RE: Lymphoma help please

shanley barber — Thu, 18 Mar 2021 21:38:25 GMT

Hi Anthony,

Many thanks for your reply. The case has progressed since I posted, and the single node is now enormous (10 x 10 cm) and others still aren’t enlarged, which is odd. Perhaps, as you say, this just him coming out of remission.
The owners have chosen not to pursue any further testing, and to just keep him comfortable with oral preds, which they can give at home and avoid the need for him coming into hospital for treatment.
I appreciate your response!
Thanks again,

Shanley

RE: Lymphoma help please

Anthony Dennison — Thu, 18 Mar 2021 17:48:10 GMT

Hi Shanley,

I'm not a specialist, but have got my CertAVP(SAM) and do a fair bit of oncology in my practice so I may be barking up the wrong tree and giving the wrong information. What I'm about to say has come from personal experience as well as chats with the lovely Iain Grant at chemopet.

Lymphoma can be a tricky one on FNAs alone sometimes as the pathologists often don't give a definitive answer without multiple clonality testing and work up. One thing to potentially look in to is flow cytometry - its a bit more expensive than standard FNA, but samples can be collected in the same way as an FNA so avoiding costs such as GA and surgical time etc. Can help with clonality of the population and the subtype to see if it is the same as last time.

The lymphoma cases I have dealt with often only have one node coming up at a time as a sign of remission before they all go, so I suspect it probably is the dog coming out of remission. Rescue therapy can be expensive; I had a case that used all their insurance money on the original CHOP course only to come out of remission within a couple of months of finishing. Limited money left so Iain suggested using epirubicin every 3 weeks as a form of rescue therapy that didn't cost the earth (still costs involved though).