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On February 4, 2021, I found a lump beneath Scout's jaw. It's lymphoma. I will be documenting our experience to help others who find themselves facing a canine lymphoma diagnosis.
Scout's veterinarian was able to detect the cancer after sending off the sample from a fine needle aspirate of his lymph nodes to the lab. We had our first appointment (three hours) with the oncologist yesterday and I'm overwhelmed, yet hopeful. Dr. Evans was direct and got to the point, which I appreciated. So, let's start with the reality of canine lymphoma, and then I'll share our game plan.
The Truth About Canine Lymphoma
The following are current truths about canine lymphoma that the traditional veterinarian community believes. While I believe that these are all true, it's always important to remember that every dog is different and those of us who feed fresh food and are conservative with vaccinations and other toxins may see better results in our dogs.
1 – There isn't a cure for canine lymphoma – we're working to get Scout into remission (and keep him there for as long as possible), which isn't a cure. In fact, very few dogs are actually cured of lymphoma (but that very few offers hope). According to UPenn, where I found the “hope,” the majority of dogs fall out of remission at some point and, at this time, we can return to chemo treatments.
2 – Lymphoma is a liquid cancer, which means that it can spread everywhere and it requires us to treat the entire body. Scout won't undergo surgery to remove a tumor; at the moment, he only has swollen lymph nodes.
3 – An important test that we opted for was to figure out if Scout has b-cell or t-cell (not good) lymphoma. His doctor believes that he has b-cell because most patients with b-cell lymphoma are healthy at the time of diagnosis and remain healthy through treatment. On the other hand, with t-cell, dogs come into the vet's office sick because t-cell is more aggressive and the dogs test high in calcium in the blood (Scout did not test high).
4 – Chemotherapy is the best way to treat this cancer; while I can choose a natural option, it may not be as successful. In fact, dogs that don't undergo chemo live 1/2 the amount of time as dogs that do undergo chemo (with exceptions, of course). Thankfully, dogs handle chemo much better than humans. I said above that lymphoma is a liquid cancer (my vet's words) and it can go anywhere, it's also an aggressive cancer that quickly adapts to the various cancer drugs, which is why the 25-week CHOP protocol is highly recommended (discussed below).
Our First Visit with an Oncologist
When I received the cancer diagnosis, I immediately began calling oncologists in the area and learned that everyone was scheduled out through mid-March and into April. So we were lucky to get yesterday's appointment. After my research, I knew the direction I wanted to take with Scout, but I wanted to hear from the oncologist first.
My brain is still cloudy with all of the information I received. So, here goes…
Dogs, MDR1, and Chemotherapy
When the vet got a look at Scout, she was concerned that chemotherapy wouldn't be an option or we'd have to go with a medication that didn't work as well because the herding breeds (border collie, blue heeler, Australian shepherd, and collie) have a variant that makes them sensitive to various medications including chemo and anesthesia.
Thankfully, when I tested my dogs with Embark Vet, part of the health screening was for the MDR1 variant. Scout tested negative, which saved us time and money because we could cross a test off the list.
What We Can Expect from Chemotherapy
Chemotherapy has a negative connotation – when we think of someone going through chemo, we think of nausea, vomiting, hair loss, and weight loss. Thankfully, dogs handle chemo better than humans and Scout won't experience hair loss and there's a good chance that he won't have any side effects. But there are a few things we need to know.
1 – Chemo causes bone marrow suppression, which means that the chemo is working because it kills rapidly dividing cells – i.e. cancer cells and bone marrow cells (but they rapidly replace); if bone marrow drops too low, dogs can get an infection, which his oncologist will monitor.
2 – Chemo may cause tummy upset, vomiting, diarrhea, and lethargy. These side effects are minor and can be treated with medication and, with many dogs, these side effects don't last long if they happen at all.
3 – My dog's heart health needs to be taken into consideration when choosing the chemotherapy protocol. On Scout's first appointment, his doctor listened to his heart to make sure it was strong and healthy. It is.
4 – Lymphoma responds best when using drugs on a rotating basis to avoid the cancer becoming resistant to the drugs. There is an option to use just one chemo drug, but the cancer would quickly adapt to it; the CHOP method (discussed below) keeps this from happening.
5 – When Scout's lymph nodes go back to normal, then he's in remission and we want him to stay in remission throughout the chemotherapy protocol. If he's still in remission after the chemotherapy protocol, then we'll have to monitor him until the cancer comes back (there is no cure). Some dogs come out of remission during chemo; others may come out 4-5 months after the chemo protocol. So, after we make it through chemo, I plan to make antioxidants (turkey tail, Poly MVA for Pets, and golden paste) a big part of his diet. I'll also continue adding Answers Pet Food (detailed formulas and other foods) to his diet to keep cancer at bay.
The CHOP Protocol to Treat Canine Lymphoma
I chose to go with chemotherapy. I personally believe in using both traditional and holistic modalities to treat my dogs. While some choose to avoid chemo, I'm screaming BRING IT ON because I think that Scout will have a better shot of a longer, healthy life going this route.
CHOP is a recommended treatment for canine lymphoma (and other cancers) that consists of two injectable drugs and two oral drugs (L- asparaginase, vincristine, Cytoxan, prednisone, and doxorubicin) given on a weekly basis for six months. The average survival for a dog with b-cell lymphoma is about a year with 20-25% of dogs making it to two years. Dogs with t-cell lymphoma survive about 1/2 the time as a dog with b-cell lymphoma.
CHOP is going to be a time commitment because I'll have to drive him to Seattle weekly for treatment. So far, our appointments are on Saturday afternoons and they won't be as long as yesterday's appointment, which lasted three hours. It's also important to keep in mind that the prognosis is based on the average dog; my dogs aren't the average dogs.
Drugs to Treat Canine Lymphoma
The following is a list of drugs we received as we start this journey:
- Maropitant – prevents vomiting via injection or tablet.
- Prednisone – suppresses the immune system, stops the spread of cancer cells, and kills cancer cells.
- Ondansetron – used to treat vomiting.
- Metronidazole – used to treat diarrhea and inflammatory bowel disease.
- Gabapentin – pain relief and anticonvulsant.
- Trazodone – anxiety relief (prior to vet appointments).
Going through the list, you can see that there are two drugs that treat vomiting; this is because one may be better than another depending on the situation – at this time, we don't know and it's better to have something on hand than allow Scout to be uncomfortable while I wait for a veterinarian appointment, exam, and prescription should he feel sick.
So far, I've only had to give him the Prednisone, starting at 2 pills daily, reducing the dosage weekly. As I update this post, he's on 1/2 a pill daily and I'm so relieved because this pill made him ravenous and parched all day and I had to work to maintain his weight (he gained 1-1/2 pounds) during treatment.
Herbs and Other Supplements to Treat Canine Lymphoma
I will be adding the following herbs and supplements to Scout's diet to give him a better long-term prognosis.
- Artemisinin – can reduce node size and make animals feel better. I give this to Scout in the morning.
- Xiao Chai Hu Tang – this blend helps to induce cell death (apoptosis) in cancer cells while slowing down cell growth and division. This blend also boosts the immune system. I give this to Scout in the evening.
- Canna-Pet CBD Oil – CBD oil can lessen any negative side effects of the chemo treatment while inducing cancer cell death (apoptosis). I add 1-2 capsules to Scout's meals twice daily. I'm also giving Scout the Heal product from CBD Dog Health. He gets a full dropper of their CBD oil 2-3 times daily.
- Prostabel – this supplement promotes and protects healthy cells; which is important during chemotherapy. I add this to Scout's morning meal.
- Apricot Seeds – apricot seeds have been used for years to fight cancer because they are rich in amygdalin (aka vitamin B17), a natural element found in bitter almonds, the seeds of apricots, red cherries, apples, peaches, and plums. The medical community warns that apricot seeds are toxic to humans and dogs because as our intestines break it down, cyanide is produced,w which some feel is only toxic to cancer cells. At this time, the “evidence” that this works is anecdotal, but it is also compelling. I've read that dogs should get 1 seed per 10 pounds and I've decided to be conservative and give Scout 2-3 pills per day, however, I'm adding multiple sources of B17 so I'm sticking with 1 pill daily in his evening meal. Other sources of vitamin B17 include celery, carrots, raspberries, blueberries, strawberries, blackberries, flax seeds, chia seeds, sesame seeds, sprouted alfalfa and wheatgrass.
- Rx Vitamins Hepato Support – And since Scout's system will be dealing with a lot during this time, I need to keep his liver healthy. This supplement supports liver functions with a big dose of milk thistle and other nutrients, including B vitamins that support tissue repair and regeneration. UPDATE: At the beginning of CHOP, his blood work showed elevated liver levels; after adding this supplement to his diet regularly, his levels normalized.
I learned about the first two supplements on the site PathWithPaws.com, which has a wealth of information about canine cancer. My experience with Sydney taught me to go slowly with the herbs, so Scout's first night he only received one capsule of artemisinin (dosage is two/100 mg twice daily) and a 1/4 tsp of the Chinese herbs.
There are many more supplements that I can add to Scout's diet, but I'm taking it easy to avoid overwhelming his system. I was also advised NOT to add anti-oxidants to his diet for fear that they will protect healthy cells and the cancer cells (read more below).
I will document any positive and negative side effects of the above supplements in a future blog post. However, so far, Scout's tolerated everything well.
A Raw Food Diet and Chemotherapy in Dogs
I was warned that I would need to take Scout off of a raw food diet while he's undergoing chemotherapy. Ummmm, no. The reason provided by the oncologist is the bacteria in the food can cause an issue; however, I'm not worried because I ordered a case of Answers Pet Food, the only brand that has successfully tackled the bacteria risk/debate through fermentation.
Plus, it's easier to feed a keto diet using Answers Pet Food products.
Cooking for Scout…
Update: We're several weeks into treatment and there is one week (see schedule below) that our vet warned is harder on the system than the rest and she requested that I cook Scout's food the week following treatment. Therefore, I picked up ground bison, lamb, and turkey to cook and mix with Dr. Harvey's Paradigm (base mix). I also lightly cooked Answers Pet Food during that week.
When I'm cooking for Scout, I'm not worried about him being in ketosis.
Essential Oils and Lymphoma in Dogs
I'm also using essential oils from animalEO to keep Scout's spirit, energy, and strength up. If you are reading this and saying “essential oils are toxic to animals,” this is a myth. It is important to buy from quality brands that source ingredients ethically and responsibly. Last year, I began adding animalEO oils to my essential oils collection and it was the best decision I made (thanks again, Diane). These oils are formulated by Dr. Melissa Shelton, a holistic veterinarian who is an expert in essential oils.
The following is my regimen:
- Monday: Aroma Boost Collection – this is a collection of five oils that I apply to Scout's back from tail to neck (in that direction) in a specific order.
- Wednesday and Friday: Boost in a Bottle – Dr. Shelton reduced the Aroma Boost Collection down to one bottle, which I use between the collection application for an added boost.
- Sunday: Liver Boost – I sprinkle a small amount on my hands and massage this oil along Scout's sides and tummy.
- Daily Diffusing of Strength, Calm-a-Mile Neat, Sunshine in a Bottle, and Warmth – alternating oils daily based on what I like. Sometimes I'll allow Scout to choose (he'll lick at the scent he likes).
If you're interested in learning more about essential oils, check out Dr. Shelton's Animal Desk Reference Guide. It's a detailed guide of oils that can be used with our pets, the benefits, and how to use them. Although I do have this guide, I will only apply animalEO oils on my dog.
Vaccinations and Chemotherapy in Dogs
I no longer vaccinate my dogs because I believe their initial vaccines (puppy series and annual booster) provided sufficient protection that lasts longer than traditional veterinary medicine tells us.
Our oncologist also warned me to keep Scout away from dogs we don't know because the chemotherapy drugs will lower his immune system – sooooo, no going to dog parks. This is when I have to remember that I'm not living the average life with dogs. We don't go to dog parks, I don't allow my dogs to interact with dogs we don't know, and I've formulated a diet that supports Scout's immune system.
We'll never take our dogs to the dog park because it's an unsafe environment for our dogs. And for the next six months, we won't be having play dates with other dogs.
Antioxidants and Chemotherapy in Dogs
One shocking factoid that I received yesterday was that I have to remove all of the antioxidants from Scout's diet because there is a teeny study that revealed that combining antioxidants with chemotherapy can result in a negative outlook. The problem with this “study” and the articles reporting this information is that there aren't any details on which supplements were identified as problematic, we're not told if whole foods are better than these supplements, and two of the nutrients are important in a dog's diet – B12 and Omega 3 fatty acids.
I reached out to the dog lover community and people shared more information that has me wondering if I need to remove two supplements from Scout's diet while he undergoes chemotherapy:
- Poly MVA for Pets – supports Scout's immune system, gives him more energy, and will help him tolerate chemo better. I think this is why his lymph nodes shrunk by more than 50%.
- Turkey Tail Mushroom – boosts the immune system while fighting cancer.
- Golden Paste – may reduce joint and arthritis pain, reduces inflammation, and kill cancer cells.
- Coenzyme Q10 – I give this to my dogs for heart health; it also boosts the immune system and supports our dogs' overall health. This is a great supplement for senior dogs.
From a blog post about one pet parent's success with cancer:
“Jeff Gold writes, ‘In the case of preventing cancer, you need to protect cells with antioxidants to prevent oxidative damage which can cause them to turn into cancer cells. In the case of treating cancer, you need to kill cancer cells with a pro-oxidant, while still protecting normal healthy cells. If you give antioxidants (normally recommended to prevent cancer) to a cancer patient, these will not only protect the normal cells, they will also protect the cancer cells!'”
From a study about anti-oxidant supplementation while going through chemotherapy says the opposite:
“This review constitutes a total of 174 peer-reviewed original articles from 1967 till date comprising 93 clinical trials with a cumulative number of 18,208 subjects, 56 animal and 35 in vitro studies. Out of total cases reported in 174 research articles, 138 research papers have reported consequences of antioxidant supplementation during or after chemotherapeutic setting of which 122 articles (88%) states that antioxidants mitigates the toxicities induced by chemotherapeutic agents. Out of 130 papers, 91 articles (70%) reports that the therapeutic efficiency of chemotherapy increases in presences antioxidants. Conjugate antioxidant supplementation was also seen to increase the survival time in the patients according to 26 reports (63%) of 41 research article. Thus our comprehensive data therefore suggests that antioxidants do not interfere with chemotherapy and can be prescribed during clinical setting to increase the standard of life.”
Update: Removing Anti-Oxidants
After speaking with a few people I trust, I decided to remove the supplements that are high in anti-oxidants from Scout's diet, replacing them with supplements that protect cells. I ordered the following:
- Apricot Seeds – 100% natural and it slows and may stop the spread of cancer while providing B17 for the system. It's believed that cancer is due to a B17 deficiency.
- Prostabel – this supplement promotes and protects healthy cells; which is important during chemotherapy.
I ordered these from Long Living Pets Research Project.
CHOP Chemotherapy Treatment
So far, Scout is tolerating chemotherapy well, with the only side effects being the increased hunger and thirst from the prednisone, vomiting from drinking too much water too quickly (happened 4x), and diarrhea after the Vincristine. I began adding canned pumpkin to his diet to help with the stool.
- Week 1: CBC (blood panel), Vincristine – injection
- Week 2: CBC, UA (urinalysis), Cytoxan – pill
- Week 3: CBC, Vincristine – injection (Scout went into remission, but went out as I started decreasing the dosage of prednisone, I do not know if they were related)
- Week 4: CBC/CHEM, Doxorubicin – 30-minute IV (cooked food for week following)
- Week 5: CBC – no chemo on this day!!! (Scout officially went into remission after this appointment)
- Week 6: CBC, Vincristine
- Week 7: CBC, Cytoxan
- Week 8: CBC, Vincristine
- Week 9: CBC/CHEM, Doxorubicin
- Week 11: CBC, Vincristine
- Week 13: CBC, UA, Cytoxan
- Week 15: CBC, Vincristine
- Week 17: CBC, Doxorubicin
- Week 19: CBC, Vincristine
- Week 21: CBC, Cytoxan
- Week 23: CBC, Vincristine
- Week 25: CBC/CHEM, Doxorubicin
Next Steps with Canine Lymphoma
Right now, I'm focused on keeping a positive attitude and loving the heck out of my dog. I'm keeping track of his mood, behavior, appetite, and stool/urine production. For the first few weeks, he was thirsty and starving. This decreased slowly as the doctor decreased the Prednisone dosage. The IV treatment requires slight sedation to keep Scout still, so he was out of it for the remainder of the day. And he did have diarrhea for two days after his third treatment. Otherwise, he's my happy dog.
I'm looking for a local acupuncturist for bi-monthly appointments. It would be so cool if I could find someone who does house calls.
As I've stated, there isn't a cure for lymphoma and the veterinarian let me know that while we can get Scout into remission, eventually the lymphoma will return. I think he has a better outlook than most dogs because I caught the cancer very early, he eats a healthy diet, and lives a healthy lifestyle. However, he's not bulletproof – so we'll take things one day at a time.
We got this.