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

What I Would Do for My Dog with Lymphoma

Updated: June 2nd, 2020


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. john steele on August 20, 2020 at 4:47 pm

    Too bad for your dog that you would not recommend T cell therapy, or autologous bone marrow transplants..these have been shown to actually cure dogs, unlike CHOP which ultimately fails 100% of the time.

  2. Claudia Neal on August 10, 2020 at 10:25 am

    My dog was just diagnosed with lymphoma. He has a stage 3 heart murmur. Would you consider him a candidate for chemo. He’s 13 years old. July 4th he had vestibular disease he recovered still has a head tilt. He’s on prednisone, one pill a day.

  3. Fred Balkin on August 5, 2020 at 10:06 am

    my 9.5 year old shorkie was diagnosed with lymphoma b cell a month ago. He has been on chop now for 4 weeks, and he is in full remission, no sign of cancer and his white blood cell count yesterday, on his fourth chemo treatment was completely normal. He had literally no side effects, other than one instance of vomiting once after the third chemo treatment but was fine and eating an hour later. Before and after this, no side effects other than maybe being slightly lethargic and quiet through the first two weeks of treatment, but clearly happy and comfortable throughout the chemo. he continues the chop protocol now…each week, but I would recommend as Dr. Ettinger does in this article, the chop protocol. Honestly it is amazing how quickly, even after one treatment, he went from his death bed to almost being himself, within 48 hours of the first chemo administration. Today, 4 weeks later you would never know he has cancer….in remission…

  4. Sue Herrmann on August 1, 2020 at 3:36 am

    Thank you for this.My lab, 13 was diagnosed 1 month ago with cutaneouse epithelialtropic lymphoma. He is 1 week post the first lomstine dose. Just now I was called by his vet, liver enzymes are up. so on to Denamarin. I am an xray tech by background, so I made the decision to do chemo based on knowledge from people. It is affordable as far as chemo goes, so my other assumption is one more dog, one more regimine, one more link to better understanding this beast of a disease. Thank you again

  5. Debra on June 3, 2020 at 8:28 am

    Hello Dr. Ettinger,
    My 13 yr. old min pin was recently diagnosed with large cell lymphoma. I would like to feed her home made meals , but don’t want her to miss out on the supplements that are in the regular dog food. I was wondering if you could recommend which type of supplements I might be able to add to her homemade stew, this is recipe that consist of quality beef, zucchini, carrots, sweet potato, green beans, which is in a min pin book that I own. If you are able to help me. Thank you in advance. Sincerely, Debra

  6. Lisa on June 3, 2020 at 6:54 am

    My dog was diagnosed with stage 3 Lymphoma on May 29th. He was showing no signs of illness (pain) other than the swollen lymph nodes. I took him to the oncologist on June 2nd. I was given the option of CHOP, but I cannot afford the $6,000 treatment. I did the flow cytometry test and I’m awaiting the results. The day after the oncology appt he seemed to be showing signs of being uncomfortable (panting, unable to settle). If the flow test comes back as B cell then I was going to treat with Doxorubicin w/cyclophosphamide). I’m worried he’s declining in the week I have to wait to get the cell test results back. What would you recommend as the next course of action? Is there something that can keep the cancer at bay until results come back, would you go ahead & start the Doxorubicin, or start prednisone? I would love to be able to have more time with him, but I want to make sure he is happy and pain free during any time we may have left. I also don’t want to spend his last days getting multiple injections if he just has the T cell & the outlook is not good. Will you please let me know your opinion?

    Thank you!

    • Lia on July 16, 2020 at 8:07 pm

      Hello Lisa,

      Sorry about your fur baby. I hope he is going better with the meds. I’m going thru the same thing is so devastating .

  7. Tania Villalba on May 18, 2020 at 6:22 pm

    My strong gentle boy Buster, 7 years old was diagnosed March 24. We decided to treat with CHOP. He had a first dose of Elspar and his lymph nodes went way down. The next week he had vincristine. 7 days later he was a mess. His heart was racing and he could barely breath and walk. His WBC count was very low. I ordered the oral chemo but did not give it to him due to his low WBC. He continued on pred. He declined rapidly that week and I could not put him through more chemo because I thought it would kill him. He passed away on May 9. I had to try treating him but he did not do well on it.

    • Lia on July 16, 2020 at 8:14 pm


      I’m so sorry is very heartbreaking. My baby was just diagnosed he also has anemia. We are trying CBD let’s see how that goes. We are crying almost every day. He was always so happy and love walks. Now my lovely Shihtzu is so tired with not much appetite.

  8. Vivien Walsh on May 6, 2020 at 3:58 pm

    Greetings, thank you for your interesting article, on CHOP. My dog, Charlotte has cancer. She has received over 9 sessions of chemo, prednisone treatment & now she will be having her 2nd surgery to remove some of the cancer. I would like your opinion. Why is this cancer spreading if she was on chemo, & prednisone. I asked for a strong chemo treatment. Please I need you insight on this to help me understand why her cancer is spreading. It’s gone to her lymph nodes in the groin area and now the oncologist has notice some of the cancer around her upper limb area in the armpit where she previously had the surgery, removing a tumor, which was last year. I called Charlotte my warrior hero. When I went to war overseas to Iraq & Afghanistan, Charlotte was right there as my main support, waiting for me. She would be waiting for me at the airbase to receive me when I arrive from war. I’m sorry I can’t lose her. I just can’t. What should be the next step after the surgery?

    • Molly Jacobson on May 7, 2020 at 10:56 am

      Aloha Vivien, I’m sorry to hear about your Charlotte. I totally understand how devastating this is for you. 🙁

      The problem with dog cancer is that it almost always “wins” the fight in the end. CHOP is amazing, it really is. It turns a 2-4 week prognosis into a prognosis of nearly a year. That’s a LOT of time to gain, which is why oncologists recommend it so strongly. Unfortunately, it doesn’t always keep the cancer from spreading. Cancer is sneaky and terrible and tricky, and it can figure out how to beat chemo. Does it always? No. But in the end, it often does. And that’s just the totally unfair, terrible, awful, sad truth.

      That’s the hard truth, but I know you can handle it. CHOP is the absolute best protocol that oncologists have to treat lymphoma. For many dogs, it increases quality of life dramatically, and gives them a LOT more time than lymphoma would otherwise have given.

      Your oncologist will be the best person to advise you about what’s next after surgery, because every case is different. She might be eligible for a “rescue” protocol, another round of chemo. Or she might not. There are definitely lots of things you can do at home with diet and supplements as outlined in The Dog Cancer Survival Guide. However, there is no magic pill or silver bullet, nothing that will guarantee that she will beat the lymphoma.

      Ask your oncologist what the recommendation is. What does the future look like? How much time does she/he think the surgery is buying? What’s the next step? What is the likelihood it “works?”

      The truth is hard to hear, but once you hear it, you can cope and make confident decisions.

      There are lots of articles on this site that can help you with the decision-making process. I hope you get some peace about this. I know for me, spending time just being with my dog helps me to remember why I’m so panicked and upset — it’s all the love we share. Try to take a few deep breaths and use that relationship as your anchor, and you will not make a mistake and you will always know you did the best for your girl that you could.

      Warm Aloha during this difficult time.

  9. Kearren Bailey on March 28, 2020 at 3:29 pm

    Hi Sue;

    Our Golden Retiever was diagnosed with Lymphoma on February 24th. Discovered during a routine checkup. We started CHOP on the 26th. Sadly, on March 25th we found out that he is not responding to the treatment. We have decided to try rescue therapy (he’s not yet 6 years old!). He is staying on prednisone until we start – hopefully next week. We are ever hopeful,that this will buy him more time. Is there anything else we should be doing to prolonge his life and give him the best quality of life possble? We live in Oakville Ontario. He is being treated at the MVOH clinc here.

  10. Susanne McMahon on March 24, 2020 at 10:35 am

    My dog has liver and spleen involvement. She will be 12 in July. She is currently on prednisone.
    She will see the oncologist in a few days. She had stopped eating and drinking but then went on prednisone and she started eating and drinking again. Because she is stage 4 and older, I wonder if the Dr. would try chemo? I don’t want to ruin the rest of her life. She still goes on walks with me.
    Please, respond to this E-mail by tomorrow. (Lymphoma)

    • Dog Cancer Vet Team on March 25, 2020 at 8:01 am

      Hello Susanne,

      Thanks for writing. As we’re not veterinarians here, we can’t offer you medical advice. However, we can point you towards the information in Dr. Dressler’s writing.

      One of the hardest things you’ll have to do as a dog guardian is to make a decision on a treatment plan. You may actually find these articles on Treatment Plan Analysis, How Old is Too Old to Treat Dog Cancers, and Why Your Personality is So Important to Your Dog with Cancer to be extremely helpful.

      You will also need to ask yourself a number of questions like can your girl handle chemo? Can you handle the side-effects of treatments? Do you have a budget? Do you think she would be the same after chemo? Is life-quality important to you both?

      As Dr. D writes in the Dog Cancer Survival Guide, there are a number of things that you can do to help your dog with cancer, with your vet’s supervision. Conventional treatments (chemo, surgery, or radiation), Nutraceuticals, Immune Boosters and Anti-metastatics, Diet, and Mind-Body strategies. This is what he calls Full Spectrum Cancer Care.

      Once you know your options, and what is most important to both you and your girl, you will be able to make a decision based on what you think would be best for her 🙂

      If you would like to book a consult with Dr. Dressler directly, you can do so via his website:

      We hope this helps!

      Sending warm wishes to you both <3

    • Peg k. on April 18, 2020 at 5:54 am

      I have same situation. Our 14 year old lab has lymphoma. A week ago she wouldn’t eat or drink or go in the yard. Trying prednisone and it has helped. She is eating and drinking regularly and will go for walks with us. Panting is getting worse though and her breathing is starting to get rattled. I don’t want to see her suffer, just happy that the prednisone has at least given us a little more time with her.

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