How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask Dr. Gary Your Own Question

Dr. Gary
Dr. Gary, Dog Veterinarian
Category: Dog Veterinary
Satisfied Customers: 17227
Experience:  DVM, Emergency Veterinarian, BS (Physiology)
15010675
Type Your Dog Veterinary Question Here...
Dr. Gary is online now
A new question is answered every 9 seconds

My dog had a swollen lymphnode in his neck removed last week.

Customer Question

My dog had a swollen lymphnode in his neck removed last week. We got the tests results back today and it is was cancerous which I guess means he has lymphnoma. Only one lymphnode was swollen and the vet said the lumps swelling went down from the time we had him checked out to the time he had surgery. (4 days). He acts very healthy and playful but the vet said this doesnt matter. I read online that one swollen lymphnode means stage 1 but not necessarily b/c we dont know where else it has spread to. The vet is sending us to a cancer specialist tomorrow and they are going to do bloodwork, ultrasounds, probably take bone marrow. They did xrays at the vets on his chest and abdomin but didnt see any lumps/masts. But they said if they are small that is what the specialist is going to do the ultrasounds for. Everywhere I read online give bleak outlooks and not much hope. My vet didnt offer much in terms of support either. Didnt say much about it just to see the specialist. My dog turns 10 on august 20th. He is a very healthy dog. The only problems he suffers from are skin and food allergies......and has had bladder stones removed 3 times but always recovers very quickly anytime he has a procedure done. In fact after the surgery to remove the swollem lympnode last week we brought him home and he was playing in 2hrs. Where they opened the skin up to remove the lump healed very quickly too so not sure if the immune system seems to be working good is a good sign. I just need some feedback. Given the info i have offered to you how much of a chance does my dog have to live 1 or 2 more years. Everywhere i have read online said a couple of months. I had to stop researching online and that's why I am messaging you. I need some kind of hope here or i'm going to go insane.
Submitted: 4 years ago.
Category: Dog Veterinary
Expert:  Dr. Gary replied 4 years ago.
Hello.

I'm sorry to hear your dog has lymphoma. The one positive here is that of all the cancers, Lymphoma is the most responsive to chemotherapy. Typically we'll stage the cancer with the bloodwork, chest films and abdominal ultrasound. You'll usually find enlarged lymph nodes in the abdomen, but we're trying to rule out lung/ spleen/ liver masses.

We'll then start chemotherapy. We typically use the University of Wisconsin-Madison Protocol. It's a 25 week protocol where there is an injection of a chemo drug given each week. Dogs will usually go into remission (lymph nodes go down, acting normal, eating/ drinking) within days of the first injection.

The goal of chemo is to return Milo to his pre-cancer quality of life and then maintain there. We shoot for 12 months survival with chemo. Without chemo or with just Prednisone (steroid), we only have a 2-3 month survival. With that said, I would highly recommend chemo if financially feasible. We're giving Milo another 10% of his life span back, so in my opinion it's worth it.

Once they come out of remission (lymph nodes back up, not doing well) then we have the option of rescue protocols or euthanasia. I think I would euthanize at that point as your chances of chemo success go down from there.

I hope this helps, let me know if you have any other questions.
Customer: replied 4 years ago.
They did chest and ab xrays at my vets today and didnt see any lumps or masts. Is that a good sign? Also how much does a typical run of chemotherpay cost for this kind of cancer ....the treatment you describe.
Expert:  Dr. Gary replied 4 years ago.
Yes, that's a good sign. Most do have clean chests/ abdomens while staging. It's just part of the initial work up so we don't miss anything.

Chemo is typically in the 1500-2000 range over the course of 6 months if done with a specialist (oncologist) or maybe 1/2 that if done through your family vet.
Customer: replied 4 years ago.
Oh I can definately afford that. Have you ever treated a dog personally for lymphnoma and at best if Milo goes into remission what the best outlook on how long he might live......and worst case scenario even if he goes into remission?
Expert:  Dr. Gary replied 4 years ago.
I don't personally treat lymphoma long term, but I have worked with oncologists and watched over their patients at night (being an ER vet). The average or medXXXXX XXXXXfe expectancy is 12 months. The ones that don't respond well may only make it 6 months. The ones that respond well can live upwards of 1 1/2 to 2 years or even more on the rare occasion.
Customer: replied 4 years ago.
See this is what I dont get. Milo acts perfectly healthy. He eats well....always hungry. He plays at the dog park. Goes on 5 walks a day. Takes his vitamins. Acts like a very happy dog right now it's just really hard for me to believe that maybe right now he is riddled with cancer. Wouldnt he be showing some signs or symptoms if this was really bad?
Expert:  Dr. Gary replied 4 years ago.
Not necessarily- usually the first thing that is found is the enlarged glands in a healthy dog. It takes owners that are very observant to catch it at this stage. It then proceeds to lethargy, labored breathing, panting and decreased appetite over the following weeks. You could wait until that point to start chemo, but then your success rate goes down slightly and there could be more chemo reactions if you start it in a clinically sick dog.

It's also possible that the biopsy was mis-read. This is not likely though. Lymphoma is very easy to diagnose on a needle aspirate or biopsy- it's pretty classic the big lymphoblast cells that are seen.
Customer: replied 4 years ago.
Yah of course i'm going to start him on therapy ASAP. When i go to the specialist tomorrow how long does it usually take for them to determine the stage of the cancer and what treatment to follow? Also my vet said that the lympnode swelling had gone down and it was smaller at the time of surgery compared to when she inspected it 4 days earlier. Is that a sign of something? Our vet sent the biopsy back in to have it re-tested. You said something about it being misread. Meaning a false positive right? The fact that the lympnode decreased in size/swelling in time in between the time the vet looked at it til the surgery can that be a good sign? And maybe she is sending it in b/c she thinks it was mis-read?
Expert:  Dr. Gary replied 4 years ago.
If the nodes are still enlarged, then it's lymphoma until proven otherwise. If the nodes are all back to normal without any treatment, then I'd be suspicious of a false positive. If it's just the one that is down some but the rest are still enlarged then I would guess it's due to the inflammatory process of the biopsy leading to it going down some.

Usually an oncologist will do the staging and then give the first/ week 1 injection of chemo the same day. Some will re-schedule, but most just go ahead and get started at that first appointment.
Customer: replied 4 years ago.
well she removed the only swollen lympnode. none of the other lymphnodes are swollen. the vet told us that normally with lymphnoma several if not all of the lymphnodes wuld be swollen. but milo just had the one on his neck that was swollen and it's not there anymore since she removed it. not one other is swollen. she looked at them the day he had surgery and again today
Expert:  Dr. Gary replied 4 years ago.
Yes, usually it's all the nodes that are enlarged. If just one, I'd be hesitant to call it lymphoma as well- in that case it's more likely an inflammatory reaction to something else in the nearby site.

What you should ask the oncologist to do is aspirate one of the nodes behind the knees of the back legs and take a look under the microscope. Even if they're normal size, you can still get a sample and that will either rule out lymphoma (normal cells) or confirm lymphoma (lymphoblasts).
Customer: replied 4 years ago.
Ok i'll do that. Hope he will be able to do it on site...... But she is re-sending the biopsy back too....to have it retested.
Expert:  Dr. Gary replied 4 years ago.
Sounds good, let me know what they find
Dr. Gary, Dog Veterinarian
Category: Dog Veterinary
Satisfied Customers: 17227
Experience: DVM, Emergency Veterinarian, BS (Physiology)
Dr. Gary and 7 other Dog Veterinary Specialists are ready to help you
Customer: replied 4 years ago.
Well the oncologist said he couldnt do the aspirate b/c his other lymphnodes were so small that he said he wouldnt be able to get a conclusive diagnosis. He said the lymphnode that was removed from my vet.......and that report that came about it being cancerous he read and decided to go ahead with chemo. He's doing something called the Wisconsin protocol?? 19 weeks. My regular vet is still sending in the biopsy she took out to be retested just to be sure.

Are powder mushrooms good for cancer in combo with chemo? I've done alot of research online and i've read good things about mushroom supplements. Then another vet on here told me they would be bad b/c of the anti oxidants in them might make the chemo meds go out of his system faster.

Let me know what you think about all this. Also 19 weeks seems awful long for a chemo treatment. I've read online they last anywhere from 6-14 weeks
Expert:  Dr. Gary replied 4 years ago.
The Wisconsin protocol is the most common/ effective chemo protocols that we use. It can be 19 or 25 weeks as there are a couple variations. 6-14 weeks is not adequate for chemo protocols. I would not use any mushrooms as there is no scientifically proven benefit.
Customer: replied 4 years ago.
Got the retest of the biopsy back today. Still says he has lymphoma. They did further testing on it and it's B-cell lymphoma ...not Tcell. I guess that's good? Also can you tell me the difference between the two? When my vet called me on the phone today to give me the results she didnt have time to go into detail about it with me.
Expert:  Dr. Gary replied 4 years ago.
The difference is that they found more B-Lymphocytes than T-Lymphocytes. They're just different types of the same cell. The thing that makes this relevant is that B-cell lymphoma typically responds better to chemo and presents with "less sick" dogs.

You treat both B and T the same, but you're just a little less aggressive with T if we don't get a response from chemo as the prognosis is not as good.
Customer: replied 4 years ago.
Question. I was doing some research online about stem cell research and I read that they are treating dogs with cancer with stem cells. Maybe bone marrow too? Not sure if they are just doing this at universities or at pet cancer clinics too. Do you have any info on stem cell treatments for dogs and where i might be able to find a place that does it. I know it would be very expensive but money is not a problem for me. I've done tons of googles for stem cell treatment for dogs in florida but cant seem to find anything
Expert:  Dr. Gary replied 4 years ago.
While very new, there are some options available. The only place I know of doing the work is NC State.

Here's a link to the research and availability:
http://www.cvm.ncsu.edu/vth/clinical_services/onco/BoneMarrowTransplant.html
Customer: replied 4 years ago.
Took milo in today for his 3rd chemo session. They took his bloodwork but his white blood cell count was too low so they decided to skip a week of chemo and put him on anti- biotics. The vet said this is pretty common not sure if he was just trying to make me feel better or not. I swear i had read online that even though white blood cell counts were low they still did chemo and also the antibiotics. The vet (oncologist) said they have a few dogs can only do chemo once every other week b/c of the white blood cell count.

So basically can u tell me if low white blood cell count is normal like this and to not give him chemo b/c of it. Milo is onl on his 3rd week so not sure since he just started it maybe that has something to do with it. Maybe his body is just trying to get used to it??
Expert:  Dr. Gary replied 4 years ago.
Yes, that is completely normal. Some will do the chemo and put the dog on antibiotics while others will skip a week. It doesn't seem to make a difference either way. The lymphoma should be in remission right now and it sounds like it is, the goal of chemo now is to keep it in remission and hope for a cure (very rare but can happen). Skipping a week is usually not going to allow it to come out of remission but it will give that bone marrow a chance to rebound as that is why the white count is low- from bone marrow suppression.
Customer: replied 4 years ago.
ok thanks
Expert:  Dr. Gary replied 4 years ago.
No problem.

JustAnswer in the News:

 
 
 
Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.
 
 
 

What Customers are Saying:

 
 
 
  • It was so professional, so personally concerned (as we were) and you answered all of our questions. George and I are so happy that I found "JustAnswer" on my Google search -- you are now in my "Favorites" list! And, yes we do love our kitty - she makes our life complete! Bev & George Boca Raton, FL
< Last | Next >
  • It was so professional, so personally concerned (as we were) and you answered all of our questions. George and I are so happy that I found "JustAnswer" on my Google search -- you are now in my "Favorites" list! And, yes we do love our kitty - she makes our life complete! Bev & George Boca Raton, FL
  • Wonderful service, prompt, efficient, and accurate. Couldn't have asked for more. I cannot thank you enough for your help. Mary C. Freshfield, Liverpool, UK
  • This expert is wonderful. They truly know what they are talking about, and they actually care about you. They really helped put my nerves at ease. Thank you so much!!!! Alex Los Angeles, CA
  • Thank you for all your help. It is nice to know that this service is here for people like myself, who need answers fast and are not sure who to consult. GP Hesperia, CA
  • I couldn't be more satisfied! This is the site I will always come to when I need a second opinion. Justin Kernersville, NC
  • Just let me say that this encounter has been entirely professional and most helpful. I liked that I could ask additional questions and get answered in a very short turn around. Esther Woodstock, NY
  • Thank you so much for taking your time and knowledge to support my concerns. Not only did you answer my questions, you even took it a step further with replying with more pertinent information I needed to know. Robin Elkton, Maryland
 
 
 

Meet The Experts:

 
 
 
  • Dr. Debbie

    Dog Veterinarian

    Satisfied Customers:

    902
    Companion animal veterinarian practicing for over 10 years.
< Last | Next >
  • http://ww2.justanswer.com/uploads/DE/debkatreyn/2011-11-28_33650_682e.64x64.jpg Dr. Debbie's Avatar

    Dr. Debbie

    Dog Veterinarian

    Satisfied Customers:

    902
    Companion animal veterinarian practicing for over 10 years.
  • http://ww2.justanswer.com/uploads/VE/vetforyou/2012-6-20_33122_PearlPhoto.64x64.jpg Dr. Andy's Avatar

    Dr. Andy

    Medical Director

    Satisfied Customers:

    13796
    UC Davis graduate, emphasis in dermatology, internal medicine, pain management
  • http://ww2.justanswer.com/uploads/doggfone1/2009-07-16_133633_vet_pic.jpg Dr. Scott's Avatar

    Dr. Scott

    Veterinarian

    Satisfied Customers:

    9550
    12 years of small animal, equine and pocket pet medicine and surgery.
  • http://ww2.justanswer.com/uploads/RY/rydergar/2012-6-6_192240_IMG0328.64x64.JPG Dr. Gary's Avatar

    Dr. Gary

    Dog Veterinarian

    Satisfied Customers:

    7758
    DVM, Emergency Veterinarian, BS (Physiology)
  • http://ww2.justanswer.com/uploads/AN/andrewDVM/2012-4-27_12585_iStock000011751407XSmall.64x64.jpg Dr. Drew's Avatar

    Dr. Drew

    Dog Veterinarian

    Satisfied Customers:

    6598
    Small Animal Medicine and Surgery
  • http://ww2.justanswer.com/uploads/1I/1ISUDVM/2011-3-1_22028_Honeymoon2005075294928803490646858.64x64.jpg Dr. Bruce's Avatar

    Dr. Bruce

    Veterinarian

    Satisfied Customers:

    6377
    13 years of experience as a small animal veterinarian
  • http://ww2.justanswer.com/uploads/BI/bigislandvet/2013-2-21_214244_IMG0357.64x64.JPG Dr. Michael Salkin's Avatar

    Dr. Michael Salkin

    Big Island Vet

    Satisfied Customers:

    6049
    University of California at Davis graduate veterinarian with 41 yrs. of experience.
 
 
 
Chat Now With A Dog Veterinarian
Dr. Gary
Dr. Gary
Dog Veterinarian
17227 Satisfied Customers
DVM, Emergency Veterinarian, BS (Physiology)