In last week's Winning the Battle Wednesday post, I wrote about my dog Reese's journey regarding getting properly diagnosed with low-grade (or indolent) T-cell lymphoma.  This week, I would like to write a few quick facts about this rare form of canine cancer and how it differs from more common forms.

Also, you can check this Doggie Fetch to get some better ideas and tips about your dog training.

*Warning: I am not a vet, so please contact your medical professional with any questions or concerns about your own pups.* 

Q: What is canine lymphoma?

A: Canine lymphoma refers to cancer of the lymphatic system-- simple, right?  Not quite.  Just like us humans, dogs' lymphatic system refers to a collection of lymph nodes that assist in a great deal of immunity functioning.  Lymph nodes can be external (like the ones under your neck) or internal (there are several in the stomach and chest).  Lymphoma can also originate, spread, or infect the spleen, thymus (an organ in the chest), or even the stomach lining.

Lymphoma typically occurs when lymphocyte cells-- a type of white blood cell-- spreads excessively and rapidly.  This mainly occurs in the lymph nodes but can also originate in the stomach, spleen, or anywhere else the lymphatic system travels.

Q: What are the types of canine lymphoma?

A: There are three parts to this-- the grade of lymphoma, the type of lymphoma, and the presentation of lymphoma.

The grade (or histologic grade) refers to whether a dog has high-, medium-, or low-grade lymphoma.  To put very simply, this just defines how fast the cancer is spreading.  High-grade and medium-grades often occur suddenly and spread rapidly and, without treatment, can end a dog's life in a matter of weeks.

Low-grade lymphomas spread very slowly and dogs can live longer without treatment.  However, high- and medium-grade lymphomas will respond much better to chemo and possibly enter into remission.  This is trickier to achieve with low-grade lymphoma.  The most common form of lymphoma, by far, is high- or medium-grade.  Low-grade tends to account for 10% of lymphoma cases in dogs, although that number may be an underestimate.

The type (or immunophenotype) of lymphoma refers to whether a lymphoma is B-cell or T-cell in nature.  Typically, B-cell is the better prognosis, as it responds more to chemotherapy (which is the treatment of choice).  However, in low-grade varieties T-cell lymphoma spreads much more slowly than B-cell.  Basically, if a dog has high- or medium-grade lymphoma, B-cell is the better prognosis; if your dog has low-grade lymphoma, however, T-cell will be the better prognosis.  Confusing, right?  However, B-cell is more common overall.

The presentation is where the lymphoma originates and is present.  For some dogs, their lymph nodes only seem to be affected, while others are affected in their stomachs, spleen, etc.  Also, dogs are classified by whether they have no other symptoms besides cancer (substage a) or if they show additional illness, such as lethargy, weight loss, or poor appetite (substage b).  Obviously, a dog has a better prognosis if they are treated in substage a.

Q: What is the prognosis of a dog with lymphoma?

A: It is hard to say-- lymphoma is one of the most common forms of cancer, but thankfully it is one that responds well to chemotherapy.  High- and medium-grade are most common and, without treatment, dogs can live for a few weeks on average (although some pups have lived longer).  With treatment, which is typically chemotherapy, dogs can be in remission (meaning that there is no sign of the cancer) for over a year.  Additional remissions can be achieved, but they are typically shorter.  With low-grade lymphoma, prognosis depends-- some dogs can live two or more years while others, especially those with indolent lymphoma, may not even die from the disease.

Q: How is indolent lymphoma different than low-grade lymphoma?

A: There is some debate about this, as the two terms are used interchangeably.  However, it is generally explained that low-grade lymphoma refers to cancer that, while still spreading, is at a very slow rate.  Indolent lymphoma, on the other hand, suggests a much slower, often stable journey.  There are three types of indolent lymphoma-- two of them are B-cell (follicular and marginal zone) and the other is T-cell (T-zone).  B-cell, indolent lymphomas had a median survival time of nearly 2 years without treatment; pups with T-zone lymphoma are reported to live anywhere from 3 years to 8 years without any treatment.  Indolent lymphoma is typically not treated with chemotherapy but some dogs reported benefits from this therapy.

Q: What form of lymphoma does Reese have?

A: As the title of this post suggests, I am very, very lucky that my pup has T-zone lymphoma, which is associated with the best prognosis.  She has had enlarged lymph nodes for over a year, has gained weight, and shows no other signs of illness.  I am hoping to keep her happy and healthy for many, many more years.

Q: How are you treating Reese?

A: Reese currently sees a wonderful veterinarian oncologist as well as her regular vet.  While we tried an oral, intense chemotherapy protocol (called CCNU), it didn't show to be that effective in reducing her lymph nodes.  For now, she is taking a low-dose of oral chemo (Cytoxan) and very low-dose of prednisone.  She will likely remain on this for the rest of her life, which is fine by me.  I also changed her diet and am giving her supplements, which I will explain in my next post.

Q: What should I do if I think my dog has lymphoma?

A: If you notice ANY swelling of ANY lymph node, get to your vet immediately and request a fine-needle aspiration, where the vet takes a needle and extracts some fluid from the lymph node.  Within a week, you should know whether your dog has lymphoma or not.  If it is inconclusive, opt for an incisional biopsy-- they more than likely just need to take a small sample of the lymph node and this is an outpatient procedure.

This should give you a definitive answer.  Also, I would recommend finding a veterinarian oncologist-- they may be more pricey initially, but they will save you a lot of money in the long run because there will likely be more trial and error with treatment otherwise.

Q: How about the cost?

A: Typically I don't go into this, but I know it's a very pressing concern.  Here is the breakdown of what things cost:

    *Aspirations (2)= $300

    *Incisional biopsy= $500 total

    *1 month supply of prednisone=$7 (cheap!)

    *1 month supply of oral chemo (Cytoxan)= $50 (go to Costco-- I saved $7 per pill! It would have been $150 otherwise-- you don't need a Costco membership to use their pharmacy)

    *Blood work (1 time per month)= $90 (for blood and liver checks)

Yes, treating Reese has been expensive-- however, in my opinion it is worth it.  She's happy, healthy, and is getting the best treatment possible.  Not gonna lie-- if your dog has the more common high- or medium-grade lymphomas, one protocol may cost up to $2000. 

for these costly procedures-- they have an interest-free payment plan, as well.  Just make sure that your vet accepts Care Credit.

Also, I would recommend buying pet insurance-- it is my biggest regret, as a lot of this would have been paid for.  I'm buying it for Paisley and will be getting it for my next pup. 

has received great reviews, FYI.

Thank you for reading through my very, very novice explanation of canine lymphoma.  As I previously stated, I am not a vet-- I am simply a pet mom who did a lot of research on this.  Please see your vet if you think your pup has lymphoma-- the sooner you know, the sooner you can treat!

Stay tuned next week for an explanation of Reese's diet and supplements that I believe have helped her greatly.