What I Would Do for My Dog with Lymphoma
Sue Ettinger, DVM. Dip. ACVIM (Oncology). Dr. Sue is a boarded veterinary medical cancer specialist. As a Diplomate of the American College of Veterinary Internal Medicine (Oncology), she is one of approximately 400 board-certified veterinary specialists in medical oncology in North America. She is a book author, radio co-host, and an advocate of early cancer detection and raising cancer awareness. Along with Dr. Demian Dressler, Dr. Sue is the co-author of The Dog Cancer Survival Guide: Full Spectrum Treatments to Optimize Your Dog’s Life Quality and Longevity.
Updated: November 2nd, 2021
Summary
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 is 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.
I would have given my dog a kidney if she needed it!
(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. It’s what I would do — and that doesn’t mean it’s what YOU should do.
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.
Best,
Dr. Sue
Sue Ettinger, DVM. Dip. ACVIM (Oncology). Dr. Sue is a boarded veterinary medical cancer specialist. As a Diplomate of the American College of Veterinary Internal Medicine (Oncology), she is one of approximately 400 board-certified veterinary specialists in medical oncology in North America. She is a book author, radio co-host, and an advocate of early cancer detection and raising cancer awareness. Along with Dr. Demian Dressler, Dr. Sue is the co-author of The Dog Cancer Survival Guide: Full Spectrum Treatments to Optimize Your Dog’s Life Quality and Longevity.
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
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
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!
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!!
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?
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!
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.
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.
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.
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!
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.
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!
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.
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.
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.
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!
Would love to know how things are Jan. Sending love and all good wishes xxx