I almost cried as I read this.  I've lost two dogs to lymphoma now; Cooper just two months ago.  To think that there may be a cure if I ever have another dog with this horrible disease makes my heart soar!  You have every right to be proud of your classmate!

Sassy March 27th, 2009 06:23:15 PM

I adore Dr. Suter! I was in my senior year when he was a resident at Davis and he was so great with everyone- clients, students, patients. I was only on oncology for 2 weeks and I learned so much practical advice from him. Glad to see his passion for the field is as strong as ever.

JV at pawcurious March 27th, 2009 08:03:57 PM

Another great one here, thanks for posting this! We're keen on informative canine cancer articles and have added this one to our tripawd tips and resources forum discussion.

tripawds.com March 27th, 2009 09:11:35 PM

I hope the protocol isn't similar to my son's. My son was diagnosed with anaplastic large cell lymphoma in 12/2000 he was 14 yrs old. The cehmotherapy regime at the time was recently off trials, the best of the best and was horrendous. He suffered greatly. He lived, but chemo in humans can carry quite a price.

I wouldn't put a pet through it, I'd have to be certain it didn't do to the pet what it did to my son.

this is one case where I might be tempted not to "do everything"

LorriM March 27th, 2009 10:19:34 PM

LorriM: You raise an excellent point that I always try to make when discussing chemotherapy in pets. Sorry I missed it in this post but here it is now:

Chemotherapy in pets is designed to be humane. In veterinary medicine we are unwilling to allow our pets to suffer what humans do. That's why the cure rate is so low with canine lymphoma's chemotherapy protocols. If our patients do not respond positively to the chemo we stop it. Some side effects are to be expected but they should be limited to milder symptoms (such as GI side effects for a couple of days post-injection). 

The goal of chemo is a prolongation of comfortable life. Anything less is unthinkable.

Dr. Patty Khuly March 28th, 2009 07:41:27 AM

After reading this post, Dr. Suter made me change a couple of things. He wants to be sure everyone understands that most of his patients are young dogs and that the demographics of the disease are now skewed towards dogs in their prime--some as young as ten months old! He also notes that the cost is $13,000 to $15,000--which is "still really expensive," he notes.

He's also offered a website for those who want to see the survivors of the procedure. It also tries to recruit money for patients whose owners can't afford this kind of care--sweet! 

Cody is in the picture at the top of this post. And here's Maverick:

Dr. Patty Khuly March 28th, 2009 09:15:52 AM

I know this isn't a guest post, but perhaps Dr. Suter might respond. It is only very recently that I have learned that lymphoma has a few subtypes beyond Hodkins, non-Hodkins. I'm wondering how this pertains to canines? And possibly treatment choice?

And then I have been corrected that when I have referred in the past to two canines succumbing to lymphoma, it is incorrect because it was a metastesis to the lymph nodes (one was TCC, the other mammary cancer). And does this also have an effect on possible prescribed treatment?

Isn't lymphoma the #1 cancer in all dogs? And would it be safe to think that a compromised immune system is involved either pre-diagnosis or at least post-diagnosis?

Barbara A. Albright/NH

Pocket's Story from NH March 28th, 2009 02:03:50 PM

Oh, and how come oncologists have a GREAT sense of humor? (human ones too!)

Barb A./NH

Pocket's Story from NH March 28th, 2009 02:06:27 PM

I'll do my best, Barbara, but he's a lurker.

Dr. Patty Khuly March 28th, 2009 04:36:36 PM

Related to Maverick's case, he was the third dog to have a Bone Marrow Transplant at NCSU under Dr. Suter's care. He actually had Acute Lymphoblastic Leukemia (ALL), not lymphoma like all the other dogs who went through this procedure. To the best of our knowledge, Maverick is the first dog in the world CURED on leukemia, which is a huge medical breakthrough. We are trying to get the word out because this is a major step in canine and hopefully also human oncology. Please visit our website, www.mavericktheweim.com for more information! You can also find Maverick on Facebook (search for Maverick the Weim) and become a fan! - Howie Altman

Howie Altman (Maverick's owner) March 28th, 2009 05:28:33 PM

Howie: Thank you for posting this here. Isn't it great to know your own dog is pioneering a cure for others? Gives ME goosebumps, anyway. Give Maverick a kiss from all of us.

Dr. Patty Khuly March 28th, 2009 05:35:58 PM

Howie: That is just amazing and I am so glad for you & Maverick! A handsome Weim, BTW!

Barb A./NH

Pocket's Story from NH March 28th, 2009 08:24:32 PM

LorriM – As the owner of a dog who went through 7 months of chemo, I can vouch for the fact that the treatment isn't as harsh as what I've heard it is like for humans. Like Dr. K. said, with each dose (3 - 4 weeks apart) our guy had a couple of "off" days where he obviously wasn't himself, but then it was back to his normal "gotta be doing something" self. He never lost his coat, but it did change texture. He only ever lost his appetite once in a while post chemo dose and then it was a matter of picking slowly at his meal, not turning completely away. He did end up with a chronic GI problem that we've finally gotten under control and also a chronically low platelet count. His endurance isn't what it once was, but he still runs hard. (Still in training as if he was going to be running hunt tests at the master level.)

My understanding is that when chemo is administered in dogs, enough of the drug is given to smack the cancer back, but not so much that the cancer is completely obliterated. It's a compromise solution that offers the best quality of life for as long as possible.

Deanna March 28th, 2009 10:16:56 PM

This gives me goosebumps too!  Although I live in the wrong place and likely could not have come up with the money, the prospect of a cure is just amazing!  I admittedly knew very little about canine cancer before my dog was diagnosed with lymphoma, but I was just amazed at what can now be done to prolong very high quality life for our dogs!  My dog was treated at the Animal Cancer Center at Colorado State University with the most aggressive chemo available.  She had essentially no side effects and went into remission after the very first dose.  Unfortunately the remission was short lived (11 weeks... she did not finish the 14 week protocol), but a rescue protocol gave her 6 more weeks of remission, all while feeling fine.  A third protocol failed entirely, although gave her no side effects!

My main reason for commenting here though is that I want to encourage people to consider the possibility of entering clinical trials with their dogs. As the video clip mentioned, most human protocols and procedures are first developed in dogs! I am such a believer in research that after all the standard protocols failed I entered my girl into a clinical trial at CSU... trying out a new dosing schedule for a drug that had  already shown some signs of effectiveness.  While it was not the magic bullet for her, and she did suffer some side effects from this drug, it gave me some peace to know that in a small way she was helping other dogs and humans (the drug is already in testing in humans too!).  If I am ever in a situation like this again, I will jump at the chance to be part of another clinical trial...  research is so important!

But back to the original topic every time I hear something about the bone marrow transplants I get so excited for the future!  I'm so glad that they are bringing this option back to the dogs!

P.S.  Dr. Suter said that lymphoma is a big problem in purebred dogs... but it is also a problem in mixed breeds...  my dog was a 8 year old lab/shepherd/greyhound? mix.

eegd March 28th, 2009 11:35:55 PM

I wonder if the clients knew that their pets are being over vaccinated thus causing alot of these cancers. I didn't know until a veterinarian killed my dog that this was the case. I lost my young dog from a drug butthat was used to sedate my healthy dog. He used a cattle & horse drug without my informed consent. That got me to researching and making calls to all of the Universitys and interviewing other vets. What I found out disturbed me greatly. I found out that our pets are being over vacinnated and things like heart murmers were being missed. I for example took my dog in for a health exam and she had a heart murmer. I did not find out until she was in heart failure which was only 2 weeks later. Unfortunately she lost her 2 month battle with this. She may have lived if when I suggested that I got to a specialist my vet told me that she could be maintained in his office. They couldn't and I lost my beloved dog in the end. I have her son with the same condition that I found, not the vet and I immediately went to a cardiologist to have him checked and he has been on heart meds for 3 1/2 years and is now 15 yrs old. His mom was only 12 yrs old when I lost her. A friend of mine had a toy poodle and they gave a rabies shot and her dog had seizures so bad that eventually she lost her. I think that vets need to tell their clients every side effect of ever medication and drug and surgery each and every time and that the truth is that they don't need vaccinations every year. Also nutrition I have not found a vet out ther except one in Canada, that really knows anything about dog food. Fortunataly I know know how to take care of my dog the right way. I wish that I did not have to lose a pet because of not knowing in order to learn what should have been told to me by my vet. I feel that it is the veterinarian's obligation to take care of our pets the right way after all we do pay for it . I want to tell all of you unknowing people with pets, REASEARCH know what you are giving your pets do not depend on your veterinarian that you have been lead to trust and believe in totally. Don't find out the hard way.

Pat D March 29th, 2009 07:29:27 AM

Thank you, Pat D, for your comment. We have yet to establish the many possible links between routine exposure to chemicals and chronic conditions in our pets. Though we've identified many correlations the question of causation eludes us in many cases. While there are some exceptions to this (vaccine-associated sarcomas in cats, for example), we still have much to learn.

You make fine points on seeing specialists and on minimizing vaccine exposure. Both are areas in which veterinary medicine has made BIG strides over the past ten years. Vaccine safety and new protocols for much less frequent vaccine administration has been a boon to animal health, IMO. So has the growing prevalence of specialty hospitals in almost every nook and cranny in the US. 

And yes, your pet's health is ultimately in your hands. You should be an educated consumer and an aggressive advocate for your pet's health.

Dr. Patty Khuly March 29th, 2009 07:40:56 AM

Barbara asks some pretty important questions which I'll try to answer: Canine lymphoma comprises about 83% of all hematologic (blood) cancers, and it comprises up to 25% of all canine cancers, rivaled only by canine skin mast cell disease (about 24% of all cancer in dogs). Lymphoma in dogs is quite similar to a variant of human non-Hodgkin's lymphoma called diffuse, large, B cell lympohma or DLBCL. In people, B cell lymphoma comprises a heterogeneous group of B cell cancers that are actually all treated quite differently. They also have very different prognoses also. At this point in time, we are still not sure if canine lymphoma is one disease, or a variety of diseases like in people. My laboratory has been trying to address this issue for the last 3 years and we are finally making some headway. It appears that lymphoma is dogs is similar to the human disease-so we are seeing a variety of types of B-cell cancers in dogs. Some of those types described in people are not as common in dogs, but overall, it appears to be pretty heterogenous, just like in people. So..that begs the question "Should we be treating these different lymphoma subtypes in dogs differently, like they do in people?. The answer is most likely yes, but we are still in the process of learning about these different types and figuring out if they also carry different prognoses (FYI, prognoses means final outcomes). Most likely, within the next few years, more specific treatment protocols for canine lymphoma will be developed, with the hope that we can "do better" than we are doing now, which means curing more than 0%-2% of these patients. Incidentally, something that ALL veterinary oncologists recognize is that we are clearly at the end of the therapeutic value of chemotherapy in dogs. What that means is that no matter what combination of drugs you give a canine lymphoma patient, it is most likely not going to make all that much difference. As Dr. Khuly stated so clearly, using these palliative doses of chemotherapy, although affording an excellent quality of life, will rarely cure a canine patient. This is exactly why I started the transplant program at NC State, since I was not happy with this very sad fact. Although still quite expensive (I'm working on making it cheaper!!), we can at least now entertain the concept of cure, which is something we've never been able to do with standard chemotherapy.

Dr. Khuly also points out (she is very smart-you guys should listen to her!!), that the true cause of most companion animal cancers is not known. We know in people that farmers who use a lot of pesticides, people who work in leather dyeing facilities, folks who have AIDS, and people with Epstein-Barr virus and other viral infections, to name a few, all carry an increased chance of getting lymphoma. Although there are some suggestions in the vet literature that dogs receiving topical insecticides, dogs living in marshy areas where insecticides are sprayed to control mosquitos, and dogs living near high tension wires may have an increased risk of lymphoma, there has been no definitive proof at this time. What I can say is that there is clearly an epidemic of NHL in people and there is also an epidemic of lymphoma in dogs. Dogs are certainly living longer these days, like people, but dogs also live in the same environment we do-drinking the same water, breathing the same air, and many times eating the same food (shame, shame!!). Dogs have also been in-bred and/or line-bred to produce all the various breeds out there today (what is it, about 350 different breeds now?).  So, I think it's probably a combination of line-breeding and environmental factors.  While we do see the occasional mixed breed dog in our clinic at NC State, the vast majority are pure breed dogs. Goldens, labs, shephards, boxers, rotties..by far the most popular breeds and by far the biggest breeds loaded with all sorts of cancers. I say, go labradoodles!!!

Finally, I beg a modicum of cautious optimism when it comes to Maverick Altman, the ALL weimeraner we treated with a bone marrow transplantation. He had no obvious evidence of disease when he left the hospital 2 months ago and he remains clinically normal at home. Acute leukemias in dogs are a very different disease entity than lymphomas. ALL in dogs is an extremely, and I mean extremely, aggressive type of cancer that many times kills dogs within weeks. Myself, and Mavericks owners, went down the transplant road agreeing that we were not sure if a transplant would help Maverick long-term or not. Again, while he is still doing well at home, I am very hesitant to start screaming the word cure and I worry about him daily. We need much more time (a few years) to determine if he is indeed, cured. I certainly hope so, but the cure rate of this disease in people is very low, with relapse being the rule rather than the exception.

I must go now--our next transplant patient, Popie from NY City, is being taxied from the Raleigh airport as we speak! Send good thoughts to Popie and his owner, Nick,  over the ensuing 3 weeks.

Dr. S

Dr. S Suter March 29th, 2009 02:33:28 PM

Thanks Steve! Though I know you say it in jest, I'm one of those shameful people who feeds their dogs my own food. But then, you already knew that about me. ;-)

Dr. Patty Khuly March 29th, 2009 05:52:03 PM

Dr. S. Suter: Thank you for posting! It is both fascinating & amazing! And yes, best wishes for Popie & Nick

Did you have to give the labradoodle comment though? You were doing great up till then.;) That's like saying humans are too inbred causing widespread cancer issues, although unquestionably certain cancers have familial connections!

But unquestionably, the Scottish Terrier Club of America is working on a propose theory of TCC having a strong hereditary component (18x more risk), along with environmental factors.

Perhaps, there was a bit of personal doom, having lived for many years between both "power lines" and an "apple orchard", with the last year of herbicides used late 80's for the power line cleanup (OMG, you never saw vegetation wither and die so FAST!)

But, only one got TCC, the other bone cancer, Pocket's dam exposed for 6 years before moving, lived another 8 1/2, with huge liver tumor & gall bladder caused death.

Now I'm next to a farm land swamp & cell tower, but NO herbicides or pesticides...including our own "wild weed yard"!

Thanks again, I'm going to read up, Barbara A./NH

Pocket's Story from NH March 29th, 2009 10:10:05 PM

I did some reading up, which just led to more questions!!!

How important is the difference between lymphosarcoma & lymphoma?

How often does picking up "atypical lymphocytes" in the blood lead to further investigation?

And the labradoodle comment was only a joke, hope it was taken that way!

Barb A.

Pocket's Story from NH March 30th, 2009 09:10:41 PM

It is exciting to see that stem cell transplants are now being used to cure cancer in dogs.  Though Dr. Suter is currently offering autologous (using the dog's own stem cells), transplant I want all to know that stem cell transplants for companion animals began in WA state by a Bellingham veterinarian, Dr. Edmund Sullivan, 2004, on a Golden Retriever named Comet. 

Comet had an allogeneic (using a relative donor match) transplant.  This transplant allowed Comet's owners, the Halletts, to enjoy four more years to be with their dog. 

My dog, a beagle named Bailey, was Dr. Sullivan's  second tranplant dog.  She too had an allogeneic transplant, but relapsed five months later, and after having a DLI (donor lymphocyte infusion) after her donor brother was given a series of turmor vaccine injections died nine months after her transplant.  The DLI appeared to be working, but she did eat tainted dog food from China.  However,  test results  did not prove this is what killed her.  

Currently Dr. Sullivan does not have access to a linear accelerator for the total body irradiation needed before a transplant.  I recently formed a charity, Comet's Tale,  at www.comets-tale.org to raise money to establish a radiation facility for pets here in WA so Dr. Sullivan can continue to save pets from cancer on the west coast.

Because it took me over a year to find Bailey's mother, five siblings, and five half siblings which I did with the help of a private detective and the press, I would like to see a registry in place for pets like they have for people.  Bailey did come from a breeder who are required to keep records of where their dogs go, but many pet owners have no idea as to  who and where their dog's relatives are.  Allogeneic transplants have a higher success rate than autologous transplants.

I have no regrets in opting for the transplant.  Hope is everything! Bailey was the best, and I will feel her little spirit with me forever.  If you care to learn more about Bailey you can go to www.savebailey.com which tells her story in words, photos, and press releases.  I am in the process of writing a book about Bailey and Comet.

Sincerely,

Cathy von Haartman

Cathy von Haartman April 6th, 2009 01:05:48 AM

Molly is Dr. S's 4th lymphoma dog to receive a transplant and I have to tell you, she is tremendously happy now and acting at least 2 years younger (help!). She was tired about two days after the hospital stay but it all has been upward and onward since then. We hope to have her website done in about a week. We will return then and post a link.

Gary G. April 16th, 2009 04:15:19 PM

My 4 yr old female Malinois hs a mass on her side near where her thigh begins. It came on overnight and has not grown over the past 5 days. Our Vet was not concerned and treated it as an allergic reaction, giving her an injection. (she had her teeth cleaned 2 weeks earlier) He told us it should be gone in 4 days. We called him on the 5 day and informed him it was unchanged. He told us to wait another week to see if it disappeared. She is acting normal and the site does not seem to cause her any pain however, we are worried about her. Does anyone have any experience with an unexplained bump on their dog?

Malinois Lady April 27th, 2009 10:04:15 PM

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amal_ May 22nd, 2009 09:34:23 AM

My wonderful 3 1/2yr old beagle mix just finished a 20 week stent of chemo for his lymphoma. He did great on chemo, with very few episodes of GI issues. He actually enjoyed going to the vets office for chemo 'cause he knew that meant dog park and a Sonic burger after. He is doing well now and we are keeping our fingers crossed that he will remain in remission for a long time. I would have had the transplant done but he is only 25lbs and we live a long way away. Maybe when remission is over Dr Suter will be ready to tryout a transplant in a smaller dog.

As for the person worried about the lump on her dog's leg then ask the vet to biopsy it. She is your dog and you get to say which road you want to take - wait and see or find out. I was a little pushy about my pup's lump and got his cancer diagnosed at a very early stage, which will hopefully help in the long run.

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