Caninecancer.org.au

Hi, My pup Clancy (7 yr old collie/lab mix) was diagnosed with lymphoma right before Thanksgiving. He started CHOP the following week with an internist as there are no Oncologists in my city(Rochester, NY). I did not have him typed but think he likely has T-Cell as he initially had a calcium level of 15.5 and was quite sick. He was in clinical remission after his second treatment. At week 7 one of his nodes (jaw) got very large, all other nodes normal. His vet aspirated and said the cells weren't "screaming lymphoma" and thought it might be an abscess. He was given Cytoxin and no antibiotic. The next week it shrunk 50% and the node on the other side was slightly enlarged. He recieved doxorubicin and it my vet shared he thought he wasn't responding to the Vincristine/Vinblastine (he was switched due to neusea. The next week (last week and week 9) his nodes remained the same. I was told that he wasn't responding to CHOP and therefore would never stay in remission off chemo. I was told we could try some other drugs to try to get him stable again and he was given Lomustine. Other than the node issue he is acting fine. I can no longer feel his nodes but am heart broken that I was told he can never go off chemo. I asked about MOPP and was told he doesn't do MOPP but that I could go to Cornell for that which is about an hour and 45 minutes away. So, I have a few questions...
1. Is it true if a dog fails CHOP they will never achieve a full, sustained remission?
2. Should I asperate to make sure it's not infection?
3..Should I have him typed for b or t-cell?
4. Should I take him to Cornell and ask about MOPP if he is responding to the Lomustine?
Any questions you can answer and/or any suggestions would be greatly appreciated!
Thank you! Michelle and Clancy

Hi Michelle

So sorry to hear about Clancy. My pup has mast cell cancer, however I have read about a new treatment for lymphoma. One of the girls on one of the FB groups I am a member of wrote -

This is the immunotherapy that my boy Jasper had in addition to chemo. It was part of a trial for dogs via the human MD Anderson Cancer Center and one of Jasper's vets is now trying to make this more widely available. It uses a dog's own killer t cells to fend off the lymphoma tumor cells. Jasper is now going on 2 years and 7 months post diagnosis. I believe the combination of this and holistic care including a balanced homemade diet has made all the difference!
https://www.facebook.com/154398801239971/photos/a.524424880904026.124132.154398801239971/907621805917663/?type=1&theater
http://www.caninetcellinfusion.info/

I hope this is of some use.

All the best

Kristy

Thank you Kristy! Im sorry to hear about your pup too. I'm a member of a few facbook groups too. They are so helpful. I didn't want to ask too many questions in one post but my ultimate goal is to get Clancy one of the anti-body treatments The closest place it is available is in Pittsburg which is 4.5 hours away. If I can figure out a way to manage to pay for it in addition to chemo I'm planning on doing it. It is supposed to work best on dogs who are in remission but I have a friend doing it at Hope Vetrinary Clinic in PA whos dog was also out of remission. Thank you so much for the info and good luck with your pup <3

Hi Michelle,
I will do my best to answer your questions:
1. Is it true if a dog fails CHOP they will never achieve a full, sustained remission?
Failing CHOP is NOT a good sign, because it implies resistance to 3 classes of drug and therefore it is most likely that this is due to the lymphoma being capable of rapidly dealing with any drug used. Lomustine is the perfect choice in the face of CHOP resistance, and remission does happen, and sometimes for a reasonable time. But for many dogs they will not achieve durable remission. So don't lose hope!
2. Should I asperate to make sure it's not infection?
There is no reason NOT to aspirate, so if there is any uncertainty then, yes.
3..Should I have him typed for b or t-cell?
Again, no harm in doing this, however as CHOP is the standard B treatment I would see little point in doing so to direct more drug therapy for a dog post-CHOP. If other treatments become available, such as drugs or antibodies aimed at the B cell receptor, then this test becomes more useful.
4. Should I take him to Cornell and ask about MOPP if he is responding to the Lomustine?
I work in Australia and do not have access to mechlorethamine (the 'M' in MOPP), hence I use LOPP, with lomustine in its place. Most of us are comfortable using whichever we have access to interchangeably. I would think if you have a good response from lomustine, then continue with it. If not, perhaps Cornell could advise you on whether many dogs that fail lomustine succeed with MOPP?

Good luck!

Ken

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Dr Ken Wyatt BSc BVMS FANZCVS
Specialist Veterinary Oncologist
Perth Veterinary Oncology

Ken,
Thank you very much for taking the time to answer all of my questions! I feel much more confident about Clancy's current treatment with Lomustine. With that in mind I will likely hold off on Cornell and instead save the funds for hopefully a next step of taking him to Philadelphia for MAB. I can no longer feel his nodes. Hopefully his Internest will not feel them either at his next appointment tomorrow and Clancy will continue to fight!
Thank you!!!!!!
Michelle and Clancy

Good luck and keep us posted.

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1. Sending tumours to the lab saves lives
2. Pet insurance allows you to give your dog the best treatments available
3. Using an oncologist gives your dog the best chance of survival.

That is fantastic news Michelle! Yes, do keep us posted on Clancy.

I reiterate that I know nothing about this cancer, however there has been more posted on this page about the treatment I mentioned - https://m.facebook.com/profile.php?id=274945509321872. I believe the lymphoma has to be a certain type for this to work but it's worth looking into! Available in US, not Australia (I believe).

All the best!

The link wouldn't open but I'm thinking you are talking about molecular anti-body treatment. You are correct there is a B-cell and T-Cell tx now available in the US that I am hoping to get Clancy at UPenn. I also read about T-cell infusion which I think is different and only available in I think Texas but I'm looking into that too (to see if it's different than MAB and where available). Next step is Cornell to see of there's a better chemo protocol. We have an apt. Wednesday. Thank you!!

Michelle
I hope Clancy is doing well. Did you see this? (need to be logged into FB for link to work). https://m.facebook.com/story.php?story_ ... p_activity

Mmmm, these FB links don't appear to be working. Try this link and go through to her FB page - http://www.drsuecancervet.com. Look for postings on today's date and you'll see this (with a video) -

I cannot contain my excitement! We have a new treatment option for dogs with T-cell lymphoma. Inspired by advances in human cancer treatment, a new monoclonal antibody therapy is now approved and available to some oncologists - including me. Canine monoclonal antibody is an innovative treatment that's designed it to target and kill T-cell lymphomas.
Bear's lymphoma is pretty resistant at this point and this new therapy is so welcome! Fingers and paws crossed for Bear. I love him so!