Species: Dog Breed: chocolate lab Age: 11-15 years
Hershey was diagnosed with lymphoma today. He has two large swollen nodes under his neck and nodes swollen to his hind quarters. He has lost his eye sight presumably from affected nodes behind his eyes according to our local vet. This all happened rather quickly. Due to his age and the fact that he has hip dysplasia, our local vet does not recommend chemo. He presently has trouble walking/standing and has lost his appetite for his regular diet but readily eats steak, burger, etc.
Based on the above, do you agree on not treating and euthenizing? I don't want to give up too early but do not want him to suffer either.
Thanks,
Gary
Dr. Marie replied:
Hi Gary...I am very sorry to hear of Hershey's diagnosis of lymphoma.
Lymphoma can be a very aggressive cancer. Untreated, some dogs succumb to the disease within days or weeks. We can sometimes buy a few weeks of quality time with high doses of prednisone.
It's really hard for me to advise on whether to euthanize without knowing Hershey. I can tell you though that lymphoma is a type of cancer that sometimes can respond to chemotherapy. Do you live in or near a major city? If so, you can ask your vet for a referral to a veterinary oncologist. These vets specialize in cancer and can give you a good idea as to what Hershey's chances are.
Dogs usually tend to handle chemo very well. They don't tend to get the side effects that people do. However, if Hershey has other age related problems such as kidney or liver disease he may not be able to handle the chemo medications.
Another factor is if Hershey is on arthritis medication such as Rimadyl or Metacam he would have to come off of this medication in order to go on the prednisone that is a part of the treatment. If he has really severe arthritis it may not be fair on Hershey to stop these meds, so this might be a factor in your decision making.
If your vet is not experienced in chemotherapy and there is no referral center close by for you to go to you can ask your vet about ordering in a medication called cyclophosphamide. It is a chemotherapy in a tablet form. Cyclophosphamide plus prednisone can sometimes give a dog with lymphoma several months of good quality life.
At any time if he is not doing well (i.e. not wanting to eat or having difficulty getting around) you could make the decision for euthanasia.
Another option if you are not convinced that it is time for euthanasia is to see another vet for a second opinion.
I hope this information helps. These decisions can be tough!
Dr. Marie
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Customer reply:
Thanks for the info. He is on previcor for the hips, 228 mg. We live about 2 hours from Boston and could seek treatment but as you say he would have to come off the arthritis medication and that would not be good for him. We feel very badly and his eye sight I am told won't come back.
Gary
Dr. Marie replied:
You're very welcome.
Yes, if he is on Previcox he would likely need to come off of that to go on chemo and if he has severe arthritis this could be difficult for him.
If lymphoma has affected his vision there is a chance that he will not regain that as well.
It may be worthwhile to take a trip to Boston to get the specialist's opinion. However, with what you have told me it is sounding like the kindest thing for Hershey may be to consider euthanasia.
If you did decide to do chemo he may need several repeat visits to Boston, so you would need to factor that in to your decision.
This is really a tough call. In most cases though, if your vet is recommending euthanasia it is probably the right call. We never want to see an animal go through more than they have to.
I wish I could give you a more concrete answer! These decisions are never easy. I do find though that most of my clients just "know" when it is time to make that decision. If you are really not sure then the trip to an oncologist would be the best thing. These vets see all sorts of cancer cases and can really give you a good indication of how well Hershey would be expected to do.
If you want to see the oncologist this would be something that you would likely need to be referred by your regular vet for.
I hope this helps you to decide!
Dr. Marie.
Customer reply:
Thank you, you have been very helpful...now to search the head over the heart.
Dr. Marie replied:
You're very welcome Gary. I pray for wisdom for your family in making these hard decisions!
Veterinarian, Dr. Marie created this site to be able to provide quick, accurate veterinary advice online. She would love to help with your pet's problem!
Dr. Marie is a veterinarian who practices in a busy animal hospital in Ottawa, Ontario. She created Ask A Vet Question as a resource for good, accurate veterinary advice online. Dr. Marie treats dogs, cats, hamsters, guinea pigs, and rats. She has been a vet since 1999.
Is an online vet visit just as good as a trip to your veterinarian? No! But, many times, asking an online veterinarian a question can help save you money. While Dr. Marie can't officially diagnose your pet or prescribe medications, she can often advise you on whether a vet visit is necessary. You can also ask Dr. Marie for a second opinion on your pet's condition.