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.
Hello doctor. Thank you for this article we are going through this exact scenario with our 13 year old Scottish Terrier who has been diagnosed with Type B Lymphoma. We have opted not to pursue the Chemo route for two reasons, neither of which you discussed, but that should be a portion of your article. First, as you alluded to the number of vet visits, but that all comes at a very high cost. In reviewing our options, we were presented with CHOP costs ranging between $10,000 – $15,000, and requires weekly treatments, and while it is stated that there is a likely chance of extending the life of the pet, it is brings me to my second reason, which is that lymphoma is a fatal disease. We have elected to bring our Molly home and give her the best home treatment for the remainder of her life, rather than continuing to run her through the mill with treatments that really are not guaranteed, and which, ultimately will end her life. Finally, I want to say that the vets and oncology team that has treated our baby have been nothing but the most caring team, and I want to thank you and individuals like you who are working to save the lives of the ones that give us so much joy. Again thank you for this article.
Is chemotherapy very expensive
My 6 year old Irish Setter started CHOP on April 21st and was in remission until August 5th. She was then put on MVPP/MOPP and was responding well except her blood platelets dropped to dangerously low levels. Is it possible to try CHOP again or does that also destroy the ability to make blood platelets? She is currently on Prednisone and supplements. What else would you do if it were your fur baby? Yes, I would give her my kidney or bone marrow if possible.
3 year old Aspen is an MDR1 mutant and was diagnosed with small intestine Lymphoma in the middle of August (tumor was blocking so she couldn’t keep food down). She immediately bounced back with prednisone. We knew nothing about chemo but knew we would “never” put a dog through it. We did a lot of research the few days following diagnosis, particularly into chemo protocols and decided to see an oncologist (3 hour drive). As a mutant she couldn’t have CHOP so she is on CCNU. She went into complete remission at 2 months (ultrasound competely unremarkable) and is doing great at 3 months post diagnosis. We know with GI Lymphoma she isn’t likely to be in the lucky 50%. But these three months have been golden. She had hiked over 150 miles with us, participated in training classes, earned additional titles in agility, scent work and barn hunt and plays her all time favorite, Frisbee! She is living her best life and when she isn’t any more we will knew what to do.
Sounds like you have all the bases covered and a great attitude that your girl shares with you. Keep her moving, and I know Aspen will tell you what she needs — it’s clear you listen deeply and have a great relationship!
What if you can’t afford chemo my daughter’s little one is as much loved by me I’m watching her panting heavily I’m trying not to cry in front of her she’s precious makes me feel bad I can’t help my daughter financially we are both pensioners so to hear that others would choose chemo is guilt ridden for us
Hi Marilyn – I am so sorry to hear about your beloved dog’s diagnosis. This page has several options for financial assistance to help with cancer treatment: https://www.dogcancerblog.com/articles/book-excerpt/financial-assistance-for-dogs-with-cancer/ Also, ask your veterinarian about the drug prednisone. Pred is frequently used for dogs with lymphoma either as a standalone treatment or in conjunction with chemotherapy, and is fairly inexpensive. Best of luck with your darling dog!
Our 12 year old Cavalier King Charles Spaniel has been having issues lately, vet took some xrays of his chest, neck and abdomen. His liver, spleen & adrenals are so swollen. We have for a whole year been chasing a Cushings diagnosis because of his symptoms, but after reviewing the xrays… he has a lot of suspicious spots where lymph nodes would be and several swollen nodes palpable in his neck and his back leg. He’s lost 10lbs (he was tubby to begin with) but now has muscle wasting. Vet says it’s very likely lymphoma, and he also has a lot of fluid around his heart and lungs, and she said he definitely has COPD (we don’t smoke, never have… that completely floored me). But due to his age, severe arthritis and all his other issues she suggested the prednisone route.
Courtney, I’m so sorry to hear about your boy. And thank you for sharing your story. This is a great example of why there are no hard-and-fast rules around cancer treatments. Absolutely everything depends upon so many factors! What’s right for one dog might just not be right for another. I hope he stays comfortable for as long as possible.
My dog was diagnosed with Lymphoma 4/1 but was mis- diagnosed for 2 months. I’ve been working with Pet Wellbeing online for holist help. I just purchased Panax Korean Ginsing and wanted to know the correct dosage in drops. I went to 3 vets and all of them told me to put him down because I’m a senior on a fixed income and couldn’t afford Chemotherapy. He’s 22 pounds and 7 1/2 years old. Please help us both, his neck is so swollen and tight, he’s starting to have trouble breathing. Thank you so much Bonnie Allen (818) 746-6392 bonnieallen323@gmail. Com
Hello Bonnie, I’m so sorry to hear about your dog. Dr. Dressler doesn’t specifically recommend ginseng for dogs with cancer, so we have no idea on what the dosing might be. Lymphoma is a very aggressive illness, which is probably why the vets you have spoken to have so little options to offer you beyond chemo (which for lymphoma can be really helpful, quite quickly. It doesn’t necessarily cure it, but can buy you good quality of life for much longer than the illness typically gives.)
I know how much you want to help your dog, and I understand how upsetting it is to be on a fixed income and feel like no one will help you. I would go back to the veterinarian you most liked and trusted and ask them if there is anything else you can do other than chemotherapy to help your boy breathe better.
Having just had to let one of my dogs go last month, I know the abyss you’re facing. I am sending you strength and love.
Molly
Our cocker spaniel, Ebony, has been diagnosed with lymphoma. We have chosen the Prednisone route as she is 13, partially blind and completely deaf. It’s a really hard decision when she is old. If she had been alot younger I would have opted for chemo. My other choices were do nothing, and we couldn’t do that to her, or the dreaded euthanasia. I guess that is the choice we will finally need to make. Anyway thanks for listening
Chemotherapy, fine but my dog has a heart condition and pulmonary condition. Would chemotherapy will be fine still?
Hi Giorgio, you will definitely want to go over all of that with your veterinarian. Pre-existing health conditions will always affect treatments. There is no cut-and-dry answer that applies in every case. So please check with your veterinarian about this for your dog’s specific case.
What if you have a dog that refuses oral meds? I don’t have the money to do what Is
is needed. She easily dehydrates.
Hi Nanci — there are lots of sneaky ideas on how to get your dog to take those meds in this article: https://www.dogcancerblog.com/articles/life-quality/how-to-give-a-dog-pills/