vincristine

Question 15

Zoledronate

Answer 15

Acute kidney injury/renal toxicity is observed infrequently in dogs