Re: Chronic lymphoid leukaemia in dogs

Rory Bell — Mon, 02 Dec 2013 13:48:47 GMT

Hi Chris

Either phone the hospital switchboard and ask for me (01638 572012) or rb@dwr.co.uk. is my e-mail. I've got a case waiting and a few procedures so if phoning, best to leave it until after 3pm. otherwise just drop me a line with your number and a convenient time(s) and I'll do my best to call back then.

cheers

Re: Chronic lymphoid leukaemia in dogs

chris robinson — Mon, 02 Dec 2013 13:12:25 GMT

Thanks, Rory!

That's really helpful!

Can I ring you or what is the best email to contact you on about this?

Cheers

Chris

PS first time, I used the forum and really impressed!

Re: Chronic lymphoid leukaemia in dogs

Rory Bell — Mon, 02 Dec 2013 10:57:58 GMT

Hi Chris

I agree it sounds like CLL is a likely diagnosis; if you wanted further confirmation then submitting a further blood sample for assessing clonality of the peripheral lymphocytes would be helpful; the reference lab you usually use should be able to help you with this. The gamopathy would by more consistent with a B cell rather than a T cell variant.

I would usually use chlorambucil and pred. Your peripheral lymphocyte count will decrease over weeks rather than days in all likelihood. The trick is to monitor the haemogram in these dogs on a weekly basis initially, looking a progressive fall in lymphocyte count with a corresponding resolution of other cytopenias and the gammopathy. Splenectomy as adjuvant treatment had not been evaluated in these dogs, is rarely indicated in people with CLL and is not something I'd usually consider unless the dog was either refractory to other interventions or the spleen had ruptured.

Early treatment versus delayed intervention has not been studies in terms of predisposing to a blast crisis; given the magnitude of lymphocyte count, presence of other cytopenias and hyperglobulinemia, and presence of clinical signs, I think instigating treatment at this stage is preferable to benign neglect.

Hope this helps, feel free to give me a ring or send an e-mail if you'd like to chat things through further

cheers

rory