Success Stories

Cody

Age and Breed:

Presenting Signs:

Diagnostics:

Chest radiographs revealed a large cranial mediastinal mass, the presence of which was confirmed by ultrasonography Abdominal radiographs showed splenic enlargement
Bone marrow aspiration cytology revealed no evidence of neoplastic infiltration

Diagnosis:

An ultrasound-guided fine needle aspirate of Cody's mediastinal mass was performed. When these samples were examined microscopically, a monotonous population of large lymphoid cells with a high nuclear to cytoplasmic ratio and a small amount of basophilic cytoplasm were seen. Mitotic figures were found in small numbers. A diagnosis of lymphoma was made.

Cody's lymphoma was staged as IVb: he had presumed involvement of his spleen (WHO stage IV), and he was systemically ill from his tumour (substage b). Although 80 to 90% of dogs with lymphoma achieve a complete clinical remission and the overall expected average survival time is 12 to 14 months, Cody's hypercalcemia and systemic signs of disease made his prognosis worse. The expected survival time for a dog with lymphoma similar to Cody's is approximately 6 months.

Treatment:

Cody was maintained on intravenous fluids and antiemetics during his initial hospitalization. Once a diagnosis of lymphoma was obtained, CHOP chemotherapy was started. Prednisone and vincristine were administered first.
Cody's serum calcium concentration and renal parameters improved within the first 24 hours of beginning chemotherapy. However, increased frequency of vomiting at this point necessitated additional antiemetic medications.
After another 24 hours, Cody was noticeably brighter and his vomiting had resolved. L-asparaginase chemotherapy was administered. Cody was released from the hospital 24 hours after receiving L-asparaginase. Cody looked great, and went home on oral prednisone and antibiotics were prescribed.

Outcome:

Cody received cyclic CHOP chemotherapy (cyclophosphamide, doxorubicin, vincristine and prednisone) for the first 4 months after his diagnosis, and did very well. His cranial mediastinal mass resolved, his serum calcium concentrations normalized, and his renal parameters stabilized at slightly above the normal range. Cody's quality of life was excellent, and he had a great appetite and activity level.
After 4 months of chemotherapy, Cody's lymphoma recurred. He was reinduced using the MOPP protocol (mechlorethamine, vincristine, procarbazine and prednisone) and once again achieved a complete remission. MOPP chemotherapy was continued for an additional 3 months, during which time Cody's quality of life remained excellent.
Cody's lymphoma relapsed a second time 8 months after his initial presentation. This time he was rescued with CCNU chemotherapy. Once again he responded well, and he enjoyed another 6 weeks of good quality life with his family.
Just over 9 months after his original diagnosis, Cody's lymphoma once again came out of remission. This time he was very ill, and rescue chemotherapy was not successful; Cody's family made the difficult decision to euthanize.

Conclusion:

The dedication and determination of Cody's owners in pursuing specialized treatment for him resulted in over 9 months of good quality life: more than half again as long as had been initially predicted. All facets of the care provided by the Western Veterinary Cancer Centre were instrumental in Cody's case: management by an experienced specialist; access to a full-service, 24-hour emergency service; and, expert and compassionate nursing care.