RECOMMENDATIONS FOR THE MANAGEMENT OF PATIENTS IN CHEMOTHERAPY

Every chemotherapy medicine, after being exhibited and metabolized by the body, remains in the urine, feces, vomit and saliva of the patient for a variable time depending on the molecule used. The following table shows the residence times in the urine and feces of human patients of the most common medicine used in chemotherapy. These data are similar to data obtained from recent studies in veterinary medicine.

The women who are pregnant or they think they might be and in the period of breastfeeding as well as children should not come into contact with manure (faeces and urine, saliva and vomiting) of treated patients.

Although the concentrations of chemotherapy in the saliva of patients are infinitesimal, it is recommended to dissuade animals from licking and nibbling owners.

Do not ever manipulate the feces, urine and vomit of any patient with bare hands but always wear two pairs of disposable latex gloves (not vinyl).

For the cleanliness and hygiene of surfaces that come in contact with the patients themselves or with any of their manure (urine, feces, saliva and vomiting), use bleach and water (1 doze of bleach to 10 of water) and paper towels after wearing disposable double latex gloves, such waste is appropriate to contain in a plastic bag before throwing them in the trash (dry).

Garments or fabrics which were in contact with the manure should be washed separately at a temperature of 90 º.

It is not necessary to deprive the usual walk in chemotherapy patients, it is recommended, however, to follow such standarts:

  • To prefer the less sunny hours of the day as some chemotherapy can have a photosensitizing affect and so it prepares for the photo-dermatitis; 
  • To feed the dog only on a leash and avoid doing urinate or defecate on the grass or on the ground but prefer the asphalt;
  • To have two pairs of latex gloves, a minimum of two plastic bags, a bottle containing a solution of water and bleach (10:1). The remedy of water and bleach will dilute the urine and inactivate any traces of chemotherapy on the asphalt. The stool should be collected with double latex gloves, placed in a double plastic bag and once at home thrown into the drain making sure to use two times as required. If the faeces are liquid act like with urine; 
  • To use the litter box for cats making sure of putting a small amount of sand. After each use pour the solution of water and bleach and collect everything with double gloves in a double plastic bag to dispose the waste in buckets. Then clean the litter box always with bleach and water.

However, it is appropriate to remember that the concentration of excrete medicine is that for not to cause a risk to the health of those who accidentally come into contact.

 

NOTES TO THERAPY

The choice of the treatment protocol especially chemotherapeutical is modulated according to the clinical condition of the patient (performance status).

Therapy with oral administration (capsules and tablets) or local (ointment) will be performed at home by the owners. Do not break or crush the tablets, do not open the capsules, and anyway handle them with the gloves; for local applications to wear double latex gloves. For doses of medication is not commercially available require the pharmacist in the preparation of capsules or tablets suitably dosed.

The administration of chemotherapeutic medicine by injection (subcutaneous or intravenous infusion) may be carried out either at our facility or to which refers the veterinarian. This decision will be taken in consultation with colleague and owners.

The duration of each infusion treatment may vary from 20 to 60 minutes and can be performed with the patient alert or uncooperative or take appropriate sedation. Such a decision will be taken in consideration on the case-by-case basis according to type of patient. 

During the course of treatment it is necessary to modificate time interval between administration and the next one or to change the dose of medication based on the general health of the patient.

At la Cittadina Fondazione Studi e Ricerche Veterinarie the preparation and the administration of chemotherpeutical medicine take place in special Unità di Manipolazione dei Chemioterapici Antiblastici (UMaCA), dotata di cappa sterile di tipo 2B in ambiente sterile ai sensi del Testo unico sulla sicurezza, artt. 36- 37 D. Lgs. 81/08 e D. Lgs. 106/09. 

La Cittadina Fondazione Studi e Ricerche Veterinarie has at its disposal the structure of recovery such as the room-boxes with air conditioning and large outdoor areas for patients undergoing multimodal treatments (chemotherapy and radiotherapy) that require hospitalization.

 

POTENTIAL SIDE EFFECTS: NOTES FOR OWNERS

The reactions to chemotherapy vary from subject to subject and not necessarily the side effects described in the pharmacological profile of the preparations may be of interest to individuals undergoing treatment. You should always remember to inform your veterinarian as soon as possible if you experience abnormal attacks or at least unusual. 

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