That’s right. I would have bet almost anything that I would never have a reason to actually purchase Epogen (EPO). But I would have lost that bet.
I know the title is a little misleading. I am getting it for my dog, Bromont.
Bromont has been really slow recently. That is to be expected with terminal HSA cancer. But his gums are whitish and obviously he is low on red cells. So we took him in for a blood test today and his hematocrit was 15.2% It was 27 two week ago, and 38, 2 weeks before that. The normal range is 37-62. So, his is less than half of normal. His red count is less than half of low also.
There are a couple reasons that could cause this. His red cell production could be suppressed in the marrow due to cytokines stimulated by the tumor, microangiopathic destruction of red blood cells as they pass through the tumors. Or, he has chronic bleeding. Or, I guess, both.
So, I got on this kick that he isn’t comfortable and that he needs more oxygen, thus red cells. After doing some a little research, perhaps not enough, I thought that maybe EPO would be of benefit to him.
So, I researched that a little more, along with my vet from K-State. It is kind of crazy. a 3000 U/ml vial of 10ml that cost $30 in the mid 90’s now costs $1500 at Walgreens. But a 2000 U/ml vial, same size is $359. So 1 1/2 times the dosage, which makes it 1/3 of the cost. (FYI, a 20000 U/ml vial is $8700. I’m not sure how much a human needs, but the stuff is pretty expensive. At least at Walgreens.)
Anyway, when Bromont went to get the blood test, we got 1 ml to start. I gave that to him yesterday.
It was pretty weird holding that little vial of water-like liquid in my hands. It contained the substance of what could be the difference between a mediocre athlete and a Tour de France winner. Just a little clear liquid, that isn’t all that hard to obtain. It all seems so silly. It seems so wrong. It was creepy.
After doing all this, I spent more time and did a lot more research and I’m of the opinion that it won’t help. I don’t think that any amount of EPO is going to enable him to make the appropriate amount of red cells to stay somewhat healthy. I’ve already special ordered the EPO from the pharmacy, so I hope they don’t make me take it. Thus, the regret.
So, I decided on a blood transfusion route now. This morning, we’re taking him to K-State to get a 5 hour blood transfusion. In theory, it will double his hematocrit. I don’t think there is any way to know how long that will last. In kind of depends on why he doesn’t have any now. His levels dropped from 27 to 15 in two weeks. I guess the best we could hope for is the same again.
I didn’t have any idea if they happen to have a bunch of dog blood sitting around. His type even. Sounds like they do. I wonder where they get that?
I’m not trying to play God or anything with my dog. I’m just trying to make him as comfortable as possible through all of this. If this makes him feel better, then I’m all for it. I’m a little torn about having him at the vet school for 5 hours, but hopefully I can sit with him the whole time while he gets the blood.
This whole process is a learning experience. What I’ve learned so far is that you don’t have any idea where you are in the process. If you would have asked me two weeks ago, on any given day, whether he would still be alive two weeks later, I might have answered, 100% no, or 100% yes, just depending on what hour of the day the question was asked.
My vet, who is an avid cyclist, told me he would keep it quiet that I got EPO for my dog. He said next thing you know, I’d be getting it for my grandmother, etc. It is so weird that the only reason I know of this drug is because of the abuse of it in our sport. I really thought that Hemopure would be the perfect drug for Bromont. Wow, now that I looked that link up, I see that it was approved for canine use in 1998. I wonder about the availability of that? It might be better than a transfusion.
Anyway, Bromont seems happy enough. He likes to go for car rides. He loves sleeping with us. Every once in a while he plays a little still. He likes to take walks, but not very far. He is a pretty picky about food, but he always was. I love the dog to death and feel obligated to do everything in my power to help him feel as good as possible as long as possible. It’s as simple as that.
Here is a vial of the drug of choice for endurance athletes the last two decades or so. It seemed so weird even holding it.
This blood test was very depressing. His blood is total shit. I hope I can do something to make him feel a little better for a short time.
Bromont on his way for some new blood.
and nobody believed Rumsas!!!!
This is not the first time a pro cyclist got some medicine for their dog, right Tyler H?
Why Regret it? If it helps your friend feel better there is no harm. It is not like you are going to use it and go smash Tommy’s time up Mt. Evan’s Hill Climb record..umm btw I am sure that is a legit time 😉
So Bromont is your codename then, right? <- Just kidding of course! Hope Bromont feels better.
Like the juice (before EPO) the boys were getting in the states in the early 1980’s that was meant for animals. Years later they end-up with testicular cancer, unexplained illnesses and off-spring with health problems and they all wonder what happened. Try telling a teenager its not worth the risk.
Maybe you could have gotten it from Greg Vanavermat, because, you know, BMC is squeaky-clean.
Tyler had a vanishing twin. Frank Vandenbroucke had EPO for his dog.
Greyhounds are used as the donors for dog blood transfusions. They are the “Universal donors” of the canine world.
Ha, great headline. Take care of that dog, he is in a way, taking care of you… And yes, you can probably get it cheaper on-line or from Mexico…
Interesting. I saw Bromont’s block of low numbers on his labs and said that looks familiar. Bromont and I seem to be on the same path. I’m stage 4 kidney cancer and my RBC counts have all been falling since December 2014. I was just looking into EPO too. My oncologist says my hemoglobin has to get to 8 before transfusion time. I’m at 9.7 now. Normal is 14.1 – 18.1.
I learned that EPO/ProCrit is not recommended for human kidney cancer patients. It seems kidney cancer tumors love the stuff. I don’t know anything about treatment for dogs.
I’m still fighting. I’m trying an immunotherapy trial currently. Scans in 2 weeks. We’ll see. I still get out for an occasional 5 mile ride. After 30 years of cycling that’s not much, but it rekindles good thoughts.
My best to Bromont. He’s lucky to have you and Trudi fighting for him.
David
Geez David, that sucks. Have you thought about going to altitude – maybe Aspen or eve higher. 3 days at 10, 000 feet will certainly increase your RBC’s…You could bring Bromont and Steve -sounds like you all could use some time getting Rocky Mountain High…
In other news. or not, Astana keeps their license! Unbelievable…
It’s just sad that cheaters will take these lifesaving drugs and abuse them and give the drugs a bad reputation. To a cancer patient who is anemic due to chemo, EPO is a wonder drug. To the young man who had testicular cancer, manmade testosterone is a wonder drug, and for my Granddaughter who was born missing her pituitary gland, every hormone the body naturally makes (growth, cortisol, adrenal, just to name a few) she has to take the synthetic hormones to say alive. So Steve, don’t regret trying to make Bromont as comfortable as possible by using modern medicine.
Steve – I commend your effort to improve Bromonts health and quality of life but I have to disagree with your statement: “It contained the substance of what could be the difference between a mediocre athlete and a Tour de France winner”.
There is not a drug on this planet that can turn a donkey into a thoroughbred, including EPO.
Why should they lose their license? It’s absolutely wrong to punish riders on the team who have done nothing wrong. Only small minded, myopic individuals see that as a solution.
Hbealey-I’d have to respectfully disagree with you on this one. I’ve personally witnessed, many times, riders that were, at best, pack fodder, turn into dominating forces. I don’t think you understand the importance of oxygen in athletics. Then add a few muscle strength drugs, plus leaning help, and you have the correct combination to manufacture a great athlete.
Makes me nervous just seeing that photo of the vial: so much wrapped in one image, on this one small blog, by one author, in the context of the past and future of American cycling.
Basso should have claimed he bought EPO for his dog Brillo. Valverde bought it for his dog Piti.
I would do anything for my boy Moose. I applaud your efforts in trying extend the quality of Bromont’s life, even if it’s by weeks or months.
Steve,
No words of wisdom, but Hang in there. Hope Bromont is comforted and comfortable.
This drug saves lives, improves quality of life, and solves major problems in so many patients every day. It is easy to be blinded by the cloud of abuse that we have witnessed in cycling, alas, our narrow lens misses the reason EPO exist. I certainly hope that the world of cycling doesn’t obscure your compassion for a loved one with pejorative dogmatic logic. I simply see a clear difference between mitigating pathology and enhancing normal physiology. The reason is different, and I certainly don’t want to cut my compassion short due to the poor decisions of others. I hope that you and your little man can spend some quality time together, and I know that pups are always grateful for even our most simple efforts.
Doubting Thomas, unless you are a doctor well versed in stage 4 cancers, you should refrain from giving someone advice on how to raise their rbc count. So typical of cyclists to consider using EPO for their dog’s problems and to suggest high altitude stays to help with someone’s stage 4 cancer.
Well wishes to David…
A. Name calling tells us a lot about you.
B. Have you been paying any attention at all to cycling? To Astana?
C. Are you serious?
Maybe “the difference between a mediocre [professional] athlete and a Tour de France winner.” would be a more precise statement?
Goodluck to Bromont. Hope he gets to hang out with you guys for as long as possible.
Thanks for the info Dewey… oops sorry Doubting Thomas.
I don’t understand why there is a difference between mitigating pathology and enhancing pathology. I also don’t see how that statement does not contradict the previously expressed aversion to “pejorative dogmatic logic.” We enhance our physiology all the time. Do you ever drink coffee or alcohol? Those have fairly pronounced physiological effects. Unfortunately, some activities have illogically formed biases toward them. I don’t race bikes anymore and I don’t have cancer either, but if I wanted to buy myself some EPO or HGH with a legally obtained prescription (this is completely possible if you have the money), I would be excommunicated from the holier-than-thou cycling world. I’m not saying it’s a great idea or that it is without risk, but, more likely, it could be done completely safely. Either way, it’s my health decision. These drugs are (supposed to be) difficult to obtain and are regulated because they pose a public health risk, but in sports the only ethical problem with PEDs is that they are against the rules (ignoring issues with suppliers and informed consent and so on, which are really more legal than ethical issues when you get down to it).
This is what these drugs were made for. Don’t think for one second it’s a bad choice if you’re trying to help the good ‘ole boy Bromont. If every athlete that ever took epo to cheat suddenly died, and Bromont suddenly improved 100% and went on to live many more healthy years, I’d be thrilled with that!
I think Bromont is extremely lucky to have you guys, and that is made clear by the fact that you realize how lucky you are to have him.
There is nothing better in this world than the unconditional love and companionship of a good loyal pooch. Think of the millions of smiles he’s provided you.
Good boy Bromont, hang in there Baby Puppy.
His retic count is regenerative, it’s not bone marrow suppression, he’s bleeding. The epo will not help but the transfusion will….for a short time. Sorry.
David, Jon here in the OC is pulling for you. Keep up the fight and try to remain positive. We have a great friend who courageously battled colon cancer and won. It was a very tough battle. But she WON!
Steve, fck the implications of EPO in sport. This is Bromont. I respect you for your dedication to your canine family member. You have a big heart. You are a good man!
Also slightly possible it’s destruction. What’s his bilirubin btw?
“If every athlete that ever took epo to cheat suddenly died, and Bromont suddenly improved 100% and went on to live many more healthy years, I’d be thrilled with that!”
Nah. Humans are flawed. Hopefully the cheats eventually get it but to wish them death is absurd. I wouldn’t even wish that on that a$$hole Lance Pharmstrong.
We can agree on Bromont, though.
David, wishing you the all the best from the OC. Fight hard! Stay positive and heal! We are pulling for you.
Steve – Bottom line is prohibition doesn’t work. It never has and never will. It doesn’t matter if you’re talking about alcohol, PED’s, prostitution…..Look at the ridiculous war on drugs our government has participated in since the days of Nixon. It has had zero effect in preventing drug use. How bout Alcohol? Did you know there were more ‘underground establishments’ serving alcohol during prohibition than there is legitimate bars open today? You are going to be perpetually frustrated as long as you continue with your flawed thinking. You cannot fix a problem with the same mind that created it.
Really? Show me proof that steroids cause cancer or have killed anyone. You can’t so please don’t spout nonsense that you know nothing about.
The reason there is a difference between mitigating pathology and enhancing physiology (you said “enhancing pathology”, and I can only assume you meant to say physiology) has it’s roots in compassion and wanting to care for others. Including out doggies. Utilizing pharm in an effort to save a life or stave off disease helps to lessen suffering and the burden of poor health. Utilizing pharm when you are healthy and don’t have any underlying pathology in order to get ahead in sport crosses a moral line in both the health of the individual, as well as the ethics of competition. It’s wrong because it breaks a trust that should be held by people competing, not because the UCI wrote down some words. The negative views held by many cyclist and former cyclist of pharm like EPO, HGH, and countless others is justly held. It is unfortunate in my eyes that this narrow view of what these drugs can do to a sport may cloud their actual intended use in saving and help lives. It’s that simple.
Sure caffeine and alcohol can alter, and in some aspects enhance out physiology. They also have virtually zero therapeutic efficacy unless you drank some methanol. So I think maybe you are not understanding the point of what I am trying to say. Probably my fault, sorry. Here ya go, real simple. Many cyclist have negative views of very helpful pharmaceutical products. I believe it is a mistake to let our past, jaded views, stand in the way of the intended therapeutic use of said pharmaceuticals.
You are free to go out and find a physician willing to prescribe you some dope. There are unethical physicians out there no doubt. But one should never breach the trust we must uphold to our patients to put them in harms way so they can keep up on the group ride. As a former cyclist I would judge your decisions to dope. But I’m sure you could deal with it. I have friends who have doped in the past, and they are still friends of mine. Regardless of you views on the ethics in sport there is a foundation of trust that should exist before anyone pins a number on. If you don’t comprehend the implicit trust in competition than you are missing the point.
Lastly, lets not forget that this is all about taking care of a loved one. I commented simply because I believe, despite being burnt countless times from the doping scene, that when it comes to care, we need to see past our anecdotal accounts and do what is right. I hope Bromont is feeling better.
Dude, seriously, you need to put your dog down. Sorry if the truth hurts.
corey s,
Your post simply makes me feel inadequate when it comes to conveying what is on my mind. Kudos!!!
Hi Steve, Sorry you’re going through this. I’ve got similar old-age problems with my dog. Console yourself with this: few dogs have it as good as Bromont did. Keep him comfortable, then let him go.
TREATS TREATS TREATS…
shut it
“My vet, who is an avid cyclist, told me he would keep it quiet that I got EPO for my dog. He said next thing you know, I’d be getting it for my grandmother, etc.”
I am intrigued by that comment and curious about the context. I hope he was just making the easy joke. If not, and he is a cyclist as you say, I assume he reads your blog and knows your position on these things, which makes it sort of odd. . . . On the other hand, few of us around the mid century mark are so blessed as to still have our grandmothers with us, so I guess that’s actually the funny part. It wasn’t a doping joke, it was an old fart/doping joke.
Never mind.
Prayers for David and Bromont.
Ten seconds of Google search gave this: “Animal studies, however, demonstrate that androgens are very strong tumor promoters for prostate carcinogenesis after tumor-initiating events. Even treatment with low doses of testosterone alone can induce prostate cancer in rodents. Because testosterone can be converted to estradiol-17β by the enzyme aromatase, expressed in human and rodent prostate, estrogen may be involved in prostate cancer induction by testosterone. When estradiol is added to testosterone treatment of rats, prostate cancer incidence is markedly increased and even a short course of estrogen treatment results in a high incidence of prostate cancer.” http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2821822/
JB, the real question here is “Are any Tour De France winners” drug free?
Keeping Bromont in my thoughts. I understand the desire to do anything and everything to help him feel good for as long as possible.