When looking at treatment options for your dog, it’s important to remember that every dog, and family, is different.
Your vet will guide you through the options, and be with you each step of the way - this is not something you have to do alone
You have the option not to treat if you feel that is best for your dog.
Treatment options are palliative, there is no cure. They aim to cause a temporary remission of the lymphoma.
Treatment can be adapted as we go along - but if steroids are started alone, we can’t then progress to more intensive treatments.
As difficult as it is, it’s important to think about End of Life Care; your vet will prefer to discuss this with you sooner rather than later.
What are the options?
Firstly, there is no hard and fast rule when it comes to this difficult decision. Your vet will discuss the options with you - every single case and patient is very different so they will work with you to find the best way forward for you and your dog, at that time.
The options range from opting not to treat, right through to referral to a specialist cancer vet. The main thing to consider will be the quality of your dog’s life; the treatment option you choose initially may not be the one you carry on with. At every step of the way through treatment decision-making we will want to consider how you and your pet are coping, and we will make opportunities to reassess and change tactics if necessary. .
When might we choose not to treat?
If your pet has become very poorly very quickly and we find out that they have lymphoma, we may decide the kindest thing to do is to take them home and spoil them for a week or a weekend before a planned euthanasia. Very poorly pets may not respond well to treatment and sometimes even trying to give them medications to keep them comfy can be challenging if they are very unwell. We need to consider how your pal is in themselves and although it is an incredibly difficult decision to make, sometimes letting our beloved pets go to sleep is the kindest option for them.
Palliative steroid treatment
The most basic option is steroid treatment. Your vet will probably have a lengthy chat with you before making the decision to opt for steroid-only treatment. Steroids can be used to suppress the cancer by acting on the immune system, which is a very basic form of chemotherapy..
We may choose a steroid-only treatment for lymphoma in cases where pets are very elderly or their temperament means they wouldn’t deal well with being in hospital for more intensive, injectable chemotherapy treatments.
Once we start with steroids though, we usually can’t go back on the decision to avoid more intensive treatments - this is because once steroids are in your dog’s system they will usually not respond to other types of chemotherapy. Following a steroid-only treatment plan we can typically expect our patients to have a good quality of life for about 3-12 weeks.
The more intensive chemotherapy treatments may seem a scary prospect initially. Most of us will have experienced chemotherapy in some form or another in our lives - be it ourselves or a friend or family member undergoing treatment. Chemotherapy in people is a scary thing, and usually comes with significant side effects. The good news is, side effects are much less of a problem for our dogs undergoing chemotherapy. Because we cannot explain what is happening to our canine patients, and it’s harder for them to let us know how they feel, we cannot use such high doses of chemotherapy in veterinary medicine - it wouldn’t be fair. We still use human medications, but at much lower doses; this is why in people we can gain a cure, whereas in our canine patients we aim for a temporary remission.
Chemotherapy may be able to be carried out at your usual veterinary practice if they have the facilities and team members to do so, or you may be offered a referral to a specialist cancer vet. You can expect your pet to be taking a wide range of tablet medications and to need to go into the clinic regularly either for treatments or blood tests to assess how things are going. Your vet will prepare you for any unwanted side effects, and if they occur then it is likely that the treatment plan will be adjusted in order to reduce these.
Using a more involved chemotherapy treatment can increase the amount of good quality life for your dog to between 6-18 months.
At My Dog Doc we understand there is a lot to take in when your dog gets a cancer diagnosis. We are always happy to work alongside your regular vet to offer advice and reassurance, and the opportunity to talk it all through.