Dear OncoLink "Ask The Experts,"
Our dog Foxy is 13 years old although she gives the appearance inside and out of a much younger dog. She was diagnosed with stage one lymphoma. She was in remission and on maintenance protocol. She did great and her quality of life was excellent.
At our visit last week, we found that the cancer is back. The two protocols that are being considered. I know the drugs this time are a lot harsher. She did well before, is that an indication she will do well this time? Will her quality of life be better with one treatment over another?
My wife and I have three year old triplets and they understand Foxy has been sick. Eventually this disease will take her from us and we will have to explain her death to the kids, which is another advice question for you regarding where to find some information on explaining this to our kids.
Foxy enjoys life so much and we want to give her every opportunity to do that as long as she has a good quality of life.
We are looking for direction and support.
Lili Duda, VMD, Section Editor of the OncoLink Veterinary Oncology Menu, responds:
When it comes to treating cancer in companion animals, there are no "right" or "wrong" answers. Rather, there are treatment options, each with their own advantages and disadvantages. The medical information (such as the risk of serious complications and likelihood of a favorable response) is only one factor that needs to be considered. Other factors are personal and include such things as the number and frequency of trips to the veterinarian that will be required, cost of the treatments, and the management of side effects such as vomiting/diarrhea, urinary incontinence, or loss of appetite and energy. In addition, every owner needs to keep in mind that a veterinarian can only talk about the "average" or "typical" patient. There is always a chance that an individual dog or cat might do much better than usual, but it might also do much worse than usual, and there is no way of predicting beforehand which way the treatment will go.
For canine lymphoma treatment, as a very general rule of thumb about one half of patients will go into a second remission, and this remission will generally last about one half as long as the first remission. Treatment is usually (but not always) more time intensive and has more side effects than the initial treatment protocol did.
Beyond these generalities, the veterinary oncology specialist who is managing your pet's care is the person best able to discuss the treatment options, side-effects, costs, etc. with you and help you decide which treatment decision (including the decision not to continue with chemotherapy) is the best option for you, your family, and your pet.
As far as the difficult task of explaining this to your children, there is a good website available called the Pet Loss Support Page. Here you can find a document called “Ten Tips on Coping with Pet Loss”. Tip number eight concerns children.
Best of luck to you and your family.
Dec 7, 2010 - Rituximab may be a better option than watchful waiting in some lymphoma patients, and a new treatment option appears effective for relapsed or refractory Hodgkin's lymphoma, according to two studies being presented at the annual meeting of the American Society of Hematology, held from Dec. 4 to 7 in Orlando, Fla. Other research being presented will highlight new options for the standard treatment of advanced asymptomatic follicular lymphoma; mantle cell lymphoma; and early, unfavorable Hodgkin's disease.