In an earlier blog I explained how we were shocked to discover that our dog had a growth on his spleen. It turned out to be lymphoma and we agreed to treat it with chemotherapy. This is our journey. Please note I am not a veterinarian, nor veterinary trained, I am merely sharing our experience with our dog.
This blog is by way of a diary and was initially published after the 11th chemotherapy session. It is regularly edited and updated as Ringo’s treatment continues. This is quite a long post but I do hope you find it helpful. I wish I had found something like it when we started this journey together.
Our Dog Has Chemotherapy For Lymphoma
The First Chemotherapy Round of Treatments (1-8)
The First Treatment
The day after the biopsy results, Ringo and I attended our appointment for the first chemo treatment. The vet said that lymphoma could be very aggressive so the sooner we started the better. The initial chemotherapy regimen was one treatment per week for eight weeks followed by a review.
Ringo was weighed and had a range of blood tests. This was to check he was well enough for the treatment and to establish a baseline. He was then hooked up to an intravenous drip. The vet then brought in a syringe containing the chemo. This was added to his drip, a bit at a time over a long period. I lost track of the time but the vet returned regularly to add a bit more in. He explained that they had to be really careful the first session to see how Ringo tolerated the drugs.
When that was finished Ringo sat with the drip going for another five minutes before the vet returned with another syringe of medication. This time it was an anti-emetic to prevent sickness. Again, that was given to him in very small doses at a time. When that was finished we had another ten minutes just on a drip.
The final thing was a prednisone injection into a muscle. I was given prednisone to give him every day at home as well as omeprazole and dioscmetin to support his stomach. The vet explained that they started with high dose steroids that would be gradually tailored down over his chemo treatment.
The whole thing took nearly three hours from when we arrived to when we left.
We Committed to Staying With Him
They did say that we could drop Ringo in and go back and pick him up, but we had agreed that one of us would sit with him through the whole process and keep him company. It wouldn’t feel right for us to do anything else.
The chemo chemicals are excreted in urine and faeces (and in any other bodily fluids) 24-48 hours after the treatment. We had to establish a routine of wearing latex gloves when handling any bodily fluids. On walks we carried a watering can in order to dilute urine. Faeces was picked up and double bagged. All of this was to involve inadvertently poisoning other animals.
After 24 hours, Ringo was showing no effects from the treatment at all. Definitely drinking and urinating a lot more. His urine was quite smelly as was his faeces.
The drinking and urinating continued all week. No other real problems apart from perhaps he was a bit tired from time to time. Ringo needed to go out every two hours at least to pee and sometimes 40 minutes after his last outing. He got me up in the night when he needed to go and we went so he could quickly pee and we could get back to bed. Luckily, after the first couple of weeks that stopped.
The First Round Of Treatments
After the first treatment the following treatments were much shorter and plain sailing. We knew to weigh him immediately on arrival at the clinic, then there were blood tests, followed by the treatment and being given medication for him at home. The prednisone was halved after the second week and then continued at that same level for the rest of his treatment to-date.
We got into a routine with Barnet Boy taking him one week and me the next. Ringo happily took his prednisone and omeprazole because they were given to him hidden in dog treats. He hated the diosmectal but came when we called him for it and gave in, albeit with a protest. Depending on the amount of water used to mix the powder, we averaged two, maybe two and half syringes full that he had to swallow. This had to be given on an empty stomach and no eating for half an hour afterwards so we set an alarm for midday and gave it to him then. Note: this changed as his treatment progressed as I outline below.
For the first few weeks Ringo continued to lose weight which was a concern. Pre diagnosis he was 13 kg but after the splenectomy and initial chemo he got as low as just under 11 kg. The vet was not overly concerned if Ringo was eating normally, which he was. Mind you, after four treatments, as well as being continually thirsty, Ringo seemed to be hungry all the time and would eat anything he came across. But he was still losing weight!
Learning From Others
I have spent many, many hours, doing research on the internet and approaching dog groups to get first hand information about chemo and the effect on the dog. But it is always helpful to hear someone else’s experience. After all, that is why I have written this post.
So it was a great relief to me at one of Ringo’s chemotherapy sessions, to meet a couple who had brought their basset hound to the vet for review. The dog was in a bad way, at end of life stage, but it turned out she too had lymphoma. They talked about the chemo, the effect of prednisone and weight loss initially, all that we were experiencing with Ringo. Their dog had been in remission for 18 months, so, in their view, they were glad they had gone ahead with the chemo. They, too, had wrestled with whether to put the dog through chemo.
Sad But Instructive
It was sad, because their dog really had run out of options now. But it was reassuring to us that the chemo could achieve what we hoped, longer with Ringo, and time to get Spud used to being independent of his brother. It has always been clear that the lymphoma could not be cured, that the best we could hope would be for a long period of remission.
This meeting, though sad, came at the right time to give us a renewed sense of hope moving forward.
Chemo Session No 6
We couldn’t believe it when chemo session number six came and went. So smooth because we were all in a routine. And we were so happy to see some weight gain. I asked the vet what happened after session no 8. He said we then have to wait and see how Ringo goes and that we would be given a full briefing on what to do and what to expect.
A Slight Hiccup
Two days after chemo session number 6 we walked Ringo with Spud before lunch as usual. Gave Ringo his diosmectal and then they had something to eat half an hour later. We sat to eat our lunch and thought it was strange there was only Spud in the dining room with us. I went to check and Ringo wouldn’t get out of his bed!
Immediately, we started to be concerned, and his behaviour got more erratic over the next half an hour. Then he was violently sick three times, all fluid. He was trying to drink loads of water at the same time, staggering as he walked and hid behind the living room door. Our first thought, which shows that we are worried under our cool exterior LOL, was that the chemo was too late and this was end stage lymphoma. So, off to the vets with both dogs as Spud was really concerned about his brother!
Rushed To The Vet
Ringo vomited again outside the vet clinic and when we took him in the first thing they did was give him an ultrasound of his abdomen. No sign of any tumours or problems thank goodness! Blood tests showed some ups and downs but in line with a dog that had been vomiting on and off for the last few hours. The verdict was it was a reaction to the chemo.
The head vet said this was common four or five days after chemo but of course that had not been our experience. And this was only two days after his chemo session. Anyway, Ringo was put on an intravenous drip and given an anti emetic. They asked us to give him omeprazole also in the evening not just in the morning and that is something that has continued throughout the subsequent sessions.
Ringo only ate half his evening meal that night but by bedtime was back to his usual self. I had to take him to the vet clinic the next day for another anti-emetic, though he was absolutely fine it was a precaution, and I had a lesson how to give the injections at home. Then the day after I gave him his injection with no problems (though a few more anxiety grey hairs appeared I have to say – it was easy in the end and he didn’t even notice me do it, but I was scared stiff I would hurt him). All back to normal and a happy dog, back to being starving and drinking gallons of water!
Chemo Session No 7
The blood tests taken before Ringo’s seventh chemo were not quite right and, in particular, showed he was anaemic. So he had to have an injection of B12 before the chemo got going. The B12 injection became a regular feature of subsequent treatment sessions.
Weariness Was Setting In
Both BB and I were both starting to get tired by now. The whole process is long and stressful, plus we were having to curtail all our activities to run our lives around Ringo. We didn’t begrudge it at all I hasten to add. But the going out with the watering can etc was really starting to pall, particularly with winter approaching. As was the fact that Ringo was eating everything in sight. That includes bugs, grass and anything else he could get into. So watching him to stop that happening was quite wearing. He didn’t understand, of course, why he shouldn’t eat some of these things if he is hungry. By now he was having a couple of extra small meals each day and more protein-based treats to try and curb the hunger.
Ringo was equally fed up. The plaster used on his arm for chemo 7 was stuck to his leg like it had been stuck on with superglue. It took me ages to get it off him, even with soaking. Even then it pulled fur from his leg and he squealed. His legs were starting to get sore from the intravenous needles, although we had done our best to make sure a different leg was used each week. He was also really fed up with having the diosmectin syringed down his throat every day. So much so, that when the alarm went off to remind us to do it he would disappear quickly!
Chemo Session 8
This turned out to be rather disappointing and a bit depressing. Ringo had lost a bit more weight. The vet said that this, plus his blood test results, meant the lymphoma was still active in his system and the chemotherapy needed to continue!
This time we were to have a two week gap though, which at least gave us a week off. The vet said we should have another abdominal ultrasound and blood test before the chemo and then we could talk about the results. This was a bit of a blow as we thought we were doing well but it was really a triumph of optimism over reality I guess.
The next chemo session was arranged for two weeks later, and would depend on the results of an Eco Doppler to check for tumours and the size of lymph notes and blood tests.
Chemo Session 9
It was lovely to have a week off chemo, it gave us second wind. And I was convinced that Ringo had actually put on weight. He was still having his extra food but didn’t seem to be hungry all the time any more. I noticed that he had stopped drinking quite so much water. He had gained 400gms in the two week gap and it was the first time he had really gained weight. To say I was happy would be an understatement! The eco didn’t find anything to worry about so that was also good news. The blood tests showed that Ringo continues to be anaemic (has been since his spleen was removed) and one of the results was high which was an indication of the lymphoma. So we agreed to go ahead with the chemo session.
The chemo session was straightforward and we were told to continue with the same treatments at home (prednisone and meds for his stomach). The plan from this point is for two weekly chemo sessions and every two visits an eco to check there is nothing growing. Then we can stretch it to three weeks between sessions and go on from there.
Chemo Session 10
Session 10 was straightforward, with nothing to report other than that Ringo had gained another 100gms taking him to 11.5 kilos which I was very happy with. Up until now, of course, the treatments had been taking place in warmer weather. By now it was early November and starting to get distinctly chilly as you can see from the photo of Barnet Boy keeping Ringo warm outside the vets before his chemo session. I need to buy Ringo a dog coat!
By this point Ringo was an old trooper. He would lift his leg for the Vet to insert the drip. And he came willingly for his diosmectin. I guess he knew he was going to have it whatever, so he chose to do it without a fuss.
Chemo Session 11
This was another monthly review and luckily the Eco Doppler showed no sign of tumours. Ringo’s blood tests were slightly improved on last time and he had also gained another 200gms in weight, making him 11.7 kilos.
I asked the vet what remission looks like and she said there isn’t really a scientific answer to that. When his blood tests have improved quite a bit more that would be a start. And assuming the Eco Doppler continues to show no tumours on his internal organs. At that point he will have a full body scan. That will check his lymph nodes and bone marrow. If that comes back clear then the chemo is stopped for a while with regular monitoring. The question then becomes how long he can go without chemo before the lymphoma returns. Hey ho. We just have to be patient! But he is doing well!
Reactions To Chemotherapy Begin
Chemo Session 12
As we approached the next chemo session we hit a technical hitch. Ringo developed an abscess on his ear. He had a sebaceous cyst on that ear since he was a puppy, it was about the size of a pea. Unfortunately it developed a bacterial infection. So, after treatment the poor little lad had to wear a surgical collar so he couldn’t scratch it.
The night before the chemo session, Ringo was behaving oddly. He kept going from bed to bed and not settling. BB said he thought he was anticipating the chemo session the next day.
The chemo session went well, blood tests were looking good. But Ringo was still behaving oddly and that continued into the next day. That evening he started retching and looking really sorry for himself. BB took him to the vet who said it was a reaction to the chemo and gave Ringo an anti-sickness injection.
But the next morning Ringo was still ill and started vomiting. So I took him to the vets again. Blood tests and a thorough examination later the diagnosis was bacterial gastro intestinal infection which he was treated for.
As far as I can make out, this may be a side effect from the chemo suppressing the immune system. We all have bacteria in our gut and sometimes they get a little out of hand. Our immune system usually copes with that with no problem. But for Ringo, little internal infections that he would normally fight off are actually taking hold. Luckily he got over it quickly with treatment and we got back to normal.
I am happy to report the next few chemotherapy sessions went without a hitch. From this point onwards I am only highlighting chemo sessions where there is a point to be made or lesson learned.
Chemo Session 15
Time for another scan and review, and this time we were to take Spud along for a scan as part of his monitoring. When Ringo was initially diagnosed, there was some concern that his brother, Spud, might develop the same problem. The vet did say that it was more likely in any puppies that Ringo sired (he was neutered when he was young so no puppies to worry about). Thank goodness the scans on both dogs were clean. Ringo’s blood tests were not as good as last time, which was disappointing. The vet said it just means the lymphoma is still active and so we carry on with the chemo.
Unfortunately five days post chemo Ringo developed diarrhoea. He was put on an antibiotic for six days plus diosmectin twice per day and after five days there was a big improvement. When he had finished the antibiotics we went back to once per day for the diosmectin but unfortunately two days later he restarted diarrhoea.
The day of his 16th chemo session he had a scan which showed no enlarged lymph nodes so the diarrhoea was not from the lymphoma or so it would appear. Blood tests were not awful but not good either and the decision was taken to delay the chemo by a week whilst the diarrhoea was treated with different antibiotics, a probiotic and again diosmectin twice per day. Basically, it was another intestinal bacteria problem.
Chemo Session 18
Ringo stayed on antibiotics though gradually reduced to one every other day. However, chemo sessions 16 and 17 went without a hitch and an Eco Doppler showed his lymph nodes were not enlarged. So at Chemo Session 18 it was time for a big review. Just for the purpose, his blood tests were all over the place! But the Chief Vet said it was because of the prednisone in his system and, apart from being a bit anaemic there wasn’t much to worry about. He was cleared to go onto three weekly chemotherapy. Happy days! Two weeks off in-between chemo. Note, whilst not completely relaxed about the process, he has now started dozing during his treatment as you can see in the photo.
Chemo Session 19
The next chemo session (number 19) went smoothly but a week after the treatment Ringo was not exactly himself. He was eating, walking, doing all the usual doggy stuff but in between was very subdued. One night he even asked to be taken out at 2am where he did a poo (normal, not diarrheal). This was a couple of days before he is due to have a blood test to check his anaemia mid way between chemo sessions. He also seemed to be going quite ‘bony’. It was possible to see his spine and the hollows behind his eyes. This was in spite of the fact that he still ate anything he could get and all the extra meals his was having.
The blood tests were actually not too bad but he had an vitamin injection for his anaemia and picked up very soon after.
The night before he was due his 20th chemo treatment we went to bed as usual. But Ringo woke me up just before 1am because he needed to go outside. He did a normal poop so I was not too worried. Until he got me up again at 1.45am and had diarrhoea. He had just squatted and suddenly there was the sound of a group of animals moving in our direction. Heavy footprints, lots of snorting and squealing plus a strong smell – wild boar. Luckily they did not emerge from behind the shrubs and I made a lot of noise. Ringo did his business but with his head turned in the direction of the noise. As soon as he had finished he ran back into the house ahead of me. Phew! That was all we needed.
In total I got up with him five times and around 4am we gave him a dose of diosmectal. On the sixth time of wanting to go out, we gave up and got out of bed, that was around 6.45am. By then the diosmectal had kicked in thank goodness.
At the vets he had extensive blood tests and the vet said he had inflammation of his intestines etc. This is starting to become a pattern! No chemo that day unfortunately. He had a prednisone shot and another vitamin shot for anaemia. Various changes to his meds again including a daily antibiotic and probiotic. And if he is well enough, he can have his chemo in five days.
The Prospects For Remission?
I had a long chat with the vet about remission and she said that she thought it might not happen for him. She said that the problem is that Ringo is a young dog and the cancer is very aggressive. The amount of chemo he would need to overcome the cancer would actually kill him. But we agreed that we had enjoyed the additional time we had with him so far and hopefully for a bit longer to come.
We keep reminding ourselves that it is nearly 9 months since Ringo was initially diagnosed. By our reckoning that means we have had 7 months extra with him than we would have had without chemo. It is so important at this stage to see each day as a bonus!
Chemo Session 20
Ringo was much improved by the time we were due to try a chemo session again. He had even gained 100gms after several weeks of weight loss. He actually weighed in at 11.4kg. His weight has been a bit of a roller coaster all through his treatment. Initially he lost a lot of weight, then gained a kilo and then started losing again. Hopefully the current weight gain will continue. As it was his ‘nine month anniversary’, the veterinary staff all made a big fuss of him.
As usual, our ‘family vet’ Sara, went through Ringo’s daily schedule and gave me instructions on when he should have all his meds. The chemo went without any problem and we agreed to return in 10 days so Ringo could have a B12 injection for his anaemia. Then the next chemo session ten days after that.
Unfortunately, Ringo had a vomiting session after eight days, though we think it was something he ate. Bearing in mind he is so hungry all the time he eats anything he can and we have to watch him all the time. So, he was taken to the vets a couple of days early and they gave him blood tests (which didn’t show anything much different), and an anti-emetic. Back on disomectin for four days, twice a day.
Chemo Session 21
Mid May, nine months since the original tumour was found on his spleen and it was time for another chemo session. It was also time for annual vaccinations but Ringo is not allowed to have them now because they might cause a problem. Live vaccines, chemo and a wrecked immune system are not a good combination. Spud has his though, and a scan which again showed him all clear.
Ringo’s scan was good and his blood test results were normal (for him). Unfortunately he had lost yet more weight and was back down to 11 kilos. The vet said this is likely to be cachexia which is basically the cancer eating away his fat and muscles. Clearly, this is not good. But the vet said we had to hold on to the time we still have with him while he is healthy. And he is such a happy little chap with no signs that he has any discomfort. As long as he stays that way we will continue with the chemo and enjoy our time with him.
However, on his ten day visit for a B12 injection for his anaemia he had put a little bit of weight on. And by Chemo No 21 (which went without a hitch) he was back up to 11.2 kilos. Unfortunately, by Chemo No 22 he was back down to 11.1 Kilos.
A couple of days before Chemo No 23, Ringo started to urinate in the house and need to go outside to pee more frequently. So we took him a day earlier than planned which was just as well as he was diagnosed with Cystitis. Full blood test and an ecco doppler scan found nothing of consequence so he was able to go ahead with his chemo session. Just a slight change in meds to change the antibiotic he was on every other day to avoid bowel problems to a daily one aimed specifically at his Cystitis. Back in ten days to check the Cystitis has cleared and to have another Vitamin B12 injection.
After that all cleared up Chemo No 24 went quickly, weight back up to 11.4kg. No 25 seemed like a huge milestone! Ringo’s weight was back down to 11kg but a scan and blood tests were all clear. And, as you can see, Ringo must be about the most laid back dog ever as he has a snooze before his 25th chemo session.
A Setback After Chemo No 25
Six days after his 25th chemo session, Ringo woke me at midnight asking to go outside. Diarrhoea! It was the start of a long night with no sleep and no fewer than 10 trips outside for him to empty his bowels. All water. He seemed fine in himself otherwise. We got him to the vet clinic as soon as it was open and he was put on a drip and given two different antibiotics intravenously. Blood tests were fine and showed no infection. Some additional meds for at home (yet more antibiotics) and we were sent home with the instruction to come back the next day. If the diarrhoea was still active he was to go back on a drip again. But he needed a scan to try and determine what was going on.
By early afternoon the day of the intravenous antibiotics, Ring was back to normal. The scan the next day showed that he had been experiencing some sort of intestinal disturbance. The good news was that it wasn’t caused by the lymphoma. The consensus was that it was either a reaction to the chemo session or that he had eaten something that had caused intestinal irritation. Either way, the problem was resolved quickly, though Barnet Boy and I were resembling zombies by the time he was better owing to lack of sleep!
Chemo Sessions 26-28
Ringo had no problems after chemo number 26, but started to develop diarreah again after number 27. Luckily, it started during the day, we caught it early and so a quick trip to the vet, oral antibiotics and diosmectin and it was fixed quickly. Interestingly, the vet wanted him to have oral antibiotics because she said clearly we were in this for the long haul and we needed to protect his veins as much as possible.
Just before Chemo number 28, Ringo developed a small growth on his head that had me worried. But luckily, this turned out to be just a warty growth and nothing to worry about. Chemo 28 went without a hitch. The vet said the next visit would entail more detailed scans, blood tests etc and a big review. But he is doing really well. His latest weight is 11.8 kilos and the vet says we should be aiming for 12 kilos as his ‘fighting weight’.
Chemo No 29
Ringo had chemo no 29 today and there is another slight weight gain so he is now 11.9kg. He had a full blood screen which highlighted a few issues. He has very high phosphorous levels which suggests problems with his kidneys caused by the chemo. So we have a special powder to put on his food (RenalP) and next time we have to take a urine sample and they will do a further check. The vet didn’t seem unduly concerned so hopefully this is just a slight hitch.
Chemo No 30
What a milestone to reach chemo session no 30! By now it is November here so at least the post chemo walk does not involve mosquito bites! Everything went without a hitch and there were no problem the first week after the treatment. Then, on day 10 he had a touch of diarreah so we gave him diosmectal immediately and that seemed to solve the problem.
A few days later the bowel problems resurfaced, but I think this is in part the fact that it is olive picking season here in Italy. What has that got to do with it you ask? Olives. Everywhere. Some on the path leading up the drive where our olives were picked. Some in the dog run where the olive trees there had dropped some. And olives all over the road that have bounced off the back of tractor trailers taking them to the olive mill. No matter how we tried to stop him, Ringo managed to eat a few. I scoured the floor of the dog run and got rid of those I found and he still found some!
One day Ringo asked to go out at 1.15am and produced an enormous poop but not diarreah. On the first walk before breakfast he did this three more times, each enormous quantities and very hard and granular. Next walk another load. In all he produced six during the course of the day up until the afternoon, then finally the last one was diarreah, literally liquid. So, of course, out came the trusty diosmectal.
The next day he was due to have a blood test to have his kidneys re checked. That meant no food in the morning. We duly went to the vet and she took the blood and gave him his vitamin injection. She did a blood screen as well as the kidney specific test. The blood screen showed a few values that were off which she said was due to the prednisone he was taking. Bearing in mind he has now been taking it for almost 18 months. She also said put him on half rations and increase the diosmectal for a few days to calm his bowels.
Later that day the vet rang to say they hadn’t been able to process the blood test because his blood was too ‘fatty’. She felt it was probably caused by the prednisone. We had go through the whole thing again but this time he has to not eat the evening before as well! Luckily, we managed that and the blood tests were fine meaning the RenalP is keeping his kidneys under control.
Chemo No 31
The next chemo session went without a hitch until Ringo got home. He immediately started diarreah which we treated by cutting his food portions in half and giving him diosmectal. That has never happened before so we are hoping it is just a blip!
Just to recap
At time of writing (5 December 2023), it is more than eighteen months since the initial diagnosis of lymphoma, Ringo is on five meals a day which is counteracting the weight loss caused by the cachexia which makes us very happy. For a week after chemo he has diosmectin in the morning first thing when we get up. He has omeprazole half an hour before breakfast and prednisone with breakfast. Every other day he has an antibiotic before lunch to prevent bowel problems. In the evening he has another omeprazole and a probiotic. Given high phosporous levels in his blood, he also has RenalP powder sprinkled on his food.
Publishing But Will Keep Updating
I am publishing this blog detailing how our dog has chemotherapy for lymphoma though our story is not yet finished. This is in the hope that it will prove helpful to someone else unfortunate enough to be in our position. I will return to it after each chemo session and update it with Ringo’s progress. So do bookmark this page and check it for updates. Let me know in the comments if you have found this post useful.
Before you go
My name is Dorothy Berry-Lound an artist and writer. You can find out more about my art and writing at https://dorothyberryloundart.com.
Thank you for reading!