Dog with Lymphoma :( any vets about?

[TheoriginalLEM]

My mum's dog has just been diagnosed with Lymphoma. I tend to think its quite advanced. He is showing symptoms (lethargic, not eating and losing weight), lymph nodes are massive and grown alot within a week.

The issue is, do we go down the chemo route?

I know this wont cure the dog but could buy him some time?

BUT

He has a bad heart murmur, cardiomyopathy and VPCs (possibly caused by hemangiomas on the spleen). So when we got scripts for vetmedin the vet said just order a month at a time, although he put six months supply on the script to reduce prescription cost. This was because his heart condition could kill him at any time :(

He is 11 years old, with arthritis that requires metacam and tramadol to manage the pain, althoguh he has been without tramadol for a few days and coping so have told my mum to hold off on this for a while.

I know that the vet (my boss - i cover reception as used to work there as a nurse years ago (non qualified) will want to push for chemo but my worry is the cost and the fact that we will only be buying the dog a year at the most??? I pay cost price for my medication but cannot expect this to be extended to my mum's dog and wouldn't ask.

Looking at the prognosis without treatment is pretty grim in terms of time - i wasn't expecting it to be so quick.

With this history WWYD?

He is also quite a stressy dog if you want to do anything wiht him, so stress is a factor for him.

My mother is going to be devestated as she only has the dog and he gets her out and about.

Not a vet but work in the field. Plus I faced the same with my cat.

Honestly? I wouldn't treat, just keep him comfortable and pain free. Better him have a good 6 months than a year suffering. Unless the chemo has no side effects I absolutely wouldn't put him through it.

Only you and your mum can make this decision. Don't think about the time. Length of time is not important to DDog - he has no concept of it. He only has a concept of how he feels now. Can he do the things he enjoys doing, is his life pain free and pleasurable and will it continue to be so. Will he enjoy any additional time you give him or WIL he just be coping as best he can with pain, breathlessness etc whilst you give yourselves time to come to terms with this?
I probably sound a bit brutal but you have to consider whether extending his life will benefit him or you?

It depends on how the chemo treatment will affect him, both in terms of side effects and stress.

I've had a cat on chemo for lymphoma for 4 years, no side effects and she's not bothered by the extra check ups. But, that's a very non invasive form that I believe isn't as succesful in dogs. (Not a vet just a pet owner)

If that year is a good year for the dog then it's worth it, that's my opinion anyway.

Sunshine -i know EXACTLY what you mean. Ive seen it so many times. For now ddog is reasonably happy but clearly not 100%.

we are waiting in fna results although biopsy better his heart wont stand anaesthetic.

poor dog

i think chemo is better tolerated in dogs than humans.

"i think chemo is better tolerated in dogs than humans."

It's given at different doses according to the cat's oncologist...with people you give them high dosages hoping that you can cure it or at least that's usually the case, but with pets it's about extending life without compromising quality.

So with my cat for instance the aim was only ever to get her into some sort of remission rather than trying to actually get rid of it.

It's not worth it for a pet if the treatment makes them ill, it's not fair on them, so it's small doses that will hopefully extend life without them suffering.

It is LEM but get your vet to discuss exactly what kind of chemo and possible side effects. I've seen sudden death in the clinic from idiosyncratic reactions to chemo drugs (rare but happens and very upsetting). However most dogs do tolerate it well.

I guess it's more about what quality of time you'll get rather than duration.

I agree Sunshine.

Since posting my vet rang and said that the met profile run today suggests his kidneys and to a lesser degree his liver are starting to be compromised. The kidney results could potentially make chemo less likely to be well tolerated.

I am leaning towards no treatment, or palliative care only but i feel so guilty for considering this.

Cost is an issue, there might be some concession as i work at the practice but it wont be full concession and my mum doesn't have an unlimited supply of funds.

Also my mum is not coping well with the diagnosis and i worry about how she will cope with the treatment and an unwell dog. She is 80 and in poor health herself. not least a broken back which happened when the dog pulled her over :( Thankfully healed but does aggravate.

The dog is big too, so chemo is going to come in pricey for a 40kg dog.

I hate to think about money but it is a factor.

If i could garuntee the dog a year, pain free and healthy then yes, go for it, but that garuntee isn't on the table.

The alternative of steriods is contraindicated due to his heart condition.

Has the lymphoma been staged this will give you an idea if chemo will benefit the dog stages 1 and 2 do best some stage 3 do well. I wouldn't offer to a stage 4. Dogs don't tolerate chemo better than humans we use lower doses than in humans hence why the side effects are less. Chemo in pets is not about cure ( unlike people).
Be aware that if the chemo protocol includes steroids (preds) this is likely to cause the heart condition to worsen.

Lonecat - thanks. Will the FNA stage it? We will get the results back in a few days but of course it might be inconclusive as he is too poorly for anaesthetic. It is in all palpable lymph nodes, there are lesions(hemangiomas?) on the spleen which we have known about for a bit. So i am thinking that sadly it is quite advanced. I noticed a lymph node enlarged in his hind leg a while back but he had a nasty hotspot on his backside so we put it down to that.

According to what i read on Dr Google, Stage 3 involves all lymph nodes? whilst stage 4 is likely to involve other organs.

All of the protocols I have looked at, and preds, seem to concentrate on slowing down the progression of the disease. What is important for me is making him FEEL better. I can tell he feels unwell and have noticed this markedly in the past few weeks. He will only eat if encouraged, even with tasty treats (although he is incredibly spoilt food wise).

Can you give any indication of time frame without treatment?

Staging involves blood tests as well. Lymphoma is a piece of string I have had an untreated dog with stage 1 survived four weeks and an untreated stage 2 who is still asymptomatic three years later.

Your splenic lesions could be lymphoma too you do see it in the spleen very rarely ( there have only been 6 cases I have been involved in the diagnosis of one of the 6) it can be isolated to the spleen or the spleen can be part of wide spread disease. We removed a spleen with lymphoma from an elderly dog with DCM the other week and actually heart rhythm improved after surgery.

I'm sorry TheOriginalLEM.

I agree re discussing it with your vet. Our first dog had lymphoma a few years ago, we did chemo, but I wouldn't do it again.

We probably had a really negative experience, but basically it made for a miserable few months for our dog. If we ever have to deal with lymphoma again in any of our dogs,I'd just aim to make 'comfortable'.

Bears, i am sorry you had a negative experience. :(

I work in a vet practice occasionally as a receptionist and a few of our patiends are on chemo and the owners seem quite positive about it and ther have been good results, hence my dilemma. However with Ddog's other complications (really bad heart condition, splenic tumours which may or may not be realated to the lymphoma but may be benign? and chronic arthritis) I am probably going to suggest paliative care only to my mum.

It is so difficult because he isn't my dog, i love him dearly but i am trying my best to be objective. It must seem that i am being heartless to my mum. She can't cope with watching him suffer although i think he just feels rough just now, i don't know how long that will be before it changes. The outcome will be the same, whether it is in a number of weeks or a number of months.

My mum will be devestated. I got this dog for my mum when my dad was in a care home with alzheimers, he has since passed away and the dog has been a giant pain in the arse. He didn't stop growing, despite us thinking he would be small collie size (not just me, the vets too _ he was a rescue abandonned at the vets as a tiny puppy. He is the size of a fecking wolfhound now . He has pulled my mum over and she broke her back due to osteoporosis and she wont leave him for more than a couple of hours without me dogsitting . BUT he is my mum's reason for living really. He forces her to go out, is company and a distraction for what is a pretty lonely life for my mum as she is not without her own issues, is quite difficult and consequently NC with most of her family. He is a great dog, funny, loving and the biggest wuss you could ever meet, which actually can make him a bit of a handful if you need to do anything with him. He will lay down on the floor and refuse to move unless you walk the way HE wants to walk, he will do the same if he so much as gets a leaf attached to him on a walk. He lays on the floor while the cat lays on his giant bed :)

He is 11 and i knew he wouldn't go on forever but i wasn't ready for this :(

Oh LEM it sounds as if this is going to be awful for all of you

I know this is a bit premature but don't let your mum refuse to get another dog (assuming she's up to caring for one) a rescue greyhound or whippet makes a great sofa dog and they are very gentle, or a small poodle or one of the toy breeds can be wonderful companion dogs if your mum is a bit frail. Perhaps an older dog though so she doesn't have to go through the crazy puppy time. Dogs are wonderful companions, and a new will help her to heal without 'replacing' your lovely DDog

I dread the day mine leaves me

I've seen many dogs who have had chemo. Some dogs do really well, however I have also seen the negative side. A close friend also did chemo for lymphoma and wished she hadn't.

I don't think there is a right or wrong and it depends on the dog/owner but personally I wouldn't do it to my dogs and would lean towards keeping them comfortable and then PTS.