Peer-reviewed veterinary case report
Preventing fever and low white cells in dogs on lomustine cancer
By Gumash, Meredith et al.·Published in Veterinary and comparative oncology·2025·College of Veterinary Medicine, United States·View original on PubMed →
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Original publication title: Prophylactic Antimicrobials for Prevention of Febrile Neutropenia in Tumour-Bearing Dogs Treated With Lomustine.
- Species:
- dog
Plain-English summary
A group of 200 dogs with tumors were treated with a chemotherapy drug called lomustine, which can cause a drop in white blood cells leading to a risk of fever and infection. Some of these dogs received preventive antibiotics to help avoid this complication, while others did not. Surprisingly, the study found that using antibiotics did not significantly lower the chances of developing fever and neutropenia (FN) after treatment. Factors like older age, lower weight, and previous treatments were linked to a higher risk of FN. More research is needed to determine the best use of antibiotics in these cases.
People also search for: dog tumor treatment side effects · lomustine for dogs · antibiotics for dog chemotherapy · fever in dogs after chemotherapy · preventing infection in dogs with cancer
Abstract
CCNU (1-[2-chloroethyl]-3-cyclohexyl-1-nitrosurea), lomustine, is an oral alkylating agent in the nitrosourea subgroup. The dose-limiting toxicity of CCNU is neutropenia most frequently documented 7 days after its administration. Use of prophylactic antimicrobials to prevent chemotherapy-related febrile neutropenia (FN) and its associated morbidity and mortality has been well-documented in human oncology, but this information is limited in the veterinary literature. The purpose of this multi-institutional retrospective study was to assess whether antimicrobial prophylaxis reduced the risk of FN approximately 7 days after CCNU administration in tumour-bearing dogs. A secondary goal was to identify risk factors for fever development in neutropenic dogs. Two hundred dogs were included in the study. One hundred and fifty-three dogs (76.5%) were neutropenic at the first post-CCNU recheck. One hundred and six (69.3%) dogs received prophylactic antimicrobials and 47 (30.7%) did not. Of the 106 dogs on prophylactic antimicrobials, 8 (7.5%) developed FN. Of the 47 dogs in the no-prophylactic antimicrobials group, 4 (8.5%) developed FN. Use of prophylactic antimicrobials did not reduce the risk of development of FN (p = 0.84). Older age (> 9 y), lower weight and body surface area, and pre-treatment with chemotherapy or radiation therapy were significantly associated with development of FN (p = 0.009, p = 0.023, p = 0.015 and p = 0.01). Patients with a lower absolute neutrophil count, and a higher VCOG-CTCAE v2 neutropenia grade were also at an increased risk of developing FN (p = 0.01, p < 0.001). Additional studies may help establish guidelines for antimicrobial prophylaxis in dogs treated with CCNU, especially for those at high-risk for FN.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/39467014/