"Chemotherapy Extravasation" TUMOR TIDBITS, A BIWEEKLY VETERINARY ONCOLOGY E-LETTER Volume 3; Number 11; March 22, 2002. Editor: Kevin A. Hahn, DVM, PhD, Dipl - ACVIM (Oncology) & Overall Nice Guy! ANNOUNCEMENTS March 23rd!!!! Come Celebrate! We're having a Celebration of Life reception Saturday March 23rd at Gulf Coast Veterinary Oncology from 2-5 pm. Bring a picture of your pet to place in our new display case. Sorry, no pets allowed since we will be celebrating in our Deli. Please RSVP at 713-693-1166. These are exciting times for us at Gulf Coast Veterinary Oncology - Please call us (Drs. King, Hahn, Cerraras, Freeman & Turner) at any time and check our web site regulary for more information! ====================================================== THIS WEEK'S TUMOR TIDBIT: CHEMOTHERAPY EXTRAVASATION oops! - You've just given chemotherapy outside the vein. Some of the more common chemotherapeutic agents used in veterinary medicine can cause significant tissue injury when they extravasate into perivascular tissues. Some of the more serious compounds include the vinca alkaloids (vincristine and Vinblastine) and doxorubicin. Other agents causing some tissue damage include mithramycin, mitoxantrone and cisplatin. Every effort should be made to prevent extravasation. Veins used for chemotherapy should not be used for blood sampling. Multiple attempts to catheterize one vein or recent venipunctures make it unsuitable for administration of any cytotoxic drugs. A careful "first-stick" approach using a small (22-23 g) catheter should be used to administer large volumes of drugs like cisplatin and doxorubicin. Small volumes (less than 1cc) can be given through a small (23-25 g) butterfly catheter. Saline should be flushed before and after administration of the chemotherapeutic to assess catheter placement and insure vessel integrity. The earliest sign of extravasation is pain. Animals will become extremely agitated, even to the point of self-trauma as these vesicants leak into surrounding tissues. Erythema may develop quickly or over several days ultimately resulting in tissue necrosis and open draining wounds. When extravasation is suspected, do not remove the catheter. Instead, use the catheter to remove as much drug as possible. Apply WARM compresses to enhance systemic absorption. Then apply COLD compresses to affected area for up to 10 hours to inhibit cytotoxicity. Keep in mind that even with the use of good first aid, intense wound management may be required. MORE QUESTIONS ABOUT CHEMOTHERAPY USE? Don't hesitate to call or email us at Gulf Coast Veterinary Oncology! ALL THE BEST, Kevin Hahn Kevin A. Hahn, DVM, PhD Diplomate ACVIM (Oncology) & Overall Nice Guy Gulf Coast Veterinary Specialists 1111 West Loop South, Suite 150 Houston, TX 77027 P: 713.693.1166 F: 713.693.1167 http://www.gcvs.com mailto:drhahn@gulfcoastvetspec.com