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16 1/2 yr old poodle lymphoma - would you treat?
I took my standard poodle to the emergency vet yesterday because his eyes (he has cataracts) looked like they had a film of blood on them. After having an eye exam I was told that he has uveitis caused by an underlying disease. We had chest xrays done which showed abnormalities, and after an examination the vet discovered that my dog's lymph nodes were enlarged. My dog has been stumbling for the past two days when on walks, coughing & panting after walking upstairs. The vet feels that my dog probably has lymphoma which is a very fast cancer and if untreated he will only have 1-2 months. He woke up this morning and is bumping into things and the vet thinks that he may have lost his eyesight due to the uveitis. His appetite remains excellent. Treatment at this point is palliative whether it be prednisone or chemo. My dog has led a very good life and I hate to see him suffer. I'm torn between putting him down now :( or treating him with prednisone which should make him feel better, won't extend his life & may cause him discomforting side effects. Just wondering what you would all do in this situation?
Thank you Ghilly for your comforting words - so kind of you :) I had two other dogs that grew up together with Bill, and who passed away before him. I am comforted by the thought that the 3 of them are together again.
I am so very sorry to hear this. :(
I know that words ring hollow at a time like this, but you were so very lucky to have had him for the length of time you did. What a wonderful ripe old age for a dog to reach! And a larger breed, too!
In time, you will be able to remember him with smiles instead of tears. And as long as you keep him in your heart, he will always be with you. I know for certain that you WILL see him again one day. May his precious soul fly free, and may you be given the strength to cope with his loss.
Ghilly
I know that words ring hollow at a time like this, but you were so very lucky to have had him for the length of time you did. What a wonderful ripe old age for a dog to reach! And a larger breed, too!
In time, you will be able to remember him with smiles instead of tears. And as long as you keep him in your heart, he will always be with you. I know for certain that you WILL see him again one day. May his precious soul fly free, and may you be given the strength to cope with his loss.
Ghilly
We had the fine needle aspirate done a couple days after my post and received the sad results, it was lymphoma. My lovely old boy stopped eating 5 days later and we knew he was telling us it was time :(
You're very welcome, 107caniche. Please keep us updated as to how your boy is doing.
Ghilly
Ghilly
I agree with your thoughts on chemo for my old boy, thank you for confirming what I was feeling ginger899. It's been so difficult to think clearly - emotions getting in the way of what is best for him. The last sentence of your post brought tears to my eyes - so nicely worded, thank you for your reply.
Thank you so much Ghilly for your informative post, you've given me a lot to think about! I'm so glad that I followed my gut by not giving him any of the prednisone that the doctor sent me home with. I am taking him to an oncologist tomorrow for a more informed opinion where I am told we will have the option of doing a fine needle aspirate and/or biopsy to determine if it is lymphoma. Thanks again for your kind words of advice :)
COMMUNITY LEADER
I agree with Ghilly. Make sure it definitely IS Lymphoma. You may need a second opinion.
I dont know much about Prdnisone treatment, but take what Ghilly said very seriously. However, Prednisone may help him possibly short-term?
As for Chemo, my feeling is that there isn't much that is "palliative" about Chemotherapy. Although dogs sometimes don't suffer such dreadful side effects as humans do, and CAN tolerate chemo better....I honestly don't think giving your old guy those sorts of cytotoxic drugs is the way to go. That sort of treatment may only buy a few months, if that, drags the whole system right down, can toxify aging kidneys very badly, and basically Cancer Chemotherapy is a bitter battle. Not palliative treatment of any kind.
It may be kinder to nurse him and love him to the max. in the time he has left. If there are any gentler treatments that might buy him a little more time, or deal with any symptoms as they arise.....they might be a good idea.
The thing is -with geriatric patients, animal and human, cancers can sometimes progress slower than with younger patients, as their metabolism is slower.
I wouldn't put him to sleep right now, not unless you feel he has lost ALL quality of life and is in pain that cannot be relieved by helpful medication. If he's still eating, still coming to you for cuddles, still pottering around a bit, leave him to decide when his time is right to let go. He will. But of course you will have to be very watchful of him.
You need a little time to come to terms with this, and he -to gently say his farewells to a life he enjoyed, with those he loved.
I dont know much about Prdnisone treatment, but take what Ghilly said very seriously. However, Prednisone may help him possibly short-term?
As for Chemo, my feeling is that there isn't much that is "palliative" about Chemotherapy. Although dogs sometimes don't suffer such dreadful side effects as humans do, and CAN tolerate chemo better....I honestly don't think giving your old guy those sorts of cytotoxic drugs is the way to go. That sort of treatment may only buy a few months, if that, drags the whole system right down, can toxify aging kidneys very badly, and basically Cancer Chemotherapy is a bitter battle. Not palliative treatment of any kind.
It may be kinder to nurse him and love him to the max. in the time he has left. If there are any gentler treatments that might buy him a little more time, or deal with any symptoms as they arise.....they might be a good idea.
The thing is -with geriatric patients, animal and human, cancers can sometimes progress slower than with younger patients, as their metabolism is slower.
I wouldn't put him to sleep right now, not unless you feel he has lost ALL quality of life and is in pain that cannot be relieved by helpful medication. If he's still eating, still coming to you for cuddles, still pottering around a bit, leave him to decide when his time is right to let go. He will. But of course you will have to be very watchful of him.
You need a little time to come to terms with this, and he -to gently say his farewells to a life he enjoyed, with those he loved.
It's so sad to see them get old, and it's even worse when aging brings illness along with it.
Steroids work by setting up a false immune system to take over for the subject's compromised immune system. This is why they are so effective in cutting back inflammation, because it mimics a perfect immune system that is able to handle anything that is thrown ts way. It creates almost a feeling of euphoria, a "high", that boosts the animal's appetite and almost gives the appearance of a miracle drug because the animal can seem almost their old self within about 24 hours of receiving an injection.
Dogs don't tolerate steroid treatments nearly as well as cats do, though. While cats need larger doses of steroids than dogs do to achieve the desired effect, they are also much less likely to develop problems from their use. Dogs tend to develop other problems due to the steroids, even during short-term use, one of which is diabetes mellitus. It can also cause elevated liver enzymes because the it's the liver that converts the prednisone into prednisolone. It can cause pancreatitis. It can cause gastric disturbances (nebulous term, I know) and gastric bleeding. It increases thirst which leads to increased water intake which, in turn, leads to frequent urination.
The problem with steroid therapy is that once you start it, you cannot just stop it, you have to wean them from the steroids. The reason for this is because, as I explained above, the steroids set up a false immune system for the patient, and if you stop giving them suddenly, his own immune system will basically be nonexistent since it will have been rendered dormant by the steroids. Weaning allows the body's own immune system to wake up and start functioning again. Some side effects can be dealt with while weaning off the steroids, but, for example, if a GI bleed results from them, he'll have to deal with the GI problems until the weaning is complete.
If the steroids will not prolong his life, if it were me, I don't know that I would make him go through it. You said that his appetite is good, and that's one of the main things to watch for when making this most horrible of decisions. I think I would just let him be, baby him and love him as much as you can, and when he stops eating it will be his way of telling you that he has had enough and can't fight any more.
Is the vet POSITIVE that it's lymphoma? The lymph nodes will enlarge when there is ANY kind of infection present in the body. Does the doctor not want to run some more definitive tests? When talking about a decision of this magnitude, I would want to be sure beyond a shadow of a doubt that it IS lymphoma before basing my life-altering decision on what the vet "thinks". That's my two cents. Others may feel differently.
Ghilly
Steroids work by setting up a false immune system to take over for the subject's compromised immune system. This is why they are so effective in cutting back inflammation, because it mimics a perfect immune system that is able to handle anything that is thrown ts way. It creates almost a feeling of euphoria, a "high", that boosts the animal's appetite and almost gives the appearance of a miracle drug because the animal can seem almost their old self within about 24 hours of receiving an injection.
Dogs don't tolerate steroid treatments nearly as well as cats do, though. While cats need larger doses of steroids than dogs do to achieve the desired effect, they are also much less likely to develop problems from their use. Dogs tend to develop other problems due to the steroids, even during short-term use, one of which is diabetes mellitus. It can also cause elevated liver enzymes because the it's the liver that converts the prednisone into prednisolone. It can cause pancreatitis. It can cause gastric disturbances (nebulous term, I know) and gastric bleeding. It increases thirst which leads to increased water intake which, in turn, leads to frequent urination.
The problem with steroid therapy is that once you start it, you cannot just stop it, you have to wean them from the steroids. The reason for this is because, as I explained above, the steroids set up a false immune system for the patient, and if you stop giving them suddenly, his own immune system will basically be nonexistent since it will have been rendered dormant by the steroids. Weaning allows the body's own immune system to wake up and start functioning again. Some side effects can be dealt with while weaning off the steroids, but, for example, if a GI bleed results from them, he'll have to deal with the GI problems until the weaning is complete.
If the steroids will not prolong his life, if it were me, I don't know that I would make him go through it. You said that his appetite is good, and that's one of the main things to watch for when making this most horrible of decisions. I think I would just let him be, baby him and love him as much as you can, and when he stops eating it will be his way of telling you that he has had enough and can't fight any more.
Is the vet POSITIVE that it's lymphoma? The lymph nodes will enlarge when there is ANY kind of infection present in the body. Does the doctor not want to run some more definitive tests? When talking about a decision of this magnitude, I would want to be sure beyond a shadow of a doubt that it IS lymphoma before basing my life-altering decision on what the vet "thinks". That's my two cents. Others may feel differently.
Ghilly
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