Median survival
with piroxicam treatment in 76 dogs with TCC was 244 days.
This has led to numerous studies
of piroxicam in animals with cancer at Purdue.
The doxorubicin -
piroxicam treatment was no more effective regarding response rate, remission duration, or survival duration, compared with the control group treated with doxorubicin alone.
Most dogs with TCC take the
drug piroxicam because it relieves discomfort and also appears to slow the progression of the disease.
Carboplatin and
piroxicam therapy in 31 dogs with transitional cell carcinoma of the urinary bladder Boria PA, Murry DJ, Glickman NW, Schmidt BR, Widmer WR, Mutsaers AJ, Adsms LG, Snyder PW, Dibernardi, L, de Gortari, AE, Bonney, PL, Knapp DW.
Evaluation of cisplatin combined with
piroxicam for the treatment of oral malignant melanoma and oral squamous cell carcinoma in dogs.
However, in a separate study, 35 % of dogs benefited
from piroxicam and mitoxantrone and showed a median survival time of 291 days.
Two of the first dogs treated (one with metastatic carcinoma, one with undifferentiated sarcoma) had advanced cancer, and these dogs had remission of their cancer when
receiving piroxicam, but no other treatment.
Patients treated with
piroxicam alone have been shown to have a response rate of 17 % and a progression free interval of 180 days.
In one study, the combination of carboplatin and
piroxicam resulted in the remission in 38 % of cases.
When piroxicam is combined with carboplatin chemotherapy, the response rate increases to 57 % and the progression free interval is approximately 335 days.
Anti-inflammatory drugs, such
as piroxicam, may be given to reduce the size of any tumors.
Without treatment, a dog generally will succumb within a few months, but treatment with the nonsteroidal
anti-inflammatory piroxicam can relieve pain and symptoms for up to nine months.
The pet owner should then talk to their veterinarian about whether to
re-start piroxicam or to switch to a different medication.
Of even more interest, dogs receiving vinblastine and
piroxicam together had the following tumor responses: 58 % partial remission, 33 % stable disease, and 8 % progressive disease with a median survival of 299 days (range 21 - 637 days).
Veterinarians in the Purdue Comparative Oncology Program and a veterinarian colleague (Dr. T Needham, Wilmington N.C.) became interested in
piroxicam several years ago when it was being used for pain relief in dogs with cancer, and unexpected remissions were noted.
Cox inhibitors
include piroxicam, aspirin, ibuprofen, Previcox, Deramaxx, Rimadyl, and others.
It should be noted that this survival was from the
time piroxicam was started until the dog died.
Ten dogs were treated with a weekly course fraction beam radiation therapy along with mitoxantrone and
piroxicam chemotherapy.
Research shows that in up to 75 percent of dogs with bladder cancer,
piroxicam slows, stops or regresses the growth of bladder cancer tumors.
Another chemotherapy protocol that has commonly been used in dogs with TCC involves a combination
of piroxicam and an intravenous chemotherapy drug called mitoxantrone.
Treatment with the
drug piroxicam may help stop tumor growth or even reduce the size of your cat's bladder tumors.
Chemotherapy — Administration of cisplastin combined
with piroxicam has induced the highest percentage of remission in dogs.
But the results showed a downward slide when treated with mitoxantrone and
piroxicam therapy without radiation.
These medications are similar to drugs like ibuprofen and
piroxicam for the treatment of arthritis in humans.
For dogs
receiving piroxicam, it is important for pet owners to observe the dog and make note of loss of appetite, unexplained vomiting, and dark «tarry» looking stools (melena).
This protocol requires more frequent veterinary visits than
piroxicam alone.
Chemotherapy can be used, such as doxorubicin,
piroxicam, mitoxantrone or vinblastine, but the response is generally not as good as with some other types of cancers in dogs.
Examples of medications that may cause drug / drug interactions are: SMZ - TMP (Bactrim, Septra), gentamicin, etodolac (EtoGesic),
piroxicam (Feldene), ketoconazole (Nizoral), cimetidine (Tagamet), ranitidine (Zantac), itraconazole (Sporanox), methylprednisolone (Medrol), erythromycin, Allopurinol (Zyloprim), metoclopramide (Reglan), prednisolone, digoxin (Lanoxin), or any type of vaccination.
These could indicate stomach and intestinal irritation resulting from
the piroxicam.
Most dogs see a veterinarian weekly while receiving vinblastine and
piroxicam.
As mentioned above, approximately 35 % of dogs receiving mitoxantrone and
piroxicam have remission, and the average survival is around 250 - 300 days.
In 76 dogs with TCC treated with
piroxicam, the tumor went into complete remission in 2 dogs, decreased in size by > 50 % in 14 dogs («partial remission), remained «stable» in size (< 50 % change) in 45 dogs, and increased in size by > 50 % in 15 dogs.
A conservative oral treatment consist of a drug called
piroxicam, or a piroxicam - like drug, given by itself.
In this situation,
piroxicam should be stopped until the dog returns to normal.
In fact, the survival ranged from 6 days to 1256 days for dogs treated with
piroxicam!
The median («average») survival of the dogs treated with
piroxicam was 244 days.
The median survival of dogs receiving vinblastine and
piroxicam was 299 days.
Another treatment option is to combine
piroxicam (or a piroxicam - like drug) with an intravenous medicine called vinblastine.
«Average» survival times with mitoxantrone /
piroxicam have been in the 250 - 300 day range.
Some dogs received other medications after the cancer became resistant to
piroxicam, and these drugs could have affected survival.
As a single agent,
piroxicam has shown gratifying results.
Some doctors recommend lifelong use of
piroxicam.
It directly damages renal tubule cells and
piroxicam may also interfere with renal blood flow.
Even with
piroxicam, median survival has been found to be more than 1 year in 20 % of dogs.