The protocols described below are the ones used during Odie's initial cancer treatment. With it, he experienced a remission period of approximately eight months (the average is eleven months).
This material is presented here with the kind permission of the University of Minnesota's Small Animal Hospital.
Twelve-Week Induction Protocol
Description - The current recommended treatment for canine lymphoma is a twelve-week, five-drug cyclic chemotherapy protocol followed by a maintenance protocol. With this therapy, 80% of dogs achieve remission with average remission duration of eleven months.
Cost - Cost for the initial twelve weeks for a 70-pound dog is $2000. Total for the entire one year of therapy including the initial twelve-week induction phase is $4000-5000.
Drugs - The five-drug combination is used so that the tumor cells are killed by several mechanisms to try to prevent the cells from becoming resistant to the drugs. The induction phase consist of the following chemotherapy drugs:
Cautions - It is not recommended that dogs receive prednisone before administration of chemotherapeutics. Dogs that are pretreated with prednisone for greater than seven days tend to be more resistant to therapy and are less likely to achieve remission and have shorter remission times. Dogs in a poor state of health or are in an advanced stage of cancer (Stage IV or V) are also less likely to achieve remission and tend to have shorter remission times.
Side Effects - Potential side effects of treatment are loss of appetite, vomiting, diarrhea, or low white blood cell count. With this protocol, there is a 25% chance of mild to moderate side effects with each drug. Usually, this is self-limiting vomiting or diarrhea, which does not require hospitalization. There is a less than 5% chance of severe reactions, which would require hospitalization.
Complete blood counts (CBC) are performed at specific weeks of treatment. White blood cell counts must be high enough before administering of any chemotherapeutics. When cell counts are too low, antibiotics are prescribed and treatment is delayed one week. In the worse case, doses of certain chemotherapy drugs are reduced by 25%. This lessens the adverse side effects but does not appear to reduce efficacy.
Schedule - Chemotherapy agents are administered on the same day of each week and continue for twelve weeks.
After finishing the 12-week induction protocol, maintenance begins. Treatments are given every three weeks until the dog comes out of remission or one year has passed. The maintenance phase consist of the following chemotherapy drugs:
Chlorambucil - Pills given orally every other day. Begin at week 12
Vincristine - Injection given every three weeks
Prednisone - Given orally every other day.