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petdrz, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 7373
Experience:  Over 30 years of experience caring for dogs and cats
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My 10 yr old male neutered shih tzu was just diagnosed with

Customer Question

My 10 yr old male neutered shih tzu was just diagnosed with epitheliotrophic lymphoma today. The diagnosis came from a biopsied tumor that was removed from his lower gum. This 1 tumor is the ONLY indicator/symptom he has. There are No other skin or dermatology problems. My Vet is waiting on a more detailed report on the specifics of the tumor, and clear or not clear margins before we discuss options. I just lost his mother to cancer, in March. Her cancer began in one of her nipples. She lived for 6 yrs after initial diagnosis because I had the tumor removed twice. By the third reoccurrance of the cancer, she was 14 and it had spread throughout her body.
I, of course, have been online reading about this E.L. cancer, for the last 2 hrs. It appears this is far worse than the cancer I dealt with, with his mother?
All of the articles I have read say there is no cure. As a matter of fact, it appears very little is known about this type of cancer in dogs??Even with the different medications/applications that are being used for this cancer, longevity appears to be as short as 2 to 6 months from diagnosis.
I do know that I will not put this baby through chemo or radiation.... I am not that selfish, to put him through it.
Finally, my question to you... what suggestions do you have for making my baby as comfortable, and as long, as possible? If it were your baby, what would you do?
Thank you so much, for your informed/professional input.
Terri G. In Mi
Submitted: 2 years ago.
Category: Dog Veterinary
Expert:  petdrz replied 2 years ago.

I am sorry that you have been waiting for a response. I recently just logged onto the site and noted that your question hasn't yet been answered. I am a licensed veterinarian with over 25 years’ experience and would be happy work with you if you are still needing assistance.

I think the decision of how to proceed needs to be researched thoroughly before deciding. You are correct that long term prognosis is not great for this type of cancer, and not every pet will respond as expected and achieve remission or even partial remission. Starting with the details of the report is the first step so that the aggressiveness of the cancer can be estimated. Next, staging is appropriate to see if there is any evidence of metastasis. That usually simply involves chest xrays and perhaps an abdominal ultrasound. If the cancer has already spread, there would be no reason to even consider any further treatment considerations.

My next step after that would be at least a consultation with a veterinary oncologist. Every case is very different and they are better poised to lay out all of the treatment options available (there are a few) as well as cost and percentage of pets that have seen achieved a response using this method. I think the most important consideration is what exactly is involved as far as trips to the vet, ease of administration and how well he does with handling those types of things. I have had 3 cats with cancer and have only considered chemo in one of them as the others would have been so miserable with all of the attention that even though they might have lived longer, they would not have enjoyed it. I have also seen some pets go through chemo or radiation with low chance of long term survival who have gone on to enjoy many more months or even years of good quality life. It really is somewhat of a crap shoot as we don't really know who will respond and who won't, but we can only rely on the statistics to get a average of how the group as a whole responds.

If you decide to not pursue further treatment at all, comfort level would be my biggest concern. Pain medication or steroids to reduce secondary inflammation can be very useful. In later stages, appetite stimulants may be needed.

I hope this is helpful. Please let me know if you have ANY other questions. My goal is to give you 100% satisfaction and if you are not yet satisfied, please reply so I can clarify for you.

Dr Z

Customer: replied 2 years ago.
Hi Dr Z. Thank you for responding to my post/questions.
In many of the research online articles I read, they spoke to the use of prednisone and other types of medicines (of which i can not pronounce or spell) combat this type of cancer too. As I wrote, I will not put my baby through chemo/radiation but what about the use and succes of many of these medicines?
Also, all of the articles described that dogs with this cancer had numerous dermatology rashes, sores or conditions. My baby has never had any skin or dermatology problems. Just the one growth on his lower right gum. I don't understand?
Thank you.
Expert:  petdrz replied 2 years ago.

Epitheliotrophic tumors of the mouth seem to behave much like mycosis fungoides or epitheliotropic lymphosarcoma of the skin as they originate from a similar cell line so that is why the research is including dogs with skin lesions. Lymphoma with epitheliotropism that are located anywhere around the mouth or gums often occur as a solitary lesion. It is for that reason that surgery and/or radiation therapy are often the best hope at disease-free interval. If those are not considered, medication is our next best effort. Treatment with prednisolone is still considered chemotherapy, but just a single agent chemo. Other meds that are sometimes used are Lomustine, Isotretinoin or Omega 3 fatty acids. These can be tough to treat and remissions if they are achieved at all tend to be short-lived, so single agent chemo would not be expected to produce the most favorable results. If they are tolerated, getting more than one drug on board would be more likely to produce a favorable result.

I hope that makes sense.