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Cisplatin is a platinum-containing chemotherapy drug. Although the mechanism of action is not understood completely, cisplatin behaves similarly to a bi-functional alkylating agent by producing cross links in DNA. Cisplatin is distributed widely into the liver, kidney and intestines and is distributed poorly into the central nervous system (CNS). Cisplatin is particularly nephrotoxic and approximately 50% of cisplatin is excreted by the kidneys in the first 24 to 48 hours. It is activated in the kidneys to produce a metabolite that is toxic to the proximal tubule cells.
Cisplatin is a mainstay chemotherapy drug to treat ovarian cancer in women. Although the majority of ovarian cancers respond initially to cisplatin, it appears that over time the tumors become resistant to platinum chemotherapy. There is research in human medicine attempting to identify other chemotherapy agents to enhance the effectiveness of cisplatin.
Cisplatin is used to treat a number of different tumors in dogs. The most common ones include osteosarcoma, squamous cell carcinoma, bladder tumors, ovarian carcinoma, and mesotheliomas. It frequently is used to treat unresectable or widespread carcinomas and may be administered intravenously, intraperitoneally, or intralesionally.
Cisplatin has been shown to improve survival in dogs with osteosarcoma. In one study, the one-year survival for dogs with osteosarcoma that had undergone both tumor resection and cisplatin chemotherapy was 45-55%.
Cisplatin is used intralesionally to treat equine skin tumors such as sarcoids, spindle-cell tumors, squamous cell carcinoma, and melanoma. When used as an intra-lesional injection, cisplatin is either mixed with sterile sesame oil or delivered in a biodegradable, slow release bead. In reports on intralesional use, systemic side effects were not noted and local side-effects resolved quickly.
A Biodegradable Matrix for Cisplatin to Treat Equine Skin Neoplasia, Marble, George P, Sullins, K.E., Marion DuPont Scott Equine Medical Center Department of Large-Animal Clinical Sciences.
Cisplatin Side Effects in Dogs
The most-common side effect is vomiting within six hours of treatment. This may be managed by pre-treatment with antiemetics such as butorphanol, dexamethasone, and metoclopramide. The degree of GI toxicity may be dose-related.
Nephrotoxicity frequently is the treatment-limiting side effect. Monitoring renal-concentrating ability, azotemia, and presence of abnormal numbers of granular casts in urinary sediment may be useful. The risk of nephrotoxicity and ototoxicity may be decreased by slowing the infusion rate.
Another side-effect may be mild to moderate myelosuppression with a bimodal nadir at seven and 14 days. White blood cell (WBC) count should be monitored regularly in animals undergoing treatment.
There is a very narrow range between the therapeutic dose and the minimum lethal dose. Dosage calculations need to be meticulously checked due to the toxicity of this drug.
Dogs and horses
May Be Prescribed by Vets for:
Carcinomas of the dog; skin tumors of the horse.
Search for Available Dosage Forms
Barbara Forney, VMD
Dr. Barbara Forney is a veterinary practitioner in Chester County, Pennsylvania. She has a master's degree in animal science from the University of Delaware and graduated from the University of Pennsylvania School of Veterinary Medicine in 1982.
She began to develop her interest in client education and medical writing in 1997. Recent publications include portions of The Pill Book Guide to Medication for Your Dog and Cat, and most recently Understanding Equine Medications published by the Bloodhorse.
Dr. Forney is an FEI veterinarian and an active member of the AAEP, AVMA, and AMWA.
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