Odds Of Lymphoma Vs. Autoimmune Disease

[Guest Tahoe]

This is my first post here. Sorry if this has been covered.

 

Our greyhound Tahoe has either autoimmune disease or lymphoma. Evidently the symptoms are the same. The tests are

inconclusive. (Of course, the veterinary hospital vet wants to conduct even more tests--I won't go into the weeks of tests Tahoe has been through.)

The treatments are: steroids for autoimmunune disease or chemotherepy for lymphoma. We're inclined to go with steriods, but if he has lymphoma, this will hasten his death. So our question is, what are the odds in the greyhound population of each disease? Do greyhounds get either disease very frequently?

 

Thanks for your help!

[Batmom]

What kinds of tests has he had?

Where are you located?

[Guest Tahoe]

What kinds of tests has he had?

Where are you located?

Test: blood work, x-ray, ultrasound, spleen asperation.

Location: Massacusetts

 

He has an enlarged spleen and one enlarged lymph node.

[Batmom]

I would probably want to do a fine needle aspirate on that lymph node ......

 

Might want to consult with Ohio State. Somebody will wander by shortly with their contact information, I suspect. They have a greyhound wellness program, and consults are generally via email and free.

[sweetdogs]

Just wandering by...OSU contact info This a tremendous program for our hounds. Dr. Couto & his team provide free consultations for greyhound owners & their vets. They will review all your records & give their recommendations. They see lots of hounds & their experience & knowledge is amazing. Don't feel shy about contacting them - they are wonderful.

 

Welcome to Greytalk & best wishes for Tahoe.

[Guest Energy11]

I, too, would get that lump biospied, AND, I'd send all info to Dr. Couto at OSU. You can send to him @ couto.1@osu.edu. OR his team @ Greyhound@cvm.osu.edu.

 

I might get the biospy done before starting the steroids. Good luck, lots of hugs and prayers coming from us!

 

Welcome to Greytalk, and we hope everything turns out okay! Dee and The Five

Edited February 14, 2010 by Energy11

[krissn333]

Yes to a biopsy...

 

Fine needle aspiration of lymph node

 

Tell your vet you want blood drawn and you want it sent to NC State for Flow Cytometry. That's how they diagnosed Ace's chronic lymphocytic leukemia. From what I understand, that flow cytometry test tells them exactly what's going on in the blood and they were easily able to say that that's DEFINITELY what Ace has.

 

I wouldn't start ANYTHING until you know something for sure.

 

Get ahold of Dr. Couto and his staff, they're wonderful and so helpful. You do have to be a little bit patient at times because they're super busy there, but, their support is very well worth it!

[ahicks51]

What is the age of the hound, and do you have any bloodwork that would include things like C-reactive protein (CRP) and sedimentation rate (sed rate)? I don't know if they even do these for dogs or not. The flow cytometry is an excellent idea.

 

If you can't make it to OSU directly, it sounds like you need to find a vet with an oncology specialty in your area. ACVIM will help you find one locally:

 

http://www.acvim.org/websites/acvim/index.php?p=3

 

A quick search shows 8 in Massachusetts: Boston; 3 in North Grafton; 3 in Waltham; and one in Northborough.

[Guest Fasave]

In January of 09, I was faced with the same issue. I was told my pup had either IBD (which is autoimmune) or Lymphoma but he had different symptoms than your pup. I'm not sure where you are at in MA but my guy was treated at Angell Memorial in Boston. I had an endoscope performed on him and received the diagnosis of IBD. They told me I was looking at 9 months either way being that he also had PLN (kidney disease) and PLE. I cooked for him with the direction of a nutritionalist and he did very well but sadly passed away at almost exactly 9 months. He was two months shy of his 10th birthday. If you are close to Boston and want to see a specialist, I recommend Dr. Carroll an internal med doc at Angell. I also agree with consulting with Dr. Couto and his team. Keep us updated.

[Guest SoulsMom]

What were the symptoms leading up to this? When Soul had severe GI bleeding last year Tufts also wanted to look for Lymphoma. Ultrasound showed nothing so we didn't do anymore tests but just put him on a special diet and he been doing very well. . . .that said I wasn't all that impressed with the care at Tufts. If he hadn't needed immediate emergency care I would have had time to do more research and taken him to Angell.

 

ETA: Soul also has an autoimmune disease---Discoid Lupus, but he doesn't need steroids to control the symptoms

Edited February 14, 2010 by SoulsMom

[Guest LindsaySF]

Agreed with a biopsy or needle aspirate. They need to see the cells in there to be sure of the diagnosis. Good luck.

 

 

 

 

[Guest Tahoe]

Everyone seems to think we should do more tests, and maybe we will. But my question was, what are the relative odds? If he's 50 times more likely to have lymphoma than auto-immune disease, that would be nice to know. No one knows this information? What do they more frequently die from? I'm all in favor of tests, but only if it makes a difference to the outcome after we get the diagnosis. Otherwise my inclination is to do what we can to make him comfortable and not put him through the stress.

Really, does anyone know the odds?

[Guest SoulsMom]

I'm no expert but I would say the odds are 50/50. They can get either condition equally. As for the outcome--autoimmune can be successfully managed. Lymphoma would probably have a lower survival rate.

 

In answer to your other question, the disease that greyhounds are afflicted by more than any other is bone cancer.

Edited February 14, 2010 by SoulsMom

[tbhounds]

If your vet feels that this may be sytemic lymphoma then w/o question you need to either get an aspirate or a biopsy of the enlarged node. I also must disagree about the use of steroids as a treatment protocol. Pred can be used if chemotherapy is not an option for lymphoma--but, I must add that if chemotherapy is going to be in your pups future withhold on using steroids.

[tornadosgirl]

I would advise to get another opinion,quickly. When our Penny was diagnosed with lymphoma, we were told (by Tufts) she would pass in 30 days if we did nothing. Personally, the odds wouldn't matter to me, if time was of the essence.

Edited February 15, 2010 by tornadosgirl

[DaisyDoodle]

Two important things--you need to talk to Dr. Couto and the Greyhound Wellness group at Ohio State University. Get them ALL of the information you already have. Tests, x-rays, anything and everything. They may be able to give you an answer to what's going on without more tests. They can also answer the question you have about the odds of it being one disease over the other.

 

The other thing. Prednisone, a steroid, IS used to treat lymphoma, along w stronger chemo drugs. It used to be thought that using pred first kept the chemo from working, but Dr. Couto has done research on this and shown it not to be the case. So, if pred would be used for the autoimmune disorder, it might be okay and not dangerous to use it for lymphoma.

 

If the lymph node aspiration or biopsy has not been done, it should be. I don't think a definitive diagnosis can be determined without it. If it's positive, the lymphoma treatment can begin in earnest--many types of lymphoma are treatable. If it's negative, then that may tell you it's an autoimmune disorder, or other tests may be needed to determine if/what type of autoimmune disorder it is.

[tbhounds]

After re-reading your post---does the vet feel your pup might have GI Lymphoma or systemic Lymphoma?--huge difference between to two.

[Guest Tahoe]

Okay, I get the idea. The vets won't give us a diagnosis--they keep ordering more tests, and we're just getting fed up with it. I can see that we have no choice but to do what they say (or find another vet, who is certainly going to want to do more tests anyway). I was hoping someone would say "Autoimmune disease? Greyhounds never get that! It's got to be lymphoma."

Thanks everyone.

[joejoesmom]

I totally understand your frustration. Sometimes an answer is hard to come by. If anyone knows the answers to your questions it would be OSU. Phone or email consultations are free. If they say that they need another test to diagnose it properly, I would believe them. They will make no money off of you since they would not be doing the test. They have saved a number of hounds from further testing, amputation and/or chemo.

 

In case you are not familiar with the program: Dr Couto at Ohio State University has a Greyhound Health and Wellness Program. They receive grants from various organizations and donations from individuals. This partially funds the program and their cancer and blood research groups. This is why they are able to provide free email/phone consulting. They also provide free chemo drugs to any retired racing greyhound. However, because of the volume of requests and limited funds, it might take a bit of time to hear back from them.

 

I am far from an expert on the subject, but my guess is that both autoimmune illnesses and lymphoma are fairly common in greyhounds (and in dogs in general). While it is true that if a greyhound gets cancer it is more likely to be bone cancer, it doesn't mean that they don't get lymphomas.

 

I am including more info on how to reach OSU. I think Dr. Couto is out for another week but someone on his staff should be able to help you.

 

OSU Greyhound Health and Wellness Program:

Phone: (614) 247-6757

Email: greyosu@osu.edu

Website: http://www.vet.ohio-state.edu/GHWP.htm

 

This email goes to the team. If Dr. Couto is traveling, you may get a quicker answer from one of his team members:

 

Dr. Couto, Department Head, Greyhound Medicine, Oncolology and Hematology

Dr. Lili Marin, Greyhound Oncology

Dr. Sara Zaldivar, Greyhound Medicine

Dr. Cristina Iazbik, Blood Bank Director and Hematologist

Dr. Bridget Urie, Resident

Dawn Hudson, Vet Tech

Ashley DeFelice, Vet Tech

 

Dr. Urie is from the United States. All of the other vets are originally from Spanish speaking countries. If you have trouble understanding them over the phone, you might ask for Dr. Urie or one of the vet techs to "translate".

 

Dr. Couto's direct email is:

couto.1@osu.edu

His phone number is the same. If he is in town, he typically returns emails in the early hours of the morning.

 

You should know that (in my humble opinion) they need more staff. Unfortunately finances do not permit it at this time. I think they do about 20 consults a day along with all of their "in canine" patients. There is no charge for phone/email consultations. Depending on their workload there may be a wait for the consultation.

 

If you decide to visit OSU please contact me. I may be able to put you up in a local home, provide moral support, or just help with logistics:

 

Finewhipador-drool@yahoo.com

 

The main number for the veterinary hospital is 614-292-3551

[Guest Cris_M]

I am so sorry you are dealing with this. Our first grey, Gabriel, went through very much the same thing.

 

We began with a possible diagnosis of auto-immune hemolytic anemia. That has a pretty sucky outcome. Then, the diagnosis moved to leukemia, lymphoma, and pancytopenia. Pancytopenia is where every component of the blood is broken down by the body. The outcome for this is really sucky.

 

Gabriel was put on Prednisone regardless of what the diagnosis was going to be. Later, when we took him the University of Georgia (teaching veterinary school), we were told that our vet had done everything correctly. I have no doubts that Gabriel received the best of care.

 

Now, to your problems....

 

The lymph node biopsy is not traumatic or particularly expensive. I think it is a test worth doing.

 

Prednisone is not expensive, either. It does drop the immune system, and a low dose antibiotic may be added to the Prednisone. This will head off most potential infections. You will still need to watch Tahoe carefully for additional infections or minor injuries. The medication to protect Gabriel's gut was the most expensive of the medications. If you go with Prednisone, I highly recommend a gut protecting med.

 

Seriously consider whether you are going to be able to do chemo. OSU will send you the drugs IF you have a vet who is qualified (experienced) in doing chemotherapy. Maybe things are different, but Dr. Cuoto told me this in a face to face conversation less than a year ago. For Gabriel, it would have been a bad choice. We were looking at a three hour drive (six roundtrip) and a dog who would have considered that a misery. The chance of the chemo helping was close to nil. If I had been working at the time, that would have necessitated a lot of time off. While this was not an issue for us, the cost can also be a problem -- even with free drugs.

 

I am not trying to be a downer about the chemo thing -- just a realist. Chemo is great for lots of reasons. And, there are also reasons not to do it. If you can't or choose not to go the chemo route, be kind to yourself about it.

 

If you aren't going to do chemo, there is no reason IMO not to go ahead and do the Prednisone.

 

My thoughts are with you and Tahoe. I know well how awful not knowing is. I remember researching everything Gabriel could have. I remember the tests while the vets worked to determine a proper diagnosis. I remember how time stretched out and how waiting to know what was wrong lasted forever. I remember how, at the very same time, time shortened and became all too quick since I knew there was no good outcome. You are going through a heartbreaking time. Just wanted you to know that someone else has been through it.

 

Hopefully, you and Tahoe will have a much better outcome.

 

Cris

[Guest mybabies3]

From experience, I would cut out the middle man and go directly to an oncologist. I did this and the first visit to the oncologist confirmed right then and there thru a fine needle aspiration, bone marrow and blood work that Schultz did infact have lymphoma. They started treatment THAT day. Hugs, love and prayers to you. I am going thru chemo for lymphoma on my heartdog.