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Dr. B.
Dr. B., Board Certified Veterinarian
Category: Vet
Satisfied Customers: 21747
Experience:  General practice veterinary surgeon with extensive experience in a wide range of species.
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Good morning, I am a passionate dog lover and completely devoted

Customer Question

Good morning, I am a passionate dog lover and completely devoted to my Standard Poodle, for whom a long, happy and healthy life is all I wish for.
I have just, completely out of the blue, received confirmation that he is suffering from lymphoma, and I am desperately anxious to make the right decision for my dog regarding treatment.
I am currently awaiting to learn whether his cancer is 'B' or 'T' type, and I have been advised that the more likely result will be 'B'.
If that is the case, should I subject him to the rigours of chemotherapy, with a 50% at best chance of reaching remission, or administer steroids for the last few months of his life - they are my options.
In helping me to make the right decision for my dog's best interests, it would be very helpful to learn whether chemotherapy is a kind and effective option, or whether I will be guilty of unkindly asking my poor dog to suffer, without a great deal of quality of life to follow.
I am desperate to make the right decision for him, and if I could gauge the likely degree of effectiveness of chemo, it would help me make the right decision . Cost and access to veterinary surgeries are not a problem, but my own emotions and love for my dog, sadly are.
I AM DESPERATE TO KNOW WHAT TO DO FOR THE BEST
Please help!
Submitted: 2 years ago.
Category: Vet
Expert:  Dr. B. replied 2 years ago.

Hello & welcome, I am Dr. B, a licensed veterinarian and I would like to help you with today. I do apologize that your question was not answered before. Different experts come online at various times; I just came online, read about your wee one’s situation, and wanted to help.

I am very sorry to hear that Charlie has been diagnosed with lymphoma and do hope his cancer typing confirms B-cell lymphoma (as this one has a better prognosis compared with T-cell). Furthermore, I do hope that his pathology report finds that his cancer is not a particularly aggressive or rapidly progressing one.

Now in regards ***** ***** treatment decisions and considering chemotherapy, this is a very individual decision for both you and your dog. To start, the first consideration is Charlie. If he is a dog that stresses going to the vets or being handled, then right off the bat chemo may not be the best option for him. That said, if he doesn't find vet visits too much bother and you have access to a good oncology or general vet team, then this is worth considering. (In fact, many of my own patients, actually look forward and are happy to come stay for the day for their chemo..and lots of cuddles and treats).

Now I suspect the reason a lot of people are torn when deciding on chemo for pets is because they consider this treatment in terms of how it is used in people. In medicine, human patients are subjected to aggressive treatment to achieve a cure. This means that they often will face hair loss, nausea/sickness, and feel generally poorly during treatment. But since our patients cannot understand suffering for a cure at the end, this is not a regular feature of chemo therapy treatment in pets. Instead, our treatments are palliative and aim for remission. That way we can have good quality time with them all through treatment and for as long as they are with us. And as lymphoma is one of the more chemo responsive tumors, this can be quite a significant amount of time (where the average life span with chemo for lymphoma is ~8-10 months+ as opposed to the month or two reported with steroid use alone).

Overall, this is a very personal decision for both you and Charlie. You need to consider whether regular visits to the vet would be something he would find daunting. If it is, then the stress may not be worthwhile for him and steroids the better option. Otherwise, as this tends to be one of our more chemo responsive cancers and with our treatment approach to help reduce cancer load and remission without causing them to feel poorly, we'd expect the treatment to be worthwhile and not cause any suffering. And of course if he did have any issue (stress or was poorly at all), the treatment could be stopped at any point.

So, it will be a case of seeing what the pathology results have to say about this cancer's type and then considering if Charlie would be a dog that would accept regular vet visits for chemo. If all is in our favor, then chemo would be a good option to consider for him as it can give us a good quality of life and time with him.

Please take care,
Dr. B.

Customer: replied 2 years ago.

Dear Dr. B,

Thank you for your reply, which I have found to be very balanced and helpful, and when I have received a response to my brief follow up questions, I will be able to rate your service fully.

I have been advised that dogs suffer symptoms of diarrhoea, vomiting and for dogs such as mine, significant hair loss.

a) From your experience , how significant usually are these symptoms - in other words is Charlie likely to suffer much distress in undergoing the treatment? and

b)from your experience, is 50% a likely success rate, following this treatment? and

c)does the typical lifespan you have quoted, i.e 8-10 months+ , include the 15 week chemo treatment period that I have been advised for Charlie?

Thank you very much so far.

Expert:  Dr. B. replied 2 years ago.
You are very welcome, Jeremy.

In regards ***** ***** rates, I find the figure to be higher with my patients (especially in non-agressive B cell lymphoma). As well, while we do see remission and survival times vary between individual (which is just the same in people), we do find some will pass that average (and I have had a few do well for a year or more with chemo). In all cases though, when we consider survival times that does include the period of treatment.

In regards ***** ***** effects and treatment failure, if these are going to be issues we tend to see these arise early in the treatment phase (which if severe for your lad would be an indicator to potentially stop treatment at that point). Otherwise, generally speaking the majority of the dogs I have worked with have tolerated the medications well or we have managed any adverse signs with symptomatic treatment. For most, those adverse signs don't tend to be severe (again since we are not using high doses as in human medicine) and any that had signs settled with anti-nausea treatment. So, while the risk of adverse signs is a concern for any treatment, I wouldn't say those potentially seen with chemo would be severe enough to be a reason to avoid treatment all together. But if we did have a particularly sensitive dog and we were worried, then pre-treating with gastroprotectants or possibly halting treatment if an issue did arise would be our usual course of action since the benefits often outweigh the potential of these risks.

All the best to you both,
Dr. B.
Dr. B. and other Vet Specialists are ready to help you
Customer: replied 2 years ago.

Dear Dr.B

Thank you very much for your very clear and helpful (and thorough) replies.

Kind Regards,

Jeremy

Customer: replied 2 years ago.

Dear Dr. B,

Thank you very much for your clear and very helpful and thorough replies.

Kind regards,

Jeremy

Expert:  Dr. B. replied 2 years ago.
You are very welcome,

I wish you both the best and my thoughts are with you,
Dr. B.