One week later ...

Well Jazz went back to the vet today after a week's worth of antibiotics and no distinct improvement in his appetite or reduction of the lump in his neck (enlarged lymph node).

As expected under the circumstances (i.e. no effect from the antibiotics), he was admitted for X-rays, and to have the enlarged lymph node removed to be sent off for biopsy, etc. He is now back home and is fine, although still somewhat bemused from the effects of the anaesthetic and with a bald patch and stitches under his chin.

I'll have to wait about a week for the official diagnosis when the results of the biopsy come back from the lab, but the vet is almost certain that he has Canine Lymphoma (i.e. cancer of the lymph system)... although she'd love to be proved wrong. The good news is that it's generally quite manageable with drugs (i.e. chemotherapy, which doesn't have the same sort of potentially devastating side-effects that it often does in humans). Depending on the grade of lymphoma (which the biopsy results will tell us) Jazz could have anything from 2-3 months (if we're REALLY unlucky and it's very advanced) to another couple of years left in him yet ... which would take him to a very respectable age for a dog anyway (he's about 12-13 now). Without treatment we'd be looking at a couple of months or less.

Sadly, chemo isn't cheap, so I'll be raiding the piggy banks :-(. In dogs, they generally use a combination of 3 drugs, one of which (Vincristine) has to be given intravenously - so that which will involve a weekly visit to the vet at first, plus an extra visit halfway between injections every week to take blood to test that the dosage is correct. On top of that, he'll have a couple of different tablets (Cyclophosphamide and Prednisolone - a steroid) to take at varying intervals. After a month or two, if things goes well, the frequency of the injections will be reduced to once every 3 weeks, and then depending on how that goes, these will later either be further reduced to once every 6 weeks or perhaps stop altogether, just continuing with the oral drugs.

The other good news is that because one easy way to detect/monitor lymphoma is by feeling enlarged lymph nodes near the surface of the skin (which are therefore relatively easy to spot - Jazz now has some enlarged nodes that weren't detectable a week ago, apart from the one that was already enlarged last week and has now been removed), it's also fairly easy to judge the effectiveness of the chemotherapy and determine when the lymphoma is in remission by observing the reduction in size of the lymph nodes. Treatment can then be adjusted accordingly.

Having had Jazz on a diet designed to keep the weight off him to look after his joints for the last 3 years, I'll now need to change that for a high-protein, high-fat, low-carbohydrate diet (rapidly dividing cancer cells thrive on carbohydrate, but fat tends to inhibit it, and anyway he's probably going to lose even more appetite than he already has, so he'll need the fat). Hill's do a prescription (tinned) food designed for this, but even my vet reckons it's prohibitvely expensive for a large dog, so I guess I'll have to get as close as I can with normal complete foods and supplement the rest. According to some of the websites I've found, supplements of Vitamin C, Vitamin E, Selenium, Garlic and Argenine can also help, although in some cases they're helping with the effects of the chemotherapy rather than the cancer itself.

He's due to go back for a post-op checkup on Thursday evening, and then again about 10 days from now to have his stitches out. We won't be starting any treatment until we get the results of the biopsy about this time next week to be sure of the diagnosis, but I think we can fairly safely predict getting pretty well-known at the vet's for the foreseeable future.

On a more positive note, everything I've seen on the web suggests that the best thing to do for him (apart from the drugs and change of diet) is to keep life as normal as possible ... so once the wound's healed, (and I asked the vet about this specifically,) he'll still be allowed to go swimming :-)

I found some useful information at Canine Lymphoma