Lymphoma In Dogs

Lymphoma (LSA) is a complicated cancer with several different types. Its ability to spread throughout the lymphatic system means it’s an aggressive cancer that’s hard to treat. 

What Is Lymphoma In Dogs?

Lymphoma is cancer of the lymph nodes and lymphatic system. The lymphatic system includes the lymph nodes, lymphatic organs like the spleen and tonsils, and the lymphatic vessels. Lymphoma may be localized or spread to the whole body. 

Lymphoma occurs in T-cells and B-cells, which are part of the immune system, where they fight bacteria, viruses and other foreign invaders. In lymphoma, either or both of these cell types become cancerous and stop functioning normally. B-cell lymphoma is the most common type in dogs. 

How Common Is Lymphoma In Dogs?

Unfortunately, lymphoma is one of the most common cancers in dogs, affecting 15-20% of dogs who get cancer. 

What Causes Lymphoma In Dogs?

There can be many causes of lymphoma in dogs. These include …

• Breed predisposition (see below)
• Poor diet
• Pharmaceuticals – over-vaccination, pest protection, some medications
• Spay/neuter – shown to increase lymphoma risk in several studies
• Autoimmune thrombocytopenia – shown to increase lymphoma risk in one study
• Herbicides  – a 1994 study showed dogs exposed to herbicides are at higher risk, although a subsequent study failed to confirm the line
• Electromagnetic radiation exposure – including living near high voltage power lines
• Proximity to industrial areas
• Exposure to paints or solvents

Types Of Lymphoma In Dogs

Lymphoma in dogs is the same as non-Hodgkin’s lymphoma in people. There are several different types of lymphoma in dogs. 

Multicentric (systemic) lymphoma. Lymph nodes throughout the body are affected, and this represents about 80-85% of cases..

Alimentary lymphoma. Alimentary lymphoma is the next most common lymphoma and it affects the gastrointestinal tract.

Mediastinal lymphoma.  This is a rarer type of lymphoma that affects lymphoid organs in the chest.

Extranodal lymphoma. As the name suggests, extranodal lymphoma in dogs affects organs outside the lymphatic system, such as the eyes, skin, lung, kidney or nervous system. It’s less common than other types of lymphoma in dogs.

Breeds At Risk For Lymphoma

Studies show some breeds are genetically predisposed to lymphoma …

• Rottweilers
• Otter Hounds
• Bullmastiff 

Other breeds that have higher lymphoma risk include … 

• Boxer
• Basset Hound
• St Bernard
• Scottish Terrier
• Airedale
• Labrador Retriever
• Golden Retriever 

Intact females are at lower risk for lymphoma, as are these breeds …

• Dachshund
• Pomeranian
• Pekingese
• Toy Poodle
• Chihuahua
• Brittany Spaniel 

Signs Of Lymphoma In Dogs

The first sign of most lymphomas is enlarged lymph nodes that can be felt under the skin in places like jaw, in front of the shoulder and behind the knee. These feel firm and can be moved around under the skin, but are generally not painful in early stages. Swollen lymph nodes due to lymphoma will grow quickly in days or weeks. 

Other symptoms may be …

• Skin lesions (skin lymphoma)
• Coughing or trouble breathing (lymphoma in lungs or chest)
• Weight loss
• Lack of appetite
• Lethargy
• Vomiting
• Diarrhea
• Fever

Routine bloodwork may also reveal signs of lymphoma, such as elevated calcium levels.

If your dog shows any of these symptoms, see your vet right away, as early diagnosis allows treatment to begin right away. Lymphomas are usually fast-moving so quick action may improve your dog’s prognosis. 

How Vets Diagnose Lymphoma

Usually when there’s a suspicious swollen lymph node, vets will recommend fine needle aspirate. Opinions differ over the risks involved, because of the likelihood of needles disturbing cancer cells and causing them to spread. If it’s possible, sometimes it may better to remove a lump surgically to biopsy it.

Imaging such as ultrasound may help reveal abnormal organs, which vets will follow up with aspirate or biopsy using different techniques.

Other tests may include blood work, urinalysis, chest X-rays,, immunophenotyping (to find out if B-cells or T-cells are malignant) or sometimes a bone marrow test, or a canine lymphoma test (CLT) that detects lymphoma biomarkers in the blood serum. 

Prognosis For Lymphoma In Dogs

Conventional treatments aim to achieve remission and not cure. The likelihood of success will depend on a number of factors, such as whether the T-cells or B-cells (or both) are affected.  Treatment is usually more successful in dogs with B-cell lymphoma. The prognosis is worse if the dog is already experiencing clinical signs of lymphoma such as diarrhea. vomiting. weight loss, or lethargy.  

Although the steroid prednisone is often used in lymphoma treatments, if a dog is already on prednisone at diagnosis, it worsens the prognosis. 

The stage of lymphoma at diagnosis also affects the prognosis. 

Lymphoma Staging

These are the staging definitions for lymphoma in dogs. In general, the higher the stage, the worse the prognosis, but that’s not always 

Stage I: one lymph node is affected

Stage II: multiple lymph nodes affected, on the same side of the diaphragm

Stage III: multiple lymph nodes affected, on both sides of the diaphragm

Stage IV: liver and/or spleen are involved (with or without Stages i-III)

Stage V: bone marrow and/or blood or extranodal organs are involved

Conventional Lymphoma Treatments

There are several chemotherapy protocols for lymphoma, but the one that’s considered most effective in nearly every case is the University of Wisconsin “UW-25” CHOP protocol.  It’s an expensive multi-drug protocol that lasts 25 weeks, usually with treatments every week, at least for the first 2 months. 

Oncologists claim that 90% of dogs go into remission within the first few weeks of this protocol,  with remission lasting 4-6 months. The protocol can be repeated when there’s a relapse and about 70% of dogs go into a second remission. The protocol is less effective for T-cell or Stage V lymphoma or for dogs who already have significant clinical symptoms.

About 50% of all dogs on the CHOP protocol survive 12-14 months from the start of the treatment. Of dogs who survive 1 year, 20% will live as as long as 2 more years. 

Treatments are given intravenously and require your dog to go to the vet clinic for each treatment. The cost of this protocol is around $5,000 to $7,000 for the first 6 months. 

Other Chemotherapy Protocols
There are other less expensive, single drug protocols. These usually cost less, but have lower success rates. However, with some protocols, dogs need to continue treatments even when they go into remission, so, depending on survival times, that can increase the cost significantly.

Chemotherapy Side Effects

Veterinarians claim that chemotherapy side effects in dogs are milder than in people. In most cases they can be managed at home, but some dogs may need hospitalization for fluids, antibiotics and anti-nausea injections. 

These are some side effects your dog may experience ,,,

• Lethargy/fatigue
• Appetite loss
• Nausea
• Vomiting
• Diarrhea
• Reduced white blood cell count, which can lead to infection and fever

Most dogs don’t lose their hair like people do with chemo. 

Additional Treatment Considerations

When treatments last longer, they become less effective because the surviving cancer cells become more resistant to chemo drugs. So, for example, in the CHOP protocol, the chances of remission from the second treatment is lower than the first, at 50%, and the second remission is usually about half as long as the first. 

Other than cost and prognosis, another factor in your treatment decision may be your dog’s quality of life during treatment. Consider how your dog will handle the stress of going to the vet’s office for treatment every week or 2 weeks, and experiencing uncomfortable side effects that may require hospitalization. With the CHOP protocol, after a few months remission, your dog may have to start over with the 25 week treatment. And with other protocols, treatment may continue ever if he’s in remission. 

If your dog has a large tumor burden, consider your options very carefully, Chemotherapy can be especially dangerous for these patients. The first chemotherapy treatment can cause something called acute tumor lysis syndrome, within 48 hours of the first treatment. The chemotherapy causes large number of cancer cells to die, and the body gets overwhelmed by the release of metabolic byproducts from the cells into the bloodstream. This leads to severe symptoms including heart arrhythmia, renal failure and breathing problems. Some oncologists will recommend hospitalization after the first treatment to manage these effects and give IV fluids to flush out the toxins. 

RELATED:  Questions to ask your vet before deciding on chemotherapy …

Bone Marrow Transplants

There’s another conventional option, and that’s a bone marrow transplant. Only a few places offer it, including North Carolina State University. The cure rate is unknown because the treatment is still new, although NCSU says this on their website: 

Cure has been obtained in 33% of B cell lymphomas and 19% of T cell lymphomas, although the dogs should be in clinical remission before the transplant is performed.”

Note that your dog must already be in remission to qualify for this surgery, so he’ll have to go through 2-12 months of chemo before beginning the treatment. 

The treatment is complicated, risky and very expensive, costing around $17,000 (not including prior chemotherapy). The process outlined below requires 2-3 weeks of hospitalization and dogs must be isolated because of infection risk, as the treatment removes all white blood cells and platelets.  

1. First, 2 weeks of very high doses of chemotherapy to clear lymphoma from the blood

2, Next, 8 days of Neupogen medication to remove healthy stem cells from the bone marrow. This is called leukaphoresis and it’s 95% fatal if dogs don’t immediately have a bone marrow transplant afterwards.

3. Bone marrow transplant.

4. Total body radiation to kill all lymphoma cells. 

5. Re-planting of healthy stem cells into the bone marrow (done via a vein).

NCSU’s claims that ““Overall, patients tolerate this therapy well, although this is an aggressive therapeutic option with risks from anesthesia, radiation side effects, and infection.”

Natural Treatment Options

The first thing to do is to find a holistic practitioner with cancer treatment experience. Look for a really skilled homeopath, herbalist (Western or Chinese) or other holistic vet. The best choice will be a practitioner who’s already achieved results with other dogs. 

You may want to join online dog cancer forums where you’ll find people with firsthand experience of managing lymphoma in their dogs. 

There are many natural cancer treatment options, depending on what type of holistic practitioner you’re working with. The big benefit of the natural options is that in most cases they’ll preserve your dog’s quality of life and side effects are unlikely. Some natural therapies can be combined with conventional options.This approach may lower the risks of side effects and increase treatment efficacy. You may consider a combination of options like …

• Western herbal therapies
• Chinese herbal formulas
• Homeopathy
• CBD
• Curcumin
• Medicinal mushrooms
• Mistletoe (studies show survival, remission and quality of life benefits)
• Ozone therapy
• Other supplements

Charles Loops DVM, who specializes in treating cancer with homeopathy, says this about lymphoma. 

“Homeopathic treatment of lymphoma can provide remission in perhaps one in every four or five cases, but with much less expense, no negative side effects, no stress, and few vet visits, if any (telephone consultations are always possible). The length of remissions when treatment is successful can completely parallel those of Western medicine. Homeopathic treatment used in combination with chemotherapy has provided some of the most successful outcomes I have seen, and homeopathic remedies can also help with the side effects of chemo, increasing the overall quality of life.”

Dr Loops (and other homeopaths) will select homeopathic remedies to suit your dog’s individual constitutional symptom picture, and also recommends a number of supplements described in this article about vet-recommended supplements for cancer. 

Steve Marsden DVM, ND, MSOM, Lac. Dipl.CH, CVA, AHG cites a number of success stories, with patients going into complete remission and living normal life spans. 

Dr Marsden emphasizes (as do other holistic practitioners) that real food diets must be part of successful holistic cancer treatments. He’s found in doing clinical studies that if you’re going to treat cancer holistically. you have to feed a fresh food diet to have a hope of success. 

Dr Marsden finds that lymphoma sometimes calls for a blended approach of very mild chemotherapy treatments with holistic therapies. In his practice he will start with all natural therapies but be ready to add some chemo if he feels the patient needs extra help. 

Dr Marsden’s lymphoma treatments will likely include LSA Combination Formula (any vet can order it at atimetohealherbs.com), This was formulated by Dr Marsden and integrative oncologist Erin Bannink DVM Diplomate ACVIM (oncology). and it’s been used effectively in Dr Bannink’s clinic for about 5 years.  It’s a combination based on the Chinese herbal formula, Minor Bupleurum, and it’s a good option if you don’t want to use chemotherapy. 

Supplements that Dr Marsden gives all cancer patients include … 

• Omega-3 fatty acids in very high doses
• Garlic (helps direct omega-3s into anti-inflammatory pathways)
• Turmeric/curcumin (for its many anti-cancer mechanisms)
• IP6 (use human dose)
• Six Gentlemen (also sold as Six Gentle Pets) a Chinese herbal formula which helps slow the onset of cancer cachexia (a frequent effect of cancer leading to dangerous weight loss)

Judy Jasek DVM specializes in treating cancer holistically. Her approach is to support the patient’s overall healing ability and “let go of the notion of fighting the cancer.” This ensures the best quality of life for as long as possible, so that your dog is still playing, eating and interacting with the family.

Dr Jasek’s protocols include …

• Fresh food diet with fewer ingredients 
• Avoid synthetic supplements
• Minimize medical procedures and surgeries
• No vaccines
• Minimal pharmaceuticals
• CBD oil
• Turkey tail mushrooms
• Essential oils like frankincense with proven anti-cancer effects
• Ozone that provides oxygen for the body, supporting the immune system and slowing cancer growt
• Mistletoe injections to reduce tumor size and pain