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Well, crap. Tell me about canine lymphoma

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  • Well, crap. Tell me about canine lymphoma

    My bestest, most wonderful dog, Riana, was found to have multiple enlarged peripheral lymph nodes (both sides, in front and behind the diaphragm) when I took her in for a heartworm test yesterday. Vet is concerned about lymphoma and did two needle aspirates, along with a full blood panel and a urinalysis. Results should be back sometime today.

    I have not noticed anything off about her--perhaps she is a tad lethargic, if I am really looking for something. She is a 11 year old Rhodesian Ridgeback who has always been healthy.

    My mom died of cancer several years ago, and I have always sworn I would never, ever put an animal of mine through that...but the prognosis of death within 6-8 weeks following diagnosis with no treatment or with prednisone is really upsetting. The literature suggests chemo is well tolerated in canines, particularly single drug regimens, and can induce fairly lengthy remissions.

    Has anyone done chemo for canine lymphoma? What protocol did you use? How did your dog tolerate it? Would you do it again? How much did it cost?

    Quality of life is my number one concern here--it is not worth it in any way if my Riana-dog is miserable. But if she feels good through treatment and gets another year, that might be worth it.

    I am also looking at alternative, supportive treatment modalities, so if you have any input on those, please share. Riana is already on a grain free food (she eats EVO dry and canned) and I've added some fish oil for more omega 3s. I also have a call in to my wonderful vet/acupuncture/eastern medicine person to see what she recommends.

  • #2
    The CHOP-based protocol is the standard of care for canine lymphoma. Prices vary as some hospitals can do chemo, some need a specialty hospital. You typically need bloodwork every 2 weeks which can be done either at your primary vet or at the specialty hospital.

    You need to get it staged first -- this includes a chest x-ray and an abdominal ultrasound. If it is just in a few peripheral lymph nodes, prognosis is better than if it is in organs or has spread to lymph nodes throughout the body.

    You also should get it typed to determine if it is T-cell or B-cell. T-cell offers a much worse prognosis than B-cell. That said, usually acute onset lymphoma at your dog's age is aggressive. The cytology of the lymph node aspirate should offer some idea of a grade (how aggressive it is) but that depends highly on the quality of the sample and the pathologist reading the sample. A biopsy may be a better indication.

    The questions you have are best answered by talking to a veterinary oncologist. I would ask for a consultation, at the very least, to give an idea of prognosis (in %) and likely course of outcome. I know people who did nothing and their dogs lived a few weeks, and people who did full on chemo and their dogs lived another year. Some dogs get nauseous and have very low blood counts from the chemo, some do not. This is why talking to an oncologist will be helpful -- they have a very broad range of experience to help you get an idea of what to expect and where your dog may lie in the spectrum.

    Just so you know, there are MANY other diseases and problems that can cause peripheral lymph node enlargement, including other kinds of cancers, infectious diseases, etc. Best to consult with an oncologist and start to freak out/worry AFTER you have all the information...

    Comment

    • Original Poster

      #3
      Yeah, this is a "plan for the worst, hope for the best" situation for me. I want to be informed and knowledgeable should the diagnosis be lymphoma, so I can hit the ground running on the decisions that have to be made.

      Do you have any sources that show a multi drug approach is better than a single drug approach? I have only found papers that show no benefit:

      http://avmajournals.avma.org/doi/abs...avma.232.6.879

      http://avmajournals.avma.org/doi/abs....2002.220.1813

      Should the diagnosis be cancer, we'll be hitting up the oncologists at CSU.

      Comment


      • #4
        Old but maybe helpful information

        We had a dog with lymphoma in the late 1970's, also the bestest dog in the world - basically our child as we were young marrieds. A gorgeous, top show quality Irish Setter who was so bright she could almost speak. Our Maggie, only 4at the time.

        Came up with enlarged peripheral nodes - prescapular, popliteal, and then a confirmed diagnosis of lymphoma. My husband was travelling for work at the time so he would drop her at the University of Missouri in Columbia vet school once a month on his way to St. Louis and they would do a then-protocol of chemo involving prednisone and vincristin and who knows what else.

        Even though this was early days of chemo development she did well for a year. The monthly treatments reduced the size of the nodes to nothing and they stayed that way until the treatment stopped working for her. She was never ill and very happy and active during that year.

        It is my understanding from a story seen last year somewhere that this is now a curable condition involving (my memory is vague on this) possibly bone marrow transplant and a lot of money. It was a Golden Retriever featured in the story who had been cured. I thought at the time how I wished they had had that available when Maggie was ill, though we could not have afforded it at that point in our lives.

        We lost a year-old kitten yesterday to a spinal cancer caused by feline leukemia virus, discussed in another thread, and so I am very empathetic to how you are feeling today. I just wanted to offer the thought that our dog certainly was unfazed by chemo and we got wonderful additional time together. Larger dogs don't often live as long as little dogs, but at age 11 she may do well if this turns out to be lymphoma and you pursue treatment.

        Comment


        • #5
          Dogs do not have the same side effects as people going through chemo. The goal in chemo in dogs is extension, not a full cure. Lympho is the one that has had the most research and success in dogs. There are several protocols to pick from. If you elect not to persue chemo, predinisone, while not prolonging the life of the dog, does keep them comfortable for a bit longer, allowing you more time. On chemo some dogs get as much as 7 years, some only weeks, it depends on the individual. Also, MAKE SURE your vet runs a tick disease panel, some tick borne diseases present some of the same symptoms as lympho, particularly swollen glands. Not just lymes, but a full tick panel. Good luck.

          Comment

          • Original Poster

            #6
            Results are on the vet's desk. Waiting for a call. (Impatiently--my regular vet is out this afternoon, so I'm waiting on his colleague, who I never, ever see regularly.)

            I will ask about tick borne disease, although they're really uncommon down here on the plains of CO. Much more common up in the mountains...

            Comment


            • #7
              Simkie--you're in Ft. Collins. You've got some of the best possible veterinarians at your fingertips at CSU. Get the consult and go from there.

              When I worked in a clinic, we had a few patients who we referred to Iowa State for chemo. As a tech (not licensed) I typically drove the patients for the owners as it was 2 1/2 hours from where our clinic was.

              Several of the pooches did really well.

              That said, with my own bestest pooch ever--who I've already spent thousands on for various things--I am not sure that I would choose chemo because the expenditure and the best case outcome still result in premature death. It totally blows that we have to outlive these critters. but that's how it works. And I'd rather have really good quality time and then a peaceful end than spend thousands and weeks on chemo.

              But that is ME. Not you.

              Many hugs. I'm really sorry.
              A good horseman doesn't have to tell anyone...the horse already knows.

              Might be a reason, never an excuse...

              Comment

              • Original Poster

                #8
                Positive for lymphoma. Bloodwork looks okay at this time. Appointment with CSU next Wednesday--earliest they could get us in. Will get a abdominal/chest film at regular vet tomorrow, as she seems to be very full through the ribs and I want to know what's going on in there.

                I still don't know about chemo, but I'll at least talk to them about it.

                Comment


                • #9
                  It never hurts to explore your options. Even if you don't do chemo, just remember, many animals are not loved one minute of their lives, yours has obviously been loved its whole life. There is nothing wrong with humane euthanasia in these circumstances, if it was you honestly think is best for your dog and you. Good luck and keep us updated. Hugs and best wished too!

                  Comment


                  • #10
                    Jingles and all fingers crossed for you.

                    Comment

                    • Original Poster

                      #11
                      Was able to get her in tonight for radiographs. Appears that we have mediastinum involvement, as well as some lumbar lymph nodes. Liver looks okay. Spleen is "generous." Have a copy of the bloodwork...while total wbc is within normal range, the individual cell counts are all over the place.

                      Sigh

                      Comment


                      • #12
                        Lots of hugs Simkie. Lots of hugs.
                        A good horseman doesn't have to tell anyone...the horse already knows.

                        Might be a reason, never an excuse...

                        Comment


                        • #13
                          Hugs to you Simkie, and I'm so sorry to hear of your dog's diagnosis. My 13 year old Golden passed in January. She had lymphoma in her stomach. Her tumor was partially blocking the tube that empties the stomach, so she presented with alot of vomiting. The cancer was also in 2 nearby nodes, but the stomach part was the worst.

                          Our vet advised us that her type of cancer was one of the most treatable. We started a chemo protocol and she did really well for a few months. Her vomiting stopped, however her appetite was just awful. We tried every kind of food, gravy, soup, meat we could think of to get her to eat. She had undergone 5 weeks of chemo, and then for a good week her energy came back 10 fold. She played ball and was our old girl. After that week she took a bad turn. Got very sick, fever and her blood cell count dove. Upon ultrasound we learned that the chemo wasn't working We were shocked to learn this, as she had stopped vomiting, so we and vet assumed the stomach cancer had shrunk, allowing food to finally pass through. But her cancer had grown substantially.

                          I will tell you that our girl was a bit of an exception. We had to let her go, as she wouldn't have made it through the night as ill as she was and we couldn't put her through more. When I asked the oncologist how she could do this job on a daily basis, she told us for every exception like ours, she was able to help many, many dogs have longer, extended lives with good quality of life. I saw those dogs in the waiting room many times, spoke with their owners. There are many, many success stories.

                          I will tell you that even though it was expensive and stressful for all, I know in my heart we did EVERYTHING we could to save her. I mean everything, including one very expensive controversial chemo med as a last resort. I would do the same thing again, based on her prognosis. So the important thing is to find out your dog's prognosis. Ask your vet the hard questions, like "If this was your dog, would you do this?" I asked that MANY times and I appreciate their answers every time.

                          Good luck with your dog and sending you lots of good thoughts.

                          Comment


                          • #14
                            Just found out today my 16 year old mutt has this. We are giving her some prednisone for comfort, but I guess it would be stupid to look into anything else.
                            sucks, though.
                            www.ncsporthorse.com

                            Comment


                            • #15
                              My 11 yo Jack has a mass of undetermined origin in her chest. So far, all it's done is impact her throat. Any pressure on it will cause a bad coughing fit. The vet has said it's likely a slow growing cancer. Her prognosis is that she'll be fine for a while then quickly go down hill. The down hill could be a week, or hours in length. I don't plan on doing anything more than making/keeping her comfortable. She's currently on butophorol to control the coughing.

                              I don't believe in trying to prolong dogs lives because they don't know what's coming. If, as I choose to believe, they go to the Rainbow Bridge, then the best thing I can do is send them on when the pain has gotten too much. They don't think about the future, or 'oh I wanted one last walk in the park.' They are dogs. We love them, but they are dogs. In the end, don't we love them because they are dogs? Who love us unconditionally and are just glad to see the sun shine rather than the rain?
                              ~Kryswyn~ Always look on the bright side of life, de doo, de doo de doo de doo
                              Check out my Kryswyn JRTs on Facebook

                              "Life is merrier with a terrier!"

                              Comment


                              • #16
                                Simkie- I have not read all posts, but have possible dumb question. Could you have the affected LN removed?? I have heard about this as a new treatment in conjunction with Breast Cancer, suposed to pprevent matasasization(?). Couldn't you just nip it in the bud by removing them??????

                                Many many jingles, I lost a Boxer to Thorasic Neoplasia, quick as a bunny, but NOT fun. Sorry for the downer, outcome for Lymphoma is MUCH better.

                                Missou- So sorry for your kitty, read your thread yesterday, kitty was at. Least happy for a whille. Small comfort, I know, but sometimes you have to grab hold of something

                                LBR
                                I reject your reality, and substitute my own- Adam Savage

                                R.I.P Ron Smith, you'll be greatly missed

                                Comment

                                • Original Poster

                                  #17
                                  Kryswyn, I am not at all willing to extend her life at the cost of her quality of life. Pain, nausea, diarrhea...generally feeling icky...these are all things I will not tolerate. I will also not allow her to be in the vet hospital, alone, or go under general anesthesia. If I can extend her life without sacrificing the quality of her life, then I might choose to do so, with consideration of the risks and what is involved.

                                  If it's checking in at CSU and hanging out for an IV infusion that has little risk of making her feel bad, with a high chance of making her feel better and extending her life? Maybe. If it's multiple biopsies that require general anesthesia and hospital stays, along with a drug regimen that makes her feel icky? No way in hell.

                                  I would really like to have more time with this dog. She is the bestest dog ever and we are so close. But I will not let my desire to have more time with her impact her quality of life for what she has left. And I will make what time she does have as good as I can.

                                  Shea'smom, I am so sorry to hear of your dog's diagnosis. It's a bad day for our critters

                                  tpup, that sounds so hard. I'm sorry

                                  If anyone is interested in the labs, I'll type them up and post them. I also have her radiographs, if anyone is interested. They are film, though, so not sure how to share.

                                  Pancakes, if you have any published studies that show multi-drug therapy is more effective than single drug therapy with doxorubicin, I'd really like to read them. All I've been able to find are the two links I posted previously.

                                  Comment

                                  • Original Poster

                                    #18
                                    Originally posted by ladybugred View Post
                                    Simkie- I have not read all posts, but have possible dumb question. Could you have the affected LN removed?? I have heard about this as a new treatment in conjunction with Breast Cancer, suposed to pprevent matasasization(?). Couldn't you just nip it in the bud by removing them??????
                                    No, I'm afraid that lymphoma is not that sort of disease. Lymphomas, leukemias and myelomas are all systemic cancers, as opposed to localized tumors. All of her peripheral lymph nodes (pretty much all of the nodes you can feel, in her neck and armpits and groin) and her mediastinum (which is deep in her chest) and her lumbar area are affected, and possibly her spleen as well. There may also be bone marrow involvement.

                                    Many many jingles, I lost a Boxer to Thorasic Neoplasia, quick as a bunny, but NOT fun. Sorry for the downer, outcome for Lymphoma is MUCH better.
                                    I'm so sorry about your boxer

                                    Comment


                                    • #19
                                      Thanx, seriously hope you have a MUCH better expperience. We didn't have time for chemo to be an option, low success rate anyway. For OUR issue.

                                      I truly hope your girl pulls through, jingles and ((hugs))

                                      LBR
                                      I reject your reality, and substitute my own- Adam Savage

                                      R.I.P Ron Smith, you'll be greatly missed

                                      Comment


                                      • #20
                                        I don't have specifics but my son's mutt dog, age 3, was dx with this in Dec, had some prednisone, and about 12 rounds of chemo, and at the moment is in remission and doing well. She didn't have much in the way of side effects from the chemo. Some was introvenous at the specialist's, and some just from the regular vet.

                                        Lots of luck and wishing the best.
                                        ********
                                        There is no snooze button on a cat that wants breakfast.

                                        Comment

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