Signalment

• Age: 13 years
• Sex: male neutered
• Breed: Shih Tsu
• Species: dog

Disease Notes

• Certainty: confirmed
• Comments: Brindly was diagnosed with lymphoma Aug 2, 2016 at another clinic based on FNA.His owners declined chemotherapy so no further workup was done. I saw him 2 days after his diagnosis.
  
  Assessment
  WNL except
  eyes-nuclear sclerosis,
  peripheral lymph nodes are moderately enlarged
  
  TCM assessment
  Previous history of vomiting when younger. Was on gastro canned which helped initially but then started vomit on it as well. Owner switched to raw several years ago and no further vomiting. Has had some soft stool this past week- no blood or mucous.
  Seems hot as restless and preferring to lay on cooler surfaces. tongue is lavender, small amount of froth, pulse is thin/wirey. Restless at night. Soft cough. No dander. Coat slightly greasy looking. No active points noted.
  
  Plan
  I initially started Brindley on Stasis breaker (Jing Tang herbals),
  myco forte (kan herbs) and Si Maio San (Kan herbals).
  As well we also started vitamins A/D and IP 6 and switched to a grain free home cooked diet.
  His owner are also giving marijuana oil-(from a family members prescription)- (I do not know dosing/strength) but owners feel it is helping to keep him comfortable.
  
  After reading through some of the cases on here I decided to add in XCHT mid Aug.
  The owners were reluctant to start Brindley on predisone and held off until the end of Aug as until then they felt his quality of life was ok. Initially his lymph nodes reduced to about 2/3rds of the original size and remained about the same size for several weeks but over the last 2 weeks they have gotten smaller and only one of his mandibular lymph nodes is slightly enlarged now.
  
  Since Brindley is doing so well now I would like to reduce his prednisone but am a bit worried about doing so. He is currently on a 2mg/kg dose and my thoughts were to reduce the dose by 0.5mg/kg every 1-2 weeks until we get to a 0.5mg/kg dose. Any advice on when you normally decide to wean prednisone in these lymphoma cases. Do you expect the lymph nodes completely back to normal or how/when do you decide to start reducing the dose?
  
  Thanks for you help
  
• Final Status:

Treatment and Outcome