here's what you need to know.Lymphoma in dogs
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Lymphoma in Dogs–Background
The first thing that we’re going to tell you is that you are not alone. Here at NaturalPet.Health, we can help you — so let’s get started.
Lymphoma in dogs can take many different forms. The most common is generalized lymphoma, which causes swelling of the lymph nodes that can be felt and seen through the skin. Less common forms include cutaneous lymphoma, which creates oozing skin sores, and several forms of “internal” lymphoma which can cause difficulty breathing, vomiting, or diarrhea.
High grade generalized lymphoma occurs in about 80% of cases, but there is also a less aggressive, “indolent” form of lymphoma that has a much longer survival rate… even without chemotherapy. This form is characterized by waxing and waning lymph node enlargement, typically of the head and neck.
While lymphoma can affect any type of dog, large breeds such as Boxers, Retrievers, and Shepherds are most commonly affected.
ARE ALL TYPES OF LYMPHOMA IN DOGS CREATED EQUAL?
There are two basic types of lymphoma, B cell and T cell. About 2/3 of lymphoma cases are of the B cell type, which carries a better prognosis than does T cell lymphoma. Dogs with B-cell lymphoma will generally live longer than those with T-cell lymphoma.
The only way to distinguish between B and T cell types is with specialized testing called flow cytometry or immunohistochemistry (IHC). These are tests done on blood samples or lymph node biopsy, and typically cost about $500.
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natural ways to slow lymphoma and prolong your pet’s comfort
Lymphoma in Dogs–Holistic Therapy
Listen, there are no good studies supporting the use of integrative therapy to help dogs fight lymphoma. Never have been, never well be… because the funding just isn’t there. However, that does not mean that such therapy has no benefit for our dogs in their journey through cancer.
- Our bias toward integrative therapy for canine lymphoma includes these facts:a) barring the occasional miracle, there is no medical cure for lymphoma
- there is VERY solid evidence supporting the use of integrative therapy in humans (see below)
- and if we can benefit our dogs in their fight against cancer… in any way… without side effects, then we should.
There are two good resources that will enable you to do your own research on natural therapies:
HERE ARE SEVEN NATURAL WAYS TO FIGHT LYMPHOMA IN DOGS– Each proven in multiple human Non-Hodgkins lymphoma studies, as listed on GreenMedInfo.com. These are listed in order of proven benefit.
The Simplest drug therapy for lymphoma
Lymphoma in Dogs–Prednisone Therapy
Because of the poor long term prognosis associated with lymphoma in dogs, regardless of treatment, some pet lovers opt to keep things simple by treating their dog with prednisone alone.
Because lymphoma is a cancer of the immune system and prednisone suppresses that immune system, patients generally respond for a variable period of time before the lymphoma progresses.
The advantage to this therapy is that it is cheap and is effective for a variable period of time. The disadvantage is that the high doses of prednisone that are required generally create side effects like panting, extreme appetite, and thirst.
Please understand that prednisone therapy may interfere with the effectiveness of rotationsl chemotherapy, so don’t start it if you are still deciding about the best alternative for your pet.
the most aggressive therapy for lymphoma in dogs
Lymphoma in Dogs — Chemotherapy
The most common recommendation for aggressive treatment of lymphoma in dogs is ROTATIONAL CHEMOTHERAPY, where a rotation of four oral or injectable drugs is used to kill any rapidly-dividing cell in the body.
This protocol is usually called the CHOP protocol (an acronym of the ingredients) or the Modified Wisconsin protocol, since that is where it was refined.
The chemotherapy drugs — L-asparaginase, vincristine, Cytoxan, prednisone, and doxorubicin — are usually given on a weekly basis for a period of several months. Each drug works to kill the lymphoma cells in a different way, and the drugs are alternated to delay the onset of lymphoma cell resistance and hopefully reduce the incidence of side effects.
DRAWBACKS to Rotational Chemotherapy:
- The injectable treatments are typically given at a cancer specialty clinic, which may mean 12-16 long road trips. Here is a link to cancer specialists in the US.
- Because the drugs kill all rapidly-dividing cells, cancer or not, we can run into the typical side effects of vomiting, diarrhea, nausea, and bone marrow suppression.
These protocols can be modified to fit the needs of a patient and their family. In some cases, logistics, patient response, or cost can dictate the use of just one drug, that can sometimes be given orally at home.
Recheck examinations and blood work are performed regularly during treatment to ensure that dogs are tolerating and responding to their protocol well, and that it is safe to proceed with subsequent treatments.
Most dogs with generalized lymphoma that are treated with a multi-drug (CHOP) protocol typically respond well, with 80-90% of them achieving clinical remission for some time. A REMISSION IS NOT A CURE, but rather represents the temporary disappearance of clinically detectable cancer. Very few dogs are truly cured of their lymphoma with treatment. The majority of patients will relapse at some point, at which time they may be treated with a different chemotherapy protocol. In general, the duration of these second and other subsequent remissions tend to be shorter than the first remission.
While every patient is an individual, The average survival for canine lymphoma patients with multicentric disease who are treated with chemotherapy is approximately 8-12 months.
One recent study (Brodsky and pals) on the treatment of T cell lymphoma in dogs used a slightly different protocol called L-MOPP for its ingredients, and achieved a remission rate of 78%, overall survival of about 9 months. Here was an unexpected finding– about 20% of these dogs survived for over 3 years!! Do the research.
a new approach
Lymphoma in Dogs — Metronomic Chemotherapy
METRONOMIC THERAPY is a new approach that relies on small doses of one to two chemotherapy drugs given orally by owners at home. The incidence of side effects is generally very low because of the smaller doses used more frequently. This approach has been studied extensively in other forms of cancer, and is actively being researched for lymphoma.
Dogs and cats with resistant lymphoma or with families who cannot afford the routine chemotherapy protocols may receive metronomic chemotherapy, although the benefits are anecdotal and published data for benefit is lacking. It is important to know that using metronomic therapy for lymphoma patients is not intended to induce remissions. It is best to use metronomic therapy following induction protocols (like CHOP, above) when the patient is in clinical remission. Using continuous low dose cytoxan, chlorambucil, melphalan, procarbazine, and/or dexamethasone may be helpful in sustaining longer remissions or partial remissions.
Lymphoma in Dogs — Emerging Treatments
NEW THERAPIES FOR LYMPHOMA include targeting JUST the cancer cells with Tanovea or priming the patient’s own immune system to fight the lymphoma with an Autologous Cancer Vaccine.
A) AUTOLOGOUS CANCER VACCINES: A new approach to fighting cancer with solid tumors (like the enlarged lymph nodes of lymphoma patients) is to surgically remove tumor tissue and use it to actually formulate a vaccine against the tumor cells. This is the most natural way to fight cancer, as the resultant vaccine is very specific for the patient’s tumor type. The lead researcher is a very well respected cancer immunologist on the human side, who chose to devote his effort to our dogs after his own dog developed cancer. We can help you with this!!
B) TANOVEA is a new drug in the veterinary field. Unlike traditional chemotherapy, which targets and attacks ANY dividing cells in the body—hence the side effects of hair loss, nausea, etc—Tanovea preferentially targets and attacks only the cells causing lymphoma. It is effective in 60-80% of cases of lymphoma, and works best with B cell types which have not previously undergone chemotherapy. It is given intravenously, every three weeks..
Kevin Toman, DVM
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