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Golden Retriever diagnosed with Lymphoma
07-06-2016, 03:43 PM,
#1
Golden Retriever diagnosed with Lymphoma
I have an 8.5 year old golden retriever.  Everyone has always said she is the sweetest dog.  She is so gentle and kind and loving.  She's always been small, runt of the litter of 10 puppies.  She's beautiful.  She maxed out at 60lbs.  Over the last few weeks, she wasn't eating as regularly but being summer and hot, we thought that was normal.  Then we started seeing her thin out.  Saw the spine and hip bones start showing.  On 4th of July she was 
45 pounds.  That's 25% of her weight gone in a matter of 2-3 weeks.  Went to vet.  He felt thickening of intestines in physical exam.  Blood tests confirmed what he expected.  Lymphoma.  He suspects in be intestines but where else we have no idea.  Her calcium levels were high and neutrophils, wbc, and platelets all low.   We opted not to do chemo or surgery.   Opted for steroid.  She starts steroids today. And Pepcid for appetite increaser.  No pain Meds yet.  They believe she is uncomfortable but not in pain. She is still eating but prefers steak and rice.  Trying to keep the appetite going.  Anyone else have similar story?   What should we expect?  Was told lymphoma is aggressive and seeing weight loss already may mean only a handful of months.  Hope is steroid will buy us a Few months.  Her muscles are beginning to atrophy in her head.  She seems sluggish but still herself.
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07-06-2016, 05:26 PM,
#2
RE: Golden Retriever diagnosed with Lymphoma
There are two forms of Lymphoma: B-cell, T-cell. The T-cell form does not respond as well to Chemo, as the B-cell type. The T-cell also has a tendency to mestastasize to the intestines more than the B-cell type. Not sure if the standard needle aspiration can distinquish between the 2 types. Probably would need Flow Cytometry. Ask your Vet if you want to pursue, and find out. My 10 yr old lymphoma puppy dog was the B-cell type, and responded well to Chemo (LCOPA protocol), and got a 9 months remission out of it. Spent another 3 months trying to get her back into remission unsuccessfully. The expense was worth the 9 months, during which she had a high quality of life.

The Prednisone alone should give close to a complete remission of 30-45 days. At which point the cancer returns resistant not only to Prednisone, but also the most effective Chemo agents Vincristine, and Doxorubicin. Once Prednisone is given for weeks, Chemo is ineffective if tried later - it's a one way street. After Prednisone becomes ineffective, one could try Elspar. Commonly given as the first Chemo drug in most protocols to provide immediate relief from any swollen tumors. Low toxicity, very expensive, and good for about 3 treatments before the cancer becomes resistant to it.

With the Prednisone palliative treatment your dog will drink more water - a lot more. She might even wee-wee in her sleep. The Prednisone will also increase the appetite. The Pepcid will prevent the Prednisone from irritating the stomach lining, and possibly causing ulcers. My current Leukemia dog is on Prilosec for the same purpose. If the dog's appetite doesn't pick up, you can ask the Vet to prescribe Mirtazapine. Guaranteed she'll dive into her food. If the dog becomes nauseated, without any signs of infection, ask your Vet to prescribe Zantac.

The first week of treatment it isn't unusual for a Lymphoma dog to come down with a severe sepsis infection. The reason being, Prednisone, or any of the Chemo drugs is initially extremely effective in killing the tumor cells, yielding tumor lysis. This means there's all kinds of spilled cell content from the lysed cancer cells, in the blood stream for any bacteria to consume (e.g. glucose, amino acids, etc). Creating a perfect environment for an infection. So be on high alert the first week for infection. If vomiting or sudden weakness and/or depression occurs, take the dog's temperature. If it hits 103-103.5 head for a Vet hospital immediately. Once you get past the first week, the risk of infection goes down till the end. Both the cancer, and Prednisone will suppress the immune system. It probably wouldn't hurt to ask your Vet for antibiotics (Enrofloxacin) up front for the first 10 days as a precaution.

Per feeding, avoid sugars (e.g. ice cream) until the end when it doesn't matter any more. Lymphoma cells gobble up sugars to grow. So much so, the dog gains very little nutrition from sugars. Instead for its carbohydrate needs it starts breaking down fat reserves - thus you have noticed the dog rapidly losing weight. A by product of breaking down the fat is elevated lactic acid (e.g. causes muscle cramps), and makes the dog feel lousy. Omega-3s in fish oil helps to "normalize" lactic acid levels. Also has a mild effect on slowing down Lymphoma (anti-angiogenesis), and mild anti-inflammatory effect. So throw 3-1000 mg pills into each meal. The regular "burp" (as opposed to burpless) type. Your dog will like the fishy taste.

Hopefully your dog will regain a high quality of life for the next 30-45 days.
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07-06-2016, 05:42 PM,
#3
RE: Golden Retriever diagnosed with Lymphoma
Thank you so much for all the information. I have been googling and reading so many conflicting information that it is overwhelming. It sounds like the side effects from the prednisone maybe just as bad as the cancer. ??
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07-06-2016, 05:55 PM,
#4
RE: Golden Retriever diagnosed with Lymphoma
She's been prescribed 20mg twice a day for first 7 days of the prednisone
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07-07-2016, 02:36 AM,
#5
RE: Golden Retriever diagnosed with Lymphoma
Hello,
Wanted to just say I am very sorry about your dog. Dragondawg gave you a very through answer, can't find much to add. A good resource is the dog cancer blog which is managed by veterinary oncologist Dr. Sue Ettinger. The website has lots of resources about lymphoma. This article in particular talks about predisone for lymphoma:
http://www.dogcancerblog.com/blog/common...-too-soon/
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07-07-2016, 07:29 AM,
#6
RE: Golden Retriever diagnosed with Lymphoma
Thank you Jennifer. I appreciate the link.
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07-07-2016, 09:26 AM,
#7
RE: Golden Retriever diagnosed with Lymphoma
(07-06-2016, 05:42 PM)Lifesgood1970 Wrote: Thank you so much for all the information.  I have been googling and reading so many conflicting information that it is overwhelming.   It sounds like the side effects from the prednisone maybe just as bad as the cancer.   ??

No, the side effects of Prednisone are minor compared to Lymphoma.  Left untreated after symptoms appear, Lymphoma can readily cause a very painful ordeal, and kill the dog in 4-6 weeks.  The Prednisone should give your dog a much higher quality of life in the next 4-6 weeks.  It will relieve the inflammatory process of the cancer making the dog feel better, and will stimulate the appetite.  A proton pump inhibitor such as Pevcid or Prilosec will protect against ulcers.

Most of the side effects one reads about Prednisone is from long term use - as in a year or more.  Where long term use can imitate Cushings disease.  The short term use of Prednisone for your dog is unlikely to cause any problems. My CLL cancer dog has been on Prednisone since diagnosis early Nov, in combo with Leukeran at a dose of 20 mg --> 10 mg.  Increased thirst,  and appetite being the side effects after 8 months.

The end for a cancer dog will most likely come in the form of an infection.  Until then, enjoy the added time Prednisone gives, and spoil your dog with affection.
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07-07-2016, 10:34 AM,
#8
RE: Golden Retriever diagnosed with Lymphoma
(07-07-2016, 02:36 AM)Jennifer Wrote: Hello,
Wanted to just say I am very sorry about your dog. Dragondawg gave you a very through answer, can't find much to add. A good resource is the dog cancer blog which is managed by veterinary oncologist Dr. Sue Ettinger. The website has lots of resources about lymphoma. This article in particular talks about predisone for lymphoma:
http://www.dogcancerblog.com/blog/common...-too-soon/

An excellent link in giving an overview of the pros and cons of Prednisone alone. 

As the article states Prednisone is sometimes (rarely)  used in the first week as part of a Chemo protocol.  But never alone. It's withdrawn after the first week if used.   If LG still wants to consider Chemo it's not too late.  But after the first week,  the probability of the MDR pump resistance appearing increases rapidly.  Causing resistance to the two mainstay Chemo drugs for Lymphoma - Doxorubicin, and Vincristine.  Lymphoma will eventually become resistant to these 2 drugs,  but much later within the context of a Chemo protocol.  

If LG still wants to stay with the palliative Prednisone there's still the possibility of using Ellspar, or an alkylating Chemo drug such as Cytoxin to extend the dog's quality of life a little after the cancer becomes resistant to Prednisone.   Where resistance to these two drugs does not involve the MDR pump.  But that's sort of a patch work approach, and inferior to a standard Chemo protocol.  

Note to LG:  If you feel blindsided, and even dazed , then welcome to the Lymphoma dog owner club.  Learn everything you can, as fast as you can.  Then you will be able to ask the Vet the right questions so as to help your puppy dog.
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07-07-2016, 11:29 AM,
#9
RE: Golden Retriever diagnosed with Lymphoma
There is one vet school in town. That does chemo treatments where I live. All vets refer to them for chemo. They are extremely expensive. I would probably be looking at into the 1,000s and they are booked till mid August. My dog doesn't have a regular vet. So the vet that diagnosed her this week. It was the first time he had ever seen her. I can request that he contact the oncology at the vet school. It would be the only way they would even see her. But that's a lot to ask and the cost and wait list to get in are all very big factors. Keeping in mind that she has already lost 25% of her body weight over the last few weeks doesn't make her an ideal candidate for chemo. I love her immensely. Cannot even imagine her being gone in a matter of months. But it's a very expensive slippery slope to go down with not even a good chance she would be a good candidate not to mention the chemo would be tough on her. She likes being at home.
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07-07-2016, 12:45 PM,
#10
RE: Golden Retriever diagnosed with Lymphoma
Through calling around I have learned of another option that isn't as aggressive and more vets administer it. Its Lomustine. Has anyone been given their dog that for Lymphoma and if so, any experiences with it?
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