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Featuring Demian Dressler, DVM and Susan Ettinger, DVM, Dip. ACVIM (Oncology), authors of The Dog Cancer Survival Guide

What I Would Do for My Dog with Lymphoma

Updated: May 17th, 2019


What would a veterinarian oncologist do for her dog with lymphoma? Dr. Susan Ettinger tells us how she would handle this dread disease.

When Guardians come in for a consultation with me after receiving a cancer diagnosis, they often ask “Doc, what would you do if this was your dog?”

I usually refuse to answer the question (with one important exception, which I will get to in a moment).

It’s very difficult for me to answer that question because there are way too many personal factors that go into the decision of what to do. In addition to the overall prognosis for that particular cancer, there could be other pre-existing conditions. It can become very complicated, and so much just depends upon the person who is asking.

So I can’t tell you what I would do, because really my answer is irrelevant at best and confusing at worst.

Everyone Is Different, No Answer Is the Same

Some Guardians want to be aggressive and take the treatment approach associated with longer survival times, even if it costs more, requires more visits to the oncologist, and has more side effects.  Others don’t.

For example, when I tell some Guardians the median survival time for their dog’s cancer is 18 months with treatment, they don’t feel that is long enough … while others will tell me that getting an extra three months is more than they hoped for.

What I would do for my dog likely not what you would do for your dog. I used to say I would have given Paige, my Labrador, a kidney if she needed it and it was medically an option. (She is no longer with me, but she did not need my kidney. And no, you cannot transplant your human kidney to your dog.)

I am pretty aggressive with medical options for my own pets. For example, I am not afraid of some side effects from diagnostics and treatment, especially when the “side effect” of not treating is worse (in my opinion).

I am more likely to go for surgery, radiation, and/or chemotherapy for my dog than choose a palliative approach such as pain management only.

But that is a pretty generalized statement.

And again, my choice may not be the choice of the Guardian sitting across from me in the exam room with their dog by their side. So, in order to keep from projecting my personal feelings onto Guardians, I usually just refuse to answer that question.

When it comes to lymphoma, I answer the question: CHOP.

Except when it comes to lymphoma. When it comes to lymphoma, I will share what I would do.

For me, that is an easy choice: I would treat my dog with a CHOP multi-agent protocol.

For much more of Dr. Sue’s insights into Lymphoma, get a copy of the Dog Cancer Survival Guide and read chapter 29, which starts on page 297.

Dogs with Lymphoma = CHOP Protocol

This protocol is a cyclic protocol usually lasting 5 to 6 months. In each cycle, the protocol includes vincristine, cyclophosphamide, and Adriamycin (doxorubicin). In the 1st cycle (usually the 1st treatment), the dog may also receive Elspar. Prednisone, a steroid, is also given orally daily for the 1st 4 weeks during the 1st 4-week cycle.

It’s typically a nineteen-week protocol, and it involves plenty of vet visits and some heavy-duty chemotherapy drugs. If it sounds like a lot, you’re right, it is.

So why do I universally recommend it?

For dogs with lymphoma, chemotherapy has a significant and positive effect on not only how long a dog lives but how well they live. Let’s look at some numbers.

Typically, a dog with lymphoma lives only one (1!) month without treatment.

The median survival time with a multi-agent chemotherapy protocol is 13 to 14 months.

So if your dog has lymphoma, and you don’t treat with chemo, you would expect to have one month more with your dog. But if you DO get the CHOP protocol, it would be reasonable to expect that your dog would live another 13 months.

Note: median survival time of 13 months means that of all dogs with lymphoma who undergo this protocol, half are still alive after 13 months. We don’t know, of course, which dogs will make be in the 50% who die earlier, and no one can guarantee your dog will be in the half that lives past 13 months. But it’s a REALLY long time compared to other cancers and other protocols!

Don’t Be Scared of Side Effects!

Dogs tolerate chemotherapy treatment so well that their life is considered good to great by most Guardians in my practice during the protocol and after the protocol (when they are in remission).

There is a LOT you can do at home to help with side effects. This webinar is a must-listen!

Dogs with lymphoma treated with chemotherapy live longer and live well.

So, yes I would treat my own dog for lymphoma with chemotherapy. No question for me.


Dr. Sue

Discover the Full Spectrum Approach to Dog Cancer

Leave a Comment

  1. Jacqueline Komoroski on November 14, 2019 at 10:11 am

    Hi Dr Ettinger
    My 6 year old female boxer, Nica, was diagnosed with lymphoma and passed away 8 days later. She was eating, active, and showing no signs of illness one day, and the next day she threw up twice and wasn’t interested in eating. We had her seen by a vet the next day. When he did an X-ray, he thought he saw a mass and referred us to a veterinary hospital. She was placed on fluids for dehydration, had an ultrasound, and blood work done. The next day we met with an oncologist at the same hospital who explained that Nica had enlarged lymph nodes and a thickening of the intestinal wall and said Nica had lymphoma. She recommended we have her do biopsy of the nodes and fluid to determine which type etc. We agreed and per the oncologist suggestion, we had her first chemotherapy treat the next morning which was a Wednesday at 11 am. The chemo she used was CHOPS. She told us the next few days may be tough, but if it worked we should see improvement. She also scheduled us for a 2nd treatment at the same time 1 week later.
    That day; Thursday;and Friday were rough on Nica. She still wasn’t interested in eating so we made her boiled chicken and rice and had her lick ice cubes from our hands because she wasn’t interested in drinking. That Friday evening I started noticing that she was having difficulty breathing and her breathing was labored so we took her back to the hospital and she was seen by an ER Dr. The Dr told us that the loss of appetite was probably from the chemo but and she did notice some labored breathing. I asked if she had noticed anything on her X-rays or ultrasound that the oncologist did that could be causing her labored breathing, and she suggested we contact the oncologist Monday morning and discuss it with her. The next day was Saturday, and she appeared to feel better. She also seemed better Sunday. She had an appetite, was drinking water, and starting to acting a little more like herself. We were so happy and thought that meant her lymphoma was receptive to the chemo. On Monday, she began to seem more tired, but was still eating and drinking. On Tuesday, the day before her 2nd chemo treatment, I began to notice she was again having difficulty breathing. In the meantime, we were calling the vet hospital daily to ask if the results from her biopsy were in because we were told type B lymphoma responds better to chops and T cell lymphoma was less receptive. I also continued to ask if the lymphoma was in her GI tract. Each time they told me the results were not in and the oncologist said she couldn’t tell. I’d looked at the differences between B & T cell and GI lymphoma and was hoping it was B cell and not GI because the prognosis seemed much better. Nica had already has x rays, ultra sounds, bloodwork, and biopsies done prior to starting the chemo so I thought the oncologist would at least be able to tell us if it was GI. I called again for results on Monday and was told they weren’t in. I called on Tuesday and was again told they weren’t in so I asked if they could check again. A few minutes later, they said they did have the results and it was T cell lymphoma. I told them her breathing was worse and they said to bring Nica in the next morning for her 2nd chemo treatment and they would check her breathing. When we arrived and spoke with the oncologist the next day we told her we were most concerned about her breathing, and we asked if we should continue with the same chemo treatment now that it was confirmed it was T cell lymphoma, because she was getting sicker, and that our number one concern was that she was having such a hard time breathing. She said she wanted to try a rescue drug because she thought it may help. We were willing to do anything to help her feel better and give us even another month, or a few weeks if she felt better. We also told her again they she was favoring her one leg and acted like she was in pain. We asked if she could re assess her lungs and give us something that could help with any pain or discomfort she may be experiencing, but she said Nica wasn’t in pain and that her breathing didn’t seem bad but that she would do another ultrasound. After the ultrasound, she told us she saw a some fluid around her lungs, but not enough to cause Nica discomfort or to have difficulty breathing and that it would help to aspirate any fluid.
    She then gave Nica the rescue chemo therapy as we waited. Nica was done with the chemo treatment at 12:30 in the afternoon. When we were leaving, We again discussed our concerns about her bread discomfort. We told her the breathing would get so labored that Nica couldn’t sleep because she was breathing so fast and hard. And, we again most concerned about her breathing and that it was causing her discomfort and keeping her from being able to close her tees and rest. We again asked if she could give Nica something for pain or to help relax her so she could rest. She told us that she did not think Nica was in pain and did not give her anything for pain and did not write a prescription for pain medication. She also never discussed an end of life plan in the event she became worse before her next treatment. That was on Wednesday afternoon. We got home an hour later and Nica seemed worse. She had no interest in eating anything even when we tried to hand feed her. The only way I could get fluids in her was by putting ice chips in my hand so she could lick them. About 2 hrs after we got home from the hospital, her breathing got even worse so I called the hospital to report what was happening. They told us we could bring her back in and they would give her oxygen. I reminded them we were just there and had discussed her breathing and that Nica wasn’t feeling well enough to be put back into the car for another hour or more so they could give her oxygen. So I again asked if I could speak to the oncologist or that they tell the oncologist her breathing was so bad that Nica couldn’t even keep her eyes closed to relax because she was struggling to breath. They put me on hold and came back and said the oncologist said we could bring her back to give her oxygen. I asked if the oncologist could give us something to relieve any pain or discomfort she may have and anything that could help relax her and told them my husband would drive to get the prescription while I stayed with Nica but they said no and that our only option was to bring her back in to give her oxygen. I laid on the floor right beside Nica telling her I was there and I loved her and got up to get more ice and she actually got up and followed me. She then laid back down on the hardwood floor. My husband had to leave for a business trip so I was alone with Nica. As I was laying beside her on the floor she tried to get up and fell back down. It was heartbreaking. I didn’t want to leave her on the hard floor so I tried putting her in her soft bed but I couldn’t get her in it. I then tried to lift her onto the couch so she would be more comfortable and so I could sleep beside her and she could see me. It wasn’t easy, but I managed to get her on the couch and laid with her. I spoke to her and told her I was there and loved her and I wouldn’t leave her side. Within min she started gasping for air and it was horrible. I tried everything I could. I put a pillow under her head and one between her legs to help open her airway but nothing helped. I somehow managed to put her in her soft bed because I thought she may be able to breath better. She had a few more gasps and her breathing stopped. I still had my hands on her and could feel her heart still beating and for a min I thought her breathing got better but then realized she had taken her last breath. A few seconds later her heart stopped beating and I realized she was gone. I laid with her and had my hand under her face and noticed my hand was warm. Then noticed she was bleeding from her mouth and nose and that the blood and fluid had soaked thru her bed and had puddled onto the floor. She had choked on her own fluids that the oncologist told us wasn’t a significant enough to cause her discomfort or worth removing.
    I apologize for the length of this message, but I was hoping for some guidance.
    When we saw the oncologist several hours earlier, before she gave her rescue chemo I asked if we could have Nica’s records so we could get a second opinion. The oncologist seemed offended and told us she had just as much experience as any other oncologist and that any oncologist would do exactly what she planned to do, and that Nica’s best shot was the rescue chemo treatment. We were so desperate to help Nica that we decided to trust the oncologist and do as she advised. In hindsight, I so wish we wouldn’t have allowed the rescue treatment because it didn’t help and she was already dying.
    I’m not a Dr., but I have to believe that an experienced oncologist who I’d assume deals with end of life care would recognize that Nica was dying and that giving her rescue chemo wasn’t in Nica’s best interest and what was most important was to advice and give us a plan for end of life care in the event we were forced to deal with that in the near future. Even if she didn’t realize Nica would die a few hours later, I would think that she would have at least given us a plan and given her something to comfort her.
    I would so appreciate if you would respond and give me any feedback. I’ve already contacted the oncologist but she only said she was sorry for our loss but did not respond further.
    Nica died on Wednesday, October 2nd and I still miss her so very much.
    My email is. Jackie87@comcast.net
    Best regards,
    Jackie Komoroski

  2. cliff stoddard on October 15, 2019 at 5:53 am

    my 12 year old English bulldog has t-cell lymphoma which was first seen in February of this year. Positively diagnosed in May. I was told that without treatment she would last 1 -2 months and with treatment a few month longer because of her age. She has already exceeded her life expectancy for bulldogs by 3 years. Because of this I chose the non-treatment option, but also changed her diet from kibble to canned dog food (Instinct limited dies because she is allergic to wheat and grains and poultry). She cant eat a normal meal as she will vomit so I give her a couple of tablespoons every 1-2 hours when she wants it. While we expected her to pass or have to put her to sleep in July, it is not October. She still has a great appetite, was outside playing with a beach ball yesterday, and doesn’t seem to be slowing down at all. While we expect this to change, I think the diet approach has worked very well. She still will vomit but this is only once or twice in a two-three week period, if she is fed a little more. She has all the other symptoms (black tarry stool, bruising, etc) but doesn’t act like her age,

  3. Marilyn Lieber on September 20, 2019 at 7:53 am

    My 9 yr old beloved Golden was diagnosed w/lymphoma Dec. 12. I was given choice: Prednisone, enjoy for 1 month then for 2nd month, watch him fade away and die–2 months; given 4-6 months on CHOP w/possibility of remission. Victor was on chemo, died in my arms, it wasn’t pretty, not like in the movies, one month after diagnosis and I had withdrawn $5000 to do his treatment. I was told 4-6 months; he lived 1 month. I didn’t even know what was going on when he was dying–it was a shock because I knew he had 4-6 months. If I ever had a dog diagnosed with lymphoma, and I did adopt a rescue 3 days after Victor died–I was devastated, I would enjoy the dog for a week, maybe 2,, then put him down as lovingly as I could. It’s not worth the chance you take no matter what you read or hear about CHOP.

  4. ann cambra on September 20, 2019 at 5:04 am

    But would you do it twice? Bob is 10.5 yrs old. started the CHOP in Jan. He did fabulously… Just found out it has now progressed. Would you do it again? or what would you do?

    • Dog Cancer Vet Team on September 20, 2019 at 7:33 am

      Hello Ann,

      Thanks for writing. In Chapter 29 of the Dog Cancer Survival Guide, Dr. Sue writes, “if a dog has relapsed, the owner usually wonders whether to start chemo again. It is helpful to know that, in general, the likelihood of a second remission is 50% and the second remission usually lasts 50% as long as the first.” For more information, check out the chapter on Lymphoma 🙂

  5. Rosalind Vaccarello on July 17, 2019 at 12:05 pm

    Thank you, Dr. Sue, for writing such an honest, common sense article about electing to treat lymphoma with a CHOP protocol. There are so many articles out there written by people with very limited knowledge about lymphoma and often no experience with chemotherapy in dogs. It is refreshing to read an article favoring CHOP and telling us why in practical terms.

  6. Lisa epstein on July 8, 2019 at 1:49 pm

    What if after a year being in remission and than it comes back to internal lymph nodes and she was coughing badly they also said she has bronchitis.

    • Dog Cancer Vet Team on July 9, 2019 at 6:36 am

      Hello Lisa,

      Thanks for writing and we’re sorry to hear that. In chapter 29 of the Dog Cancer Survival Guide, Dr. Sue, a veterinary oncologist, writes about Lymphoma, treatment options, protocols and what to do if the lymphoma relapses–there is a lot of information there that you may find helpful. It would also be a good idea to consult with your vet to find out what you can do to help lessen the coughing.

  7. Mich on June 6, 2019 at 2:21 pm

    I have treated my girl two times. She went into remission both times. You would never know she was sick. She loves to play and run around. She is on maintenance. Her last chemistry was 5 weeks ago. Now I fear she is out of remission. I am hoping that she just caught something but chances are that is not the case. I don’t know what my options are now. Chemo for a third time?

    • Molly Jacobson on June 6, 2019 at 3:36 pm

      Hi Mich, thanks for your comment. I’m sorry to hear about your girl being out of remission 🙁 Your oncologist will definitely have recommendations about what to do next. There might be another rescue protocol you can try, but it’s totally on a case-by-case basis, of course. So many factors go into those decisions! Touch base with your vet/oncologist and see what they say. In the meantime, I’m sending lots of aloha from all of us here on Maui. <3

  8. Kate on May 15, 2019 at 5:24 pm

    That’s hard to answer in a general “one answer for lymphoma” perspective. We have a Rottie that was diagnosed with lymphoma. We also had testing done to determine WHICH cell ( B or T) lymphoma it actually is. It turns out she has T cell which is much more aggressive. 6-8 months prognosis WITH chemotherapy, 1-2 months without. So you feel that putting your dog through 19 weeks of chemo just to get a few extra months with her is worth it?

    • Dog Cancer Vet Team on May 17, 2019 at 8:08 am

      Hey Kate,

      Thanks for writing and for sharing your opinion! Knowing your personality and why it’s so important to your dog with cancer is a really important part of Treatment Plan Analysis.

      For some people, it is worth it. They are willing to do everything that they can to stop cancer and they believe the side-effects and risk are worth it. For others, like Type C personalities, they will want to keep their dog as comfortable as possible, and they’re not willing to prolong life if life quality suffers. This is why, in the treatment plan analysis stage, you need to decide what type of personality you have, as it will help you make decisions for your dog’s treatment plan 🙂

      People who have a Type C, and even some Type B personalities, may not agree with Dr. Sue, but as she writes in the article above, that is what SHE would do for HER dog with Lymphoma based on HER personality, and other factors 🙂 There really is no “one-size-fits-all” approach to dog cancer treatment plans because each person, and their dog, is unique 🙂

  9. Meagan on May 11, 2019 at 6:45 am

    Thank you for this Susan.

  10. Don Baum on May 10, 2019 at 3:35 am

    My 15 year old CairnTerrier is 1/2 way through his second CHOP treatment. The first remission lasted 18 months. He is not tolerating the second treatment as well as the first. He received a treatment 3 days ago and is now lethargic and not eating. He is drinking water and his other bodily functions are normal. Is it “normal” for a second CHOP regime to cause more problems than the first ?

    • Molly Jacobson on May 11, 2019 at 9:49 am

      Hello Don! It’s hard to tell what is “normal” with dog cancer, right? So let’s think about it: eighteen months in a dog’s life is over a decade in a human’s life. When I was in my twenties, I could stay up all night without any noticeable decline in function the next day. A decade later, I was shocked at how horrible I felt the next day. And now that I’m in my late forties, I wouldn’t even think of staying up all night, because I know that I would barely function for days after. So it goes with our dogs. They age faster than we do, so their ability to handle stress or change can decline faster than we would expect. In addition to being nearly a decade older than he was with the first round of chemo, he’s also been actively fighting cancer this whole time. His body has been doing a tremendous amount of work to stay healthy with the help of the CHOP protocol. Unfortunately, when it comes to cancer, things rarely go the same, or as we expect. I would call your oncologist and tell her or him about the symptoms you’re seeing and ask what they think. An appetite stimulant might be in order, for example. Sometimes when a dog feels all-over-bad he just doesn’t want to eat. An appetite stimulant like the neurotransmitter-based Entyce might help him to eat, which MIGHT help him to feel better. Or maybe he’s nauseous, and needs an anti-nausea med. (Did they send you home with Cerenia or similar?) This might just be a harder round on him than the first one, making extra support necessary, or it could be that it’s just not helping as much as it did the first time. I would check with your oncologist and see what they say. Doses can be adjusted for next time, and maybe more preventative meds are needed up front. I hope that helps!

    • Lauren on May 30, 2019 at 6:35 pm

      With Lymphoma in Dogs, it always comes back, each time more resistant, and is eventually fatal. I’m very sorry. I only got a couple months

  11. Marilyn Lieber on May 7, 2019 at 10:30 am

    I chose to do chemo for my 9 yr old Golden after he was diagnosed w/lymphoma in December 2017. I decided to scrape together the 6-10 thousand to do this. He had 3 chemo treatments, did ok, then began to fail the Weds. after a 3d chemo treatment on the preceding Friday. I did not know what was going on, I took him to the beach to rejuvenate him as he loved the surf and beach, but he didn’t want to go to the beach and spent a very restless night so I came home before dawn. We watched the sun come up at the local park until PETCO opened so I could get a pill gun as he was not easily taking those big pills down. I got that, immediately went home, forced a pill down him, he had some difficulty getting up the stairs when we got home, but seemed normal, just tired, by noon. I chose to do normal things while he rested. About 1 pm I found him in the hallway, sprawled out, I asked him what’s the matter?, I knew he had 4-6 mo. with chemo treatment…. I sat with him, then he couldn’t keep his head up, so I rushed, got his blanket, covered him with it, talked to him, and watched him slowly die in my arms. This is what happened to my Golden. He did have T-cell lymphoma which translates to T = terrible rather than the other type, but no one prepared me that he might die so early while on chemo. I am not sure I would ever choose chemo again given what happened. All the vets and hospice (whom I had contacted but they hadn’t come by yet) sent Sympathy cards, the one vet sent flowers–I threw all away. I did’t want to be reminded about what happened. This is my story about choosing chemo (CHOP) for lymphoma.

    • Molly Jacobson on May 7, 2019 at 11:08 am

      Oh, Marilyn. What a story. I’m so sorry. Thank you so much for your share.

  12. Jeff V on May 7, 2019 at 7:06 am

    Chemo did nothing for my 8 1/2 year old dog that had epitheliotropic lymphoma.

  13. Molly on February 12, 2019 at 8:58 am

    My five year old Boxer, Fiona, was diagnosed with T-Cell lymphoma on November 23. We started chemo the following week. First week was fine. Second week we had terrible gi side effects. I ended up at emergency vet where they told me she had an arythmia. Never, never have her vets found an arythmia. Off to the cardiologist who said, yes, she has an arythmia but at this point it is a watch and see, no medication needed. Back to chemo where they switched vincristine with vinblastine. She went into remission after 3rd treatment and we began chemo ever other week together with oral procarbazine and prednisone. 2 weeks ago after her last injectable chemo, she “pulsed” off the prednisone and the procarbazine. 10 days after the chemo (now she is on nothing for 2 weeks) she stopped eating. The oncologist decided NOT to give her last chemo so now we are 4 days overdue on that. She still is NOT eating. She is acting fine, has plenty of energy (she caught and killed a squirrel in the yard yesterday-ugh). She will just NOT eat. I have been pureeing venison and feeding her with a feeding syringe. Before you suggest offering other things…I have tried chicken, beef (raw and cooked), port, turkey, lunch meat, yogurt, bananas, broth, hand feeding, different bowls…..nope. Her poop is solid. As per the vet 4 days ago, we are giving cerenia and metronidazole. She just won’t eat. She is supposed to have her chemo tomorrow and an ultrasound. I am terrified of what is inside even though the oncologist believes she is still in remission. Her nodes are undetectable. She is playing, pooping solid, waggy. I am scared.

    • Becky R. on February 13, 2019 at 11:50 am

      Have you tried an appetite stimulant? After my dog’s first chemo treatment, he had some GI upset and just wasn’t interested in eating. On the vet’s recommendation I gave him the appetite stimulant, Entyce (I think that’s how it’s spelled). It didn’t even take a full hour to work – he chowed down and hasn’t stopped eating since and that was back in November.

  14. stacia B. navarro on December 13, 2018 at 7:23 pm

    so, what about a second round on chemotherapy? our beloved , had 15 months cancer free.. and lymphoma is back.. we have started chemo again… what are your thoughts.. our Barton is 10 years old….?

    • Dog Cancer Vet Team on December 14, 2018 at 7:27 am

      Hello Stacia,

      Thanks for writing, and we are sorry to hear about your dog. We’re not veterinarians here in customer support, so we can’t offer you medical advice. However, we can provide you with information based off Dr. Dressler’s, and Dr. Sue’s writing 🙂

      You know your dog the best, and will be able to decide what treatment options YOU think would be best for your dog. Is he mentally, and physically, able to undergo another round of chemo? Are you willing to handle the side-effects? How important is life-quality to you? Those are just some of the things that you will have to take into consideration when making your decision, and for each dog guardian, the answer will be different because each dog, and their situation is unique.

      Here are some articles that you may find helpful in making a decision for your boy:

      In Chapter 29 of the Dog Cancer Survival Guide (this entire chapter is dedicated to Lymphoma) Dr. Sue writes that her treatment of choice for Lymphoma is the CHOP protocol, as these combination protocols have had the best success rates (CHOP protocol usually last between 19-25 weeks). However, each dog, and their health situation is unique, so each approach needs to be tweaked.

      When a dog has relapsed, owners usually wonder whether to start chemo again, so you aren’t alone 🙂 In this situation, Dr. Sue writes that, in general, the likelihood of a second remission is 50%, and the second remission usually lasts 50% as long as the first. We highly recommend that you get a copy of the Dog Cancer Survival Guide and read what Dr. Sue has to say on Lymphoma, relapses, treatment options, and alternative chemo options.

      As Dr. D writes in the Dog Cancer Survival Guide, there are many things that you can do to help your dog with cancer, such as conventional treatments (chemo, surgery, or radiation), diet, nutraceuticals, mind-body strategies and immune system boosters and anti-metastatics. Here’s a link to the Dog Cancer Diet PDF that readers of the blog can get for free : https://store.dogcancerblog.com/products/the-dog-cancer-diet

      Once you know your options, and what is most important to both you and your dog, you will be able to make a decision based on what you think would be best. Consult with your vet, or oncologist, and don’t be afraid to ask questions! You are your dog’s guardian 🙂

      We hope this helps!

  15. Maggie on December 12, 2018 at 3:14 pm

    I did the CHOP protocol for my rottie Jasmine (Jazz) which started in April and ended in August. Yesterday I got the sad confirmation that she came out of remission. What would you do next?

    • Dog Cancer Vet Team on December 13, 2018 at 8:34 am

      Hello Maggie,

      Thanks for writing, and we’re sorry to hear about Jazz. We’re not veterinarians here in customer support, so we can’t offer you medical advice. However, we can provide you with information based off Dr. Dressler’s writings 🙂

      Consult with your vet– they know your girl, and will be able to make recommendations on treatment options. From there, you will be able to decide what treatment options YOU think would be best for her. Do you think Jazz would be able to go through that type of treatment again? Are you willing to handle the side-effects? How important is life-quality to you? Those are just some of the things that you will have to take into consideration when making your decision.

      Here are some articles that you may find helpful in making a decision for your girl:

      As Dr. D writes in the Dog Cancer Survival Guide, there are many things that you can do to help your dog with cancer, such as conventional treatments (chemo, or radiation), diet, nutraceuticals, mind-body strategies and immune system boosters and anti-metastatics. Here’s a link to the Dog Cancer Diet PDF that readers of the blog can get for free: https://store.dogcancerblog.com/products/the-dog-cancer-diet

      Consult with your vet, or oncologist, and get their advice on what they would recommend, and make a decision based on what you think would be best for your girl 🙂

      We hope this helps!

      • Mary on December 19, 2018 at 9:12 am

        My five year old boxer, Fiona, was diagnosed with lymphoma the day after Thanksgiving. We have her on MOPP protocol (she is t-cell). She is in remission. Yea! I give her omega 3, K-9 immunity plus, Apocaps as well as some fresh parsley, fresh ginger and a high protein, low carb diet. Anything else that anyone would recommend to try to hold her remission

        • Dog Cancer Vet Team on December 20, 2018 at 7:58 am

          Hi Mary,

          Thanks for writing, and we are so happy to hear that! 🙂 We’re not veterinarians here in customer support, so we can’t offer you medical advice. However, we can provide you with information based off Dr. Dressler’s writing 🙂

          In the Dog Cancer Survival Guide, Dr. D writes there are many things that you can do to help your dog, such as conventional treatments, diet, nutraceuticals, mind-body strategies and immune system boosters and anti-metastatics. Molly wrote an amazing article on Magical Thinking and Dog Cancer that you may find helpful 🙂

          Diet is also important for dog’s with cancer. Here’s a link to the Dog Cancer Diet PDF that readers of the blog can get for free 🙂 : https://store.dogcancerblog.com/products/the-dog-cancer-diet

          Your vet may also be able to make some suggestions/recommendations that will work alongside Fiona’s current treatment plan 🙂

          We hope this helps!

      • Marilyn Lieber on January 19, 2019 at 2:56 pm

        My almost 9 yr old purebred Golden was diagnosed w/lymphoma on Dec. 12, 2018. Put on Prednisone immediately &he responded very well, back to old self, eating, playing, etc. Got to oncologist about 4 days later, said they had to do PARR test to know exactly how to treat; I went to another dr who was closer and I did’t have to leave my dog for hours as I did with the oncologist. Victor was on CHOP. He had 3 treatments, was doing fine then about 6 days after the 3d treatment, he wsasn’t himself–the next treatment 2 days later would have made him lie there for 4 hours due to stronger med; I elected to take him to holistic vet telling chemo dr I just couldn’t bring him in for 4 hr treatment. Saw holistic vet, got boatload of meds to give him on Thurs, decided to take him to the beach and stay over night Friday, Friday nite he was restless so I got up at 5:30, drove him home in the dark to our place–he got weaker and weaker, was till walking around drinking, but finally laid down in the hallway, wouldn’t swallow water offered thru eye dropper nor broth, just went thru his teeth, his eyes became lifeless; he died in my arms one month exactly after initial diagnosis regardless he had the best care possible. They told me without treatment I had 4-6 weeks, on Prednisone maybe 2 months, on chemo 4-6 months — BUT he only had a month. The only thing I can figure out is the lymphoma was so aggressive (t-cell) that it just took over and he could not fight it anymore with any kind of treatment, even the best. One ‘stinking’ month. I was in shock, still am, they found me staggering down the usual walk he and I took every a.m., took me into the clubhouse, called the peramedics who diagnosed me in extreme grief — I’m slowly recovering but mostly because a friend took me to a shelter and I adopted a dog about Victor’s size, mixed lab-golden-pointer, fawn colored, short haired not long long haired red Victor, and new dog is Victor III because Victor 1 (mixed golden died at 15-1/2), and I knew I could not survive w/o a dog. I only wanted to die.

        • Molly Jacobson on January 19, 2019 at 6:15 pm

          Aloha Marilyn. I’m so sorry to hear about your Victor. Lymphoma is very, very, VERY aggressive in general, and it definitely sounds like your pup’s was super-aggressive. I’m so sorry you went through that. I hope your new Victor will provide lots of cuddles and comfort. Much peace to you as you grieve and heal.

        • Linda Kelly on February 12, 2019 at 8:09 am

          Your words made me cry and I can relate to all that you went through with your beloved dog. My Topper an Australian Shepherd was diagnosed with T-cell lymphoma and went through some chemotherapy with the drugs listed and she died 4 months later not sure all the vet visits were worth it; I really feel that way but also know that something had to be tried. Topper was exposed to pesticides and I was very ignorant about it all until later. It was something I could have prevented it and it still bothers me. SO glad you have a new puppy and I have a new Tibby from the same person that I received all my Aussies from; life is horribly sad at times but somehow we must do our best. God Bless you.

          • marilyn lieber on February 12, 2019 at 12:05 pm

            Thanks for your kind, compassionate comments. I guess any breed can get lymphoma but do mixed breeds? I’m now convinced never to go purebred ever again but I doubt I’ll need to consider getting another dog. I felt guilt about my boy’s diagnosis because he had a waiver from any other vacinnations for state of PA, didn’t know I could get it for any state in the US, just petition the State Official (waiver was due to his surviving successful Mast Cell Tumor removal), and the vets here said they would not see the dog unless it had Rabies vac.

            I will never know if the Rabies vac. in Sept. caused the lymphoma to develop—never will know but I do recall the first vet that saw him here in OR said something about getting him an ultrasound and I have no idea why. Maybe upon physical exam he questioned something but he didn’t go into detail; at the time I thought why does this guy want me to spend over $600 for an ultrasound w/o explanation?

            So there is also titering that can be done to see if the dog still has immunity to specific diseases and if I”d had my head on straight, I would have elected to have him titered rather than agree to a vacinnation.

            But done is done. My boy is gone, my new boy is working out and I’m so glad he’s mixed breed. They are stronger, heartier, and I read that with mixed breed the bad genes are bred out as the gene pool is mixed up.

            As for avoiding pesticides, just stay clear of any lawns that look like a green carpet with no weeds and hope for the best otherwise. And research the food you feed your pet through dogfoodadvisor.com, check over the ingredients for any cancer eincouraging ones. Get a 5 star food.

            Thanks again for your compassionate remarks. Good luck w/your new pup.

  16. Caren JAMES Campbell on December 7, 2018 at 4:22 pm

    My golden retriever has mesenteric lymphoma and has not responded well to the chop treatment. It has made him extremely sick. He’s experienced extreme nausea and loss of appetite. At this time we’re going to suspend chemotherapy as it is not improving the quality of his life.

  17. Joanne on December 1, 2018 at 2:41 pm

    Which supplements would u use

  18. Carey on November 23, 2018 at 2:41 pm

    My dog (Lhasa Apso) was diagnosed with lymphoma several months ago and is on chlorambucil (once a day). My problem is that her appetite has gone to heck in a hand basket. I’ve tried a number of things including special dog foods and giving her adequate amounts of protein, all to no avail. Perhaps you can suggest some things I might have overlooked.

  19. Autumn on September 23, 2018 at 3:37 pm

    Our beloved 11 almost 12 golden retriever did not finish his dinner Friday night then this morning Sunday the same. This dog is el piggo so knew something wrong. Still active no pain, etc. took him to vet today Sunday and had abdominal xray and labs drawn. Abdominal xray showed tummy full of rocks guess why no appetite. It was packed. Decided surgery needed to be done tonight before they passed to intestine or something, anyway needed surgery soon. So got psyched up for this and vet returns can not do surgery. Labs off and showing lymphoma or leukemia. They will be sending blood or slides to some specialized lab for confirmation. Told still may need rock removal? What to do? How would this surgery affect everything else. Will have to give chemo a whole lot of thought. Been there and done that with a much younger dog who didnt need stomach surgery on top of it. Right now our thoughts are stomach surgery and palliative care for lymphome or leukemia. Any thoughts.
    Much appreciated. No apparent lymph node enlargement so obviously biospy as to type not done at this time. We want him to have quality over quanty. Previous experious with chemo not good, for dog or us and didnt really seem to increase life but then who knows. Must know he was not a happy dog. Want to bring him home and baby him to death…literally . Thanks for any thoughts.

  20. Wendy Taylor Barnes on June 26, 2018 at 5:54 am

    Would you say age has a contributing factor to consider when giving dogs chemo my dog is 15 and the vet says he doesn’t recommend chemo and has given her steroids.

    • DogCancerBlog on June 27, 2018 at 3:49 am

      Hi Wendy, thanks for writing and we’re sorry to hear about your girl. There are many factors that will influence a veterinarians and your own decision on what treatments to use– finance, life-quality, guardian type, your dog’s personality and many more. The Dog Cancer Survival Guide dedicates a whole chapter (#20) on Treatment Plan Analysis that goes through each of these topics.

      You may also find this post on “Cancer Treatment at My Dog’s Age?” to be beneficial. Here’s the link: https://www.dogcancerblog.com/blog/but-cancer-treatment-at-my-dogs-age/

      Your veterinarian will be able to tell you why he doesn’t recommend giving chemo to your girl. You could always ask your vet what else you could do to help manage side-effects, pain and help increase your dog’s quality-of-life 🙂

  21. Rob Siemens on May 29, 2017 at 6:42 pm

    This is a short summary of our journey with lymphoma so far, and what has worked for us. Our dog Tucker, a 9 year old yellow lab, was diagnosed in early December 2016. We got the typical diagnosis of 1 month to live if untreated, 3-6 months with prednisone, and 6 months-1year with chemo. We decided to wait to see the chemo specialist before putting him on prednisone, however they could not see us for two weeks (busy schedule) and Tucker went downhill quickly. His breathing became very laboured, and he lost his appetite completely. His nodes were about the size of golfballs. We were sure he would die in the next week if we didn’t do something, so we decided to forego the chemo and go straight to prednisone. It took effect fairly quickly, and within 2-3 days he seemed like his old self again. We monitored his lymph nodes and would “up” his dosage whenever they seemed noticeably enlarged. He has had a great last 5 months, coming up on 6, and we are convinced that the prednisone as well as our extra care for him has gone a long way in prolonging his life…

    We put Tucker immediately on a high protein diet, with ground beef, and beef liver mixed with a high quality dog food. We also give him at each meal a mixture of supplements including: Omega 3 fish oil capsules (his coat has never looked so shiny and felt softer, and the omega 3 is very beneficial for the body overall), Turmeric capsules (great for anti-inflammation), and Milk Thistle (helps regulate the liver, as the steroids are quite hard on the liver). We mix it into his food, and he gobbles them all up with every meal. The prednisone seems to give him a constant appetite, so we have never had any issue with him eating his pills. I’ve also been cracking a few eggs into his food a few times a week for extra protein. The cancer cells feed off carbs, and don’t like protein, so a low carb, high protein diet is key. This, along with the supplements has done wonders for our special boy, and we hope it will continue to carry him through for a significant period of time to come. Hopefully some of this information from our experience can help with any of you who are wondering what to do with your precious pup 🙂

    • Susan on June 4, 2019 at 1:40 pm

      How is your dog? My 13 year old Golden was just diagnosed. On pred and I am deciding what to do…

  22. Rebecca Fyfe on July 4, 2016 at 6:29 pm

    Dr. Sue, The CHOP protocol is not working for my dog. What should I do?

  23. D Sleeper on December 26, 2015 at 12:59 pm

    I know this thread is old, but I’ve been through the ringer for my beloved little doxie mix rescue. I’d had him 4 years and he was perfectly healthy. I noticed enlarged lymph nodes but he seemed fine so I watched him. One week later the nodes under his jaw were as big and hard as walnuts. We went to the vet who wanted to do every test available, including aspirate biopsy. I had found a large tick on him 2 weeks before, and I asked if we could do the blood draw, and antibiotics and give him 2 days to respond( I was told that the nods would not resolve with antibiotic treatment, they would continue to get larger) after 2 days they were 75% resolved. We kept him on doxycycline for 9 days but he couldn’t eat- he doesn’t tolerate them well.

    I brought him back as he had started to breath hard. THe vet took him off antibiotics because he had started to eat again but it was short lived. 5 days later I was back with him having coughing fits and high respiration. Took x-rays and while the vet said they couldn’t rule out cancer completely, it looked like pneumonia. For 6 days we did injections of baytril but he continued to decline and I brought him back and the vet felt he needed a hospital setting for supportive care. She was still convinced it was not a cancer because of how he responded. We went to a superior animal hospital in out area and within 12 hours we had the answer. He had cancer, very advanced now, either lymphoma or leukemia. WE started elspar and prdnisone immediately and he was given supportive care. His lungs hemorraged within 5 hours of starting his treatment.
    My little love and I learned the hardest lesson- my oncologist confirmed that antibiotics can suppress the inflammation and his nodes CAN shrink with their use. They never got big again even after he was off antibiotics.

    He lived 6 weeks from the first sign of enlarged lymph nodes, and exactly 1 month since his first vet visit for his problem. I wasn’t sure about chemo, but what I understand now is that the chemo protocal is really just the best palliative care. He was in wonderful hands with a wonderful Dr but I had been to visit him that day and 2 hours after I left he stopped breathing. I know he had people holding him and loving him- he had to be euthanized as his heart was still beating, and I wouldn’t get there in time and I wouldn’t leave him in that state in case he could actually be conscious as his body shut down. But he was in tremendous distress for 10 days, and frankly the ICU of a teaching animal hospital is not a restful place for an animal to be treated. It is loud, scary and any watchful creature will not be able to close their eyes and sleep.

    I hope this helps someone…if my vet had even suggested another blood test we’d have perhaps given him a better chance and less pain. This disease progresses so fast – don’t hesitate if you can help it.

  24. vcapp on November 30, 2014 at 11:19 am

    I came across this site in my frantic search for any information and reading what is here and one of the posts in particular were so helpful, I had to post our story thus far hoping it will help anyone else in the same spot. To make a long story very short, we took our 5 year old border collie lab to our normal vet on Saturday November 15th with a distended belly after swallowing 6 inches of a bully stick (AKA pizzle stick) three nights prior. He had mild diarrhea for two days but his belly felt tight and we could hear a lot of gurgling but not much else going on. He was less interested in eating food but still eating half of his portion until that morning when he really didn’t want to eat at all. Our fear was that he had an obstruction from the bully stick. Our vet took an xray, couldn’t see anything as she said he had fluid in his stomach. She then pulled some of the fluid and did a quick blood test. His blood test came back normal with the exception of a slightly elevated liver level (255 and it was supposed to be around 100). The fluid in his belly was pink tinged and he had a mild fever 102.9. Our vet sent us directly to the ER vet to get an ultrasound where he was promptly admitted and they ruled out everything from infectious disease, bacteria, septicemia, etc. over the weekend. By Monday, we had a confirmed diagnosis of large cell lymphoma of the liver. We were in such shock. Prior to the bully stick and the eating just that week, we didn’t have any external signs of cancer or tumors or anything. At this point, I just wanted my dog back and home. We decided to at least start chemo in the hospital that day with an l-spar injection and prednisone while I figured out what this all meant. I picked our dog up on Tuesday and had an appointment with an oncologist on Thursday. I was honestly so fearful of going to the oncologist, shell shocked by everything we had just gone through. Our oncologist was amazing and they were so understanding, kind and supportive and helpful. My biggest fear was that my dog would suffer, that I would have to leave him again to be monitored and be miserable and I wasn’t down for any of that. They suggested we start the Wisconsin protocol and see how he did after one treatment. Of course my dog is half border collie and we couldn’t start the Vincristine until we knew if he carried the MDR1 mutation which with Thanksgiving and everything else took 10 days to get results – weekend and holiday ERs seems to be our MO. So we ended up starting out of order with oral chemo on Nov. 17th followed by the Vincristine Nov. 28th since we received normal/normal test results for MDR1 the 25th (YAY!) I have to say that he is doing amazing so far. He has had some GI upset after each treatment but not the day of. So far it has been day 2 or 3 after the chemo and only lasting that one day. On those days, he isn’t interested in eating much but with the anti-nausea medicine (cerenia) he is eating. I’ve seen some folks suggesting chicken broth or things like that. What has worked for us when he won’t eat believe it or not are Gerber Graduates chicken sticks (the baby food), boiled chicken and organic turkey hotdogs. He will almost always eat one of those. On our “normal” days he acts like a 1 year old puppy, LOVES walks, playing and his normal border collie personality shines through. I am actually counting down the days until we can wean him off the prednisone which so far has been doggie crack with more energy than ever. We are still very early on with only two treatments under our belts but so far I am so glad we decided to give the chemo a try. It is still so hard to accept but we are living every dog day we have up to the best and will do so for as long as he is happy. I will not wait for him to start feeling “bad” and I plan to have his last day be one of his best. I wish all of you in the same position the best and hope this story helps.

  25. Kihei's mama on August 25, 2014 at 8:15 am

    Advice needed please!

    My beautiful chocolate lab Kihei was 3.5 years old when diagnosed with presumptive CNS lymphoma. He presented with vomiting and diarrhea but then had seizures in the hospital. MRI revealed minor lesions on the brain. Numerous ultra sound and aspirites did not reveal anything conclusive. Type A or B test also inconclusive. We did 10 month round of chemo with Cytosar, prednisone and CCNU. Only side effect was elevated ALk Phosphate which is almost back to normal (he is on denamarin). He was diagnosed in March of 2013 and stopped chemo in November 2013. He has been doing great but recent routine blood test should elevated creatinine (2.8) and BUN 32. Re check and creatinine dropped to 2.5 two days later. Now they are recommending an ultrasound to look at kidneys. We have spent a crazy amount of money on our boy without even a conclusive diagnosis. We are committed to keeping him happy and healthy but I am so lost in feelings of worry and despair and anger. I have lost many loved ones to cancer and had cancer myself so I don’t deal well…but to have such a wonderful amazing dog come down with this at such a young age and without a conclusive diagnosis we just wonder what is really going on. Any advice or guidance would be beyond appreciated. It just seems like one thing after another. If you didn’t know, you would think he looks like a normal happy crazy energetic chocolate lab…its just every time we go to the specialty hospital they tell us something is wrong. Any advice or words of wisdom are appreciated

  26. Ashley on August 23, 2014 at 11:05 pm

    My 7 1/2 year old American bulldog, Mia was diagnosed with lymphoma about a week ago. A little background: Approximately 9 months ago my husband and I noticed enlarged/swollen glands in her neck/throat area. We waited a few weeks to a month not thinking too much of it. When the swelling did not go down we took her to the vet. They pulled a sample from the area and sent her home with antibiotics. When the results came in we were not given much insight or information at all. We were mainly told that it was too early to see anything and to bring her back for a second round of antibiotics. The swelling did not go down. We were back and forth for a couple of months with the vet until we decided to take her somewhere else for a second look. At this point there were clusters in her throat/neck region and they were getting bigger. After taking her to another vet they did a white blood cell count. The results came back normal. There were no other swollen lymph nodes. They recommended a biopsy as the next step. We waited a couple of months and took her back in for the biopsy. This brings us to the diagnosis of lymphoma. At first we decided against the chemo thinking that it would make her feel bad. We decided that whatever decision we were going to make at this point was going to be for her and not for us. We scheduled her for surgery to remove the affected lymph nodes and to get her started on prednisone. After researching the chemo option and realizing that the cost was not as high as we expected it to be my husband and I decided to inquire about it with our vet. I asked the question “if it were your dog, and it were financially feasible, would you do the chemo?” I could tell he was also reluctant to answer that question but it came down to “yes, without a doubt, I would do the chemo.” I was told that lymphoma generally responds very well to chemo. We would have had to drive 2 1/2 hours for each visit to the oncologist but I was willing to do it. Thankfully our vet has gone back and forth with the oncologist and is making it possible for us to do the chemo at our vet instead. The only downfall is that our vet does not have the vincristine. (I believe that is the one he said. It is the one that costs about a thousand dollars for a bottle) They are going to give her the doxorubicin and something else that I cannot remember the name of at this time. All the while my sweet girl has been her normal self. She has shown no signs of pain or distress. The ONLY reason we knew to get her checked out was the swollen lymph nodes. This was AT LEAST 9 months ago when it started. I just keep thinking “wow. They say without treatment they have weeks to 3 months to live. We are going on 9 months and her diet has not changed one bit, she is energetic, happy, tail wagging constantly, playful, and just as cheerful as she has always been. I am so devastated about her results. She is more than a dog to me. I am sure you all feel the same way I do. When you have a dog and you love them and care for them the way you’re supposed to they become more than a pet. They become family. She has brought so much joy into my life. She has such a sweet disposition. Everyone loves her. She is always wagging her tail and scooting around on the floor because she can’t keep her composure (cause she’s so happy to see you) yet she still wants to be a good girl and sit like she’s supposed to) and any time you walk up to her she puts her paw up to shake your hand. (it’s actually her way of saying she wants to be pet) She is such a good girl. She listens so well. I’m getting carried away. 🙂 Since all of this I am so thankful to know that the chemo is a step we are able to take. Like I said we are only making decisions for her and not ourselves and now that we know and understand the chemo a little better I see that it is actually a very good option and I am so glad to know that I can give my baby girl more time with us and also the chance to live more comfortably. I do still know that the reality is I am going to have to make some hard decisions throughout this whole process. I’m just going to take it one step at a time. I’m so glad I stumbled across this page because you all have given me hope, encouragement, and information that I didn’t have before. I hurt for all of you who are going through this or have gone through this. I think the biggest thing to remember is the love and life you and your pet gave to one another.

  27. rene on August 15, 2014 at 12:07 pm

    My mix breed had lymphoma 2 years ago and it has come back. We did the Wisconsin protocol and had wonderful results. I would like to know what kind of results people have gotten if the did the protocol and 2nd time around

  28. Michaela on July 30, 2014 at 10:18 am

    Hi Dr. Sue
    My 13 yr old Jack Russel was diagnosed with lymphoma 9 months ago in November. She started CHOP but after one cycle her lymph nodes were even larger and the vet decided she had an aggressive cancer that was not responding and switched her to MOPP. They cautioned that she likely only had a few months but she did 6 full cycles of MOPP (surprising to the vet) and had obtained complete remission about 3 cycles in. We ended any chemo after the 6 cycles so after 3 months without any chemo at all she has just come out of remission and we are considering rescue protocols. Most of the information out there is what to do after coming out of remission after CHOP but her lymphoma was resistant to that before she even started. Our vet has recommended either single-drug lomustine or multi-drug DMAC protocols. I was just wondering what you would recommend considering MOPP worked well but CHOP did not. Thanks

  29. Susan Kazara Harper on July 8, 2014 at 5:40 am

    Hi Gloria’s Mom,
    For the team, we know this is difficult, especially with an experience with lymphoma already. The thing is, a needle aspirate is very unreliable for correct diagnosis. You don’t mention why you’re against surgery — be it the cost or your dog not tolerating sedation well. Yet a full biopsy by removing a piece of the tumor or suspected area is the best way to confirm, or rule out lymphoma. If it is lymphoma and you wait, it’s almost guaranteed to get worse. If it is and you can get a treatment plan going, you have a young, robust dog who stands a good chance of fighting back. If you wait and worry, all you get it worry. I know it’s difficult. You may consider using Apocaps as you have a ‘suspected lymphoma’ situation. Check with your vet, and check our www/apocaps.com. The Dog Cancer Diet can only help, as well. You can download it from the upper right section this blog. Good luck!

  30. Gloria'sMom on July 3, 2014 at 10:13 am

    Hi there-
    My three year old lab mix had very hard lymph nodes in her neck and had been throwing up sporadically. Knowing about lymphoma, having lost a dog too it in the past, I was very worried that was what was going on. We did needle aspiration and blood work. Cytology came back “suspicious” for lymphoma but inconclusive. Blood work also had slightly elevated lymph count but everything else was normal. I went to a holistic vet for a 2nd opinion and she also felt it probably was lymphoma, but we wouldn’t be able to tell without a full biopsy – which I’d really rather not do. So, I changed her diet and have her on a bunch of natural supplements. Any thoughts on dogs who come back with borderline test results like this? Thanks!!

  31. Spayer59 on June 4, 2014 at 6:28 pm

    My 10 year old golden got her first chemo treatment last Wednesday . But this week she has some smaller lymph nodes but also some are bigger than previously. Why does this happen?

    • Susan Kazara Harper on June 4, 2014 at 8:01 pm

      Hi there, the chemotherapy protocol is pretty powerful, and complicated. The body has a lot of balancing to do as it processes all everything. You may find some lumps reduce quickly and rebound though you think you’ve seen the last of them. Others may increase for a time. In the early days, simply make note of what happens… keeping a diary or calendar helps throughout this journey, and also note if there are changes in your dog’s eating, poo-ing, and generally how each day goes … “bright/happy”, “tired, lethargic”, etc. Or you can use a 1-5 scale, which you set up yourself and just make a note of which number applies each day. It can all go towards putting together a good picture of response as the days go by. This may be invaluable for your vet at the check-ups. The Dog Cancer Survival Guide is full of invaluable information which will help. Take care of that Golden pup of yours, keep your moods (both of you) up, and stay positive. All the best!

  32. stretch7 on May 30, 2014 at 5:58 am

    2 weeks ago my 11 year old Standard Poodle was diagnosed with lymphoma after I took her to a vet because of a mass on her upper front leg.
    After reading about it, I was devastated .

    The regular Vet was gone for a week so I had to wait that long to talk to him.
    Now I’m not a religious fanatic, but I do pray and go to Church every Sunday.
    So I prayed and asked everyone in the neighborhood who knew my dog to pray.
    When I finally saw the vet, something didn’t seem right in the biopsy report., and he asked me if I wanted another biopsy. I said yes the results being the first lab tests were wrong and she doesn’t have lymphoma.
    I firmly believe my dog was saved because of God’s intervention and am telling everyone.
    And this posting is part of my deal for the survival of my best friend.

    • Susan Kazara Harper on May 30, 2014 at 6:10 am

      Wonderful news! We know you are so relieved, and this is a good lesson in following that gut feeling and getting a second test or a second opinion. Nothing wrong with asking for help from your friends (on every level). Congratulations.

  33. Meerkat on April 28, 2014 at 10:06 am

    Our rescue Yorkshire Terrier aged approx 9 to 10 years was diagnosed with Lymphoma a month ago. He has a solid lump below his ear and in his shoulder, on the same side. The initial aspiration biopsy came back clear, but a surgical biopsy proved a positive result for Lymphoma. Blood tests suggest it has not yet affected his main organs and we started on steroids immediately on the vets recommendation, he has now had a first dose of vincristine and apart from sickness and loss of appetite he is doing well. He will have four of these treatments once a week alongside cyclophosphamide given only on the day of the vincristine. I will keep you posted so as to offer support to others. The decision to go for this treatment is to enhance Meerkat’s quality of life, hopefully give him some extra time for his beach walks and to enjoy being with the family. No easy route but so far so good. In the first day of the chemo his lumps became soft and I know this will only be a temporary reaction, but hope it is a start. After the second day he’s been the first at the door and also taking the lead as usual, so I hope this will be worth it for him.

    • Susan Kazara Harper on April 28, 2014 at 12:49 pm

      Love, love, love the name Meerkat. He must be such a beautiful boy. We’re so glad he’s responded well to the treatment… every day is it’s own. Lack of spread is a good thing, so get his nutrition right (www.dogcancerdiet.com) and let him show you how to live each day. All the best to you all!

      • Meerkat on April 28, 2014 at 11:19 pm

        Thank you so much Susan. His second chemotherapy is this coming Friday and it is a struggle to get him to eat anything right n.com/products/pd-canine-nd-canine-canned.html and continuing to try and get him to have omega rich foods such as fish and freshly cooked chicken etc… keeping carbs at bay, easier said than done as he prefers a mouthful of cooked sausage than anything… I did let him have some yesterday to try and get him going since his appetite is so reduced. We will soldier on. He has the weekly vincristine for a month then every third week, supported by pred 5mg a day which we are getting him to via opening his mouth and dipped in honey. I do wish there were more people to talk to… I do feel so alone with this and I am asking the vet if he can possibly give him less sedation next time as that is knocking the life out of him for a day. Do hope I’ve done the right thing for him. His lumps have gone soft so not sure why. xxx Thank you so much.

        • Susan Kazara Harper on April 29, 2014 at 9:10 am

          Hi, I do understand what you’re going through. It’s difficult and you want to do the right thing for Meerkat. Bottom line, if he wants to eat things that aren’t on the dog cancer diet, better he eats than doesn’t eat. Equally, if you want more help navigating this, I’m emailing you my support line contact number. I’d be happy to go through food options with you. It’s so important, and can be such a worry. Please try to give him one food at a time; don’t mix. The right carbs, like broccolli and vital colored vegetables will do him a lot of good. It’s the sugary carbs we want to avoid. Do you have the Dog Cancer Diet? If not, download it at the blog home page on the right. Dr. D has listed all the foods that are very helpful for fueling dogs and fighting cancer. Keep your energy up, you’re doing a great job. Hugs to Meerkat!

  34. Richard on April 5, 2014 at 1:51 pm

    Our Chocolate lab “Mocha” was first diagnosed with Lymphoma in November of 2012. We elected to follow the Chemotherapy treatment and she did great – tolerated the medication well, with few side affects. We were told to expect a remission of up to 15 Months. That was just what we got – she lived a happy and healthy extra 15 months. When the cancer came out of remission we started a second treatment, but she did not tolerate it well and we stopped the treatment after a month. Mocha died a couple weeks later. I would certainly do the first treatment again just because we got that extra 15 months. Very sad to lose her, but grateful for the time we got.

    • Susan Kazara Harper on April 6, 2014 at 11:14 am

      Hi Richard, Very sorry that Mocha has passed. Fifteen months is a good amount of time, but of course nothing is ever long enough. We all understand your loss.

  35. Julie on January 10, 2014 at 1:14 am

    My 3 y/o Golden was diagnosed with lymphoma in July and is about done with CHOP. The nodes in his neck just enlarged a bit in the last few weeks 2-3 cm in neck, but no where else. Doc said we will complete the CHOP he has vincristine and doxorubicin left. We briefly discussed other options yesterday like another round of chop or mop. She said he could remain where he is in partial remission or this could progress. Its tough, because none of us have a crystal ball. Do you think another round of CHOP would help? She said Elspar isn’t available anymore. He is acting fine, happy golden, but I am scared.

  36. Jan on December 9, 2013 at 5:32 am

    My 11year old yellow Lab was diagnosed with T cell lymphoma in July 2013 and is still going strong. She has several tumors in her neck, several of which are quite large . We chose not to treat her as we were told to expect her to survive only 4-8 weeks. She is not in pain, continues to eat well, and went bird hunting a couple of weeks ago. She seems to sleep a bit more, but she is also 11…we are thankful for every day we have with her!

    • Meerkat on April 28, 2014 at 10:09 am

      Would love to know how things are Jan. Sending love and all good wishes xxx

  37. Becky on October 22, 2013 at 9:31 am

    Why are so many dogs getting cancer? This is not normal. Could it be the crappy, processed food we feed them, the overuse of antibiotics, the over-vaccination and the horrible, toxic flea treatments we use? We are told by those in the veterinary industry that all of these things are perfectly safe for our dogs. It certainly keeps them in business, treating our dogs for all the things these toxic products cause.
    I watched my husband go through chemo for lymphnoma. I would NEVER do it to my dog. We are assured that dogs tolerant chemo better than humans. Really? Perhaps they just can’t tell us how crappy they feel. We’re also told that all the things that are most certainly causing so much cancer are safe. Why would we be told the truth about side effects from expensive treatment that keeps veterinary oncologists in business? Sorry if this sounds pretty cynical but I absolutely believe that all the things we are told we should do to be responsible dog guardians are most of what’s causing all this cancer.

    • Helen Peoples on May 28, 2014 at 1:17 pm

      My dog is only comim up on two and im waitin on hearin bck if he has lymphoma. He has had his puppy vaccinations and 1 yearly booster and has always been on iams dog food. He wears a flea collar and is never around chemicals. We use a steam mop with tap water. I hve a dog that is ten years old who gets all the same treatment and is healthy as anythin but yet the baby is the sick one. Cancer can b caused by genetic mutation and most of the reason it seems to hve become more common is simply because people r more aware of symptoms and science has become better at findin the causes and diagnoses is more common. Even twenty yrs ago people wouldnt hve taken there dog to the vets like they do now.

      • Susan Kazara Harper on May 29, 2014 at 3:51 am

        Helen, We’re all hoping your two year old gets good results from those tests. You’re right, there are many, many causes of cancer. If you do have a fight on your hands, please consider Apocaps as part of his treatment. Both of my dogs who had cancer thrived and beats the odds, and I’m sure Apocaps was a big reason. And for your 10 year old, take a look at EverPup (www.everpup.com) the ultimate daily supplement designed by Dr. Dressler to help keep healthy dogs healthy, and also to help keep the process of apoptosis (natural cell death) working as it should. Thinking of you with fingers crossed.

      • Kimberly Peters on December 27, 2016 at 9:07 am

        I am so sorry to hear about your pup. My 7 year old dog has it. Not to speak of my situation in response to your own, but we have two from the same litter and only one has this devastating disease. We don’t use chemicals either. I was told by two veterinarians that this is common in our breed. Perhaps it is with your dog’s as well. ❤

    • Aaron Dear on November 17, 2016 at 8:46 pm

      Well Becky, I’ve postulated this same question about both dogs and humans. I think the 2 main things to consider are:

      1) Food. Particularly, the amount. This has less to do with the types of food we feed to dogs (which is still important, but not implicated) than the amount of food we feed to them. Take a glance at fasting and cancer studies – a science still in its infancy, but evidencing promising results. Simply feeding all the time – whether meals or snacking – may give the body a different signal than fasting.

      2) Living longer gives more time for bad things to happen. Instances of cancer in humans is higher when humans live longer lives, and I imagine the same goes for dogs. This is paradoxical but true: the longer you live, the higher chance your cells have to go haywire.

    • Teresa Marie Hernandez on November 30, 2017 at 1:05 am

      I could not agree with this any more. I feel the same way. I have 3 dogs all different pedigrees. They all have the same problems sadly.

  38. Sandra Dighton on May 28, 2013 at 4:22 pm

    My Casey has been through 2 CHOP protocols and has done pretty well. The problem is that the high protein diet has caused his BUN to elevate and he has protein in his urine. Any advise to adjust this situation would be greatly appreciated! BTW, Casey is in his 15th month since diagnosis.

    Thanks, Sandy

  39. Debbie on May 12, 2013 at 6:26 pm

    My 12 year old Jack Russell was diagnosed with lymphoma this past week. We are devastated of course but are going to try the chemo. The oncologists told us much of what I hav read and pray that we are doing the right thing for our precious baby. He got his first treatment of eispar and Friday and goes tomorrow for another treatment. We will do everything we can for him to have a good quality of life but we don’t want him to suffer. We will take it a week at a time to see how it goes.

  40. Gina S on May 11, 2013 at 2:05 pm

    Dr. Sue,
    Sorry for the delay in reply. I didn’t see that you had replied. No Oncologist yet. There is an internist at the Vet hospital where Cosmo has been going for 8 years. She specializes in cancer and is directing the protocol. Cosmo has had weekly chemo for 9 weeks. His lymph nodes have all shrunk. He has had: Elspar, Vincristine, Cytoxan, Dexamethasone/Adriamycin IV, Vincristine, Cytoxan, Dex/Adriamycin IV, Vincristine, Cytoxan so far. In 2 weeks we go to every other week. He takes Pred 5 mg, Flagyl 1/2 tablet of 250 mg, Pepcid 5mg, and GlycoFlex. We’ve consulted with Penn Vet Hosp on evaluating his food. I’m keeping him on Wellness Simple, but adding in wet food and their protein wet (All are Salmon). I’ve also added Nutri-Vet Fish Oil. His red cell is up to 29. His weight is up to 23 lbs. I walk him more now. He is happy and back to his old self with only an increase in thirst and he moves around from floor to crate to bed when resting. He is also VERY clingy to me. He knows he’s feeling better. We are at approx. $4500 with a payment plan. Hope we can keep this up!

  41. SarahP on May 3, 2013 at 10:57 am

    I would like to take a moment to say a big thank you for 1. having this blog, and 2. caring enough to actually respond to people going through this difficult battle. It really says alot about your character and the love you have for our dogs…so thank you.

    After a long, difficult week of testing, we received an official diagnosis yesterday for our little one and the diagnosis is lymphoma. She began getting swollen lymph nodes last week. We will do everything in our power to fight this, whatever it takes. We take her to U Cal Davis on Monday morning to meet with an oncologist. We will give her whatever treatment they recommend. With that said, after days of research, reading, purchasing books, downloading diet guides, etc. I’m still at a complete loss on exactly what herbal supplements and natural “remedies” I can give her to help with this fight. I’ve already changed her diet to cancer fighting foods, following the Budwig diet and the ebook cancer guide. With that said, could your recommend, or point me in the general direction, where I can find out about any other type of vitamins or supplements (I’ve read alot about essiac tea/flaxseed oil/epa oil/arginine) that will help her during this fight. I’ve already ordered the Apocaps. I am finding so much information that contradicts, I’m beginning to be confused and I want to do this right. Thank you so much, and thank you for caring.

  42. Beth & Gabby on April 29, 2013 at 2:55 am

    I’m confused. I did read your book — amazing. From some of your postings below, I did not know that you needed to start the Apocaps after you finish with the prednisone — I did not see that in the book and I did consult a Vet nutritionist discussing the Apocaps.

    Gabby (13 years Polish Lowland Sheepdog) has stage 4A lymphoma and is on the CHOP protocol. I started Apocaps about a month ago — soon after I saw her diagnosis and seeing her oncologist and nutritionist. She is currently being weaned off the pred.

    Did I do something wrong?


    • Dr. Susan Ettinger on May 4, 2013 at 3:13 pm


      The recommendation is to avoid using prednisone, a steroid, and Apocaps together since they both can be anti-inflammatory and cause stomach irritation. If she is tapering off her pred now, I wouldn’t worry.

      I am so happy to hear that the book was helpful, and I hope Gabby continues to do well. And you too – got to remember to take care of the caregiver too!

      All my best, Dr Sue

  43. Julie Allen on April 18, 2013 at 2:56 pm

    Our 3 yo Great Dane, Buford, has just been diagnosed with B cell Stage IV a Lymphoma and I just want to say, thanks for this article. This gives me some hope. He has had his first chemo treatment and we will reassess in 4 weeks.

    • Dr. Susan Ettinger on April 28, 2013 at 2:50 pm

      I am so glad the article was helpful. You can also read my posts on chemo side effects. I hope Buford does wonderfully!
      All my best, Dr Sue

  44. Sharon on April 16, 2013 at 11:45 pm

    My sweet Molly 9 1/2 has just been diagnosed with lymphoma. She is a frightened dog. Scared of everything and everyone especially men and the vet! I have decided not put her through the trauma of chemotherapy and weekly visits to the latter. Instead I am considering steroid therapy to help relieve the immediate risks of pressure to the airways and eventual breathing difficulties. I hope that I will be able to recognise when she is unable to continue to be our best friend, and that I can be brave enough to let her go.

    • Dr. Susan Ettinger on April 28, 2013 at 11:31 am

      Sorry about Molly! There is no wring or right decision when it comes to treating or not. You made an educated decision and that is all that Molly could ask from you.
      I know this is hard. I wish you strength and quality time with your Molly.
      All my best, Dr Sue

  45. Beth on April 7, 2013 at 4:36 pm

    Hi Dr. Sue,
    Tonight I came across your blog. Our Beau, a Brittany, will be 8 on 04/15. He was diagnosed with lymphoma this past Wed and we are devastated. The only signs were that he vomited his dinner Sunday night, vomited both meals on Monday and vomited breakfast on Tues. We initially thought maybe he had a virus but after that decided he needed to go to the vet. Bloodwork showed elevated liver enzymes (8X normal). X-rays indicated a mass on his liver or gallbladdar and the vet also suspected pancreatitis. The vet recommended we see an internist and get an ultrasound. She started him on Tramadol for pain and Cerenia for N/V.
    On Wed we went to the internist for the ultrasound and got the devastating news. The internist says it is stage IV due to the liver involvement. She was unable (as was our regular vet) to palpate the tumors on exam. She offered a biopsy and a referral to an oncologisy and told us about CHOP. Most of this was a blur and we were numb as we had assumed he had panacreatitis or something wrong with his gallbladdar. We chose to decline the aspirate/biopsy, oncology consult and to decline CHOP for philosophical as well as financial reasons. I have been very torn, but know that we don’t have a spar $5000 as my husband has been unemployed nearly a year.
    The internist added predinosone to the mix. Beau’s pain and N/V stopped by Wed night. His appetite is quite variable at this time. He refuses his normal premium dry dogfood and we started him on RC low fat gastro diet on Tuesday. He ate that well until Thursday when he refused it. We made him some rice with beef broth and he chowed down. Then we mixed cheese with the RC food and he ate a little better. This morning we mixed rice, cheese and RC and he ate well. He still likes his treats.
    We took Beau and his brother Luke to the lake on our favorite 3 mile hike and he did great. We bought him a hamburger on the way home and he ate his share. We came home and played ball and again he did great. We noticed yesterday that he seemed constipated and we don’t know if that is from the Tramadol or from the tumor. We gave him a stool softner and some canned pumpkin and he “asked” to go out. He ran around in the yard barking and assumed the potty pose. It was too dark to see if he was successful or not, but he at least tried for several minutes.
    So, all that background to ask, are there some complimentary therapies we can try since we are not able to try chemo? We are on a roller coaster. Friday was a dark day as we contacted the local hospice/euthanisia vet and he will do the final injection when the time comes. Saturday was the pits as we dug his grave for when the time comes. (We live in a rural area on five acres of property and have found a peaceful spot in our woods). Today was great and with the exception of his excessive thirst (from the predinose) no one would have known he is sick.
    So, again, any thoughts on complimentart/alternative therapies such as fish oil, milk thistle, etc. We keep hoping that since we declined the aspirate/biopsy and the vet is only 99% certain of his diagnosis that maybe he does not have lymphoma. Thanks for “listening” and any response.

    • Dr. Susan Ettinger on April 28, 2013 at 11:18 am

      I am sorry I did not see this post sooner.How is Beau doing now? Is he still on pred?
      Dr Sue

  46. Christine Newman-Aumiller on April 6, 2013 at 4:50 pm

    Our four year old pit bull Beckham has B-cell lymphoma, diagnosed in mid-February. We were able to get him into a clinical trial at Purdue using the CHOP procedure (he got the normal CHOP protocol) and his first two weeks of treatment were wonderful. His nodes all shrank to the point they were non-existent. After the third week, however, the nodes began to increase again (different nodes, however). The oncologist had high hopes that the doxorubicin, which he said was the most powerful of the drugs in the protocol but no luck. Beckham’s nodes in the face have swollen to the point his lovely pit bull head is twice its normal size. We are going back on Monday and will be looking at alternatives.

    What are the choices after the CHOP procedure has failed? How effective are the other protocols? Should we just focus on making him comfortable rather than the chemo?

    • Dr. Susan Ettinger on April 28, 2013 at 11:15 am

      The rescue protocols (what we call the protocols after the 1st line one is o longer working) are reviewed in the Guide. I like the MOPP rescue protocol, or oral Lomustine. Recommendations are often based on the individual pet and other potential medical issues. For example, if liver values are elevated, Lomustine may not be the right choice. There are LOTS of chemo options to try for lymphoma, so I would not give up yet. But of course, it is okay to stop chemo. Good luck you and Beckham. Purdue is a great place!
      All my best, Dr Sue

  47. John on March 25, 2013 at 6:33 pm

    Hello, My little girl Roxy (6 1/2 year old solid black german shepherd) was diagnosed with lymphoma in late June 2012. We did the Wisconin protocol Chemo. I would HIGHLY reccomend doing the chemo. Roxy never really felt sick after the treatments and lived a high quality life.

    Today was the hardest day of my entire life. At around 5:43pm… I had my vet come over and I said my final goodbye.

    In December of 2012, Roxy came out of remission. I tried 3 different rescure protocols with negative results. Her lymphnode on her rear left leg was the size of a golf ball. It stayed like this for around 2 1/5 months. I thought maybee it would stay this way for awhile and she could get maybee another year. Then after about 3 months, the lympnodes in her neck came back. She stopped eating and became very lethargic. Her legs became very swollen and today, her face became swollen.

    I miss my little girl so much.

    My best advice I can give you guys is just love your dog every day. Take them to the beach, the lake and let them live the best lives you can give them.

    The chemo will give you the time you need to show extra love. I’m so sorry you guys have to deal with this. I know how you feel and pray that all of you will have success with your dogs. Best of luck to you all.

  48. Jane on March 25, 2013 at 9:19 am

    Dr. Susan Ettinger,

    I just got a call from my vet and she said the lab that did the needle aspiration in july could use that sample and do some DNA test for $350. I don’t understand. I called the lab and they would not talk to me. How could a sample be inconclusive 7 months ago and now give you results. I will spend the $350 but not if I am just going to get the same answer. I am so upset — right now I wish I had cancer and would die. I cannot deal with any more pain. My boy is suffering and I am helpless.

  49. Laura on March 21, 2013 at 5:48 am

    To Arlene…..

    I hope you stop the chemo while you can. A dog doesn’t understand some distant buying of time. 5 or 6 days of sick in a week or two week period is a lot of days of a dog feeling badly. They are all about NOW. They are in the moment….that’s what we love so much about them. I regret profoundly putting my dog through a hopeless chemo regimen and making his last few days so miserable. My whole life was about making the dog happy….about doing what was right FOR HIM. That meant leaving social functions and concerts and baseball games early. That meant never leaving him with a stranger. That meant fixing his food every day for him from scratch. That meant hiking him, when I really wanted to be on a bike or skis. And the idea that I chose poorly for him at the last moments of his life will haunt me forever.

  50. Laura on March 20, 2013 at 5:18 pm

    I am devastated…..our precious Harley did not make it through this battle. Less than 10 days after we started the Wisconsin protocol, Harley died. We had to put him down on Friday evening. He had tolerated the first round of Elspar and dex. But the next drug in the protocol, the vincristine injection did not go well for him. He had pain immediately following the treatment…..he was leaping around the car in distress, so much so that i took him back to the vet. They had no clue as to why he had this reaction. He calmed down after a bit, and had one good day the next day which was Wednesday. Then thursday he started downward, drooling and panting–miserable. By Friday he was flattened, tired out from panting, and malnourished from loss of appetite. I tearfully put him down while he laid in my arms panting. It was the most heartbreaking moment of my entire life…and I was holding on to my mothers hand when she left this world. This was worse. I would NOT recommend this protocol for a dog to anyone. A dog doesn’t know it’s doing it to get “more time”. A dog doesn’t have a concept of “more time”. We look to these animals because they are so in the moment. And trying to buy more time is a human construct.

    Harley had a lifetime of medical challenges. He had chronic allergic bronchitis that led to multiple pneumonias and steroid use (pred and then an inhaler instead). I’m sure those drugs took their toll on his immune system and that may have made him a poor candidate for chemo. He had torsion surgery. He had UTI’s. But this one last battle he could not fight. And if I had this to do all over again, I would NEVER EVER EVER put my dog through chemo. I just want this out there so that there is a more realistic picture of what doing chemo with a dog means. “Most” dogs may tolerate, but not all. And it’s a big price to pay for your precious most trusting of friends who is counting on you to do the right thing by them. My baby is gone and we are bereft. Horrible experience.

    Thank you for all the feedback and resources, etc. For now, I just want this other viewpoint out there. Best to all of you…..

    • Dr. Demian Dressler on March 26, 2013 at 4:35 pm

      Dear Laura,
      I am so sorry for your Harley and for you in this.
      🙁 That sounds horrible.
      I’m sending you my best thoughts right now.
      Dr D

  51. Gina S on March 19, 2013 at 9:26 pm

    Thank you for your reply Dr. Dressler. I had read your suggested reading yesterday. It helped me with my latest discussion today with my vet. She told me we will figure out a plan together. It pains me to include budget as a concern, also. I hope your guide include specific types of chemo chemicals and supplements that will not interfere with effectiveness of the Pred and the chemo killing the cancer cells, while giving my Cosmo some natural protection to his liver, heart, stomach, spleen, etc in a non-toxic way. Of course breed comes into play, for ex: Cavaliers and their heart as well as current blood levels as a result of treatments, existing conditions like IBD. There must be documentation out there on such things since this form of cancer (I am learning) seems to be common. I can’t be the only one seeing the need for nutritionist (and oncologists or any specialists) to partner with a primary vet in caring for a pet. Sometimes what is read online from someone else case is taken out of context and wrongly used as a remedy. For example, I read Turmeric was a good natural anti-inflammatory (that I came across in a blog Q&A), but he had thrown up once already that day. I added a pinch to his dinner and he threw up again but with blood. Maybe I caused it? Oh the guilt. Hopefully the guide will give me some guidance and I can find a nutritionist who can help us make educated decisions. Thank you again. It’s wonderful what you and Dr Ettinger are providing here. Every bit helps! – Gina and Cosmo

  52. Jane on March 19, 2013 at 7:21 am

    Dr. Susan Ettinger,

    I wrote to you in Feb. about my boy with lymphoma. I am frustrated with my vet. Back when she said he had lymphoma she said the test were inconclusive (she did it twice) but they showed lymphoma cells. With her experience she said he did have it and she thought it would be a waste of money to do more test if I was not going to do chemo. But now it is almost 7 months — he has gained almost 5 lbs and he is only a 15 lb dog, papillon. She did another needle aspiration and said since he is on predisone the test would not be able to tell if he had lymphoma. She said a x-ray would not tell me anything. What do I do? From what I read he should not be alive if he has lymphoma. 7 months of predisone cannot be good for him. I called another vet and they said they would take him off the predisone for 2-3 weeks and redo the aspiration but we could still get inconclusive results and if that happened they would take out the node to do a biopsy. That would cost around $2000. I am a disabled veteran and recently had a dog with epilepsy dumped at my home — he has taken a huge bite out of my budget. But if I take him off the predisone and he has lymphoma I will kill him. Since I wrote last I loss a second cat — my grandma always said things come in threes. I am so afraid that I will do the wrong thing and he will die. I need some guidance I have no idea what to do for my boy. Please help me!

  53. Gina S on March 18, 2013 at 9:17 am

    Update: Cosmo vomited twice on Sunday(yesterday). The 2nd time with blood. I had given him a pinch of Turmeric. That could have been it… He had some protein in his urine when it was tested last week. His Spleen and Liver were reactive with early lymph changes. Bloodwork today showed liver and pancreas levels elevated. He was given an injection for nausea. We dropped Prednisone down to 1 tablet 2x/day. Stop Clavamox. Stop Prilosec and replace with Pepsid. Add Carafate 3x/day 2hrs after other meds. He still will take the Flagyl in the am with the Pred and GlycoFlex with dinner. His chemo is being postponed to make sure he is holding his food. Again, I appreciate it if you have any suggestions. Thank you!!! – Gina and Cosmo

    • Dr. Susan Ettinger on April 5, 2013 at 9:54 am

      Just replied Gina. Have you consulted with the oncologist?
      Dr Sue

  54. Gina S on March 17, 2013 at 1:56 pm

    I have a wonderful, precious 8 yr old Cavalier King Charles Spaniel, Cosmo. He has been diagnosed with Lymphosarcoma. Who knows how long his nodes have been large. Could have been 1-2 weeks. If you can give me any direction, I would greatly appreciate it. He’s had allergies for a long time, IBD (July 2012) takes Flagyl, arthritis/hip dysplasia since 1yr old (takes GlycoFlex), Spine trauma from collar 2009 (took Rimadyl, luckily I refused Pred steroid use). No heart issues previously.
    Over the weekend of 3-09-13, we noticed large ‘glands’ under his jaw(concerned this is effecting his breathing), bulging in lower ab area as well as his skin rather red in inner thigh. He also for the past week had been uncomfortable sleeping moving from crate, to bed, to floor. Occasional hack/cough to clear his throat. He has felt heavier in weight lately.
    I brought him in on Monday 3-11. Blood taken, xrays of both chest and abdomen. We could see enlarged lymph nodes above his heart and in other areas. His organs also looked ‘thickened’. Aspirations done of his lymph nodes in his shoulder and back leg (nodes have been enlarged in that area in the past due to inflammation from hips). It didn’t look good.
    Tuesday 3-12 dropped off for an ultrasound. His bark was horse from nodes pressing on his vocal cords. Vet confirmed results of aspirations: lymphosarcoma. His spleen and liver may also be involved. When pressing on his spleen, he had discomfort. Biopsy was done. Urine shows protein, I think. He had chemo. Overnight stay. Weight 25.5 lbs.
    Wed 3-13-13 Responded well to chemo, shrinking of the nodes. Picked him up, he was his happy tail-wagging self. His bark was to normal.I noticed lymp node shrinkage, but not as much as from vet’s point of view. They do feel squishy.
    His first chemo was with Elspar. Sessions will be weekly for 6 wks. Sometimes an needle injection, sometimes IV over 2 hrs or so. He is on Pred. Took him off Rimadyl. Clavamox for 7 days, Prilosec antibiotic for 14 days. Chemo is CHOP(COP?) protocol. 6 weeks. Up to $2100 so far.
    He had allergies and we didn’t know for sure from what. Food? Environmental? He would get his anal glands cleaned often. I would give him benadry which sometimes helped. I switched his food to a grain-free food. He was too heavy, so I switched him to Core Wellness reduced fat turkey/chicken which was grain-free. Added to food and treats consisted of apples, carrots, frozen string beans and yams, which help when he is constipated (also can be from allergies and anal glands).
    Due to IBD, I change his food AND stop giving him the fruit/veggies. Switched to Wellness Limited Ingredient “Simple” Dry Salmon and Potato. I wasn’t sure if the proteins were the IBD issue, so I chose Salmon. He gained the weight he lost over the summer (from 18.9 lbs to 22 lbs) His weight is now over 25 lbs.
    Thurs 3-14-13 Vet called me to set up Chemo #2 on Tues 3-19. He is thirsty, peeing a lot, still breathing issues, still unsettled sleep. She said we will work on a plan together. I continue research on line for treatment, diet, supplements and herbs. There is an oncologist in the area I could see. Don’t know if he is T-cell, but vet thinks he may be. Bone marrow was not tested yet. I don’t know the results of the biopsy of spleen or liver yet.
    I feel like I am cramming for a test (against time) to research this cancer and find the best supplements for him to take and I want to get him these right away. Do you have any suggestions? Thank you!

    • Dr. Demian Dressler on March 19, 2013 at 4:57 pm

      Dear Gina,
      sorry about your Cosmo.
      It is very difficult for even a vet or medical person to research all the supplements in a critical way in a short amount of time. Luckily this has been done for you in the Guide, which has downloadable forms for different electronic readers (kindle, nook, etc) so you can get the info you need.
      Also here is a post I would read that will get you started.
      Remember to get your vet’s input in all health care steps,
      Dr D

    • Dr. Susan Ettinger on April 5, 2013 at 9:50 am

      A complete overview of lymphoma is in the Guide, plus lots of other helpful info to assist you and Cosmo through this journey.
      I do recommend an oncologist. I personally believe cancer should be managed by a person who specializes and focuses on cancer.
      Remember lymphoma is very treatable and most patients tolerate chemo VERY well.
      All my best, Dr Sue

  55. Arlene Westerlund on March 13, 2013 at 5:19 pm

    Hi Laura,

    As you can see from Dr. Ettinger’s response many dogs do very well with chemo. My own vet is treating a poodle as well and the only side effect he had was some swelling of his legs which stopped with a adjustment of his dosage. No gastrointestinal side effects.

    Heidi has not been so lucky. She has lost her appetite, sometimes a little, sometimes alot. She is nauseous, but she only threw up once, and last week had diarrhea for a couple of days,She is usually sick for 5 days, maybe 6, just getting better in time for her next treatment. So, it has been very upsetting. Then, she also developed an anemia first, and then low white count and low platelet count. She had a scheduled week off in her protocol, and because of her low counts, she was given a second week off. We will see what next week’s blood tests tell us. Despite her normal sized lymph nodes now, her vet is not sure if it is because of her chemo or if the lymphoma is still active in her bone marrow. However, because of her break in the chemo, she is feeling very well now. She is eating all her regular dinner, on her own, and looking for my food as well. And she wants to go and sit outside in her favorite place on the back steps, not trying to hide under a bush like she did for a ccouple of days. I assume there will be an adjustment to her dosage due to the counts, assuming they are ok for her to continue. Maybe this will help her nausa as well.

    Laura, I too had cancer last year, and while I did not have to go through chemo, they were thinking for awhile that I would so I learned a little. While they can give you some idea what each drug’s side effects might be, each person’s journey with chemo is different, as is each person’s journey with radiation (which I did get). I am learning that it is no different with our dogs. The doctors just have to do their best to help keep the side effects to a minimum if and when they occur.

    All the best to you and Harley. So sorry you too have to go through this.

    And, Dr. Ettinger, I would love to get your comments on Heidi’s low white, red, AND platelet counts.

    Thanks so much.

  56. Laura on March 9, 2013 at 10:51 am

    Arlene, our dog Harley just had his first treatment with the elspar, and as of day 3 has totally lost his appetite. i’ve gotten him to eat some cooked fish out of my hands, and some cooked carrots. but he won’t really touch much else. is this the first treatment you spoke of, where your girl heidi wouldn’t eat for 4 days? this is going to seriously weaken harley, and he’s supposed to have treatment two on tuesday. if you see this, i’m wondering if you can shed a little light. thank you…..

  57. Laura on March 8, 2013 at 2:20 am

    Hi there

    Our 11 1/2 year old Standard Poodle named Harley was just diagnosed with widespread lymphoma. We are awaiting the typing, either T or B cell. He had his first chemo treatment on Tuesday, along with a Dexamethasone injection, and now oral pred. He’s doing great. Did not present “sick”, just lymph nodes enlarging quickly. We think this has been in his body for a long time, as it’s spread to the liver and spleen and mediastinum. My husband is pretty clear to treat with chemo. I am so worried that he won’t be himself, or he will lose all his precious curly hair and will be miserable. I already make his food from scratch, so special diet is not an issue. I am just really wanting to know how poodles go through the Wisconsin CHOP protocol, and how they handle their hair loss. Is it “suffering” for a poodle to lose his hair? Do they lose all of it??? It’s 4:19 in the morning and I can’t sleep I’m so upset. Harley is doing great for now, playful and loving and hungry. What constitutes suffering for an animal….I’m afraid that the side effects of chemo will overwhelm him with despondency. Thank you for your advice…..

  58. Arlene Westerlund on February 10, 2013 at 5:05 am

    Hi Dr. Ettinger and Dr.Dressler,
    My Golden Retriever Heidi has been diagnosed with lymphoma. She is 15 but otherwise doing well. The tech at the oncologist I saw said that her bloodwork was awesome for her age. Even though she is an old girl, my heart is breaking. The oncologist started her on the Wisconsin Madison protocol. I have hasd to switch her care to my regular vet due to financial constraints. He tells me that the protocol he is using is a modified CHOP. He is substituting Leukeron for one of the other drugs (don’t remember which one) after she gets that other one once. His protocol will be 17 weeks. She just had her first with him on Friday. But, he told me that she is in remission already from the on treatment at the oncologist. Is that usual, to get remission after only one treatment? Does that indicate anything as far as how long she will stay in remission?

    Her fine needle aspirate indicated a large cell lymphoma. Her biopsy said B cell and low grade. What dos low grade mean for her? I have read about indolent lymphomas, but the onclogist said indolent and low grade are not the same thing. But, what does it mean for Heidi?

    She tolerated the chemos pretty well, especially Fridays. A little loss of appetite for her regular food (but not for her treats). Her appetite loss after treatment 1 was more upsetting. It was for 4 days despite cerenia and for 2 of those days she wanted nothing, not even treats.

    Thank you so much and looking forward to your response.

    Arlene and Heidi

  59. carol on February 5, 2013 at 5:55 pm

    My Ben is a 6 yr old Golden…. noticed the swelling in his neck a couple of weeks ago….. today went to the vet and did the needle aspiration to conform lymphoma , Hate to be materialistic… but in all the comments, no one has discussed the cost involved in these treatments. with 2 children -college looming. we have to consider that…. tomorrow we get the actual diagnosis … can anyone give us an idea of what the cost of the treatment would be..

    • Dr. Susan Ettinger on February 8, 2013 at 6:29 pm

      It depends on the protocol you choose. For a mutli-agent CHOP protocol for a Golden for the 5-6 months of chemo, it will likely run you over $5-8000. There are lots of options for lymphoma, so I work with my clients to try to find a protocol that fits their schedule and budget. Asking about cost is important, and it is financially responsible to know what to expect. Also there are can be unexpected things, like urinary tract infections, extra antibuitics, rarely hospitalization for severe side effects. So you have to know about all this. Good luck.
      All my best, Dr Sue

  60. Michael on February 5, 2013 at 11:40 am

    Look up dichloroacetate, (DCA). I am currently using it to treat my dog who has lymphoma. There is a site called, thedcasite com, which has a lot of info on the subject. Many people as well as animals have had amazing results with DCA. I hope this info is as helpful to everyone who sees it as it has been for me.

  61. Linda Richard on February 1, 2013 at 9:29 pm

    Dear Demian
    The latest on Annie: Today she went to our vet to see if the two weeks of prednisone shrank the lung mass. It didn’t. (No bigger, either.) So it isn’t likely to be lymphoma. Our vet says it doesn’t appear to be a primary cancer, too opaque. But where is the cancer it came from? The heart is enlarged. Perhaps hermangiosarcoma? LeAnn, our vet, uses your diet for her own two dogs with cancer. Her mom and dad live on Maui. But she doesn’t have a copy of the book, which is so good, Demian. I just received it yesterday from Amazon. I have your first one. You have taken it so much deeper. I don’t know why but I feel more hopeful tonight. I think because I have been reading your book and have made my second batch of your diet for Annie. She is asleep beside me now. I am thinking of trying to get her into UCDavis for a work-up. LeAnn fears a biopsy is too dangerous. But perhaps the films and blood work will reveal more to the doctors there? Thanks for listening.

  62. Jane on January 30, 2013 at 2:53 pm

    My 3 year old Papillon was diagnosed with lymphoma 6 months ago. He is a big baby he is afraid of his own shadow — so we decided against chemo. The vet put him on predisone 2.5 mg 2 times a day. He is hungry all the time and has gained some weight. I think these are the side effects of the predisone. Recently his lympho nodes on his neck are swollen more then usual. He seems to have some trouble breathing — he snorts alot. He has always been a lazy dog but he seems to be a little more uncomfortable. I don’t know what to do. Is there a test I can do to see if the cancer has spread? I was told when he loses his appietite I will know he is sick but does the predisone mask that. I don’t want him to suffer. What do I do? Please help me I just lost my cat last week and I am not ready to suffer another loss. Any suggestions are welcomed. Thank you

    • Dr. Susan Ettinger on February 8, 2013 at 5:37 pm

      Sorry about your cat and now your dog. If the lymph nodes are more swollen, it is likely that the pred is no longer working, so you need to get to your vet. Remember we never stop pred without a slow taper. Pred typically only keeps the lymphoma under control for about 2-3 months. I am sorry about everything you have been through, but I recommend you recheck your dog with your vet asap.
      All my best, Dr Sue

  63. Linda Richard on January 29, 2013 at 9:29 pm

    Dear Demian,
    My beautiful golden retriever Lindy died at ten of hermangiosarcoma six months after early diagnosis, surgery and treatment at UC Davis associated Veterinary Specialties in San Francisco. Because he was a Maui dog and you and I had worked together to help abolish quarantine in Hawaii, Lindy was included in your Apocap trial on Maui. Now my twelve year old cocker bichon, Annie has lymphoma. Just diagnosed ten days ago. On prednisone to see if the lung tumor will shrink enough to begin chemo. Enlarged liver and spleen, thickened intestinal walls, high calcium levels in blood, ongoing bladder infections and crystals on Royal Canine the past year, and lots of Baytril. I now live in Ashland in southern Oregon. No vet oncologists here. Lindy had the best care in the world. My poor Annie has to make do. Still the vet here says she can do chemo. Any thoughts for her? Thank you, once again for being there for us and our dogs in these dark nights.

    • Dr. Susan Ettinger on February 8, 2013 at 5:30 pm

      Hi Linda,
      Sorry to hear about Lindy and now Annie. Lymphoma is treatable, but if you are going to treat with chemo, you want to get that started ASAP. In addition, being on pred prior to chemo can make chemo less effective – it’s not a guarantee but still something to know. If you cannot find an oncologist, maybe there is an internist in the area with an interest in oncology. Check out http://www.ACVIM.org and click on find a specialist. It sounds like Annie has her fair share of issues and it would be helpful to seek out a specialist. Remember, lymphoma is a systemic cancer, meaning we expect to find it in multiple sites like liver, spleen and even lungs, so this should not be a reason to delay chemo. I hope you get Annie treated soon, if that what’s you decide. If you have, the Guide, I have a whole chapter on lymphoma. Hopefully that will help.
      All my best, Dr Sue

  64. Juli on January 17, 2013 at 2:57 pm

    Dr. Sue,
    Thank you for your response, however, my Mochi passed away on January 12. We decided to have an ultrasound because he started having horrible side effects from the doxorubicin. Vomiting, nausea, and bloody diarrhea that couldn’t be fixed with meds. My oncologist suspected that it wasn’t just side effects. The ultrasound showed that his tumor had grown and spread 25% during chemo. We did everything we could for my baby, but in the end the cancer was just too aggressive. We are devastated but so relieved he isn’t in pain anymore. I do appreciate your book and I know a lot more about canine cancer than I did before.

    • Dr. Susan Ettinger on February 3, 2013 at 11:53 am

      I am so sorry for your loss. Mochi was lucky to have such a dedicated Guardian. KNow that you did all you could for him. Again, sorry for your loss.
      With sympathy,
      Dr Sue

  65. Nina on January 17, 2013 at 5:47 am

    Dr. Sue,

    My 12year, 3month old bichon started drinkng a lot more so I took her in for a checkup. The bloodwork revealed high globulin levels, indicative of multiple myeloma or lymphoma. I went to the oncologist and had more tests done – tick titer – negative, urine test that looks for cancer – negative . . . the next step would be an ultrasound of spleen and aspiration and bone marrow aspiration. All very expensive. While I have the funds to perform these tests, I’m torn whether I should put my 12 year old dog through it when she active and seems to be fne. it is almost like she is on a steroid now – getting into trash, looking for food in the pantry and drinking a lot. She is very playful too. Can you give me some guidance? It sounds like the chemo treatnment is about $5000 and that is after we go through many tests to confirm she actually has cancer.

    • Dr. Susan Ettinger on February 3, 2013 at 11:51 am

      As I wrote in the blog, I think lymphoma is treatable and treatment is well-tolerated. And yes it unfortunately gets expensive but there are alternative protocols to the CHOP protocol that are less expensive. The trade-off is that the remission rates are lower and the survival times are shorter, but they are still better than pred alone. So ask an oncologist about other chemo protocols. But you have to get the diagnosis 1st. If you need more info, have you read the lymphoma chapter in the Guide? Good luck. I know this is not east.
      All my best, Dr Sue

  66. Liam Floyd on January 10, 2013 at 11:41 am

    I am in the UK and have just lost my Bichon Frise due to lymphoma.

    She was on the COP protocol from being diagnosed with lymphoma and lasted around 9 months before she relapsed.

    No further chemotherapy was applied after the relapse thus was only given Prednicare, Antepsin, and Zantac until her death two months later.

    I concluded (after the Vet’s advice and lots of crying) that attempting alternative chemotherapeutic agents after the relapse would be unfair on the dog because of her having to make many visits to the surgery in such a short period – she had to be sedated for each session.

    What has angered me was the Vet’s failure to give me the option of introducing doxorubicin as a ‘rescue’ procedure immediately after the relapse.

    I have just looked through a letter he sent a while back outlining his plan for my dog; introducing doxorubicin in the event of a relapse was his intention – my heart sank.

    Due to the vet’s incompetence, did my dog die prematurely?

    • Dr. Susan Ettinger on January 13, 2013 at 5:35 pm

      I am so, so sorry for your loss. But it’s hard for me to comment as I was not directly involved with your dog’s care and the decisions that were made. You should talk to your vet and try to work through this. Hopefully that will answer your questions and proved some closure.
      I am thinking of your during this time of sadness.
      All my best, Dr Sue

  67. Kathryn on January 10, 2013 at 4:36 am

    Thanks Dr. Sue. Yes I read your book and started Henna on your suggested diet last month. I also give her Milk Thistle, LArganine, LGlutamine, mega doses of Fish Oil/Krill Oil. Her energy levels have increased dramatically. Thank you!

    Here are my concerns….

    Our oncologist says that Henna never really reached remission with Mod-Wisc protocol and switched her to a dose of Dacarbazine (every 3 weeks) based on the charts below:

    Measurements of lymph nodes:

    date of visit: initial 9/12 9/20 & 9/27 10/4 10/25 10/31 11/7

    left sm 2.5×2 2×1.8 prominent prominent 1.2×1.2 prom to N? 1.4×1.2

    left ps 2.4×2 1.2×1.5 prom normal 1.6×2 prom to N? 2.3×2

    rt sm 1.6×2.2 1×1.2 prom prom 1×1 prom to N? 1.4×1.3

    rt ps 2×2.4 normal prom normal 1.5×1.5 prom to N? 2×2

    left pop 1.4×1.5 1.1×1.7 prom 1.5×1.3 1.3×1.3 prom to N? 1.3×1.3

    rt pop 1.2×1.6 1.5×1.6 prom 1.6×1.2 normal prom to N? 1.8×2

    drug given: lspar vinc prom doxo vinc prom to N? DTIC

    Assess: OR D Prom/R? D S/D R? OR

    OR = out of remission prom=prominent N=normal D= Decreasing S=Stable R=Remisssion

    Our oncologist suggested keeping henna on Dacarbazine for another 3-4 treatments and then putting her on a monthly dose of Vincristine since she seems to response well to Vincristine.
    Based on the charts above, do you think I should ask about those other options you mentioned: MOPP/MVPP protocol, oral Lomustine or Elpsar to re-induce remission?
    I’m really enjoying my extended time with Henna and I want to do everything I can to make sure it’s a long and high quality as possible! Whatever you can suggest to us would be greatly appreciated.

    Thank you so much!

    • Dr. Susan Ettinger on January 13, 2013 at 5:17 pm

      I am so happy you are reading the book and it is helping you and Henna.
      I am always hesitant to make specific recommendations on a pet and I not personally seeing and examining. But I agree if Henna is not in remission on the UW protocol, the right thing to do is switch and find a protocol that gets a complete remission. I personally like the MOPP/MVPP protocols and Lomustine protocol but there isn’t a wrong/right one at this point. Keep working with your oncologist to try to get and hold the remission. Sounds like you are in good hands!
      All my best, Dr Sue

  68. shirley bruce on January 10, 2013 at 1:20 am

    my boy lewis is 8 and couple of weeks ago we found a small red mark on his neck so took him to vet who said was an insect bite and gave him an antihistamine injection a few days later he had this big lump where he was injected,the vet said would have to do biospsy and this week weve been told lewis has lymphoma,i cant take this in as he hadnt even a small lump until this injection!just back from vet again who said hel only live few weeks untreated or if treated we have to go hundreds of miles to a specialist every few weeks for chemo and it will cost thousands he said i cant stop crying i want him to be treated but i didnt realise we would have to go so far and i dont know if this means leaving him there or what?i just cant cope without him hes my baby and i love him so much but scotland doesnt have many options,reading other stories i thought it was just courses of tablets im maybe a bit stupid thinking that someone please help me or tell me all that is involved i am so scared

  69. Laura L on January 8, 2013 at 9:17 am

    My standard poodle was diagnosed with multicentric lymphoma when she was 7 years of age. She underwent chemotherapy with the Madison Wisconsin protocol which she tolerated pretty well. She is now in her 6th year of remission, has never gone out of remission, and is now 13-1/2 years of age. In addition, she developed atypical Addison’s shortly after completing the course of chemo. We are so blessed to have her for all these extra years. She is a strong, brave girl.

    • Dr. Susan Ettinger on January 13, 2013 at 5:11 pm

      I love these stories!!! There are long term survivors, and it is great to share your dog’s story and success. Wishing her continued health and remission!
      All my best, Dr Sue

  70. Juli on January 6, 2013 at 6:50 pm

    My beautiful 9 year old lab, Mochi, was diagnosed with a very aggressive lymphoma in his small intestine on December 14, and started chemotherapy that day. It is a stage iv cancer. He just had his fourth treatment yesterday (Wisconsin protocol) and besides a few expected side effects, seems to be doing ok. My question is how long before the doctors know if it’s working? At what point do they take another ultrasound to see the tumor? My oncologist seems more optimistic than she was in the very beginning. Btw, we took him to emergency in October because I was paranoid about bloat, they took xrays, nothing but gas, 2 months later a massive tumor. Can it be that it actually grew that fast? I’m reading your book (my new bible, I call it), Mochi is on the diet and k9 immunity plus. Thoughts?

    • Dr. Susan Ettinger on January 13, 2013 at 5:09 pm

      Internal lymphoma such as of the intestines is harder to determine response, than the generalized lymph node form (where lymph nodes can be measured on exam). It is reasonable to do an ultrasound after the 1st cycle, but it does add to the bill, so if Mochi is doing well (not losing weight, eating, no vomiting or diarrhea), it is reasonable to hold on the ultrasound. If you want to be sure, chat with your oncologist about the ultrasound.
      Also, so glad to hear you have the book and like it! =)
      All my best, Dr Sue

  71. Connie Calmes on January 3, 2013 at 6:26 am

    My 3 1/2 year old female Aussie/Border Collie was diagnosed on Dec. 7. I didn’t think twice about not treating her. I work with someone whose 9 yr old lab is in her 4th year of remission on the wisconsin protocol which is what my Sasha is on. Her first round of vincristine left her with terrible diahhrea. The cytroxil she took two weeks later because her white cells were low. We just gave her the Cytroxil on 12/29. She had 2 really good days and now has blood in her urine. It is not an infection and her white cells are good enough that the doctor said she can have her next round of vincristine tomorrow, January 4. He also suspended her last week of prednisone until next week. She is so miserable with the bloody urine and no appetite or energy. Is it really ok to go with the next round of treatment? He said he was lowering the dose this time since she had such bad diahhrea the first time. I feel like I read so much about dogs not suffering through side effects from the drugs but my poor little girl has been hit hard. When do we know if we are doing the right thing. 🙁

    • Dr. Susan Ettinger on January 13, 2013 at 4:55 pm

      Hi Connie,
      It is frustrating when your pet has less common side effects. Yes most dogs tolerate chemo well, but when your pet isn’t, the low risk doesn’t seem to matter any more.
      Keep working and talking to your oncologist, who should be able to tweak things to balance efficacy (killing cancer cells) and mainlining a happy dog. Hang in there. It should get better!!
      All my best, Dr Sue

  72. Anne on January 2, 2013 at 1:17 pm


    My 4 year old Scottish Terrier, Louie, was diagnosed with lymphoma just today. The diagnosis was based on a fine needle aspiration of the enlarged lymph nodes under his chin–which are currently the only ones affected. Louie goes back to the vet tomorrow for blood work as well as x-rays and blood typing which the doctor said will help determine what stage the lymphoma is in. The Dr. also told me today that he would be able to start the COP protocol tomorrow. As I am frantically researching everything online (I just noticed his swollen lymph nodes 2 days ago—-this has all happened so quickly!) I have been reading that CHOP protocol is generally thought of as better than COP, however I can’t find any reasons why. Can someone explain this to me and what is the preferred method of chemo treatment for dogs?
    I appreciate any help you can provide!
    Thank you!

    • Dr. Susan Ettinger on January 13, 2013 at 4:43 pm


      Sorry to hear about Louie, but remember lymphoma is very treatable. Without chemo,the median survival time (MST) for dogs is 30 days. With CHOP protocols the remission rates are high (85-90% plus), the MST is 12-14 months. For COP the remission rates are lower (approximately 60-70%) and the MST is about 6-7 months. There is more info on the different protocols in the lymphoma chapter in the Guide. The CHOP protocol adds doxorubicin. For clients who elect against the CHOP protocol, I consider single agent doxorubicin, over COP. Talk it over with your veterinarian/oncologist.Good luck.
      All my best, Dr Sue

    • Dr. Demian Dressler on January 29, 2013 at 5:29 pm

      Anne, the survival times published are a bit longer…
      I would definitely start educating yourself on all the tools at your disposal. The Guide can help!
      Dr D

  73. Amy T. on January 1, 2013 at 10:41 am

    Hi Dr. Sue,

    I love what you do on here. Thank you for what you do.
    I am writing regarding my 3 year old male, GSD, Diego (100 lbs today). He was diagnosed with b-cell lymphoma on December 7th, after we noticed tiredness and lack of appetite. The lymphoma did not spread, but he does have enlarged liver and spleen. He had lost 14 lbs since July of 2012. We immediately started him on the CHOP protocol on the 11th of December at Ohio State Veterinary College of Medicine (combined with an antibiotic as needed, Cerenia for 4 days post-treatment, prednisone, and Pepcid). He went into complete remission after his 1st treatment! He will have treatment #4 this week, and then one week off, and the protocol repeats itself. We also started seeing a holistic vet (DVM) and he prescribed acupuncture therapy every 2 weeks, in addition to AniHox supplement (liquid) and CurcuVET-SA150 (capsules). Overall, Diego remains in complete remission and continues to do well. The only side effect we have really seen is that he fluctuates with his energy. Seems as though after the treatment he has more energy and days 5-7 his energy is less. Not sure if this is related to the day 5 GI upset that can occur post-chemo. Our concern, and I realize we are jumping ahead, is what to do if and when he relapses (i.e. after the CHOP protocol and Wisconsin has run it’s course). My understanding is that remission number 2 and 3 is more difficult to obtain then remission 1. Our hope with combining the holistic approach with conventional medicine is that Diego’s immune system will grow stronger and may be able to fight the cancer or at least prolong remission. He is also on EVO Red Meat (no grain, high protein, low carb), but has occasional diarrhea. We are happy and grateful that he is with us today (he is our Christmas and New Year’s miracle). We would do absolutely anything for him, as he is the fabric of our home and family… my very best friend. We just want to make sure we are doing everything right during this time and are prepared to have another plan if he comes out of remission during the next year or so. Do you have any feedback regarding our treatment right now, and any knowledge of approaches after chemotherapy? We have a lot of faith, but struggle at times. We greatly appreciate it. Thank you and God bless.
    -Amy T.

    • Dr. Susan Ettinger on January 13, 2013 at 12:59 pm

      Hi Amy,
      It sounds like you are taking a very integrative approach and being very thorough. You are in good hands at OSU and the CHOP protocol is the way to go. Most dogs are off the chemo for about 4 -6 months before relapse. At that point, chemo is restated. YOu are correct that each subsequent remission is typically hard to obtain and shorter, but these are just generalizations. I always so I am happy when my patients make “liars” out of me and do better than the statistics. There is also a whole chapter on lymphoma in the Guide too. Good luck with Diego!
      All my best, Dr Sue

  74. Sandra Dighton on December 15, 2012 at 1:49 pm

    Also, he has been asymptomatic almost the entire time. He threw up one time after being treated with Doxy and he had been on a two week course of antibiotics for a staph infection. His chest x-ray and bloodwork were all normal when we took him in Thursday…….wouldn’t even know he was sick if it wasn’t for those lymph nodes!!!

  75. Sandra Dighton on December 15, 2012 at 12:51 pm

    My Casey did the CHOP protocol starting in March. He finished the entire course of treatment and went into remission almost immediately. He lost remission last week (approximately three months after treatment). They have restarted the CHOP with Elspar included. My question is, I have not been giving him fish oil because he has a clotting disorder (although, he has never shown any symptoms, just had him tested because of his breed). Do you think that this and Apocaps could help him? He takes Denamarin, Fortiflora, Pepcid AC, and antioxidants. Any suggestions would be greatly appreciated.

    • Dr. Susan Ettinger on December 29, 2012 at 6:21 pm

      As long as Casey is not on steroids (pred) or NSAIDs (like Rimadyl, Deramaxx), I add Apocaps but at lower dosages when also on chemo. Check with your oncologist before adding. There is more info in the Guide and check out http://www.Apocaps.com
      All my best, Dr Sue

  76. Holly on December 12, 2012 at 7:17 am

    Our Yorkie, Zoe, was diagnosed with lymphoma in October 2010. ( He also has diabetes.) Believe it or not it is 26 months later and he is still here! Yes, it has been costly. Our vet confers with an oncologist on the protocol. Basically it was vinchristine, Methotrexate and cytoxan. To begin, it was every week. Then he went into remission. The 2nd time we did the same protocal and then remission again. Now he is out of remission and the lumps under his neck have grown alot. We are on an every other week protocol but he is stil eating, running around bringing us his toys, so we haven’t seen a big detrioration with him. The vet said he may last a few more months. One thing that we realized is that he has had some seizures and vomiting and we are not attributing this to the methotrexate. It is a rare side effect, but the last two times he got it this happened. We will know when he is ready when he stops eating and being himself.

    • Dr. Susan Ettinger on December 29, 2012 at 6:12 pm

      Go Zoe!! Love the stories of dogs exceeding the survival times and enjoying life along the way! Zoe is lucky to have such a dedicated family. Thanks for sharing.
      All my best, Dr Sue

  77. Estelle Nelson on December 7, 2012 at 6:41 am

    My 14 year old Cocker mix was diagnosed with epitheliotropic cutaneous lymphoma in July 2012. He also has Cushings diagnosed in 2011. He began chemo in August first Elspar then Vincristine then Cytoxan and he has been on Prednisone since the beginning. When these di not produce remission, the onc tried Accutane and then Masitinib but nothing has worked. The skin tumors, lesions are progressing very rapidly and are now on his face head and ears. These are bleeding and draining alot. Is there anything that I can put on the lesions to decrease the bleeding and drainage or that might cause them to dry up?

    • Dr. Susan Ettinger on December 29, 2012 at 6:05 pm

      It sounds like your oncologist has tried the main options. Have your tried Lomustine? That can be useful for skin lymphoma. Sometimes consulting with a dermatologist for other supportive skin meds can help too. I find antibiotic useful when there are secondary infections. I am sorry – these can be tough cancers.
      All my best, Dr Sue

  78. Mike on December 1, 2012 at 4:04 pm

    My wife and I recently went out of town for two weeks and had our four dogs in a kennel. When we came home on November 12th, and the next day, we noticed our 14 year old german shepherd, Renata, had two swollen back legs. I called the vet, and she though Renata had phlebitis from being in the kennel, and suggested rimadyl, which I gave her. By the end of the week, it was apparent this was ineffective, so I started prednisone on November 17th, and took her to see the vet on Monday, November 19. The vet noticed right away the swollen lymph glands and took a biopsy to send in. I continued the prednisone, and the swollen legs about disappeared. The vet suspected lymphoma, which was confirmed a few days later. I was uneducated about this, and didn’t know what to ask concerning types, stages, etc.

    The vet thought, concerning Renata’s age and breed, that chemotherapy was not a good option, and that we had maybe a month. So, I continued the prednisone and she did well until last night, when she started panting for long periods. This morning she wouldn’t eat or drink, was drooling, and clearly uncomfortable. I took her to another vet this morning (mine doesn’t work weekends). She was much more positive about chemotherapy, and thought I should try it for a few days and continue the prednisone also. I gave her her first dose this afternoon of cyctophosphamide. I had to force feed her, as she would not eat it hidden in hamburger or pill pockets. She did eat some canned dog food tonight, but will not drink. She has had weak hind legs for some time, but today is losing her ability to stand up. She will walk a few steps, and then sit down.

    I believe everyone thinks I should have her euthanized, but I don’t know what I should do. Any advice you can give me would be appreciated. I want to do what is right for the dog. I have no idea if the cancer has spread to other organs, but the lymph system, at least on the areas you can feel, is all swollen.

    • Dr. Susan Ettinger on December 5, 2012 at 6:07 pm

      Hi Mike,
      Sorry about Renata. It’s hard to give you specific advice through a blog, but I do believe that lymphoma is a treatable cancer. Dogs that get treatment have high response rates, live longer, and live well. How did she respond to the cyclophosphamide? I recommend a multi-agent CHOP protocol. Check out the chapter on lymphoma in the Guide and try to see an oncologist if feasible. There is no wrong or right answer about treating, and it is ahrd when the people around you may not support your decisions. Also if you haven’t found this post, it might help, plus I have many on chemo side effects. Good luck!
      All my best, Dr Sue

  79. Robert and Irene on November 14, 2012 at 5:22 pm

    Our 8 year old Miniature Schnauzer Toby was diagnosed with Lymphosarcoma the end of April 2012. Our Dr. does not like to stage them because of the treatment cost involved. We started chemo treatments within a week and after 3 days all of his lymph nodes were back to normal! We were very happy with this. He did the 4 weeks on and one week off treatment for a couple of months and then it was every other week chemo. He also takes Ranitidine and prednisone and has during the whole treatment. During the every week chemo he had the prednisone every day and now with every other week he is taking it every other day. Tomorrow is his last chemo treatment. He has taken it for 6.5 months. I am excited that he has lived this long! I am also worried that without the chemo it’s going to come back. How long does it usually last when then are off chemo? He seems very healthy now. He runs and plays and seems to feel really good. Every 4th round of chemo in each cycle was the hardest for him. He would lay around for a day (usually 3 days after chemo). Then, he would bounce back. He has had some diarrhea with it. Also, he has to go potty a bit more frequently. He wants to eat everything!!! He’s on the Hill’s N/D diet now. He was on the U/D for bladder stones that he had removed in January. But, he hated the u/d food so much and was acting like he was starving so we decided to risk the bladder stones and the doc gave him the N/D. Any insight or advice would be highly appreciated! Thanks

    • Dr. Susan Ettinger on November 24, 2012 at 5:27 pm

      Robert and Irene,
      Congrats on completing the chemo protocol!! I am not sure which one you used but most dogs are off CHOP chemo protocols for about 4-6 months before relapsing. Some will go longer and some sooner. Did you check out the lymphoma chapter in the Guide? I would also consider supplements like Apocaps. I typically start at week 4 after completing the prednisone. Sounds like your dog was on pred longer, but it is fine once they are off. Good luck!
      All my best, Dr Sue

  80. pamela on November 12, 2012 at 4:24 pm

    my 7 yr old english cocker spaniel was just diagnosed with atypical cutaneous lymphoma. is chemo an option? my vet says i should do it but only gives a 50/50 chance that it will help at all. i don’t really understand.

    • Dr. Susan Ettinger on November 24, 2012 at 5:08 pm

      Hi Pamela,
      I do recommend chemotherapy for cutaneous (skin) lymphoma. While response rates may not be as high as with the generalized form, chemotherapy is helpful. I also recommend staging to look for internal involvement and phenotyping to determine B vs T-cell type. Most skin forms are T-cell, but it is good to know for sure.
      All my best, Dr Sue

  81. Kathryn on November 10, 2012 at 1:09 am

    Could I be hurting her Lymphoma treatment by giving her Milk Thistle, L-arganine, L Glutamine, FIsh Oil, and Missing Link poweder? 3 weeks ago I started giving Ester-c, but eventually the Oncologist sugessted I discontinue bc it was aided free radicals. I need advice please.

  82. Kathryn on November 10, 2012 at 1:04 am

    I forgot to mention that complete stagin was done:
    She was stage IV B cell, but not in the bone marrow. mildly enlarged liver and spleen. blood count revealed mild lymphocytosis (6700)

  83. Kathryn on November 10, 2012 at 12:57 am

    I’m concernd because my dog started the modified WIsconsin protocol and after week#4, the vet accidently gave her 2 weeks off instead of only 1 week. During these first 4 weeks, the vet commented that her lymph nodes were decreasing and then finally week #2/3 they reported she was in complete remission. We then came back week#7 (instead of 6) and started Round2 of the Mod Wis protocal. Week 8, the vet says this protocol isn’t working and we should switch to Dacarzabine. She commented that her lymph nodes has enlarged.
    I’m very concerned why the sudden switch if she was doing so well on ModWiscon? Did the 2 weeks off cause her lymph nodes to enlarge again? This new Dacarzabine, will is work on it’s own? Now they have her coming in every 3 weeks as opposed to every week. I’m extremely concerned!

    • Dr. Susan Ettinger on November 24, 2012 at 5:03 pm

      Unfortunately and frustratingly, some dogs with lymphoma relapse early. I agree that a switch in protocols is the next step. I personally do not go to dacarbazine next, but I am also not the oncologist directly treating your dog. There are many rescue options, including the MOPP/MVPP protocol, oral Lomustine. I also like Elpar to re-induce remission. But again, I am just making general recommendations and nothing replaces the direct doctor-patient-Guardian relationship. So talk to your oncologist about the options. Also, have you read the lymphoma chapter in the Guide? Good luck,
      All my best, Dr Sue

  84. Carrie on November 8, 2012 at 5:49 pm

    Dear Dr. Sue,

    My dog Tate, a 4-year old Wheaten Terrier, was diagnosed with Stage 4 B-Cell Lymphoma at the end of July. It’s definitely been a journey! I’ve been keeping a careful record of everything that has been going on with him week to week. I decided to go ahead with the CHOP protocol and he went into clinical remission fairly quickly, I was so pleased. But after the 10th treatment, I needed to re-assess things due to financial constraints. After the 10th treatment which was the cyclophosphamide, we decided to do the last 2 treatments with doxorubicin (spaced out by 2-3 weeks). His last doxorubicin was Tuesday. This drug has been tough on Tate, nausea, loss of appetite, diarrhea. Howeverm overall he’s done really well. Good energy and playful. Everyone at Pieper Memorial loves Tate! The oncologist gave my info on relapse which was kind of a bummer but I am glad to have it so I can be proactive. I hope he can be cancer-free longer than the 3-4 months the vet mentioned. What do you think about this time frame? My other question now involves maintenance. I have tried many food options, all homemade meal, no grains, wheat etc (which I have also followed). It’s been tough though because Tate is super picky. One day he likes chicken, then he doesn’t even go near it. Is there an appetite stimulant you can recommend so I can ensure he is getting a well-rounded diet? I’ve wasted so much food! I need some tips! Thanks so much.

    • Dr. Susan Ettinger on November 24, 2012 at 4:52 pm

      Hi Carrie,
      It sounds like you are taking great care of Tate. I too have had patients switched protocols after starting CHOP, and it is hard to guesstimate how long the remission will be. And remember these are just guidelines. So enjoy each day you have together!
      Now that he is off chemotherapy, I would be surprised if you need an appetite stimulant to get him to eat. If he does not like the homemade diets, it is more important he eats a well balanced diet, and it is ok to use commercial ones, especially if he won’t eat the other.
      All my best, Dr Sue

  85. DDinSB on November 7, 2012 at 7:00 am

    Thank you for your quick response. Traveler had the doxarubricin on Friday, his typing had come back “T” cell, and he just went down hill over the weekend, refusing food and water, vomiting, then bloody diarrhea. He went to sleep on Monday evening. I can’t believe that from diagnosis of lymphoma to the end only took 2 weeks. The elspar treatment gave us 5 really good days together to revisit his favorite places — but I had thought that since he responded so quickly and so miraculously to the first treatment that I’d have him several weeks longer.

    I don’t know if he was just much further along than we knew, or his system didn’t tolerate the doxarubricin, or if I’d waited longer he may have rallied.

    Thank you for this website, your blog, your great advice. Lymphoma sucks.

    • Dr. Susan Ettinger on November 24, 2012 at 4:42 pm

      So sorry to hear about Traveler. Know that you did all you could to help him fight his cancer. Thinking of you in this sad time.
      With sympathy, Dr Sue

  86. Holly on November 3, 2012 at 3:47 am

    Sorry to add another – but Finn still has watery projectile diarrhea, which started when I gave him half a capsule of Krill oil the day before yesterday. He was up all through the night last night. We give psyllium husks to the horses – is it safe to give to Finn whilst he is on Chemo?

    Many thanks


  87. Holly on November 2, 2012 at 5:37 am

    Dear Dr Sue,
    my 7 yr old Harrier Finn was diagnosed with multicentric lymphoma on 23rd October at The Queens Veterninary Hospital, Cambridge, UK – having been referred by my local vet on Oct 18th, when I had noticed enlarged lymph nodes in his neck that morning.

    He started on a CHOP protocol (Vincristine, Cyclophosphamide, Dobxorubicin, Furosemide and prednislone) on the day he was diagnosed. I been reading The Cancer Survival Guide, which has helped so much with my mental state. I have changed his diet (with some hiccups…. diarrhea), but for the most part he is now eating protein veg and I am trying to introduce krill oil slowly. I am giving him a tumeric/artichoke supplement, ginger, Vit D and protexin. I have emailed his oncologist with a list of other supplements I would like to feed including:

    K9 plus immunity
    Transfer factor
    Digestive enzymes
    Modified citrus pectin
    L- Glutamine

    As I would like to know if they are safe to feed durig his chemo (I notice you say notto feed apocaps whilst taking predisnlone) It’s been two days and I haven’t had a reply – and I’m thinking no one will get back to me over the weekend. I would really appreciate if you could advise me if I can give any of these during his chemo – I am desprate to make the right decisions for him, and give hime the best chance possible.

    Thank you for the Cancer Survival Guide (pass the thanks to Dr D aswell if you can)

    Many thanks

    Holly and Finn

  88. DDinSB on October 28, 2012 at 12:56 pm

    Dear Dr. Sue:
    My 7 1/2 year old Sheltie, Traveler, was diagnosed by vet with lymphoma on Tuesday – he’d been somewhat lethargic & had lost his appetite. Then his lymph nodes started growing like crazy (tripling in size in 1 week). Though vet was sure lymphoma, lab techs wouldn’t call it (based on aspirate slide). Did follow-up serum electrophoresis, still unconfirmed, then did that 4-way test for the tick borne diseases and he turned up ++ for all 3, ehrlicia, borellia, and the other one. Vet said she just “knew” it was lymphoma, even if the techs couldn’t call it based on the slide. I didn’t want to do a biopsy and further traumatize Traveler, have him be sedated, heal from incision…still waiting on the T/B cell test, but I wouldn’t be surprised if that’s inconclusive as well. Given that Traveler had symptoms, and the nodes were growing at a frantic pace, I decided to go ahead and treat based upon vet’s diagnosis (she’s saved my dog’s life twice – as a puppy he swallowed a rock that got stuck, and then later he got some crazy virus that nearly killed off his liver). Plus, his testicles hadn’t descended as a puppy and she’d had to open him up to get those, too. So — this has been an expensive little dog! Anyway — I told her after much thought I didn’t think I or my dog could go through a full 6 months of treatment, but I wanted to do something. So she gave him Elspar yesterday, and we will do the doxorubricin next, 1 or 2 x. She did urge me to see oncologist at the beginning, and she did urge me to do the Wisconsin Protocol, but she also accepted that my budget, my career, my own emotions, Traveler’s health and history of reacting very poorly to any drugs led me to my decision to try to do something, even if I couldn’t do everything. We also put him on doxycycline just in case he did have something underlying the other odd test results. 24 hours after Elspar, his nodes are almost gone. He did throw up @ about 4:00 a.m. and have some loose stool. So given that he had a mild reaction to the miracle drug that seems to rarely cause reactions I think I may have made a good choice. Who knows.

    My questions: Would you change course (for next scheduled drug, doxorubricin) if we only do 1-2 treatments more? AND do you think it’s possible he had a low level infection (so low it wasn’t really picked up in cbc from July of this year) that caused inflammation that led to lymphoma? Was it a genetic predisposition? He’s been food very high quality, holistic dog food and treats since I got him at 5 months old, and I garden organically. Sometimes he’s been in parks (for about a year of agility work), but mostly on beaches, trails, and in woodland areas…

    Thanks for your guide and website. I will buy the guide for more info on supplements. Right now focusing on milk thistle, and the flore-essence essiac, and salmon oil.

    • Dr. Susan Ettinger on October 28, 2012 at 6:01 pm

      Sorry about Traveler. This is a really hard question to answer about protocol without a consultation, and I don’t want to give you incomplete advice. Briefly, because the single agent doxorubicin protocol is typically 5 to 6 treatments, so I am concerned that 1 to 2 treatments are unlikely to give Traveler a durable response. But sometimes, you can only do what you can do. Maybe consider COP protocol if you can do it for longer? It sounds like you have the Guide so look over the protocols there. Good luck with Traveler!
      All my best, Dr Sue

  89. Alison on October 25, 2012 at 9:07 am

    Hi Dr Sue

    We just found out my st bernard bailey has the highest level of lymphomatic cancer and the vet said its millignant she has lost wait and only eats jumbo bones but she is so lively and play full i don’t know whats best to do for her, do chemo or leave her live the rest of her life what she has left in peace?? the vet said she may stop eating completly on chemo and end up starving herself to death any advice would be much appreciated??

  90. Steve on October 23, 2012 at 8:32 am

    Hunter Update – – – We took Hunter back to the veterinary oncologist yesterday for his one month check since starting his mild chemotherapy protocol Leukeran (Chlorambucil) 4mg capsule orally every other day and prednisone 20mg every day to treat his low grade lymphoma. His blood work came back great and his lymph nodes are back to normal size. With the exception of the thirst side effect from the prednisone, so far so good! He is tolerating the meds with no visible impacts. He is as active as ever, playing like a puppy and woaking a couple of miles a day. He just celebrated his 9th birthday and we are keeping our fingers crossed for a couple more.

    • Dr. Susan Ettinger on October 28, 2012 at 5:37 pm

      Great news Steve!! Keep us updated. And happy birthday Hunter! – Dr Sue

  91. Rosa Maria on October 14, 2012 at 3:29 pm

    Update on Miss Bailee– the fine needle aspirate results were read by 2 different pathologist, which was negative for lymphoma, but showed reactive lymphoid hyperplasia. The dr thinks she still may have lymphoma, or something else, but unsure what. So there were two options given to us: 1. treat with medications or 2. surgery to get biopsies of liver, intestine, and lymph nodes. I wanted to do surgery at first, then after thinking about it, I really don’t want to put her through that right now since she has been so sick. We went for a second opinion, and the dr said after examining her and looking over all her test results, he doesn’t think she needs the surgery and doesn’t think she necessarily has lymphoma, but of course isn’t 100% sure, which is understandable. At this point, we are treating her with meds, but a part of me still wants to do surgery to confirm what’s going on. A big part of it is money. We just spent close to $2k this past week and the surgery is going to be another $2-$3k. Unfortunately with us just moving to Hawaii and the cost of living here is extremely higher than we’re we are from, we can’t really afford it right now. So — I’m hoping after she finishes up all her meds, and we return for a follow up, she is doing better. She is doing better than she was, but I still am uneasy about her whole situation. Would a second fine needle aspirate be a good idea?

    Thank you,

    Rosa Maria

    • Dr. Susan Ettinger on October 23, 2012 at 4:06 pm

      Hi RosaMaria,
      You can also have the aspirate submitted for advanced diagnostics such as PARR or flow cytometry – this can help in some cases with a lymphoma diagnosis.
      I am sorry this is so hard and complicated. – Dr Sue

  92. Rosa Maria Russell on October 10, 2012 at 6:23 pm

    Hi Dr.Sue,

    Thank you so much for writing me back. I really appreciate your time and input! We have not received the final results back from Bailee’s biopsy. We were told the results should be back by today. I was told that she is in bad condition, if it is lymphoma. The one vet said usually once the dog shows actualy symptoms, it’s pretty advanced. Is this true? I’m praying that she does not have lymphoma, and it is something else less serious, and treatable. I am a bundle of nerves waiting for the phone call. If it is lymphoma, I definately would like to treat her with chemo. I understand that it depends on the dogs condition and stage, to consider how well the chemo will work, correct? I am also wondering, should she respond better since she is only 2.5 years old or am I just aiming at wishful thinking? I am a nurse and I worked on the chemo floor at a hospital in Michigan as a nurse assistant (before becoming a nurse), so I’ve seen what patients go through. I understand that dogs take it better than humans. If I am mistaken, please correct me. She has been eating the past week, but not dog food. I’ve boiled her chicken, made her rice, etc, all in small amounts and she tolerates it well. She is also on some anti-nausea & a couple other meds to help with her issues. She seems to be bloated, and has been having different types of stool. It’s been real dark brown, not liquidy, but not solid. Yesterday she had one very liquidy, almost explosive bowel movement, but today it was a lot better and a tan color. She’s been very tired, sleeping a lot, and on her walks (which I’ve shortened a lot), she is a lot slower. Is there any way you can give me a rough estimate of how much chemo & treatment would cost for her? I understand there are a multitude of contributing factors, so if you’re unable to I completely understand. I’m assuming since we’re in Hawaii, it will be much more expensive than it would be if we were in the states.

    Thank you in advace,

    Rosa Maria

    • Dr. Susan Ettinger on October 23, 2012 at 3:56 pm

      Rosa Maria,
      Have you received results?
      The cost of chemo is variable depending on the protocol picked and I am not sure how much it would be in Hawaii. I wish I could help more with tha.
      Thinking of you and Bailee, Dr Sue

  93. Rosa Maria Russell on October 8, 2012 at 3:21 pm

    Hello. My 2 1/2 year old female chocolate lab, Bailee, just got home from a 2 day stay at a vet hospital in Oahu, Hawaii. She was admitted due to vomiting, diarrhea, loss of appetite, and her bloodwork results showing low protein levels and high wbc’s. She was put on an IV, X-rays were done which showed nothing, and an ultrasound was done which showed 3-4 enlarged lymph nodes (“enlarged mesenteric lymph nodes– probably lymphoma” — per dr report sent home with us) and an enlarged liver. The vet called me the night she was sent home and told me she is pretty sure our dog has Lymphoma, and it’s at the end stages. A biopsy was done and results are suppose to be in within the next 2 days. Due to the fact she is so young, I would like to know if the chemo would be worth it to try? In my opinion, I keep thinking yes, due to her age. She is at home, eating, very finicky, but seems do be doing a lot better. After the initial news, I was devastated, and still am. I’m feeling very confused as to which way to turn, since my husband doesn’t want her to suffer, and thinks chemo will just prolong her suffering. I am a nurse and I’ve seen chemo patients do well, and not so well. As far as I’ve read, it seems that dogs take it much better than humans. She’s my baby girl, and I will do it if it means getting another 1, 2, 3+ years, or am I hoping for an outcome that isn’t going to happen? Opinions would be greatly appreciated.

    Kind Regards,

    Rosa Maria

  94. Steve on September 18, 2012 at 10:39 am

    We were given a bit of a silver lining today in an otherwise cloudy lymphoma case. Our golden retriever Hunter turns 9 this Friday, and we are looking forward to him celebrating this birthday and a few more to come!

    We discovered a swollen lymph node on the right side of his neck back on 7/18 and have been on an emotional roller coaster ever since. As with any golden owner, one of your worst fears is lymphoma. The initial needle aspiration results were inconclusive, so we opted for a lymph node biopsy right away on 7/20. The biopsy and blood test didn’t reveal lymphoma either, so the vet recommended a broad spectrum antibiotic for a couple of weeks. After $1300 of testing and surgery we were happy thinking that Hunter just had an infection that would be cured with antibiotics.

    Unfortunately, after the course of antibiotics and a family vacation, we were back at the vet’s office on 8/28 as now his left lymph node showed signs of swelling as well as some in his back legs. Having already gone through the test and wait game that takes weeks, and then treating him with antibiotics that did nothing, we felt we had already let over a month of valuable time slip by. The vet offered performing another needle aspiration, but we declined. The diagnosis was either; lymphoma, lymphoma, or lymphoma and it was clear that our local vet was in way over her head which could cost us more valuable time and money with no results.

    We spent a lot of time doing research about lymphoma treatment and came to the conclusion that we didn’t want to put Hunter through any intense chemotherapy processes. The choice for every owner is different. We weighed the pros and cons over and over and over and just couldn’t see putting him through the discomfort for a few “quality” months before a rescue protocol would be required and more discomfort. Hunter has been the best dog ever, a therapy dog at local hospitals, and valued family member. Before we just threw in the towel, we wanted all the facts and data in order to make the best decision possible, and Hunter had yet to be completely diagnosed. As he was asymptomatic to this point, we were keeping our fingers crossed that his cancer was a mild form that required a less potent treatment protocol.

    We took Hunter to an oncologist on 9/6. I cannot recommend highly enough to take your dog to a cancer specialist immediately after suspicion of lymphoma (correct diagnosis and getting you off of the emotional roller coaster)!!!! She performed an examination of him and went over his charts and information from our local vet and was convinced Hunter had low grade lymphoma, the best bad news you can get on the subject. She explained everything she was going to do, performed a needle aspiration and sent it off to Colorado State University for a PARR test (results take 7 to 10 days). Not every lab vets use are able to detect lymphoma and a less experienced lab will air on the side of inconclusive (my suggestion is to pay a little more to send it to a top notch lab facility). Next Hunter had an abdominal ultrasound and a chest x-ray which revealed no signs of cancer in his organs. So we spent $900 for Hunter’s diagnostics (no biopsy surgery required) and visits, and had to wait 10 days to hear that the PARR test showed T-cell indolent lymphoma. Now with all the facts and data, we are on the course of treating Hunter with a mild chemotherapy protocol Leukeran (Chlorambucil) 2mg capsule orally every other day and prednisone 30mg every day. The oral maintenance route should be very well tolerated due to its low dosage. So we have $150 per month in medication and blood work/checkups and no reduced quality of life, with a lifespan measured in years…the best possible outcome in the worst of all situations!

    Please note that the $$$$ figures are provided here as reference points only. Every vet will charge different rates and the cost factor for diagnostics and treatment impact everyone’s decisions differently. Quality of life is the most important factor (for your dog and your family). A veterinary oncologist’s office is a great source of information from the clinician as well as the families dealing with their pet’s cancer treatments. In the office you can truly get an understanding of what quality of life means.

    Also please note that Hunter’s case is one of the less common types of lymphoma, which is why we recommend seeing a specialist. Like in humans, not all lymphomas are the same in dogs, and one chemo protocol does not fit all. Get all the facts and data you can before making any decision…and don’t waste as much time as we did before getting your pet to the oncologist.

    • Dr. Susan Ettinger on September 24, 2012 at 4:18 pm

      Hi Steve,
      I am so happy you saw an oncologist to get the correct diagnosis and treatment options for Hunter. T-cell lymphoma is a less common form of lymphoma, and as you have learned treated with oral chemo- much difference than intermediate and high grade lymphoma. Thanks for sharing your story. I am clearly an advocate of getting to an oncologist for any cancer, whether common or rare, and hunter’s story is a great example.
      Good luck with his treatment, and happy 9th birthday!
      All my best, Dr Sue

  95. rose on September 15, 2012 at 7:59 am

    My golden was diagnosed with lymphoma today. He is an 11 1/2 year old male with his enlarged lymph nodes in several areas. I am considering chemotherapy, but wondering if, because of his advanced age, it would be futile and just put him through more pain and suffering. He has been my best bud for a long time and I can’t bear to say goodbye, but I need to do what’s best for my dear freind. Thanks, rose

    • Dr. Demian Dressler on September 19, 2012 at 3:40 pm
    • Dr. Susan Ettinger on September 24, 2012 at 4:11 pm

      Hi Rose,
      Sorry to hear about your dog, but lymphoma is a very treatable cancer. I have a few posts on this site but there is a comprehensive chapter in the Guide on lymphoma, so I would suggest you check out my blog and the chapter.
      Without chemo, most dogs with lymphoma sadly live only 1 month, but with a multi-agent chemo protocol, median survival times extend to greater than 1 year. And chemo is very well tolerated in most dogs. So I hope you can see an oncologist and Learn more about the options. Good luck.
      All my best, Dr Sue

  96. jennifer on August 31, 2012 at 4:05 am

    Never mind answering my question I last sent. I lost Comet to renal failure 2 weeks ago today. Her lymph nodes were down considerably although not completely shrunken. Fortunately, she went fairly quickly. Started with diarrhea and threw up once on Wednesday, but was still eating although not as well. Only would eat liver on Thursday and more diarrhea. Got bad that night. On IV with a fever on Friday and lost her that evening. At least it didn’t go on and on.

    • Dr. Susan Ettinger on September 7, 2012 at 11:55 am

      I am truly so sorry about your loss of Comet. May the good memories shared through the years help you through the pain now.
      With sympathy, Dr Sue

  97. Sheila W on August 24, 2012 at 6:09 pm

    K9 Medicinals. 3+ years later and Jake is still here. Go figure.

    • Dr. Susan Ettinger on August 27, 2012 at 4:38 pm

      Great news for you and Jake! I love happy stories!
      All my best, Dr Sue

  98. Pamela Dove on August 21, 2012 at 4:29 am

    My rottie was diagnosed with asymptomatic B cell lymphoma but stage IV-V. I did the 19 week chop and we finished July 31st. He went into remission after treatment one and stayed in remission the whole time. At completion I am wondering what to expect. It was a lot of chemo. His G.I. tract is very sensitive and was prior to treatment. He has spurts of good energy but they are short. He is on the best diet and supplements there are according to Dr. Dressler and others. So should I expect him at eight years old to be the same before treatment. I think not and other than monthly check ups what else should I do to help him- B-12 injection’s?

  99. Donna on August 15, 2012 at 3:11 am

    After a week of saying he couldn’t feel anything, the vet finally agreed that the lymph nodes in my babys neck are enlarged. His suggestion was to continue as we are, but I have read over and over again – including on here – that when things aren’t working it might help to change drugs. We asked about doxorubicin and after a while he admitted that he had never used it before. After all the delay, we have consulted another vet, but I think my baby is probably too weak to try any new drugs or maybe even go on much longer – he is showing signs of kidney failure. I am sad that I put my faith in a vet who, in the 12 weeks he treated my dog, did not take his temperature once or do a bloodtest. But mostly I am just sad about the thought of losing my brave baby.

  100. jennifer on August 12, 2012 at 7:32 am

    Thanks. I currently have her on pred (40 mg after a week a 60 mg per day) in the morning with food, then after 3-4 hours, I am giving her the other supplements but cut the Apocaps from 3 three times a day to 2 once a day, and not with any other supplements. Her lymph nodes have shrunk to their smallest after a week on pred and she is now due for her 4th doxorubicin. Would it be okay to give her the Elspar? Should I wait to see if the lymph nodes go down completely after the next doxorubicin? How long should she be on the pred? I’ve seen some say for a month and others continue to give it every other day after the initial high dose and weaning down. She is a Golden and weighs about 70 pounds.

  101. John B on August 9, 2012 at 7:11 am

    Update on my Roxy. She is still going strong. Chemo is going great and she is playfull and acting normal. I give her fish oil and a lil bit of brocoli to help with her immune system. I walk her every day and make sure she gets plenty of exercise.

  102. jennifer on August 4, 2012 at 5:43 am

    I have a dog with lymphma. We have been doing the Doxorubicin every 3 weeks. I also have her on Fish Oil, L-Arginine, K9 Immunity, Transfer Factor and then 3 times a day she is getting Apocaps but not with the above (atleast 3 hours apart). She also had been getting doxycyine.

    She has never gone into remission although the glands in her neck shrink after treatment, but then get somewhat bigger again. After the 3rd treatment, the glands ALMOST disappeared, but are back bigger again, although not quite as large as when we started. I never have used pred yet.

    My husband is a GP vet but not an oncologist. He has been doing the treatments. Comet is a 13.5 y.o. Golden Retriever and has never missed a meal and seems to feel great. Any suggestions on what we should do next would be greatly appreciated. Should we give her pred? If so, how much and should I discontinue the Apocaps or anything?

    • Dr. Susan Ettinger on August 10, 2012 at 11:07 am

      Hi Jennifer.
      If the lymphoma is not staying is complete remission, ideally you should switch protocols. Maybe consider a multi-agent protocol, or have him consult directly with an oncologist. Pred may help, but if doxorubcin alone is not working I would switch chemo drugs. Also we don’t recommend Apocaps at full dose with pred. Good luck!
      All my best, Dr Sue

  103. Donna on August 3, 2012 at 10:54 am

    My 5 year old goldie was diagnosed with a highly malignant lymphoma at the beginning of June, and we started him on chemo (vincristine, cyclophosphamide and prednisolone) immediately. I changed his food to Orijen for the high protein/low carb content. His lymph nodes went down straight away and his appetite improved, but now one side of his neck looks swollen, he seems wheezy and he has little bruises on his tummy. We are going to the vet in the morning, and I am so scared. I can’t stand the thought of losing him 🙁

    • Dr. Susan Ettinger on August 10, 2012 at 10:17 am

      Hi Donna, Hope things turned out ok at your visit!
      All my best, Dr Sue

  104. christa on July 27, 2012 at 6:06 am

    Thank you so much John B and Dr. Dressler. my dog was truly amazing. As to you BnK, you will know when your dog is suffering. The prednisone put 20lbs on my baby and she was doing good until she wouldn’t run anymore to catch the frisbee and walking up one step took time. What made it the hardest is that her mind was still there but her body was slowly shutting down. That is what made our decision so hard. She was playing in the sprinkler and eating cheeseburgers before the vet came (her last meal). My Vet gave me 3-6 months but she lived 2 months to the day that she was diagnosed. Enjoy the time with Lucy while you can. Cherish it. You will know in your heart when the time is right. Good luck and god bless you and lucy.

  105. BnK on July 25, 2012 at 6:27 pm

    Hi Dr. Ettinger,

    I just posted a detailed message for Dr. Dressler https://www.dogcancerblog.com/blog/life-quality-is-my-dog-in-pain/comment-page-1/#comment-8233) because I was wondering about Lucy’s level of suffering … but now I see you address Lymphoma directly, and wanted to know if you have any suggestions?

    To summarize, Lucy started chemo in August and finished in January w/ successful remission, but her lumps came back at the end of May and her Doc has estimated 2 – 3 months. We don’t want to put her through chemo a second time. Her appetite is insatiable on Prednisone which I feel is a form of suffering even if it’s not pain.

    Any suggestions would be so greatly appreciated. Thank you so much for all you do!!!


    • Dr. Susan Ettinger on August 10, 2012 at 9:33 am

      HI Bnk,
      Quite a journey you have been on. I lost my precious Paige, my Lab, 6 weeks after my 2nd son was born. Devastating!
      In my opinion, the increased appetite is not a form of pain, but ask your vet about lowering the dose. I would add Apocaps AT DECREASED DOSE while on pred and follow the other tips in the Guide. I personally think she will do better with the addition of chemo. Have you considered the chemo drug Lomustine, which is typically only give every 3-4 weeks for relapsed lymphoma? It’s ok not to treat with chemo – no one will fault ou when you make an educated informed decision to treat. And you sound extremely dedicated. I know it is hard. Keep us updated!
      All my best, Dr Sue

  106. John B on July 24, 2012 at 2:49 pm

    This is a message to anyone thinking about chemo for their dogs. My Roxy (6 year old German Shepherd) has been doing chemo for a month now. She is doing great with it. She is playfull as normal, eats and acts completely normal. I would highly reccomend the chemo for your dogs. It does not effect dogs like it does humans. She is completely happy and is doing great with it.

  107. John B on July 24, 2012 at 2:46 pm

    Im so sorry to hear about Zoe Christa, As you said, you know she is in a better place and in heaven. Lymphoma is horrible….

  108. christa on July 15, 2012 at 11:45 am

    Update on Zoe. we had to put my beautiful girl down on July 13, 2012. the prednisone was eating at her skin and she was developing nose bleeds. i miss her so much. lymphoma is horrible. hopefully one day they will have a cure. until then i know my dog is in heaven.

    • Dr. Demian Dressler on July 24, 2012 at 9:36 pm

      Thinking of you Christa
      Dr D

    • Dr. Susan Ettinger on August 10, 2012 at 8:50 am

      Sorry to hear about Zoe. I am so sorry for your loss and the sadness without her.
      With sympathy, Dr Sue

  109. John B on July 7, 2012 at 6:32 pm

    My Roxy has been on Chemo for almost 3 weeks now and she is doing great. She had pretty bad diarrhea and vomiting for a day, but I think thats because of some treats I was giving her and not the chemo. She is doing great right now playing and running around like nothing is wrong. I would stronly suggest the chemo if you can.

  110. John B on July 4, 2012 at 6:18 pm

    Jo Shane, my German Shepherd Roxy was just diagnosed with Lymphoma which is cancer in the lymph nodes. I started her on chemo immediiately. It will cost me around $5,000 for the 6 months of chemo. If I were you, I would contact a Vet Oncologist to see your options.

    With Chemo, they say I can buy her a little over a year to live. Its worth it to me.

  111. John B on June 30, 2012 at 4:44 pm

    Thank you Doctor.

    I started her on 500mg of fish oil and a new dog food (Evo). She loves the dog food and began to have explosive diarrhea when I started giving her the fish oil so I am going to stop that for a couple of days to see how she feels. Once she feels better, im going to mix in a little bit of fish oil with her food.

    If there anything else I can do to help my dog fight the cancer? Exercise? Other natual products?

    After the first treatment of chemo she was acting great and normal. She was playing and running around like she didn’t have a care in the world.

  112. joe shane on June 30, 2012 at 6:40 am

    Dr. Sue………..my 12 year old australian shepherd had a spleenectomy last March 6th……successfully removed and has been fine since, this is June 30th…….I have been having ultrasounds every 2-3 weeks and constant red bood cell counts……..she became panting and tired the last few days, I took her for an ultrasound, all of which we saw only a ‘slight’ mark on her heart which never changed, we considered it possible fat…….her liver has been clean and there has been NO fluids in her abdominal …she became a litte laborious in her breathing, I thought heat…..so i rushed her to the emergency room in Denver colorado, I live in the mtns…they diagnosed her with uncurable lymph node cancer….giving her a month I am devastated…………I have had her on a chinese herb program….
    I am not sure how my vet who did the ultrasounds missed this…….the big alert was when her red count went from 48-50 to 32……now up to 34……..

    What can I do to save her!!!!!……….RSVP Please

    • Dr. Susan Ettinger on July 7, 2012 at 8:22 am

      Hi Joe,
      I am sorry about your dog. While lymphoma may not be curable, it is very treatable. Dogs that receive chemo live statistically longer and tolerate chemo very well.
      If you have not already, check out my posts on chemo and side effects. There are quite a few. There is also a ton of info on lymphoma in our book, the Dog Cancer Survival Guide.
      And most importantly, please go see and oncologist. If there is not one near you, try a board-certified internist.
      I truly believe that dogs that get chemo live longer and live WELL! I hope you will consider chemo. The majority of my clients that choose to treat tell me their dogs have great energy and minimal side effects.
      Good luck,
      Dr Sue

  113. John B on June 26, 2012 at 2:59 pm

    Hello, My dog was just diagnosed with Lymphoma last sunday. We just started the University Madison chemotherapy treatment today. Deborah, please keep me up to date on your progress. Your dog has lived 2 years since being diagnosed and i pray for that as well.

    My little girls name is Roxy. She is pure black and going to be 6 in september. I really hope and pray the chemo works and she can live a couple more years. Deborah, did you change your dogs diet? Did you give it fish oil? Thanks for any information!

    • Dr. Susan Ettinger on June 29, 2012 at 4:30 pm

      Hi John,
      Sorry to hear about Roxy! You’ve picked a great chemo protocol for her. If you decide to add Apocaps, which I recommend, please wait until AFTER you finish any prednisone steroid (usually around week 4). Fish oils are good too. Check out the Guide for more advice, and I have a whole chapter about lymphoma and another on the different chemo drugs.
      For my patients, I advise to not make too many changes in the early weeks, because you want to make sure you see how Roxy is handling the chemo. Sometimes diet changes, fish oils, etc can cause diarrhea that you will blame on the chemo.
      Also check out my Facebook page for some inspirational stories of my patients.
      Good luck with Roxy!
      All my best, Dr Sue

  114. Lauren Spalding on June 23, 2012 at 11:59 pm

    Hi Dr D and Dr.Ettinger,
    Update for Ellie. She had her 2nd treatment for Lymphoma (in her 3rd round of Chemotherapy) using the modified Madison Wisconsin protocol – Doxy has been replaced with Mitoxantrone. She is currently in “Gross Remission”!! She is also receiving Acupuncture. No side effects to date – She’s such a tough little girl.
    Another Vet who specialises in Natural therapy has made a concoction of the following herbs to give Ellie but would like to know your thoughts on this before doing so as I don’t know the effect some of these will have:
    Bupleurum, Skullcap, Licorice root, Ginseng, Fresh Ginger Rhizome, Jujube, Angelica Polymorpha, Astragalus membranaceous, Cinnamon Bark, Oldenlandia, Scutellaria barbata, Will some react with others and impact on the Chemo.
    Can some of these herbs be toxic to Ellie or does combining all of these mitigate their toxicity??
    I’m also wanting more feedback on whether it’s safe for me to give Ellie the K9 Immunity and Apocaps while having Chemotherapy along with the herbs if you think it is safe to do so.
    As you have encouraged and promoted the use of such supplements in your book I guess I am wanting to confirm that it “Is safe” to give them in conjunction with Chemotherapy.
    I look forward to hearing your valued opinion.
    Warm Regards
    Lauren and Ellie

  115. Deborah Webb on June 23, 2012 at 11:27 am

    My 9.5 yr old chocolate labmix was diagnosed by fine needle aspirate with LSA almost two years ago. No further diagnostics were made. She was treated with a short version (11 weeks) of Madison-Wisconsin minus Elspar and went into remission right away, i.e. her nodes were too small to aspirate. In October of 2011 her nodes had enlarged just a little bit, but enough to take another fine needle aspirate and determine that she was out of remission. We did a second 11 week Madison Wisconsin protocol (still minus Elspar) and she went into remission again, just not quite as quickly. In May 2012 her nodes were not really enlarged much however one of the popliteal nodes seemed a bit firm to the vet and she managed to take an aspirate which again came back positive for LSA. This time we did some more diagnostic tests, chest x-rays came back clean, no enlarged lymph nodes. Abdominal x-rays (I believe) and ultrasound showed enlarged lymph nodes in her abdomen and a fine needle aspirate of the spleen showed lymphoblasts there. I believe the liver was clean, I remember that I was told that it appeared somewhat small and maybe that the aspirate had been inconclusive. We still don’t know cell type, but the vet figured it was probably a low grade lymphoma, moving relatively slowly. We started Ronya on a rescue protocol of Elspar/CCNU/Prednisone. It appears that probably the Elspar put her in remission right away. Her second shot of Elspar and her second dose of CCNU would be due tomorrow, Sunday June 24, and she is currently on 30 mgs of prednisone daily for another two days, then on thirty mgs every other day for the rest of the protocol (the protocol includes totally five doses of CCNU three weeks apart). Enter big misfortune and the reason for my request for advice: two nights ago Ronya tore her cruciate ligament in her left knee while jumping into my car. She already tore the cruciate ligament in her right knee two and a half years ago and had successful TPLO surgery. I understand that LSA is life-threatening and a cruciate rupture is not, however, Ronya can hardly walk at all and this is no quality of life. I would like to go ahead with the surgery (the vet suggested swivel lock) but do not know how to time it around the chemo therapy, neither do my vets. There are no veterinary oncologists in Alaska. I do not know if I should go ahead with the chemo tomorrow or not, my ortho vet thinks this would exclude surgery for at least three weeks. Is this true? Or should we maybe only do an Elspar shot and no CCNU? And should she get off the pred? If so, how much time would it take to wean her down and how to proceed? PLEASE advise, and operate under the assumption that 1) I am not ready to put my dog down, and 2) I would like to go ahead with surgery as soon as possible. Thank you so much. —– Deborah Webb

    • Dr. Susan Ettinger on June 24, 2012 at 3:39 pm

      Hi Deborah,
      Thanks for contacting us, and I am sorry for all that you have been through!
      I have patients that need surgery while going through chemo. Typically my surgeon and I try to plan on surgery the week after chemo – first check the blood work, specifically the white blood cells (neutrophils count) the day of surgery or one day before max. No surgery if the counts are low from chemo the week before.
      Typically chemo can be restarted at the time of suture removal but for orthopedics, you would need to check with the surgeon. I would taper your lab off pred for the surgery as it can delay would healing. Check with your vet about the taper. How quickly you taper depends on the dose and how long your dog has been on the pred. I cannot make those specific recommendations.
      Good luck and keep us updated,
      Dr Sue

  116. Tammy G on June 20, 2012 at 4:26 am

    Update on Tucker… Tucker has stage V, t-cell lymphoma. He started his first chemo Feb 1, 2012 (CHOP). and then had a high dose of cylcophosphamide in preparation for a bone marrow transplant at NC State that did not work out. When he returned we took him to UW Madison where they started CHOP again but he came out of remission. They started him on CCNU (lomustine) and this was a dream drug for him & us. His lymph nodes were smaller than ever recorded, he ate very well, he was super active and happy. He stayed on this for 8 weeks and came out of remission again. He is now on his third week of Vinblastine & Prednisone. I am amazed he is still doing well and we are enjoying everyday he is here. Unfortunately we just found out our other dog has massive liver tumor–large cantaloupe-sized. He is not doing all that well and we wish he had the options that Tucker had with his lymphoma. We’d love for him to feel & look as well as Tucker does after 4 months with aggressive lymphoma. A lot of people I’ve encountered along the way have misconceptions of chemo and say they would never “put their dog through that” but that is unfortunate for them because it really give you more quality time with your beloved pet.

    • Dr. Susan Ettinger on June 24, 2012 at 3:32 pm

      Thanks for the update on Tucker, and I am sorry to hear about your other dog.
      Many people do have misconceptions about chemo in dogs and cats, and one of my missions is to educate people that chemo is very well-tolerated. And happily, the majority of pets that do get chemo prove me right – they are living longer and living WELL!! =)
      All my best, Dr Sue

  117. christa on June 5, 2012 at 12:40 pm

    Well it has been almost a month since my baby zoe was diagnosed with lymphoma. after bringing her back to the vet 2 weeks ago she had lost 3lbs which wasn’t good. i brought her back today and she lost .08 lbs which excited me. however her spleen is now enlarged. my vet has encouraged me to try the prednisone and also amoxyciline. she said the pred will reduce the cancer cells and we will have her around for a little bit longer. thank you for the info. I just don’t want her to suffer.i have read about this drug called EZ clear for cancer. has anyone tried it?

  118. elisa on May 29, 2012 at 5:15 am

    My dog had four doses of CCNU and his liver enzymes tripled. The CCNU helped him but his liver is suffering.

    • Dr. Susan Ettinger on June 2, 2012 at 3:18 pm

      Elisa, ask you oncologist about a liver protectant. Once the liver value elevated resolves, sometimes CCNU can be used again at lower doses. Good luck!
      All my best, Dr Sue

  119. Deborah on May 25, 2012 at 11:12 am

    My now 9.5 year-old chocolate labmix Ronya was diagnosed with multicentric lymphoma almost 20 months ago. I chose to treat with CHOP and we achieved a long first remission and a not so long second remission. Ronya did well with the chemotherapy and I do not regret the decision. However, we are now facing a new decision, rescue treatment with L-Spar/CCNU/Pred or no treatment? Aside from a firmer and slightly enlarged popliteal lymph node Ronya is clinically symptom free, one would never guess that she is sick. Her bloodwork (calcium levels, liver values) also came back fine. We have not done any other diagnostics than the lymph node aspirate and no staging. If I understand correctly, CCNU has a higher toxicity than CHOP. I am worried about liver tocxicity or possibly lethal sepsis caused by neutropenia… I know the disease is eventually lethal but I do not want to prematurely kill my dog with the treatment. It would be horrible for me to have my dog maybe be hospitalized because of severe side effects and potentially die all by herself in the hospital. But then, there are many dogs who are just fine with the treatment… what to do? Do you have any thoughts or suggestions? Thank you so much —– Deborah

    • Dr. Susan Ettinger on June 2, 2012 at 3:15 pm

      Deborah, I think Lomustine/CCNU is a good rescue chemotherapy option, and as for toxicity, both Lomustine and doxorubcin/Adriamycin )that Ronya has already received) are in the same category of potentially being severely myelosuppressive to the bone marrow. I personally find CCNU is tolerated and safe with good monitoring. Prophylactic antibiotics can also be helpful. As for the liver toxicity, most oncologists use CCNU with a liver protectant like Denamarin. And monitor liver values prior to each treatment just like white blood cells. You are clearly very educated about the pros and cons of treatment, and while there are risks with treatment, there is the risk of not treating – the lymphoma will progress. You just need to find the decision that feels right for you. And remember, there is no “right” decision. I wish you and Ronya luck.
      All my best, Dr Sue

  120. Lee on May 21, 2012 at 6:31 pm

    Our 12 1/2 year old standard poodle was diagnosed with lymphoma. We’re thinking at this late stage in his life, we should let nature run its course. Do you agree? And if so, are there any types of supplements/meds or foods that we can offer to perhaps prolong his life or at the very least, make him more comfortable?

    • Dr. Susan Ettinger on June 2, 2012 at 3:06 pm

      Lee, I am sorry about your poodle, but this is a complicated question – more than I can address on a blog. I personally think lymphoma in dogs is a very treatable disease. Dogs with chemotherapy live significantly longer and tolerate treatment well. There are also a variety of protocols so it’s not all or none. I recommend that you meet with an oncologist who can go through the many treatment options, side effects and costs. You can also check out my chapter in the Dog Cancer Survival Guide. Treating is not for everyone, but remember treated dogs not live longer, they live well!
      All my best, Dr Sue

  121. Lynda on May 21, 2012 at 12:21 am

    My vet has treated her dog after a second reoccurrence of the disease.

    I’ve treated my dog once already and she responded really well for 18 months. It’s back again. Would you recommend treating her a second time?

    • Dr. Susan Ettinger on May 21, 2012 at 4:28 pm

      Hi Lynda,
      A first remission of 18 months is great! I sure would consider re-induction with a CHOP multi-agent protocol, if you are up to it.
      If not there are alternative “rescue” protocols that are often less expensive, with less frequent visits. The trade-off is response rates are often lower. But there are options, and that is a good thing. So make sure you get all your options, and good luck!
      All my best, Dr Sue

  122. christa on May 4, 2012 at 7:30 am

    My 41/2 year old shephard was diagnosed today with lymphoma. She is an amazing dog. The vet said that with chemo she could live another year and without she may have 3-6 months. the lymph nodes in her neck are the size of baseballs and she has them on her hind legs, under her armpits and when an x-ray was done it was determined that she had several small ones in her chest. I am really at a loss for what to do. any suggestions from someone that has gone through this.

    • Dr. Demian Dressler on May 9, 2012 at 4:08 pm

      Dear Christa,
      I am so sorry to hear babout your young girl with lymphoma. This is difficult. Have your read the Guide? It is a roadmap for your journey and your decisions. You can also search this blog using the search bar or your browser window. There is a diet download free at the top of this page as well.
      I hope this helps
      Dr D

    • Dr. Susan Ettinger on May 21, 2012 at 4:37 pm

      Hi Christa,
      I too am sorry about your dog’s diagnosis. Lymphoma is a very treatable cancer, and in my opinion, dogs tolerate treatment very well. With that said, treatment is not for everyone. I hope you had a chance to meet with an oncologist and discuss the options. As Dr D said, there is a ton of info in the book – I wrote a chapter dedicated to lymphoma in the Guide, plus there is info on the different chemo drugs, and more info on side effects. In addition, there is more info on this blog site.
      Good luck!
      All my best, Dr Sue

  123. Billy Bird on April 20, 2012 at 8:49 pm

    My dog and soulmate Malcolm was diagnosed with lymphoma in August 2007. Not long thereafter he was also diagnosed with having an auto-immune disease that meant that chemotherapy was not an option for him. Malcolm could have radiotherapy, to which he responded well, and in addition I went down the same, alternative route for his treatment as described in the post by Dagmar on 21 October 2011. Malcolm sadly died at the end of May 2009, at the age of 13 and a half, and only in the last 10 days did he feel ill, he had nearly 2 years of a very good quality of life up till then. I regret that it wasn’t until a couple of weeks before his death that I found out about CV247, which was developed by John Carter and is said to give amazing results. Should any of my current dogs find themselves unlucky enough to get cancer, CV247 will be my first port of call for sure.

  124. Tiffany on April 20, 2012 at 1:38 pm

    Can you plese tell me your thoughts on half body radiation?

    My dog has been gettng chemo for lymphoma since last Thanksgiving and it does great and is in remission. Blood values good and side effects minimal. So it is now time to consider half body radiation. I have a consult on 4/30/12.

    Like your state in your article, doing chemo on a dog with lympohoma is a no brainer. That was actually and easy decision. But the half body radation isn’t. The stats I have read (about 6 studies I found online)…1/2 say they dont know if it extends remission. The other half do but the articles are not convincing enough. Money isnt an issue and I expect she would handle it well (i understand this could be different and you never know)…but can I put her through something that we might not benefit from?

    Do you have any stats/info that would help one make an informed decision? Thanks so much for your time!

  125. Tammy G on March 26, 2012 at 3:34 am

    First, I want to say I am so sorry to read about Jack’s passing. What a special boy and special parents. I can’t help crying just reading your touching post about Jack.

    Our dog Tucker is going through a similar thing as we speak. He is a 7 yr old black lab mix (looks like a flat coated retriever). He was biopsied January 24th and we started chemo immediately upon diagnosis of t-cell lymphoma. He felt better immmediately after his first chemo and his second with doxorubicin put him almost back to normal aside from some stomach issues. We were looking for a more of a cure from this horrible disease, so we took him to NC State for a bone marrow transplant (stem cell transplant). Tucker did not fair so well through this process because when they harvested his cells he still had lymphoma in his blood, so his harvest was considered contaminated. He also had bled into his bladder when his platelet count dropped and had a very large clot in his bladder. Luckily he came out of the procedure without major issues but now our only option is chemo for him. He had a couple doses again and is doing fabulously. It is hard to think that he is on a shorten timeline because he looks wonderful, great appetite and energy level. The dr.’s at NC State give him around 2-3 months to live with chemo as his lymphoma is very aggressive. We feel like our pets are entitled to the best we can provide for them…which is different to different people. One of our cars is on it’s last legs so we had intended to get a new car, but instead we spent the money on Tucker and continue to do whatever we can for him to have a longer, happy life. Things are just things but our pets give so much back to us. Plus, Tucker is an absolute dream of a dog…sweet to the core. We are also giving him Apocaps, Glutamine and fish oils to help. I’ve purchased the Dog Cancer Survivor’s Guide which has a lot of good information too. Good luck to all of you dealing with cancer and your pets.

  126. Shalee on March 25, 2012 at 12:55 pm

    Our 10 year basset was diagnosed with Lymphoma in Sept 2010. His lymph nodes were swollen and he had lost weight….other than that, you would not have known he was ill. We were told 6 weeks w/o treatment, 2-3 months with prednisone or a year or more with chemo. We went with the Winconsin protocol of 26 weeks of treatment knowing that if it affected his quality of life, we could stop anytime. It consists of 4 drugs…a pill (Cytoxin), a shot under the skin (L-asparaginase/Elspar), a shot in the vein (Vincristine) and a IV (Epirubicin). Other than one vomiting episode with the Epi, he sailed through. We administered Cerenia (anti-nausea) everytime he had the Epi and you woudl have never know he was taking chemo. His last treatment was April 2011. He just celebrated his 12th b-day. In Sept 2011, his sister was diagnosed. We never hestitated to start the chemo with her She took her last treatment yesterday and came through with flying colors.
    As for treatement…..it cost about $2500 (we live in Oklahoma). We go once a week for the first 1/2 of treatment and then every other week for the last 1/2. We pay each time we go so its easier, but our vet offeres a payment plan. As long as we give Cerenea, a few days after the Epi (before they get nauseous and wont eat) they never got sick. The Cerenia is expensive…4 pills for $50 for a 75 lb. dog. And don’t let your dog get near any other dog you don’t know. Their immune system is very low and they can get an infection very easily. Other than that, it was better than we had ever hoped for. Good luck to all. Remember, you can always stop treatment if its not going well for your baby.

  127. Dr. Nancy on March 21, 2012 at 3:50 pm

    Dr. D thanks for info re: increased absorption with the addition of liquid lecithin to Apocaps. Would you think 4 or 6 mL liquid lecithin for a 60 lb lab? Is there any reason that we would NOT want to use the powdered lecithin that is available? If it can be used what quantity? I was thinking it might be less messy.

    I also wondered if you had any experience with the use of Yunnan Bai Yao (a Chinese herb used to offer some relief of bleeding and pain in hemangiosarcomas). Thanks in advance for your reply.

  128. Billy G. on March 13, 2012 at 2:24 am

    Dr. D., Dr. Ettinger,
    It is with heavy hearts and great sadness that we must share with you the heart breaking news of Jack’s passing. He battled his cancer valiantly for five months, but in the end it became too much. Fortunately we were able to bring him home from the vet’s office last night and he passed with Jennifer and I cradling him in our arms. While Jack was a little more than a month shy of his ninth birthday he packed a lot of life into the years he was on this earth. He will always be remembered for the refrigerators he raided, the food he stole, the begging (and the drooling), the beds he shredded and squirrels he chased. But what makes him most memorable was the love and happiness he brought with him. This alone made him a fantastic dog, a great companion and a superb family member. And Jack was just that, a family member. Nothing less.

    From the day we brought him home as a 25 lb., eight week old puppy until this morning he never stopped loving. I always joked with Jennifer that Jack loved me more than she did. I told her that I could prove it. I said to her “ if I locked both of you in the trunk of a car for an hour, only one of you would be happy to see me when I opened it.” And that was Jack. No matter what the situation, or mood I was in or what was happening he was always there tail wagging and smile on his face wanting to play, nuzzle or cuddle.

    Jack had a knack for touching the lives of the people he encountered. My dad used to call him his first grandson. He did possess many human qualities, from the way he sat on the couch to his personality traits. The oncology department at Red Bank Veterinary Hospital were great to him and he touched them also. His oncologist called this morning from her personal cell phone while she was on vacation when she heard Jack was not doing well. When we brought him there this morning the oncology staff stopped by the room to say goodbye, give us hugs, share stories and tell us how much Jack meant to them. It was a very touching and memorable moment.

    Jack also taught us a lot and we will continue to benefit from him being in our lives. He taught us loyalty, generosity, sharing and how to love and give freely. He also taught us to take joy in simple things such as a walk in the park, running on the beach, a ride in the car and of course to eat a meal with gusto and enjoy food. 

    Jack had no fear of death, and he never complained or felt sorry for himself. He dealt with his chemotherapy treatments and occasional side effects with not even a whimper. When he was feeling down or weak he was still himself and giving right up to the end. I believe he lived his life so that in the end he was able to go peacefully and without any regrets. He was always a smart dog (what dog that figures out how to open refrigerators isn’t smart?). It’s like he knew that life should NOT be a journey to the grave with the intention of arriving safely in an attractive and well preserved body, but rather to gallop and skid in sideways, wearing his best collar and a nice big bone in his mouth, body thoroughly used up, totally worn out and barking “WOO HOO what a ride!” That will always be my fondest memory of him.

    As you can understand, this has been a difficult time for us. Jack will be and is already missed. I still look over to his bed and expect to see him or hear him coming up from the basement. I think I will also miss him waking me up at 7am on Saturday mornings to go for a walk in the park. But he is in a better place now. A place that has no cancer, no more chemo, no more pain, no more suffering. He is with my dad in Heaven and I know he is taking care of him and making him happy like he did for us.

    Thank you everyone for all of the kind words, photos, memories and condolences. Jennifer and I truly appreciate them all.

    It has been said, ‘time heals all wounds.’ Not in this case, not with Jack, not ever. The wounds will remain. In time, our minds, protecting their sanity, will cover them with scar tissue and the pain will lessen. But it will never be gone. Just as Jack will never be gone from our minds and more importantly from our hearts.

    Thank you!

    Billy, Jennifer and Jack.

    • Dr. Demian Dressler on March 16, 2012 at 12:36 pm

      Dear Billy and Jennifer
      We are sending you our thoughts and our sympathy for your loss of beloved Jack. I hope your thoughts of his departure can turn to those of your happy days together.
      Dr D

    • Dr. Susan Ettinger on March 16, 2012 at 4:50 pm

      Bear Billy and Jennifer,

      I am so so sorry to hear about Jack. Your last post was touching. He was lucky to have such a dedicated family taking care of him. May you remember the good time shared through the years and may those memories ease your sadness.
      Four plus years after the loss of my beloved Paige, and there is still a hole in my heart.
      My deepest sympathy,
      Dr Sue

  129. Dr. Nancy on March 12, 2012 at 6:01 pm

    Thank you for all you do to help animal owners deal with cancer Dx in their animals.

    I looked at the link you provided with results from your small clinical trial and saw one dog suffered with hemangiosarcoma and wondered if there was any specific data from this study (or your experience) re: any increase in longevity with the use of Apocaps combined with the Dog Cancer Diet for hemagiosarcoma. If you could share info that it would be great.

    Also, in your study it says 2 caps/40 lbs (1 cap/20 lbs) 3x/day which would be 3 caps 3x/day for a 60 lb dog or 9 caps total. On the Apocaps packaging it says 3 caps 2x/day for a 60 lb dog which is 6 caps total. Any significant advantage to the higher dose in your clinical opinion?

    Thanks in advance for your reply.

    • Dr. Demian Dressler on March 16, 2012 at 12:20 pm

      Hi Dr. Nancy
      I have had quite good experiences with HSA in dogs using not only Apocaps but also in combination with diet, immune support, antimetastatics, brain chemistry modification, and the other steps outlined in the Guide of which you are aware. Although I am prohibited from making health claims by the FDA, I can say that I have been quite favorably impressed and in some cases even amazed. Oncologists are starting to use Apocaps as well, which is good news.
      the pilot study was proof of concept, so we used higher than labeled doses. If more capsules can be tolerated, I am not hesitant to use more. Another way to increase blood levels is by giving several ml’s (1-6, depending on the dog’s size) of lecithin at the same time as the Apocaps. This is very messy and a serious hassle, but again I have been favorably impressed with this method in a few dogs. However, be sure to have your veterinarian supervising all of your dog’s health care steps.
      Dr D

  130. Laurie on March 11, 2012 at 6:55 pm

    My bengal cat was diagnosed with Small Cell Lymphoma of the small intestine two years ago this April. I have had him on daily chemotherapy (Leukerin 3x week; 10 mgs Prednisolone daily). Overall he is really doing well and taking the chemotherapy very well. The biggest problem was that his immune system would be weak and he tended to get weekly outbreaks of an ocular virus, and then he wouldn’t want to eat much because he didn’t feel good. However, six months ago, in addition to his chemotherapy, I started to daily give him 200 mg of DHA (algae based, not fish oil based) as well as some Vit D3. It has made a remarkable difference. He rarely gets the virus attack anymore, and when he does get it, it is gone in a day or so. His appetite is greatly improved. (But I have to say that yesterday and today his appetite is not good–I took him to his doctor for a routine checkup last week. Going in the car and being in the clinic stresses him–and unfortunately, he typically doesn’t do well for a few days afterwards…).

    I have a question: I would love to get the homemade Anti-Cancer Diet for cats –would that be available?

  131. joanne on March 8, 2012 at 3:28 pm

    my german shepard died 2 years fron lymphoma gave hm a year of chemo
    he dealt with the chemo fine but every different treatment was more expensive and there is NO CURE we did it for ourselves now have a Dobe that just had a tumor removed do not know what is was yet we love animals never want our dogs to suffer the way our shep did the last 5 days of his life hard decision lymphoma is not curable do not not do it to yourselves or the dog

  132. Judy on February 28, 2012 at 7:20 pm

    Hi Doctor,

    Our little Sophie, who is a Papillion Chihuahua, has been diagnosed with lymphoma about 2 weeks ago. Our Veterinarian said that she has mid to high grade cancer and that her liver has been affected. We showed the Dr. Sophie’s belly and where she has bruising and redness along with swelling. The Dr. said it is a subcutaneous hematoma and did not elaborate. What could this be? The area is directly above her genitals and the swelling seems to be in a pocket on each side of her midline and the pockets are about one inch long and an eighth of an inch wide. She has not had difficulty with bowel movements or urinating but her appitite has reduced greatly. Sophie starts chemo tomorrow and we will be sure to ask the Vet. many questions. Thank you in advance for your input. We greatly appreciate you and the wonderful blog!

    • Dr. Demian Dressler on March 7, 2012 at 12:55 pm

      Dear Judy
      a hematoma is from blood under the skin (a bruise). It could be the tumor is bleeding or it could be that there are blood clotting problems related to the cancer and liver infiltration.
      Have you read the Guide? As usual, to be effective as a Guardian during this process, it is really important to give yourself the education you need.
      I hope this helps

  133. Elisa on February 14, 2012 at 9:27 pm

    My 7 year old boxer was recently diagnosed with Lymphoma (substage b) . The general practice veterinarian misdiagnosed him two months earlier with “idiopathic hypercalemia”. He was treated with corticosteroids and Sub q fluids, one month later his calcium was back up. The oncologist biopsied the enlarged lymph nodes in his abdomen and they were confirmed to be lymphoma. The first two days of his treatment he received L-asparaginase and Vincristine(0.66) along with IV fluids, Prednisone , Reglan and Pepcid. The following week he received Vincristine(0.60) again and then week three he was treated @ home with Cytoxan(12.5mg &50mg)EOD. The next drug in his protocol should of been Adriamycin (Doxorubicin) however his ECG revealed (1)single ventricular premature arrhythmia. The oncologist expressed concern due to the related cardiac toxicities and Vincrsitine was administrated as a replacement.
    I am concerned with the dose reductions and the effectiveness of the use of Viscristine instead of the Adriamycin. Other drugs such as actinomycin and mitoxantrone were not mentioned as alternative options . What would you recommend I do?

  134. Cathy S on February 12, 2012 at 1:50 pm

    Dr. D or Dr. E,
    My 31/2 yr old Afghan was diagnosed with lymphome Grade IVa, type B on Oct 17, 2011. She has been receiving the Wisconsin Protocol, doing well. MSU calls her in a clinical remission as we no longer feel any enlarged nodes. I have been feeding EVO (high pro) plus adding some suggestions from the dog cancer diet and giving high doses of fish and krill oil, and 500mg of arginine. Is it still worthwhile to start the apocaps? She has 5 more treatments left.

  135. Billy G. on February 6, 2012 at 4:21 am

    Not good news from Jack’s visit to the oncologist yesterday. Seems like his lymph nodes are slightly enlarged. His Dr. has changed from Wisconsin protocol to one called MVPP. It is very sad since Jack is happy and active and eats like crazy. Not the news i wanted to hear. I was hoping he would make it through the 19 weeks of the MW protocol before a rescue protocol would be needed….

  136. Billy G. on January 29, 2012 at 3:48 pm

    Thanks Dr. E… Dr. Vickery from Red Bank Vet Hospital checked him today and all of his nodes were normal except for the one popliteal. I showed he video of him eating with gusto. Also, my wife and i took him for a long walk yesterday and he was chasing squirrels and cats. Just that one stubborn node that is driving me crazy. He had Adriamycin today so am hoping that does the trick.. Thanks for writing back.

  137. Billy G. on January 22, 2012 at 8:26 am

    Good afternoon,
    Dr. Dressler and Ettinger,

    Jack had another round of chemo today. He continues to do well with regards to energy, appetite and attentiveness. I did however notice that his left leg popilteal node seemed more prominent than any of his others. I showed the oncologist today and she said it might be developing a resistance. Also said he is on the best protocol for lymphoma. He took oral cytoxan last week and vincristine this week. She said she might swap out the cytocan if it’s not working. Have you had any cases like this? Thank you.

    • Dr. Susan Ettinger on January 29, 2012 at 9:41 am

      Hi Billy,
      Glad to hear Jack is doing well as he goes through treatment. Yes, I have cases where a dog isresistant to one of the drugs of the protocol. That’s why Jack is being treated by an oncologist who can examine him at each visit, monitor his progress, and make modifications to his protocol. Chemotherapy protocols are not recipes nor written in stone, so listen to your oncologist – she sounds like she is doing what I would.
      All my best, Dr E

  138. Billy G on December 31, 2011 at 11:17 am

    Jack continues to respond well to his chemo and diet. He is energetic and no sign of the swollen nodes although I worry every day they show up. He hasn’t had any side effects from the chemo at all. He has his one month check up on January 2nd.

    • Dr. Susan Ettinger on January 3, 2012 at 6:40 pm

      Great news on Jack!! Thanks for reading and sharing his story!
      Glad he is responding and tolerating treatment. Take it one day at a time and enjoy each day with our beloved companions! They are the best!
      Warm regards, Dr Ettinger

    • Dr. Demian Dressler on January 4, 2012 at 5:02 pm

      Good news!

  139. Billy G. on December 27, 2011 at 5:25 pm

    Jack is on his fourth week of chemo and diet, supplement changes. He continues to do well. I am paranoid about the lymph nodes coming back. It’s probably a bad thing but i check the nodes every day. But his energy level is amazing, appetite is voracious, not one single side effect from the chemo and the doctors said this past Monday he is doing well. He has his 4 week evaluation and we continue to hope for good things. Dr. D, i just read the piece in your book about the sugar cane binders in the K9 Immunity plus. I have these for Jack, I am going to get the regular ones once done. Thanks for so much detail. It is appreciated. Now find a cure for cancer 🙂


    • Dr. Demian Dressler on January 4, 2012 at 4:52 pm

      Thanks Billy,
      as for that cure thing…working on it. Sigh.

  140. Pam Isabelle on December 18, 2011 at 2:23 pm

    We are currently treating our 8 year old Beagle for Lymphoma. She was diagnosed on 10/29, and started treatment 5 days later. We have absolutely no regrets about what we are doing for her! I just wish that we could have been better prepared. 24 hours after she had the Vincristine, she was up all night vomiting, the poor lamb! When I called the next morning, they gave me Cerennea (sorry if that’s not spelled correctly) and that took care of that issue. Now I keep it in the house. She also had Hemorragic Cystitis Thanksgiving week, and though she isn’t bleeding anymore, she still suffers from the Cystitis.
    Is there a brochure that could be given to Guardians who are making a decision about treating their dog? We are both Nurses, so we are prepared for the unexpected. But what about the Guardian who is just trying to do what they can for their much loved pet?

    • Dr. Susan Ettinger on January 3, 2012 at 6:50 pm

      I am sorry about your beagle’s lymphoma and the complications. I do provide info sheets to my clients about general side effects and what to do at home. In addition, I personally send home dogs with Cerenia for nausea and a diarrhea medication too, so you have them on hand.
      While I am not sure what handouts your oncologist has on hand, there are detailed sections on lymphoma, chemotherapy side effects, and the individual drugs in the Dog Cancer Survival Guide. I also recently posted about GI side effects. Bone marrow side effects including low white blood cells should be available this week on this blog. Good luck with the continued chemo!
      Dr E

  141. Billy G. on December 7, 2011 at 2:48 pm

    My beloved Rhodesian, Jack was recently diagnosed with Canine Lymphoma. He had his first treatment using the CHOP Protocol on Monday December 5th along with prednisone. I also have him on a high protein cancer diet described by Dr. Dressler along with Apocaps, K9, Fish and Krill oil. When i checked his lymph nodes this morning they were significantly decreased in size. I was sooo happy and he seemed to have his energy and spirit back. The vet who performed Jack’s biopsy called today and said his was an “aggressive” lymphoma. I am hoping he continues to respond to the meds. Next chemo appt is Sunday. Thanks for all the info including the books. It is helpful and comforting.

    • Dr. Demian Dressler on December 10, 2011 at 5:51 pm


  142. Julieta on November 14, 2011 at 5:33 pm

    Dear Dr. Dressler:

    We have a 10 year old terrier mix (Yorkshire terrier) with stage IV A lymphoma (cells B). She was just diagnosed on 10/17. We felt an enlarge lymph node under her chin and took her in right away. We decided to do chemotherapy right away and she went into remission after first treatment. Juju is under the Wisconsin Protocol and is responding very well. She just get a bit tired for a day or so and diarrhea for a day or so as well.
    Questions for you:
    We haven’t changed her diet much – she eats chicken breast and dry food (grain free). The Vet said that the less changes for her the better, she has a sensitive stomach to begin with. I understand how important her diet is specially during treatment. What should I add to her diet? Should I follow our Oncologist advice and no change her diet?

    My other question is about radiation. What is your recommendation/thoughts about 1/2 body radiation on dogs with Lymphoma – does it really work? Would the remission time be “way” longer if we were to use radiation and chemo together vs chemo only?. We are really concern about the side effects and toxicity of the radiation and how sick she can get. She is only 12 pounds! =(.
    Is it worth it to put the animal through such an aggressive treatment?.
    Could you please give me your opinion on the subject?

    thank you for your time.


  143. gloria weisz on November 10, 2011 at 7:33 am

    im not sure what the name of the cancer was our vet did tell us, but i forgot. she had a small growth on her ankel that suddenly got alot bigger and very firm; he gave her 3 to 6 months, that was back in jun e this year. now it completely encircles her leg and weighs about a pound or more looks like a cullaflower beneigh her skin.i cant see any pain systems although there has to be pain. i am currently awaiting our vet to get back to us about pain killers for jake, i know its a boy name for a girl; best dog i ever had, a schnauszer/terrier mix; i swear shes half human. i love her soooo much but vets are sooo expensive we cant afford the treatment and jake is at least 10 years old. we adopted her eight years ago. can you give us any advice? thanke you for reading this

    • Dr. Demian Dressler on November 12, 2011 at 1:40 pm

      Dear Gloria,
      We need more info. The cancers are all different and we need the name of the cancer. You should discuss apocaps and neoplasene with your vet, as well as payment options for surgery, radiation, and chemo. Some vets accept Care Credit payment plans- you should find out about this.
      There is also a list of charitable groups in the Guide.
      Dr D

  144. […] my last blog post on lymphoma, I shared that I would personally treat my dog with a multi-agent chemotherapy protocol if she was […]

  145. Dagmar on October 21, 2011 at 5:56 pm

    One of my clients’ dog was diagnosed with lymphoma and given max. 4-6 weeks, max. 6 months with chemotherapy. My client decided to stay away from chemotherapy anyway and went the alternative way (herbs, Flower Essences, acupressure, Quantum Touch) and change of nutrition (including Budwig diet) instead and to all our surprise the dog improved, put on weight and lived a happy life for another 9 months. Only at the very end the dog was given prednisone, that was all.

    I just wanted to share as I believe, if people are willing to commit preparing their own dog food and adding the relevant supplements and supporting the immune system the dog can have a very good chance of survival even without chemotherapy. And yes, the dog had swollen lymph nodes all over her body which settled down in no time after starting her on the new diet/supplements, herbs, Essences and acupressure.

    • Dr. Susan Ettinger on November 1, 2011 at 5:14 pm

      It is great to hear that this dog did so well. Thanks for sharing your story!
      Best, Dr Sue

  146. Mark on October 18, 2011 at 1:20 pm

    Our Great Dane was diagnosed with Lymphoma 5 weeks ago. In talking with our vet and a small animal specialist, I asked the very same question and both of them said given our dogs situation they would both choose chemo as well. Even Dr. Marty Goldstein said chemo for lymphoma is a good option.

    Great article.

    Sadly for a few reasons we didn’t choose the multi-agent protocol, but hoping for the best with the single agent along with a ton of supplements (CoQ10, Turmeric, ACL, ALA, IP-6, Glutamine, Ginger, Fish Oil, L-Theanine, Arginine, etc, etc)

    • Dr. Susan Ettinger on November 1, 2011 at 5:01 pm

      Mark, I am so sorry to hear about your Great Dane.
      When treating lymphoma, it is important to remember there are many good options, and chemotherapy protocols are not “one size fits all.” You have made an informed and educated decision, and your dog is lucky to have a dedicated Guardian like you!
      Good luck!
      Dr Sue

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