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.
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?
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
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?
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 🙂
Thank you for this Susan.
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 ?
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!
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
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.
Oh, Marilyn. What a story. I’m so sorry. Thank you so much for your share.
Chemo did nothing for my 8 1/2 year old dog that had epitheliotropic lymphoma.
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.
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.
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….?
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!
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?
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!
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
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!
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.
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.
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.
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.
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.