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Cutaneous Lymphosarcoma

by MKinoshita - August 10, 2009

Hi Steve -
I have a 12.5 yr old FS Brittany Spaniel with Cutaneous Lymphosarcoma dx'd by biopsy. She presented with partial alopecia, collarettes with large dandruff flakes, not puritic. Parital response to antibiotics. She became lethargic and inappetant, lymph node enlargement. Started her on Hoxsey-like formula, 4 Marvels and pred. She responded well - appetite and energy returned, fur regrowth (tho' not full coat - extemities more affected still). Still large dandruff. She pants a lot when excited and "whistles". She has now developed 2 skin lesions with purple bruise-like lesions, slightly raised (hyperplastic tissue) - one on cranial shoulder area on on caudal ventral abd.
I was wondering if I should switch to Chai hu jia Long gu mu tang or add vit a/d or increase dosage of the current herbs? (On 2 mL hoxsey bid, 1 g SMS bid, 2.5 mg pred daily, 53 lb dog) Pulse rapid, slippery, deep (hard to feel).
Tongue - underside red/lavender, mild white coat, edge slightly swollen.
Thanks
Michelle Kinoshita

by marneemadsen

August 10, 2009

HI Michelle,
You may want to check out some previous posts regarding safflower oil for cutaneous lymphoma from Erin Bannick.

Marnee Madsen

by naturevet

August 10, 2009

Hi Michelle,

If the case doesn't feel stable, I'd roll in Chai Hu Jia Long Gu Mu Li Tang and see if you get better stability. If you do, you maybe able to phase some of the current protocol out. Lately, we've also had success applying Xian Fang Huo Ming Yin to active lesions topically, using some sort of salve you have on hand as a base. We've had pretty consistent success with these in the cases that aren't just Blood deficient, so I'd give them a try.

S

by Peggy Lewis

August 12, 2009

Does this dog have mycosis fungoides (cutaneous T-cell lymphoma)? We currently have a dog recently dx w. this and I was wondering if this discuusion would be applicable to him.
Thanks--Peggy Lewis

by MKinoshita

August 12, 2009

Peggy,
The skin biopsies came back as Epitheliotropic Cutaneous Lymphoma (Cutaneous T-cell Lymphoma) - we sent the bx to a dermatopathologist.

Steve spoke about using Chai Hu Jia Long Gu Mu Li Tang with or without Qing Ying Tang at the COMS lecture this past spring (for cutaneous lymphoma).
I thought the dog was more Damp Heat, so started lymphoma protocol 1st (SMS, Hoxsey, pred).

Good luck with the case.
Michelle Kinoshita

by MKinoshita

September 27, 2009

Hi Steve,
I was hoping to give a good update but...
Started dog on Chai Hu Jia Long Gu Mu Li Tang, weaned off Hoxsey and SMS, continued on Pred but decreased to 2.5 mg EOD (49 lb dog), made a salve with Angelica and Mastic to apply to purple/red skin lesions.
Breathing improved - only occ'ly wheezes and whistles. Skin lesion on shoulder resolved but one on inguinal region gradually increased and she acquired smaller (1-2 cm), non-raised, erythemic patches on ventral abd. Added QYT 2g in pm, decreased CHJLGMLT to am (3g). Her energy improved - best it has been for years. But her large dandruff flakes have increased,
the non-raised erythemic patches resolved initially with QYT added, but have recurred 2 weeks later and multiple purple/red lumps (some with ulcerations or crusts)have appeared on the dorsal and lateral aspects of her body. She licks these (itchy?). Still patchy alopecia on extremities. Nose is depigmented. Lymph nodes enlarged but size stable. App excellent but she has been very gradually losing wt. Mucoid occular d/c (grey or yellow) today but no conjunctivitis.
Her tongue is purple/lavender on the underside, no coat on top, red on top. Pulse - wiry, rapid, when 1st palpated I thought it was superficial but felt it was deep later.
I am starting her on Vit A/D daily and the owner is sourcing out Hollywood Safflower oil (not available in Canada).
I decreased the QYT to 1 g thinking it was causing more Dampness. Should add/use something stronger for Blood Stagnation/stasis? Other suggestions?

Thanks

Michelle Kinoshita

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