Lymphoma cancer in dogs.

What are lymphomas?
Lymphoma is a diverse group of cancers that originate in lymphocytes – a type of white blood cell in the immune system.
The commonly affected sites are lymph nodes, spleen and bone marrow, but lymphoma can occur in almost any tissue in
the body where there is lymph tissue such as the gastrointestinal tract, eyes, central nervous system, bone, testes,
bladder, heart, and nasal cavity. Lymphomas typically affect middle-aged dogs (6-9 years old), and certain breeds such as
boxers, bull mastiffs, basset hounds, Saint Bernards, Scottish terriers, Airedales, and bulldogs appear to be at higher risk.

Lymphoma can be classified into several categories:

• 
  Multicentric lymphoma
  
  


• 
  Mediastinal lymphoma
  
  


• 
  Alimentary/intestinal lymphoma
  
  


• 
  Cutaneous (skin) lymphoma
  
  


• 
  Extranodal lymphoma
  
  

How common is lymphoma in dogs?
Lymphoma is one of the most common cancers in the dog. It accounts for approximately 7%-24% of all dog cancers and
83% of all hematopoietic (blood cell) cancers. The annual incidence is estimated at 1.5 cases per 100,000 dogs younger
than 1 year and 84 cases per 100,000  dogs 10-11 years old. Multicentric lymphoma (affecting many lymph nodes in the
body) is the most common type of lymphoma in the dog and accounts for approximately 80% of all lymphoma cases.What are the symptoms of lymphoma in dogs?
The symptoms are variable and will depend on the cancer’s location and how advanced it is. Commonly observed findings
are painless swollen lymph nodes, enlarged spleen and bone marrow involvement. The dogs may also show nonspecific
signs such as lack of appetite, weight loss, vomiting, diarrhea, shortness of breath, increased thirst, increased urination
and fever.

Dogs with gastrointestinal lymphoma can experience vomiting, diarrhea, weight loss, and lack of nutrient absorption. Dogs
with lymphoma in their chest cavity can have edema (swelling) of their neck, head or front limbs. Dogs with skin lymphoma
will show tumors that appear as nodules, plaques, ulcers or dermatitis (inflammation of the skin). Dogs with lymphoma in
their central nervous can experience seizures, paralysis, and partial loss of movement. Dogs with eye lymphoma show
infiltration and thickening of the iris, eye inflammation, blood in the eye, presence of puss, or glaucoma.

How is the diagnosis made?
Pets with suspected lymphoma will have a variety of tests done to confirm the diagnosis, including physical exam, blood
tests, urinalysis, imaging studies and biopsy. In many cases, fine-needle aspirates of the affected area is sufficient to
confirm lymphoma but biopsy remains as the gold standard for any cancer diagnosis. After confirming the diagnosis, it is
important to evaluate how advanced the disease in order to plan an appropriate treatment. More than 80% of dogs show
signs of advanced disease by the time of diagnosis so it is important to evaluate whether the bone marrow is involved (by
bone marrow aspirate or biopsy) and whether the disease has metastasized (spread) to other organs (by imaging
techniques such as ultrasound, X-rays, CT scan or MRI).Does cancer cause pain in pets?
Pain is common in pets with cancer, with some tumors causing more pain than others. In addition to pain caused by the
actual tumors, pets will also experience pain associated with cancer treatments such as surgery, radiation therapy or
chemotherapy. Untreated pain decreases the pet’s quality of life, and prolongs recovery from the illness, treatment or
injury. It is, therefore, essential that veterinary teams that are taking care of pets with cancer should also play a vital role in
educating pet owners about recognizing and managing pain in their pets. The best way to manage cancer pain in pets is to
prevent it, a term referred to as preemptive pain management. This strategy anticipates pain ahead of time and
administers pain medication before the pet actually experiences pain, thus ensuring the pet’s maximum comfort.

To learn more about which tumors are likely to cause a lot of pain, how to recognize pain in pets with cancer and what
cancer pain management options are available for your pet, please visit the

Cancer Pain Management section.How important is nutritional support for pets with cancer?
Cancer cachexia (a term referring to progressive severe weight loss) is frequently observed in pets with cancer with
advanced cancer. Pets with cancer lose weight partly because of lack of appetite and partly because of cancer-induced
altered metabolism. Some of the causes for decreased appetite are related to the cancer itself (for example, tumors may
physically interfere with food chewing, swallowing, and digestion process) and some may be related to the side effects of
cancer treatment (for example, some chemotherapy drugs cause nausea and vomiting, and radiation therapy can cause
mouth inflammation).

Proper nutrition while undergoing cancer treatment is essential to maintain your pet’s strength, improve survival times,
quality of life and maximize response to therapy. Adequate nutritional support was shown to decrease the duration of
hospitalization, reduce post-surgery complications and enhance the healing process. Additionally, pets with cancer need to
be fed diets specifically designed to provide maximum benefit and nutritional support for the patient. To learn more, please
visit the

Cancer Nutrition section.What are the treatment options for dogs with lymphoma?
Multicentric lymphomas
The treatment strategy for a dog with lymphoma will depend on the subtype, how advanced the cancer is and the overall
health of the pet. Chemotherapy remains as the treatment of choice, and combining several different chemotherapeutic
drugs has shown greater benefit compared to single drugs. The most effective chemotherapeutic drugs currently in use
include the combination of doxorubicin, L-asparaginase, polyethylene glycol-L-asparaginase, vincristine,
cyclophosphamide, and/or prednisone.

If multi-drug therapy cannot be used, single drug doxorubicin or prednisone can be offered as an alternative. For
doxorubicin, complete response is expected to be observed in 50-75% of dogs, with a median survival time of 6-8 months.
For prednisone, the response lasts 1-2 months but if pet owners decide to try

chemotherapy after the prednisone, they
should be aware that the chemotherapy will be most likely be ineffective. Therefore, the earlier the pet owner chooses a
more aggressive multi-drug therapy, the better the chance of favorable outcome. In the rare cases where only one location
is affected by the cancer, it may be possible to treat it with surgery or radiation therapy rather than chemotherapy. The role
of radiation therapy for treating lymphoma in dogs is currently under investigation.Non-multicentric lymphomas
There is not much information available for the treatment of non-multicentric lymphomas in dogs. If the cancer is localized
to a single site, surgery and/or radiation therapy are recommended and where the disease is present in multiple locations
of the body, chemotherapy is the treatment of choice.Bone Marrow Transplantation as a New Treatment Option for Dogs with Lymphoma
Canine bone marrow transplantation for lymphoma is the replacement of irradiated bone marrow with normal stem cells
after chemotherapy is concluded. It allows veterinary oncologists to treat lymphoma with the most aggressive
chemotherapy possible. They can administer a dose of total body irradiation high enough to kill lymphoma cells that may
be resistant to chemotherapy or residing in locations in the body where chemotherapy cannot reach. To learn more about
this new treatment option, please visit the Bone Marrow Transplant for Dogs section.How do I find a qualified veterinary oncologist?
To locate a qualified veterinary oncologist worldwide who can discuss with you appropriate cancer treatment plan for your
pet’s cancer condition, please visit the “Locate a veterinary oncologist” section.  How much does chemotherapy cost to treat lymphoma in dogs?
The cost of chemotherapy will differ from a clinic to clinic but according to Purdue University School of Veterinary Medicine,
the cost of the UW-25 protocol (a current standard of care at Purdue) is approximately $ 4000-$ 5000, depending mostly on
the size of the dog. The cost is somewhat less for smaller dogs since they receive smaller amounts of chemotherapy drugs.
The cost of chemotherapy does not have to be paid all at once, but is paid on a per-visit basis over the course of 25 weeks.
There are several other chemotherapy protocols that are available for treating canine lymphoma, some of which are less
expensive and require less frequent visits.Are there any clinical trials investigating new treatments for dogs with lymphoma?
There are several available clinical trials investigating new treatments for lymphoma in dogs. To learn more about these
trials, please visit the Clinical Trials for Lymphoma in Dogs section.

Additionally, there are several clinical trials available for cats and dogs with any tumor type for which your pet may qualify.
To learn more these trials (which are partially or fully funded by the institutions), please visit the

Dog Clinical Trials (any
tumor type) or Cat Clinical Trials (any tumor type) section.  

To learn more about veterinary clinical trials in general, please visit the

Pet Clinical Trials section.What is the prognosis for dogs with lymphoma?
The prognosis for dogs with lymphoma will depend on the lymphoma subtype, location of the disease, how advanced it is
and the overall health. Generally speaking, the earlier the diagnosis is made, the better. Without treatment, most dogs will
die of the disease in 4-6 weeks. Fortunately, a high percentage of dogs have a good response to chemotherapy without
major side effects. Dogs that respond to chemotherapy and achieve complete remission (absence of disease) usually
remain free of symptoms and return to a very good quality of life. About 25% of dogs are long term survivors (longer than 2
years) and some are cured.Read about other pet owner’s experiences with lymphoma:
www.bullmastiff.blog.com - a story of Yoshi, a 7-year old male bullmastiff, diagnosed with lymphoma in 2010.Additional online resources about lymphoma in pets:
Frequently asked questions about lymphoma in dogs (from Purdue University)
www.caninecancerawareness.org/html/CanineCancerLymphoma.html
www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/10500.htm
www.veterinarypartner.com/Content.plx?P=A&A=575
www.marvistavet.com/html/canine_lymphoma.html
www.vetmed.wsu.edu/clientED/lsa.asp
www.vrcc.com/library/disease_k9_lymphoma.shtml
www.lymphomainfo.net/lymphoma/animal.html
www.vin.com/proceedings/Proceedings.plx?CID=WSAVA2005&PID=10916&O=Generic
www.vetspecialists.co.uk/06_Animal_Welfare/Oncology_Facts/Canine_Lymphoma.html
www.dogcancer.net/lymph.htmlSources:

• 
  Withrow Stephen J, and David M. Vail. Small Animal Clinical Oncology. St Louis: Saunders Elsevier, 2007.
  
  


• 
  Morrison Wallace B. Cancer in Dogs and Cats: Medical and Surgical Management. Baltimore: Williams&Wilkins, 1998
  
  

Canine Cancer Awareness | Matilda"s Journey

I cannot believe it, but Matilda has completed the L-CHOP Chemotherapy Protocol Treatment for Lymphoma. She is in remission, and doing pretty well. I thought I would want to celebrate if we reached this day. Instead of losing her six months ago, her life has been extended, and is pretty good. Our neighbors saw her last night, and remembered when they had helped me get her back into the apartment when she had collapsed in front of the building and was diagnosed the next day. They were excited by how bright and alive her eyes are now, and how fast her tail was wagging, and that she was trying to get them to give her their food.

I am extremely thankful to have her still, and to see what a strong soul she is. She loves life, and struggles to hang in there even when not feeling that great. As soon as she feels well, she does her dancing around, flinging her long legs all about, nosing me and insisting on certain treats. Always, on our walks, she wants people on the sidewalk to pet her, and to hang out with whatever people and dogs are there. The sweetness of this 13 year old pup combined with the knowledge that she was put up for adoption from a divorcing couple when she was age eight make her my hero.

When she feels better from this last chemo, I want to do something special for her. Maybe I will invite her favorite people over, and we can all read to her and cuddle with her. She loves that!

Matilda is alive and safely sleeping and being treated at Blue Pearl Veterinary Partners, the Emergency and Specialty Hospital in our area. This is the top place in NYC, in my opinion.  The dog in this picture is Coco, a Great Dane who was waiting to see if her Bull Dog friend was going to be OK. She wasn’t that happy about having her picture taken, and gave me a little growl.

What is speculated regarding Matilda is that a cut on her paw, which just showed itself this morning is infected in a major way. This can happen when one’s immune system is compromised from chemo. So this cut has become an abscess, but in a somewhat complicated way. She had a cut  several weeks ago that was treated, and thought to be healed. Apparently when one is undergoing chemo, something like that can continue to be a problem, even when it seems to have healed. So they have worked on the paw, and she is getting intravenous antibiotic, blood work has been done, and her high temperature has been brought down. (She was so stressed having to walk out to the taxi to get to the vet, that she began panting at a level I’ve rarely seen). She is staying overnight, and I will pick her up tomorrow night. They think that this infection could be responsible for all the symptoms she was having.

 I’m hoping for good results, and that I will be able to take care of the wound properly. The vet assured me that this infection could have happened in a matter of hours. It seems daunting, since it is between her toes. Greyhounds have these very long toes with webbing in between. Matilda’s toes are very close together, and the little toes are turned in and encroaching on the other toes. It isn’t uncommon for greyhounds to have problems with their toes.

 Matilda thanks everyone for the good wishes and prayers.

Matilda is essentially herself. She has a food issue, but has managed to eat enough to be over the weight she was when she became ill with Lymphoma and began chemo December 13, 2012. She now also has arthritis , and her walking is a bit impaired. She is in remission, and has only one more chemo treatment left, which is a week from tomorrow. Her spirits are excellent. She has a sense of humor, dancing around and flinging her legs wildly, while moving her head up and down like a horse, in order to get certain treats.

I have to keep in mind that her health situation might fluctuate. We have bought her time, but who knows how much. Kelly K of Wishcuit reminds us that dogs and humans get cancer at the same rate, and that there are dogs beating the disease with the advent of new  treatments. Go to Wishcuit.com for more info on how she is doing this work.

And of course, how do we humans cope with the advent of a life-threatening illness in that special dog in our life?

Rainer Marie Rilke once said that our “deepest fears are like the dragons guarding our deepest treasures”. I want to be the person who who digs deeper, transforms anxiety, and can be present and at peace with Matilda.
        
Tillie decided to wear a kerchief or babushka for her picture that got separated from this post. Some people might have observed that she resembles Meryl Streep in the film The French Lieutenant’s Woman. 

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7-Mycosis fungoides (cutaneous epitheliotropic T-cell lymphoma)

7-Mycosis fungoides (cutaneous epitheliotropic T-cell lymphoma)

Filed under: Uncategorized — Leave a comment

April 23, 2011

These are links to a videoclip (prepared by Dr. John R. Minarcik, human pathologist from IL, USA) of a histopathology case of mycosis fungoides (MF, epitheliotropic T-cell lymphoma, epidermotropic cutaneous lymphoma) in a person: http://www.youtube.com/watch?v=roRa2-NWN3g&feature=relmfu, and to microscopic pictures of a case of the same disease in a dog http://www.cytopath.co.uk/caseofmonthaugust2010.html (Case of The Month section from the Cytopath Veterinary Diagnostic Laboratory in Herefordshire, UK) and in a horse http://vp4.afip.org/wsc/wsc95/images/c28c4b.jpg and http://vp4.afip.org/wsc/wsc95/images/c28c4a.jpg (AFIP Dept Vet Pathol DODVPR WSC).

Cutaneous epitheliotropic T-cell lymphoma is a neoplastic disease of the skin of humans, dogs, cats, SD rats, Syrian hamsters, pigtailed macaques, squirrels, and coatis. It is characterized by the infiltration of the epidermis and adnexal structures of the skin by neoplastic lymphocytes (neoplastic T cells). Clinically, epitheliotropic cutaneous T-cell lymphoma in dogs can occur throughout the skin, and can also have a marked tendency to involve mucocutaneous junctions (lips, nasal planum, eyelids, perianal junction, perivulvar junction) and oral cavity (buccal mucosa, gingiva, palate, tongue). Footpads and interdigital folds can be involved too. The broad spectrum of clinical signs in early-stage cutaneous epitheliotropic T-cell lymphoma is a diagnostic challenge. The disease in dogs closely resembles human mycosis fungoides in that most cases are initially presented with lesions that clinically and histologically resemble many inflammatory skin diseases (including lupus erythematosus and pemphigus), and often progresses rapidly and unrelentingly to a more aggressive, severe tumor stage. Early diagnosis of canine epitheliotropic cutaneous T-cell lymphoma by histopathology/immunohistochemistry/PCR is essential in order to start soon with a specific oncologic therapy.

Monoclonal antibodies specific for canine lymphocyte antigens used for the immunohistochemical phenotyping of T lymphocytes from cutaneous epitheliotropic T-cell lymphoma in dogs include: CD3-specific mAb, CD4, CD8 alpha, CD8 beta, CD21, CD45RA, TCR beta subunit, and TCR gamma delta.

The immunophenotypic features of epitheliotropic lymphomas of the skin of humans are: most cases are CD4+ (CD4 positive helper T cell) and TCRab+ (T cell receptor alpha beta positive), and few cases are CD8+ (CD8 positive cytotoxic T cell) and TCRgd+ (T cell receptor gamma delta positive).

The immunophenotypic features of epitheliotropic lymphomas of the skin of dogs are: most cases are CD8+, and few cases are double negative CD4- and CD8-.

The immunophenotypic features of epitheliotropic lymphomas of the skin of cats are: CD3+ and double negative (CD4-, CD8-). An article about feline cutaneous epitheliotropic lymphomas was just published on Vet Dermatol (Early View, 05.02.2011) – read the abstract of this paper here:  http://www.ncbi.nlm.nih.gov/pubmed/21535252

The key histopathological diagnostic feature of epitheliotropic T-cell lymphoma is the tropism of the neoplastic lymphoid T cells for the epidermal or mucosal epithelium and the adnexal structures of the skin, in particular the wall of the hair follicles. The intraepithelial neoplastic lymphocytes are either diffusely distributed within the epithelium or form discrete aggregates (nests) referred to as “Pautrier’s microaggregates”, “Pautrier’s microabscesses” or “Pautrier collections”. Diffuse infiltrates of neoplastic T cells tend to remain in the lower levels of the epidermis. Tropism to the cutaneous adnexa may be more prominent than invasion into the epidermis, and complete obliteration of the hair follicles and adnexal glands of the skin may occur. Infiltration of apocrine sweat glands may be striking in some cases, and is highly diagnostic for epitheliotropic T-cell lymphoma since inflammatory infiltrates generally do not occur in such location.

Suggested readings: I recommend that you read more about mycosis fungoides in the following books and papers:

Books:

Gross TL et al. 2007. Skin diseases of the dog and cat: clinical and histopathologic diagnosis http://books.google.com/books?id=VKa2Wo3Wc-kC&printsec=frontcover&source=gbs_navlinks_s#v=onepage&q&f=false

Elder DE et al. 2007. Atlas and synopsis of Lever’s histopathology of the skin http://books.google.com/books?id=-uqJzY08OqUC&printsec=frontcover#v=onepage&q&f=false

Articles:

Doe R et al. Canine epidermotropic cutaneous lymphoma. Am J Dermatopathol. 1988 Feb;10(1):80-86. http://www.ncbi.nlm.nih.gov/pubmed/3177825

Moore PF et al. Canine cutaneous epitheliotropic lymphoma (mycosis fungoides) is a proliferative disorder of CD8+ T cells. Am J Pathol. 1994 Feb;144(2):421-429. http://www.ncbi.nlm.nih.gov/pubmed/7906096

Olivry T et al. Investigation of epidermotropism in canine mycosis fungoides: expression of intercellular adhesion molecule-1 (ICAM-1) and beta-2 integrins. Arch Dermatol Res. 1995;287(2):186-192. http://www.ncbi.nlm.nih.gov/pubmed/7539248

Magnol JP et al. Clinical, morphologic and immunophenotypic data based on 10 cases of canine muco-cutaneous epidermotropic T-lymphoma (analogous to Mycosis Funcgoïde). Important of an animal model of spontaneous pathology. Bull Acad Natl Med. 1996 Feb;180(2):449-462. http://www.ncbi.nlm.nih.gov/pubmed/8705383

Wilcock BP & Yager JA. The behavior of epidermotropic lymphoma in twenty-five dogs. Can Vet J. 1989 Sep;30(9):754-756. http://www.ncbi.nlm.nih.gov/pubmed/17423425

McKeever PJ et al. Canine cutaneous lymphoma. J Am Vet Med Assoc. 1982 Mar 1;180(5):531-536. http://www.ncbi.nlm.nih.gov/pubmed/7061338

Day MJ. Immunophenotypic characterization of cutaneous lymphoid neoplasia in the dog and cat. J Comp Pathol. 1995 Jan;112(1):79-96. http://www.ncbi.nlm.nih.gov/pubmed/7722010

Czasch S et al. Central nervous system metastasis of a cutaneous epitheliotropic lymphosarcoma in a dog. J Comp Pathol. 2000 Jul;123(1):59-63. http://www.ncbi.nlm.nih.gov/pubmed/10906257

Fivenson DP et al. T-cell receptor gene rearrangement in canine mycosis fungoides: further support for a canine model of cutaneous T-cell lymphoma. J Invest Dermatol. 1994 Feb;102(2):227-30. http://www.ncbi.nlm.nih.gov/pubmed/7906287

Donaldson D & Day MJ. Epitheliotropic lymphoma (mycosis fungoides) presenting as blepharoconjunctivitis in an Irish setter. J Small Anim Pract. 2000 Jul;41(7):317-20. http://www.ncbi.nlm.nih.gov/pubmed/10976628

Ferrer L et al. Immunohistochemical detection of CD3 antigen (pan T marker) in canine lymphomas.  J Vet Diagn Invest. 1993 Oct;5(4):616-620. http://www.ncbi.nlm.nih.gov/pubmed/8286465

Neta M, Naigamwalla D, Bienzle D. Perforin expression in feline epitheliotropic cutaneous lymphoma.  J Vet Diagn Invest. 2008 Nov;20(6):831-5. http://www.ncbi.nlm.nih.gov/pubmed/18987241

Chaubert P et al. Improved polymerase chain reaction-based method to detect early-stage epitheliotropic T-cell lymphoma (mycosis fungoides) in formalin-fixed, paraffin-embedded skin biopsy specimens of the dog. J Vet Diagn Invest. 2010 Jan;22(1):20-29. http://www.ncbi.nlm.nih.gov/pubmed/20093678

Foster AP et al. Cutaneous T-cell lymphoma with Sézary syndrome in a dog. Vet Clin Pathol. 1997;26(4):188-192. http://www.ncbi.nlm.nih.gov/pubmed/12658584

Fontaine J et al. Canine cutaneous epitheliotropic T-cell lymphoma: a review. Vet Comp Oncol. 2009 Mar;7(1):1-14. Review. http://www.ncbi.nlm.nih.gov/pubmed/19222826

Santoro D et al. Investigation on the association between atopic dermatitis and the development of mycosis fungoides in dogs: a retrospective case-control study. Vet Dermatol. 2007 Apr;18(2):101-106. http://www.ncbi.nlm.nih.gov/pubmed/17355424

Bizikova P et al. Canine cutaneous epitheliotropic T-cell lymphoma with vesiculobullous lesions resembling human bullous mycosis fungoides. Vet Dermatol. 2009 Aug;20(4):281-288. http://www.ncbi.nlm.nih.gov/pubmed/19659540

Affolter VK et al. Indolent cutaneous T-cell lymphoma presenting as cutaneous lymphocytosis in dogs. Vet Dermatol. 2009 Oct;20(5-6):577-85. http://www.ncbi.nlm.nih.gov/pubmed/20178497

Moore PF et al. Canine epitheliotropic cutaneous T-cell lymphoma: an investigation of T-cell receptor immunophenotype, lesion topography and molecular clonality. Vet Dermatol. 2009 Oct;20(5-6):569-576. http://www.ncbi.nlm.nih.gov/pubmed/20178496

Fontaine J et al. Canine cutaneous epitheliotropic T-cell lymphoma: a review of 30 cases. Vet Dermatol. 2010 Jun;21(3):267-275. http://www.ncbi.nlm.nih.gov/pubmed/20141606

Shadduck JA et al. A canine cutaneous lymphoproliferative disease resembling mycosis fungoides in man. Vet Pathol. 1978 Nov;15(6):716-724. http://www.ncbi.nlm.nih.gov/pubmed/751310

Thrall MA etal. Cutaneous lymphosarcoma and leukemia in a dog resembling Sézary syndrome in man. Vet Pathol. 1984 Mar;21(2):182-186. http://www.ncbi.nlm.nih.gov/pubmed/6610244

Fournel-Fleury C et al. Canine T-cell lymphomas: a morphological, immunological, and clinical study of 46 new cases. Vet Pathol. 2002 Jan;39(1):92-109. http://www.ncbi.nlm.nih.gov/pubmed/12102223

Ramos-Vara JA & Miller MA. Immunohistochemical detection of protein gene product 9.5 (PGP 9.5) in canine epitheliotropic T-cell lymphoma (mycosis fungoides). Vet Pathol. 2007 Jan;44(1):74-79. http://www.ncbi.nlm.nih.gov/pubmed/17197626

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Lymphoma in dogs

Lymphoma in dogs

Lymphoma is one of the most common malignant tumors to occur in dogs. The cause is genetic, but there also suspected environmental factors involved, including in one study an increased risk with the use of the herbicide 2,4-D. This risk was not confirmed in another study.
Commonly affected breeds
· Boxer
· Scottish Terrier
· Basset Hound
· Airedale Terrier
· Chow Chow
· German Shepherd Dog
· Poodle
· St. Bernard
· Bulldog
· Beagle
· Rottweiler
· The Golden Retriever is especially susceptible to developing lymphoma, with a lifetime risk of 1:8.

Classification

The cancer is classified into low and high grade types. Classification is also based on location. The four location types are multicentric, mediastinal, gastrointestinal, and extranodal (involving the kidney, central nervous system, skin, heart, or eye). Multicentric lymphoma, the most common type (by greater than 80 percent), is found in the lymph nodes, with or without involvement in the liver, spleen, or bone marrow. Mediastinal lymphoma occurs in the lymph nodes in that area and possibly the thymus.

Gastrointestinal lymphoma occurs as either a solitary tumor or diffuse invasion of the stomach or intestines, with or without involvement in the surrounding lymph nodes, liver or spleen. Classification is further based on involvement of B-lymphocytes or T-lymphocytes. Approximately 70 percent are B-cell lymphoma. Cutaneous lymphoma can be classified as epitheliotropic (closely conforming to the epidermis) or non-epitheliotropic. The epitheliotropic form is typically of T-cell origin and is also called mycosis fungoides. The non-epitheliotropic form is typically of B-cell origin.

Signs and symptoms

General signs and symptoms include depression, fever, weight loss, loss of appetite, and vomiting. Lymphoma is the most common cancerous cause of hypercalcemia (high blood calcium levels) in dogs. It can lead to the above signs and symptoms plus increased water drinking, increased urination, and cardiac arrhythmias. Hypercalcemia in these cases is caused by secretion of parathyroid hormone-related protein.

Multicentric lymphoma presents as painless enlargement of the peripheral lymph nodes. This is seen in areas such as under the jaw, the armpits, the groin, and behind the knees. Enlargement of the liver and spleen causes the abdomen to distend. Mediastinal lymphoma can cause fluid to collect around the lungs, leading to coughing and difficulty breathing. Hypercalcemia is most commonly associated with this type.

Gastrointestinal lymphoma causes vomiting, diarrhea, and melena (digested blood in the stool). Low serum albumin levels and hypercalcemia can also occur.
Lymphoma of the skin is an uncommon occurrence. The epitheliotropic form typically appears as itchy inflammation of the skin progressing to nodules and plaques. The non-epitheliotropic form can have a wide variety of appearances, from a single lump to large areas of bruised, ulcerated, hairless skin. The epitheliotropic form must be differentiated from similar appearing conditions such as pemphigus vulgaris, bullous pemphigoid, and lupus erythematosus.

Signs for lymphoma in other sites depend on the location. Central nervous system involvement can cause seizures or paralysis. Eye involvement, seen in 20 to 25 percent of cases, can lead to glaucoma, uveitis, bleeding within the eye, retinal detachment, and blindness. Lymphoma in the bone marrow causes anemia, low platelet count, and low white blood cell count.
Diagnosis

Cytology of lymphoma in a dog
Biopsy of affected lymph nodes or organs confirms the diagnosis, although a needle aspiration of an affected lymph node can increase suspicion of the disease. X-rays, ultrasound, blood analysis, and bone marrow biopsy reveal other locations of the cancer. The stage of the disease is important to treatment and prognosis.
· Stage I – only one lymph node or lymphoid tissue in one organ involved.
· Stage II – lymph nodes in only one area of the body involved.
· Stage III – generalized lymph node involvement.
· Stage IV – any of the above with liver or spleen involvement.
· Stage V – any of the above with blood or bone marrow involvement.
Each stage is divided into those with systemic symptoms (loss of appetite, weight loss, etc.) and those without.

Treatment

Complete cure is rare with lymphoma and treatment tends to be palliative, but long remission times are possible with chemotherapy. With effective protocols, average first remission times are 6 to 8 months. Second remissions are shorter and harder to accomplish. Average survival is 9 to 12 months. The most common treatment is a combination of cyclophosphamide, vincristine, prednisone, L-asparaginase, and doxorubicin. Other chemotherapy drugs such as chlorambucil, lomustine (CCNU), cytosine arabinoside, and mitoxantrone are sometimes used in the treatment of lymphoma by themselves or in substitution for other drugs. In most cases, appropriate treatment protocols cause few side effects, but white blood cell counts must be monitored.

Allogenic stem cell transplantation (as is commonly done in humans) has recently shown to be a possible treatment option for dogs. Most of the basic research on transplantation biology was generated in dogs.

When cost is a factor, prednisone used alone can improve the symptoms dramatically, but it does not significantly affect the survival rate. The average survival times of dogs treated with prednisone and untreated dogs are both one to two months. Using prednisone alone can cause the cancer to become resistant to other chemotherapy agents, so it should only be used if more aggressive treatment is not an option.
Isotretinoin can be used to treat cutaneous lymphoma.

Prognosis

Untreated dogs have an average survival time of sixty days.. Lymphoma with a histologic high grade generally respond better to treatment but have shorter survival times than dogs with low grade lymphoma. Dogs with B-lymphocyte tumors have a longer survival time than T-lymphocyte tumors. Mediastinal lymphoma has a poorer prognosis than other types, especially those with hypercalcemia. Otherwise, the stage of the disease is the best prognostic factor.

Lymphoma in cats

Lymphoma is the most common malignancy diagnosed in cats. Lymphoma in young cats occurs most frequently following infection with feline leukemia virus (FeLV) or to a lesser degree feline immunodeficiency virus (FIV). These cats tend to have involvement of lymph nodes, spine, or mediastinum. Cats with FeLV are 62 times more likely to develop lymphoma, and cats with both FeLV and FIV are 77 times more likely. Younger cats tend to have T-cell lymphoma and older cats tend to have B-cell lymphoma.

Cats living with smokers are more than twice as likely to develop lymphoma. Older cats tend to have gastrointestinal lymphoma without FeLV infection,though tests more sensitive to low level FeLV infections and replication-defective FeLV have found that many of these cats have been previously exposed. The same forms of lymphoma that are found in dogs also occur in cats, but gastrointestinal is the most common type. Lymphoma of the kidney is the most common kidney tumor in cats, and lymphoma is also the most common heart tumor.

Classification
Gastrointestinal lymphoma is classified into low grade, intermediate grade, and high grade. Low grade types include lymphocytic and small cell lymphoma. High grade types include lymphoblastic, immunoblastic, and large cell lymphoma. Low grade lymphoma is only found in the small intestine, while large grade can commonly be found in the stomach.

Cats that develop lymphoma are much more likely to develop more severe symptoms than dogs. Whereas dogs often appear healthy initially except for swollen lymph nodes, cats will often be physically ill. The symptoms correspond closely to the location of the lymphoma. The most common sites for alimentary (gastrointestinal) lymphoma are, in decreasing frequency, the small intestine, the stomach, the junction of the ileum, cecum, and colon, and the colon.

Cats with the alimentary form of lymphoma often present with weight loss, rough hair coat, loss of appetite, vomiting and diarrhea, although vomiting and diarrhea are commonly absent as symptoms. The tumor can also cause life-threatening blockage of the intestine. Cats with the mediastinal form often have respiratory distress and fluid in the lung cavity. If lymphoma develops in the kidney, the cat may have increased water consumption and increased urination.

Lymphoma of the kidney presents as bilateral kidney enlargement and failure. If the lymphoma is located in the nose, the cat may have discharge from the nose and facial swelling. Lymphoma of the heart causes congestive heart failure, pericardial effusion, and cardiac arrhythmias. Ocular lymphoma in cats often presents as anterior uveitis (inflammation of the inside of the eye). Cats who are also infected with FeLV often present with pale mucous membranes due to anemia. Anemia is a common problem in all cats with lymphoma, but hypercalcemia is rare.

Diagnosis is similar to dogs, except cats should be tested for FeLV and FIV. It is important to differentiate the alimentary form of lymphoma from inflammatory bowel disease because the signs are so similar in cats. A biopsy is necessary to do this.

Treatment and prognosisChemotherapy is the mainstay of treatment for lymphoma in cats. Most of the drugs used in dogs are used in cats, but the most common protocol uses cyclophosphamide, vincristine, and prednisolone. Gastrointestinal lymphoma has also commonly been treated with a combination of prednisolone and high dose pulse chlorambucil with success. The white blood cell count must be monitored. Remission and survival times are comparable to dogs. Lower stage lymphoma has a better prognosis. Multicentric lymphoma has a better response to treatment than the gastrointestinal form, but infection with FeLV worsens the prognosis.

Lymphoma in ferrets

Lymphoma is common in ferrets and is the most common cancer in young ferrets. There is some evidence that a retrovirus may play a role in the development of lymphoma like in cats. The most commonly affected tissues are the lymph nodes, spleen, liver, intestine, mediastinum, bone marrow, lung, and kidney.

In young ferrets, the disease progresses rapidly. The most common symptom is difficulty breathing caused by enlargement of the thymus. Other symptoms include loss of appetite, weight loss, weakness, depression, and coughing. It can also masquerade as a chronic disease such as an upper respiratory infection or gastrointestinal disease. In older ferrets, lymphoma is usually chronic and can exhibit no symptoms for years. Symptoms seen are the same as in young ferrets, plus splenomegaly, abdominal masses, and peripheral lymph node enlargement.

Diagnosis is through biopsy and x-rays. There may also be an increased lymphocyte count. Treatment includes surgery for solitary tumors, splenectomy (when the spleen is very large), and chemotherapy. The most common protocol uses prednisone, vincristine, and cyclophosphamide. Doxorubicin is used in some cases. Chemotherapy in relatively healthy ferrets is tolerated very well, but possible side effects include loss of appetite, depression, weakness, vomiting, and loss of whiskers.

The white blood cell count must be monitored. Prednisone used alone can work very well for weeks to months, but it may cause resistance to other chemotherapy agents. Alternative treatments include vitamin C and Pau d’Arco (a bark extract).The prognosis for lymphoma in ferrets depends on the their health and the location of the cancer. Lymphoma in the mediastinum, spleen, skin, and peripheral lymph nodes has the best prognosis, while lymphoma in the intestine, liver, abdominal lymph nodes, and bone marrow has the worst.

Lymphoma in Dogs - Pros and Cons of Lymphoma Treatment

The symptoms include vomiting, diarrhea, tiredness, respiratory issues, lesions on skin and loss of urge for food.

In the innovative phases of lymphoma, the basic signs contain fat loss, anemia, reduction of urge for food and weak spot. As the lymph circulates through the human body, other organs this kind of as the spleen, liver and bone marrow can be influenced. If left untreated, canines with lymphoma have a daily life expectancy of four-6 weeks following diagnosis.

Dog lymphoma therapy

Lymphoma in dogs can be dealt with with chemotherapy, prednisone therapy and blood stem mobile transplant.

Chemotherapy

Chemotherapy is the major treatment method for lymphoma in dogs. With this treatment, much more than 80% of puppies will go into remission for at the very least twelve months. The many chemotherapy protocols are either multi-agent or single-agent.

Multi-agent chemotherapy requires a combination of drugs offered orally or by injections. It is a lot more effective than single-agent chemotherapy and produces more time remission. Nevertheless, toxicity and the chance of undesired side consequences are higher as far more drugs are employed. This type of chemotherapy demands greater time motivation and larger expenditure.

Single-agent chemotherapy protocol employs a single chemotherapy drug. It is significantly less harmful and costly than multi-agent chemotherapy. Any adverse aspect influence is attributed to the solitary drug, so a distinct drug can be used instead. As it is significantly less successful than multi-agent chemotherapy, the initial remission period of time is shorter, about seven months.

The period of remission and decision of chemotherapy protocols rely on the major area of tumor, lymphoma phase, all round health of dog at the starting of treatment method and any changes in organ function. Most canines reply to chemotherapy with nominal (if any) aspect consequences. The common side consequences are nausea, reduction of urge for food, diarrhea, vomiting, tiredness, hair decline and sluggish hair development. Critical facet results are unusual and only seen in 5-ten% of canine.

Prednisone therapy

Lymphoma in puppies can be dealt with with prednisone (corticosteroid) in which chemotherapy is not recommended. Chemotherapy can be pricey, so some pet house owners select prednisone treatment rather. Canine provided prednisone knowledge considerable advancement in the limited time period and can lead a much more cozy daily life. Despite the fact that sick, they try to eat, transfer and come to feel better although going through prednisone therapy.

Even though prednisone therapy is low-cost, it is not as successful as chemotherapy. Remission is quick, about two-three months with feasible aspect outcomes. Prednisone remedy ought to not be carried out prior to chemotherapy as it minimizes the performance of the latter.

Blood stem mobile transplant

Stem cells are harvested from bone marrow. Only stem cells that are free of charge from cancer are reintroduced into the pet right after it has undergone total entire body radiation to eliminate of remaining most cancers cells in the entire body.

Though this treatment method raises the survival rate substantially, it is really costly.

Your vet can suggest you on the most suited lymphoma treatment for your canine. You want to take into account the expenses, time determination, lifestyle span and your dog’s convenience in selecting regardless of whether to move forward with remedy.

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