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2greysdad

Carboplatin - Swelling at IV Site

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Ginny had her second round of Carboplatin on Friday and the following day her ankle was quite swollen just under where the IV was administered. It didn’t seem to be painful. We saw one of the general practice vets yesterday. She updated the oncologist over the phone. We were told it’s mostly likely a blood vessel inflammation and sent home with Rimadyl. They didn’t think it’s an infection and the oncologist wasn’t comfortable prescribing antibiotics.

Today the swelling hasn’t changed but Ginny is in some discomfort and limping on that leg. Has anyone had a similar problem with chemo? Our concern is that if the ankle becomes more painful she won’t be able to walk (she had her front right leg amputated about a month ago).

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I've never had this happen.  I'd take her back to the oncologist, or to an emerg centre that has oncology among its specialties (probably on call on the weekend) to get an opinion.  My concern would be whether or not any of the chemo agent had leaked at the site.  If that happened, then it needs to be addressed sooner rather than later. 

 

ETA:  cold packs might help, wrapped in a dishtowel or similar, and applied for as long as she'll let you, up to 10 minutes.  

Edited by Rickiesmom

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The oncologist who is in charge of her treatment wasn’t in that day so the vet spoke to her on the phone. The oncologist said this drug doesn’t leak out and cause tissue damage. They  also recommended hot compresses - I assume to improve blood circulation. I had the surgeon (who happened to be there) look at it and he said it’s most likely a blood vessel inflammation. He wasn’t very concerned.

 

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Any high powered drug can cause tissue damage.  And it diesn't "leak out" so much as it is from an incompetent placement of the IV.  If the needle doesn't get right into the vein or perhaps pokes through, the drug can get into the surrounding tissue.

Take her temperature.  If it's elevated at all I would go into the evet today.  You can't afford to have her lose function in her only other front leg.  If it's OK, I would probably use alernating hot and cold packs to see if I could get the swelling down.  If there's no improvement in about 8 hours, I'd head to the evet anyway.


Chris - Mom to: Whiskey (KT's Phys Ed), Lilly, and Felicity ( DeLand )

35764734494_93de5b5963_b.jpg

Angels: Libby (Everlast), Dorie (Dog Gone Holly), and Dude (TNJ VooDoo), Copper (Kid's Copper), Cash (GSI Payncash), Toni (LPH Cry Baby),

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We went to the vet as soon as we saw the swelling, and we just updated the oncologist. I believe you are right. There are some cases where Carboplatin caused significant damage in greyhounds. I’ll try to get them to have the oncologist call us.

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No change today. We have been in touch with the oncologist as well as dr. Couto. It seems that it’s some sort of an inflammation. If it’s drug extravasation, we will have to wait and see whether it gets worse. She’s on painkillers and antibiotics in the meantime. Also hot compresses every few hours.

The oncologist is following up with the nursing staff to find out what kind of catheter was used for the infusion etc. 

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The leg is still painful but it is less swollen. Hopefully, it won’t get any worse. As a precaution, the techs will use IV catheters only going forward. 

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27 minutes ago, 2greysdad said:

As a precaution, the techs will use IV catheters only going forward. 

Glad there is improvement - the IV catheters sound like a very good idea.  Gentle hugs to your girlie.

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Fingers crossed things are on the mend


gallery_12662_3351_862.jpg

Jen, CPDT-KA with Zuri, lab in a greyhound suit, Violet, formerly known as Faith, Skye, the permanent puppy, Cisco, resident cat, and my baby girl Neyla, forever in my heart

"The great thing about science is that you're free to disagree with it, but you'll be wrong."

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Gosh I hope things are better. I had the extravasation experience and it was horrible. “Luckily” it was on a front leg - and it had been a rear amp - because my poor guy was on two right legs for a while. What a fighter he was. We got through it but it was a long, long recovery. Much worse than the amp. I too consulted with Dr Couto and there was no doubt. The pain was extreme for my guy so I’m hoping you are dealing with something else. :hope  (And, given my experience, shame on the oncologist for not taking this seriously. It was carbo that caused the problems for my guy.) 

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Thank you for the good wishes. GreytMom, could you tell me more about your experience? What were the initial symptoms and how long did it take for any ulcers/drainage to appear?

Ginny's ankle was very swollen for about 5 days. It's day 9 now and the swelling is almost gone. However, a small patch of skin on her leg is getting very irritated. The skin is red and the fur looks a bit crusty. We noticed that she started licking it and we put a sock on to protect it. The oncologist has been taking it quite seriously. We have been in touch every day or two. She had us come in on Friday. She believes the wound is just a superficial irritation from licking and prescribed an antibiotic ointment. The leg doesn't look that bad right now but we certainly hope it won't get any worse. I am posting a picture for your reference.

 

ginnys%20leg_zps1zyr5e1a.jpg

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Fwiw, I SWEAR by this stuff for fast wound healing (it does have anti-bacterial properties as well:

Veterinus Derma GeL Tube 100ml - 3.4 fl.oz. + Free Sample Tube 10ml https://www.amazon.com/dp/B003MCHX4E/ref=cm_sw_r_cp_apa_i_j-MbDbWJWA5JX

Cold laser would likely also help speed healing if there's no infection there.


gallery_12662_3351_862.jpg

Jen, CPDT-KA with Zuri, lab in a greyhound suit, Violet, formerly known as Faith, Skye, the permanent puppy, Cisco, resident cat, and my baby girl Neyla, forever in my heart

"The great thing about science is that you're free to disagree with it, but you'll be wrong."

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NeylasMom, thank you for the suggestions. We will try the gel.

We started her on hbot 2x a day plus cold laser once a day. She is tolerating the sessions fine. Today is day 3 and it's still early to tell whether it's helping. We are  dealing with a full-blown extravasation and it's very tough on the dog. Her foot is very painful and swollen and she has large ulcers. We have to help her to get around on 2 legs. Hopefully, she won't need debridement surgery.

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Oh no, sorry to hear that. I wondered about you guys yesterday and was hoping no news was good news.


gallery_12662_3351_862.jpg

Jen, CPDT-KA with Zuri, lab in a greyhound suit, Violet, formerly known as Faith, Skye, the permanent puppy, Cisco, resident cat, and my baby girl Neyla, forever in my heart

"The great thing about science is that you're free to disagree with it, but you'll be wrong."

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I am so sorry - it was my initial worry but then things seemed to be improving.  I hope the oncology clinic is covering treatment costs for Ginny's leg (they certainly should) and that healing progresses without further complication. 

Sending healing thoughts and gentle kisses to your girlie.

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How is Ginny's leg?  Do you have everything you need in the way of harnesses to help you help her get up and move about?  I wanted to PM you but you don't have enough posts.

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She cannot put much weight on the leg so walking is even more challenging. We have to help her all the time. The lower portion of the foot remains very swollen. The wound is no longer increasing in size, there is some dead tissue that is white and parts of it have turned black. The affected area is approx 3.5” down her leg and it ends at the hock. We met with the surgeon on Saturday and he basically told us that we need to wait a little bit longer to see whether the necrotic tissue will need debridement or it will peel on its own. He believes the swelling is partially a result of blood vessel damage and it will come down as her body figures out new routes for the blood to travel. She may need bandages for weeks once the dead tissue comes off. 

We had x-rays done last week and her lungs are clear. Otherwise, it would have made absolutely no sense to keep her around. That being said, she still enjoys things like car rides, food, and laying in the grass.

If any of you are doing chemo, insist that they use an IV catheter and not a butterfly needle to minimize the chance of this happening to your dog.

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It sounds like the damage process has run its course, and healing has begun, however slowly.  You are good and loving hound parents for staying the course and keeping her spirits up with things she enjoys.  Please update this thread anytime, without waiting for a prompt.   Many of us have had hounds, often more than one, who have been through chemo, sometimes with complications, and we care about Ginny.  And also understand how exhausting and discouraging it can be at times to deal with it all on a daily basis.

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That truly sounds horrible. I'm so sorry you and Ginny are dealing with this and hope it's only improvement from here. Do post updates as you think of it, I always check for them though I have nothing helpful to add.


gallery_12662_3351_862.jpg

Jen, CPDT-KA with Zuri, lab in a greyhound suit, Violet, formerly known as Faith, Skye, the permanent puppy, Cisco, resident cat, and my baby girl Neyla, forever in my heart

"The great thing about science is that you're free to disagree with it, but you'll be wrong."

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About 2 weeks have passed - hoping so much that your Ginny's healing has continued without further setback. 

Please update us when you have a moment.

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This is what Ginny’s leg looks like now. https://i1243.photobucket.com/albums/gg545/borcho22/558DA744-1F9A-459D-B30D-60C45806C9F0_zps2l3enmno.jpeg

The swelling is almost gone but she’s still avoiding putting any weight on it. The scab is about ready to peel off. 

We have been taking her to hbot treatments for about 17 days and I think they helped quite a bit. The wound has been very clean.

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