Moving From Chemo Into Remission for Dog Lymphoma

We are moving from chemo into remission for dog lymphoma. I never thought I would be typing those words in all honesty. We were so shocked originally when our dog Ringo, then six years old, was diagnosed with lymphoma. As I wrote in a in earlier blog, a nodule was found on his spleen and a biopsy post splenectomy revealed the news. Ringo then had to go through chemotherapy, I outlined all of this in another, long post. As with those original blogs, my aim with this post is to support other dog owners by sharing our experience. In this blog, we look at what it actually means when a dog goes into remission. As is my way, this is a regularly updated blog post as our experience continues so do bookmark it and come back regularly to check for updates.

Moving From Chemo Into Remission For Dog Lymphoma

A Recap

Following a splenectomy and the discovery of lymphoma, Ringo underwent chemotherapy for approximately 18 months. He started with eight weekly sessions, then the sessions became two weekly and then every three weeks. It got easier after the first eight sessions!

It was a shock when the vet told us that it looked like Ringo had gone into remission. To be honest, after such a long time on chemo we had stopped even thinking about it. Indeed, Ringo was on chemo for so long, the vet had said she wasn’t sure he was going to go into remission but he was managing okay on the chemo so we just kept going. We weren’t even sure what remission looked like! We do know that remission is not a cure, and that what we are hoping for is that the remission lasts a long time.

Now, suddenly we were having to think about weaning him off medications and the need for regular monitoring as we move from chemo into remission for dog lymphoma. In other words a complete change in our mind set! We went furiously back through various literature to find out what it means and what we would be doing next. But, whilst there is a lot of literature (see here for example) on what lymphoma is, treatment, expected chances of remission etc, there was very little practical information

Medications At Time Of Remission

Apart from the three weekly sessions of chemotherapy, at the time he was announced as in remission he was on the following medications.

• Omeprazolo half an hour before breakfast and dinner to protect his stomach.
• Prednisone with his breakfast.
• An antibiotic, every day for five days post chemo then every other day.
• A probiotic with his dinner.
• RenalP powder on his dinner to help support his kidneys.
• Vitamin injections every 10 days to support anemia.
• Diosmectal for diarreah as required.

Weaning Ringo Off His Medications

Predinisone

The first thing we had to wean Ringo off was prednisone. He had been taking two tablets with his breakfast so we had to give him one and a half tablets for a week, then one tablet for a week. Then we had blood tests to check he was coping okay with the change. We were then given the go ahead to continue. So half a tablet for a week then a quarter of a tablet for a week.

Once Ringo was off the prednisone he had a major review with the vet, with indepth blood tests and an ecodoppler. His weight was 12.5 kg, he had put on 300gms in two weeks! The vet called him a little cinghiale (wild boar). Clearly we have to watch he doesn’t put on a lot more!

Ringo was having some issues with his stomach the day we had the vet appointment and the ecodoppler confirmed he had a touch of gastritis. The vet said this was from the prednisone and we would keep watch on this. He had an injection to stop further vomiting as he had vomited spectacularly as he was lifted onto the vet’s examination table.

Possible Heart Problems?

There were distinct improvements in his bloods in some areas, including the anemia, though the vitamin injections have to continue for a while yet. But there were also some concerns. Three of his blood levels suggested a risk of heart attack or stroke, so Omega 3 supplements were added to his daily routine and further blood tests will be done in three weeks to check the levels again. It is possible he may need to go onto an anticoagulant. The vet said this was caused by the chemotherapy.

Next steps

The next medication to cut down is the antibiotic. We have to give him one on one day then nothing for two days for a week then one capsule per day and nothing for three days until the next vet control in three weeks time. At that point, we will be given further instructions. We were also told to suspend the probiotic when we had finished the packet.

The vet said that in June, ie three months after finishing the chemo and prednisone, Ringo would have a full body scan. This will check is no sign of anything in his lymph nodes or other signs of lymphoma. Only then would he be declared in complete remission.

Thoughts So Far

The Change Is Complicated

Well, we were so happy to hear that he had gone into remission but have been shocked how complicated the change has been so far. Yes, we read all the literature we could on the subject but never found anything detailed on what happens when the dog goes into remission other than the need to wean off prednisone.

The Stress Continues For The Time Being

We had thought that remission would mean fewer visits to the vet and less expense. Because, trust me, all the chemo and medications is not cheap. Even here in Italy where things are much cheaper than in the UK or USA. But, in fact, I think we have actually increased our visits to the vet for the all the monitoring. Our lives are dominated by alarms and pieces of paper to remind us what we are actually giving Ringo at what time. Because we were so in the routine of the pre post post chemo rota that it became second nature. We didn’t have to think about it! Now, we have to stop and check with each other, what are we doing now? What pill is he due now? We have got this far we don’t want to make a mistake and make him poorly.

The Treatment Has Caused Other Problems

We had thought long and hard before even starting Ringo on chemotherapy. But we felt we were ‘between a rock and a hard place’ so to speak. Luckily he responded well to it with few side effects. Those he had were manageable. But the chemo and prednisone have been hard on his little body, leaving him with gastritis, anemia, kidneys that need a little bit of support and potentially heart problems. We would still take the chemo route faced with the decision again, but at least this time we would be better informed. Let’s face it, we still have Ringo with us and he is now eight years old and having a good life.

Moving On

Of course, this phase will pass. We shall eventually settle into a routine without so many meds and without so many visits to the vet. But, for the time being at least, the monitoring visits and tests will continue for some time to come.

Colic!

Well, we thought we were doing so well when Ringo started to have problems with his intestines. It started with him clearly having some discomfort (and quite a lot of flatulence). Then he vomited and from that point on he had issues with toiletting. He was peeing as normal but straining to pass something and no stools were emerging.

Sleepless Night

Then we had a sleepless night when he had me out of bed more times than I care to remember. The first time was just after his night time walk. We had all settled down to go to sleep and within minutes he was asking me to take him out. I took him out and he had dreadful diarreah. So we had to give him the first diosmectal he had taken for weeks. He asked to go out three further times, once he urinated, one time he strained and nothing happened and the third time he turned straight round and asked to go back in again! He woke me up many other times for attention and each time I cuddled him and put him back to bed and put on his blanket.

Diagnosed With Colic

The next morning I took him to the vet where he he had various tests and was diagnosed with colic and a slight temperature. He was put on a drip and given an antibiotic and buscopan to ease his cramping. The vet confirmed this was a knock on from the chemo etc. Sigh. He was put on minimal food and we had to go back the next day for another treatment.

Another Dreadful Night

After another dreadful night when I discovered that the noise from a dog’s innards actually could keep you awake, we returned to the vets for another treatment. Back on a drip and this time an antibiotic, buscopan and an anti-sickness injection in case he had nausea. His temperature was back to normal. His blood tests were actually both surprising and wonderful. They were normal! It looks like his heart problem had resolved and he showed no sign of anemia. The vet said it is great but we mustn’t get too excited and wait until the next blood test to see if this is permanent (fingers crossed). Back again the next day for another treatment.

The next day we rolled up at the vets bright and early. Temperature still normal, thank goodness. An ecodoppler showed his bowels etc were getting back to normal. There were still signs of gastritis though, as we discovered, this is chronic so will flare up from time to time. The vet could also see a narrowing of the gallbladder which she thought was another knock on from the chemo. She said that would right itself in time. More time on a drip and the same injections again and we were sent home with antibiotics for the next couple of days with a check up in four days.

Still Ongoing Problems

Unfortunately, Ringo started to have problems again in the early hours of Easter Sunday and we ended up trudging in to the vet again. This time he had already had his antibiotic in the morning and the vet said there was a big improvement overall. He spent some time on a drip, and then had another buscopan injection. She removed his cannula as she said he didn’t need it any more. She has given me a buscopan injection that I can give him in the night if he gets colic pains. Otherwise, a check up in three days time. In the meantime, we have to go backwards slightly and reintroduce his daily antibiotic for a while and also the probiotic we had just finished as he needs a bit more support moving forward.

At the check up they confirmed chronic gastritis that we will all have to learn to live with. Plus a gallbladder issue that we need to keep an eye on. We have to carry on with the current medication for another couple of weeks then have another check.

The Next Check Up

Blood tests were really good after the follow up visit. Only mildly anaemic so he had his vitamin injection but did consider whether it was really necessary. Unfortunately, his gall bladder continues to show problems and has a build up of bile. They have put him on special medication for that for ten days which will be followed by a review. If there is no improvement, it is likely Ringo will have to have his gallbladder removed.

I will update this blog with his progress following each vet control visit.

Before you go

My name is Dorothy Berry-Lound an artist and writer. You can find out more about my art, and where you can buy prints, at https://dorothyberryloundart.com.

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Thank you for reading!