- Hi, everyone, I'm Dr. Sue, Cancer Vet.
For my next vlog, I'm super excited
'cause I'm back in the clinic.
So let's see how my patients are doing,
including Pokey, who's out over two years
for her lymphoma.
She's off chemotherapy, and I'm gonna answer a question
that I commonly get, can we cure lymphoma in dogs?
Hey, everybody, welcome to the vlog!
It has definitely been a while
since I've done a vlog like this,
so I thought it would be fun to get back in the clinic
and show you guys my new place.
Some people have asked, "What's going on in your new job?"
So I've been here for a couple of months.
I love love love it, great team.
Super excited to introduce you to Joe and Katie.
All right, everybody, want to introduce you
to the amazing Katie, woop woop.
So Katie's my assistant, you've been working for me
for about. - Two months?
- Two months, so I've been here for three months.
So what do you think?
- Love every minute.
- And she's awesome.
- Learning so much.
- So Katie is a dedicated assistant to our team,
and she's just been awesome.
You've been with the hospital
for a little bit longer, right?
- Yeah, yeah.
I would do surgery.
- All right so I'm gonna put you on the spot.
What has surprised you most about the oncology service?
- I think how much people are willing
to do for their pets, honestly.
- Yeah? - Especially
in their older age, 'cause I didn't know people
were willing to take that good a care of pets
when they're 14, 15, 16.
- [Dr. Sue] We repeated her blood work
'cause of the high cholesterol
and triglycerides on the fasted sample.
We got the big urine and culture,
and then, I'm either gonna see you back
in two to four weeks, but we're gonna wait
for everything to come back
before I can book your appointment.
And her lymph nodes feel great,
so her lymphoma's still in remission.
Two years, four months later, baby girl!
- [Man] Yeah. - [Dr. Sue] That's my sweetie.
- [Man] Yeah, goodies.
- So for the last couple months
I've been at a new place, and it's a great place.
I'm only there two days a week,
but a lot of my patients are still with me,
which is super fantastic.
So this video, the first patient that we're gonna see
is Pokey, the question that you guys are all thinking
when you're watching this video is
"Can we cure lymphoma in dogs?"
And again, this will be, can we cure other cancers, as well.
But I'm gonna focus on lymphoma in dogs
and let's talk about Pokey, 'cause she's a great example.
So Pokey was diagnosed in, two years
and four months ago, so in February of 2017
with multicentric B-cell lymphoma,
so the most common type of lymphoma that we see.
Dad elected to her on CHOP multi-agent chemotherapy,
so that is considered to be the standard of care
and the best chemotherapy protocol that we have.
She went into remission.
She finished her protocol five months later,
like most dogs do.
We also did, at the time, we put her
on a monoclonal antibody that was available
on the market at the time
and that is no longer on the market now
because it was not shown to be effective
for the majority of dogs, which tolerated it very well.
She relapsed four months after finishing chemotherapy,
which is average, so it's what we expect
for the majority of dogs going through chemotherapy,
and I was really disappointed because I expected
with a combination of the monoclonal antibody,
this immunotherapy which would help boost
her immune system to attack the cancer cells
and the chemotherapy would be killing her cancer cells
that she would do better.
And typically, when they relapse, and again,
I have other videos that we'll link up
about when dogs relapse, I tell the owners
that the second remission will be
about half the length of the first.
And this is a really good example.
Pokey's a really good example of why statistics
don't always predict the individual.
So her first remission was average to a little bit short,
so it was only about nine months,
including her chemotherapy.
So five months of chemo, about four months after that,
that's when she relapsed.
So how long should her second have remission been?
About 4 1/2 months, right?
So we went back on the CHOP multi-agent chemotherapy
protocol, and often, when they're done with chemo,
they'll graduate and they'll go off chemo again.
But I had a discussion with dad about maybe keeping her
on maintenance chemotherapy.
And this is not standard for every dog,
and this is where it's great to have an oncologist,
a cancer specialist, and have that discussion,
but we decided to keep her on maintenance chemotherapy,
and we did that for a full year.
She was also on lots of supplements,
so, not for a spoiler alert, but miss Pokey
is still in remission and we are
two years and four months out.
So her second remission has been longer than her first.
So a really good example that statistics
will not predict the individual,
which makes me super excited and super happy.
So let's go back to the question.
Can we cure lymphoma?
When do I call sweet Pokey a cure?
I don't know that we know that answer.
You know, to go back to the overview,
if you're watching this because your dog
was diagnosed with lymphoma, in general,
we don't cure lymphoma in most dogs.
Usually when they're in remission,
and I put that in air quotes
'cause that will something that your cancer specialist
or your veterinarian will say,
there's usually some degree of microscopic cells
still present, and at some point those cells divide
and start to repopulate their lymph nodes.
So at some point her lymphoma will probably relapse,
and that's probably what she'll succumb to,
which is hard, because I love this dog
like she's my own and her dad has become
a dear friend of mine.
While the chemo was getting made,
she just sat on the little mat
and just sat there waiting.
She was like, I know the routine.
She's just perfect, perfect.
All right, guys, our next patient is Lucy.
I love Lucy, "I Love Lucy." (chuckles)
Anyway, Lucy is a five-year-old female spayed Great Dane.
She is just fabulous.
I know, five just seems kind of young
when it comes to cancer, but unfortunately,
large and giant breed dogs, they age more quickly,
and she was diagnosed with osteosarcoma
in the distal radius, so right above the wrist,
and that is one of the most common locations
I actually, guys, just did a bunch of videos on bone cancer,
so we put a link below, so if you want more information
on bone cancer, I have three new videos
all about bone cancer in dogs, so.
This is a pretty classic age, so five to seven years.
Classic breed, Great Dane, large and giant breed dogs,
classic location, so miss Lucy is coming in today
for her third of six carboplatin treatments.
She's doing pretty well, and we're gonna
run some blood work, give her her chemo.
All right, blood work on Lucy, everything is normal.
And if we're lucky, maybe we'll get to meet dad,
'cause he's super fantastic.
I think he has a couple of Great Danes.
Say bye, Lucy! - She's like all right,
see ya. - She's ready to go.
- Tell her, say bye. - Good girl!
All right, see you in three weeks?
- (kisses) You're so handsome.
So Yam is a kitty, this orange boy.
I love orange boys.
He was just diagnosed last week
by our internist, Dr. Whitney,
with large cell gastrointestinal lymphoma
of the small intestines.
Yam's symptoms were weight loss and diarrhea.
And he actually had really stinky diarrhea
two times during the exam room.
Other common symptoms of gastrointestinal lymphoma
in kitties can also be poor appetite to anorexia
and vomiting, and sometimes they'll have all of those
and sometimes they'll just have one or two of those.
And they could just have one, it could just be weight loss,
which can be confusing.
Anyway, their other kitty, which I didn't get his name,
oh yes I did, Mickey, was just diagnosed
with small cell lymphoma, and the big difference
with small cell or low-grade lymphoma
is that's treated with steroids and oral chemotherapy
called Leukeran or chlorambucil.
And he's doing really well and he's gaining weight,
and his symptoms have resolved,
and they really were hoping and excited that Yam
could be treated that way.
Unfortunately, he can't, and the best treatment
for high-grade or large cell lymphoma
is injectable chemotherapy.
So that's we started this week with Yam.
If you're looking for more information on lymphoma,
again, we have lots of videos,
so you're going to wanna check out the lymphoma playlist.
I think I also have a, one of my lectures from Norway,
from a couple of months ago
is all about kitty gastrointestinal lymphoma,
and I talk about both low-grade and high-grade,
I have a Q&A that we just did a couple of months ago,
so lots of information, lots of resources.
So he's getting his first chemo.
We're starting with Elspar.
He'll come back next week for vincristine.
Hopefully we'll get that diarrhea under control.
In addition to his steroids, I'm adding a probiotic
and diarrhea medication, metronidazole.
And also gonna be testing him for something called
maldigestion profile, see if he needs
some B12 supplementation,
'cause that will often be abnormal
in kitties with either high-grade or low-grade lymphoma
and supplementation can be really helpful.
CBC looks good on Yam, actually looks great.
Look at that, like no error messages, perfect.
Whoo, boring blood work, I like it.
All right, I'm gonna write out chemo orders.
You want to premed with eight milligrams of Benadryl?
- My day is officially complete.
I can get out of my work clothes into my comfy clothes.
I hope you enjoy the vlog.
It's fun to be back in the clinic,
or at least share what's going on in my world with you.
If you enjoyed this, please comment, share, let me know.
Thanks for watching so much.
It's always a pleasure to help you
through the horrible journey of cancer,
and I appreciate you being here.