C O L D  R I V E R  V E T E R I N A R Y  C E N T E R

Integrated approach to lymphoma

CASE REPORTS

• Allergies in a dog

• Allergies in a cat

• Arthritis

• Colitis. otitis

• Cushings disease

• Ear infections

• Feline chronic renal failure

• Heartworm

• Inflammatory bowel disease

• Kennel cough

• Kidney failure, disc disease

• Lymphangitis

• Lymphoma

• Oral papillomas

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Many dogs and cats come to Cold River Veterinary Center with a history of chronic illness. They have multiple health problems and generally are not making progress with conventional treatment. Our job is to find the underlying problem and promote healing using non-toxic, natural therapies. Nikki is a good example of how the body can heal when given the right combination of nutrition and immune support.

Eye problems

Nikki is a 15 year old neutered male Toy poodle who was referred to us for treatment of central corneal defects in both eyes. Nikki had been vaccinated annually for distemper, parvovirus, corona virus, and kennel cough, with rabies boosters every two years. He was on a heartworm medication monthly. His caregiver provided him with a pet vitamin, glucosamine and chondroitin sulfate for degenerative joint disease, brewers yeast and garlic.

History

Medical records from the referring veterinarian helped us understand the extent of Nikki’s health problems. He was diagnosed with a heart murmur in March, 1999. A deformed nailbed necessitated amputation of a left front toe that month. Abnormal blood tests drew a suspicion of hyperadrenocorticism (Cushing’s disease), or excessive production of cortisol hormone.

By May, 1999 Nikki had developed a cough at night and was uncomfortable falling asleep. On his February, 2000 exam he was found to be overweight, had a pendulous abdomen, harsh lung sounds, and a productive cough (phlegm). He had an enlarged, hard nailbed in his right front toe. Blood tests performed in March, 2000 showed several significant abnormalities that were consistent with Cushing’s disease. He was placed on Theophylline, a bronchodilator, 50 mg twice a day for the cough.

One month later, Nikki was back to the veterinary hospital for itchy, red, cloudy eyes. The veterinarian noted injected sclera (bloodshot eyes) and bilateral cataracts. Nikki was to receive an antibiotic and hydrocortisone eye ointment for conjunctivitis.

Two months later, in July 2000 the eyes still had injected vessels and new central cornea opacities (ulcers). This condition was treated with Tobramycin antibiotic eye ointment and artificial tears to provide more lubrication. The right front toe was amputated due to bone decay, visible on a radiograph.

One week later the episcleral injection was getting worse, and baby aspirin was prescribed, along with Tobramycin ophthalmic ointment and artificial tears. A chest x-ray film showed an enlarged heart. The Theophylline dose was maintained, 50 mg twice a day for cough due to heart disease. Nikki was on Amoxicillin and Baytril antibiotic for a cloudy discharge from his paw. Finally, a urine cortisol/creatinine test was recommended to rule in or rule out Cushings disease.

Nikki’s exam at CRVC

We saw Nikki as a new patient in August, 2000. He certainly had a weight problem. The corneal ulcers were present, as were the injected vessels over the whites of his eyes. His temperature was normal, 101.5 F, heart rate 84, with fair pulse quality. Acupuncture association points were sensitive at BL-15 (heart), BL-18 (liver), BL-23 (kidney), and BL-25 (large intestine). What broke up the bad news was a comment from his Mom: Nikki likes to eat vegetables!   

We obtained blood and urine samples to prepare a nutritional treatment plan (BioMedical Profile). The results can be seen in the table below. We found that Nikki’s thyroid activity was essentially nil. Hypothyroidism depresses tear production, lowers disease resistance, and delays wound healing. Low thyroid can cause dry eye disease in dogs (keratoconjunctivitis sicca). In addition, Nikki had signs of hepatopathy (liver disease), high cholesterol, and hyperkalemia (abnormal potassium level). A urine cortisol/creatinine screen did not support a diagnosis of Cushing’s disease however.

Serum chemistry profiles                                   

    *These values are at one end or outside of the reference range for dogs.

Home foods

We recommended a diet of fresh, whole foods including vegetables, whole fruits, sweet potato and liver. Thyroid medication and 7 nutritional supplements were prescribed. Therapy was directed at detoxifying and decongesting the liver, promoting repair of the corneal ulcers, and supporting heart function. A recheck was scheduled for November, 2000.

After 3 months of nutritional therapy Nikki’s imbalances had significantly improved. His cholesterol had dropped 330 points, and was now within the reference range. The chronic hyperkalemia had resolved. We noted there were still markers for liver inflammation. On physical exam there were signs of gingivitis, his heart rate was 120, temperature 102 F, the left patella was easily luxated (dislocates), and a tick bite was found.

Lymphoma

In late December, 2000, Nikki’s guardian felt a swelling under the throat. We performed a fine needle aspirate of a laryngeal lymph node and sent slides to a pathologist. The diagnosis was lymphoma, a malignancy of lymphocyte blood cells. Before heading home, we gave Nikki an acupuncture treatment to which he responded beautifully. His next nutritional treatment plan listed just 4 supplements, plus thyroid medication.

Chemotherapy

Nikki’s integrative cancer therapy started December 27, 2000 at CRVC. We are administering a modified lymphoma treatment protocol, avoiding the most toxic chemotherapy agents. We support the immune system and liver detoxification while the patient is undergoing cancer therapy. Cancer in dogs requires an integrative approach, using nutritional therapy and conventional medicine for a favorable outcome.

Follow up

Nikki has been treated as an outpatient at our clinic every 2 weeks. He is doing splendidly, having no immune suppression or adverse effects of chemotherapy. He is healthy at 11 pounds, happy and active. His Theophylline dose has been decreased, and we have recommended a homeopathic remedy as an alternative therapy for the cough that is secondary to heart disease. His recent blood test revealed a perfect mineral balance, the liver inflammation has resolved, and his thyroid level is optimum. 

After scaling the calculus from his teeth we treated Nikki with an antibiotic for tooth abscess.  His blood cell count showed a vigorous and healthy immune response- a hallmark of our integrated approach to cancer therapy. If his lymph nodes stay small we will be entertaining thoughts of finishing the chemotherapy. Nikki's caregiver is helping keep his teeth clean with regular brushing, a good preventive measure against further tooth and gum disease. Thank you Nikki, for being a great patient!

William K. Kruesi, D.V.M.  11/24/04