Our Links contain medical and
technical information concerning the diagnosis and treatment of Canine
Lymphosarcoma. We won’t try to restate or analyze that information here,
but instead offer a few comments.
This is when you confront the fact that your dog is ill. You hand him over looking "normal" and get back a dog with a Mohawk, his sides shaved for the ultra sound. Don’t let the words "Stage V" scare you away. Although our dog was classified as Stage V, he had the advantage of being young and otherwise in good health (with no apparent symptoms other than external lymph node and spleen enlargement at the time of diagnosis). And he had the disposition of a fighter. Berry’s initial prognosis was 4-8 months overall life expectancy; but as of 11/24/01, he has survived and prospered for a year and nine months.
Keep in mind that, even though only a small wound is visible, bone marrow aspiration is an invasive test. Berry was the only dog in recent memory at VHUP to develop an abscess at the test site. The cut healed over quickly and looked ok at his next weekly visit to VHUP. Then, two days later, a golf-ball size abscess mushroomed into being overnight on Berry’s hip, resulting in a weekend trip to the VHUP Emergency Service. When Berry was re-staged, we monitored his bone marrow test site closely.
Check out the Owners’ sites in our Links section. You will see different treatment "protocols". An oncologist will select a protocol based on his or her training, experience and professional perspective; on your dog’s particular type of lymphoma; and, as time passes, on reactions, if any, to drugs used. We haven’t done enough reading (or possess enough experience) to be able to evaluate whether there may be any "single best" way.
Dosages of drugs -- which must be high enough to be medically effective but not so high as to cause unnecessary damage -- are based on general rules. Initial dosages may be adjusted based on the reaction of the individual dog and the cancer. Unfortunately, this part seems to be a sort of educated "trial and error".
You will see in the Links different reactions to the same drugs. Canine oncologists have enough experience with the chemotherapy drugs to be able to treat the side effects, too. Your job is to be observant of every detail of your dog’s life between treatments to report on the timing, duration, and intensity of any side effects.
Vincristine can impair fast growing cells in the digestive tract and slow the passage of food through the stomach and intestines. Berry suffered from vomiting and dehydration following the first administration of vincristine, resulting in two emergency room trips, and IV fluids. Ask your vet if he or she will prescribe metoclopramide or another antiemetic (anti-nausea) drug in anticipation of possible side effects, to be given at the first sign of physical discomfort, disinterest in food, vomiting or changes in bowel movements. In any case, watch for side effects and seek treatment before dehydration occurs – adequate water is very important to a dog in chemotherapy.
Prednisone is commonly used in cancer treatment, initially in relatively large doses, then typically decreasing over time. The initial, high dosage of Prednisone made our dog drink and pee every 2-3 hours (hence, his nickname "Sir Peezalot"). Anticipate this possible side effect – if someone is at home during the day, put your dog on a new schedule for trips outdoors, or, if this is not possible, plan to confine your dog in an area where he can pee when he needs to without doing damage. This problem will probably go away once the prednisone dosage is reduced.
Cytoxan seems like a scary drug for your dog because the instructions make clear it is toxic. You must not touch the pills and must use rubber gloves and carefully dispose of the container. And it is important to keep your dog drinking (and peeing!) during the Cytoxan course of therapy to flush the drug byproducts from his system. Cytoxan can cause bladder irritation in dogs, as discussed in at least one of our dog owner Links. It had no negative impact on Berry.