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The Big C- lymphoma in dogs.
I expect that most us know someone who has been affected by, or even died from, the ‘Big C’- cancer. Cancer is a very difficult thing to understand. I could never grasp as a child how a lump could kill you. The fact is that cancer is merely uncontrolled growth of cells. All our cells are programmed to replicate to replace dying cells. They are also programmed to stop replicating when there is enough. Sometimes this process goes wrong and the cells don’t stop. They become abnormal and don’t stop growing. The rate of growth increases and the cells invade into normal tissue. The severity depends on which cells are affected and whether the masses can be removed.
There are, of course, treatments available such as chemotherapy and radiation therapy. These concentrate on trying to target and kill the abnormal cells and work because they target fast- growing cell- types. This is why people on chemotherapy lose their hair and suffer intestinal upsets. These cells are normal but replicate very quickly by nature of their jobs so tend to get killed by the treatment. This is one of our biggest problems with cancer. It is basically a part of us. The things we are trying to kill are cells the same as all our others. It is not like aiming a drug at a bacteria or a virus which is different to the rest of our body.
A couple of weeks ago I had a dog called Jess booked in for me to operate on. I had seen her a few times in the past and was surprised to see she had been booked in to have a mammary mass removed. The reason I was surprised is because Jess is only 5 years old and was neutered at a young age. Mammary tumours are almost unheard of in bitches that are neutered before their 3rd season. I wasn’t too concerned because 50% of these tumours are benign and can easily be removed. However, when we saw Jess that morning things had already changed. We were about to take a blood sample to make sure she was fit for the anaesthetic when we felt two large lumps under her chin. They were enlarged lymph nodes. I checked the rest of her body in the places where the other nodes are and they were all much bigger than they should be. In fact, what had first been thought of as a mammary tumour was a lymph node in her groin.
My day had suddenly got a whole lot gloomier. Cancer is hard to come to terms with any time but when young animals are involved it is even harder to swallow. There never seems to be any justice. There is a saying that goes, ‘only the good die young’. At work we always say that it is always the nicest animals with the nicest owners that seem to get the worst problems. Jess is no exception. She is a German Shepherd dog with the most lovely nature and the sweetest owners you could wish to meet.
I decided there really was no point in removing the mass and decided instead to take some biopsy samples of the lymph nodes. The most likely thing was lymphoma. This is a type of cancer that spreads through the lymph system. In a way this was possibly better that it could have been. Lymphoma is one of the types of cancer that can respond very well to chemotherapy because the drugs can get right to the heart of the problem. It tends to be very large, single tumours that do not respond because there is very poor penetration by the drugs into the mass.
Jess went home that night on antibiotics just in case she had a very nasty infection that could be making her lymph nodes react. It was a slim glimmer of hope and was soon snuffed out when we received the biopsy results the next day. Jess did indeed have a highly malignant form of cancer called lymphoma/ lymphosarcoma. The sample showed that the form she had was replicating at a very high rate and as such made her a good candidate for chemotherapy.
I had a long chat with her owners when we found out. It is different to the choices humans have to make. Chemotherapy in animals does not have the same side- effects that human chemotherapy does but the drugs are the same and can make the animals feel unwell. Sometimes people understandably don’t want to put their animal through it, particularly if they are old. There are many things to consider such as, if you do put them through it, what is the outcome likely to be? Is the end result worth what the animal must tolerate? What is the likelihood of a cure or how long is the animal likely to live with or without the drugs?
I always try to guide owners without placing pressure on an already strained and difficult time and I hope Jess’s owners feel happy with the conclusion we came to. Jess is a young and otherwise healthy dog, she has a type of cancer that we know can do very well with chemotherapy and, on the most basic level, her treatment is going to be extremely expensive but she is insured so we can do everything we need to to try and help her.
At the time of writing this article Jess had just started her chemotherapy and is on two types of tablets and a drug called ‘vincristine’ that has to be injected intravenously at various intervals. Although her future is uncertain at the moment, at least we can be happy in the knowledge that she has a good chance and we are in a position to do all that we can for her.