Normally a needle aspirate is sent off to a Pathology lab for confirmation. A biopsy is usually only done if you wish to pursue immuno-typing it as "T" or "B" type.

Your choices are the following:

1. Do nothing. Lymphoma will rage through the dog and kill it in 4-6 weeks. It can be a painful death. Obviously not a recommended option.

2. Treat pallatively with high doses of Prednisone. This will give you a remission time of 30-60 days. Once the cancer comes back the end usually comes soon there after. However Prednisone is a one way street. If you should decide later to try Chemo, it will be too late. Prednisone induces resistance to multiple front line Chemo drugs (e.g. multiple drug resistance or MDR).

Lymphoma is the most treatable of the cancers with Chemotherapy. There are rare exceptions, but most dogs will respond very well to it. Despite a couple of unexpected set backs my 1/2Lab-1/2 Golden lasted 1 yr 3 days post diagnosis. She underwent a modified LCOPA protocol. In the time of her first remission of 7.5 months she had a high quality of life. The second week after her first treatment a life threatening infection flared up, and the last 24 hrs of her life overnight she was in a Vet hospital sick with a severe infection. Outside of those two times, she seemed content and happy throughout her year of illness.

The only real issue usually with Chemo is how much the owner is willing to spend. Combined with initial diagnostics, blood work, treating a Lymphoma dog with Chemo can be expensive. Back to the options...

3. Treat non-agressively with Chemo using the older COP protocol. Advantage lower cost, and will usually give a 4-6 month remission.

4. Treat agressively with a multiple drug approach. The key being the inclusion of Doxorubicin and Elspar into the protocol. The primary protocols are LCOPA, and the now in vogue Madison-Wisconsin. Remission times can range from 6 months to 1.5 years. Combining the Madison-Wisc with half body radiation is yielding remission times of 2+ years in some cases.

I would urge you to seriously consider Chemo. I would do it all over again, and if I had known of the possible benefits probably would have thrown in the 1/2 body radiation in lieu of the maintanance Chemo treatments after the first remission had been obtained. With proper supportive drugs such as Metoclopromide/Zofran along with an acid blocker such as Cimetidine your dog will probably not experience any nausea. The worst case scenario is if the cancer is already resistant to the drugs, but the only way to find out is to try the Chemo.

I note your location is Coastal NC. I would urge you to get a referral to the Veterinary Specialty Hospital of Carolinas, and make an appointment with Dr. Jerry Waddle.

http://www.vetspechosp.com/vets.cfm

Tell him "Daisy" sent ya. I had mine there in the June 2002-2003 time frame.

It may be some distance from the coast, but it will be worth the trip for you. He will usually want to see the dog the first couple of treatments, but after that he can set things up so that the local Vet of your choice can administer some of the other treatments. Since your current Vet is not too ethusiastic you might want to consider another to partner with the Oncologist.

If you should go to Dr. Waddle ask him about supportive drugs for nausea such as Metoclopromide. He is very accomodating. Since I arrived at his door 3 weeks post diagnosis and 1 Chemo treatment I have no reference point for this, but you should ask him for antibiotics to counter any latent infection. Approx. 70% of Lymphoma puppies have a latent secondary infection at the point of diagnosis which can flare up after the first Chemo treatment. I almost lost mine the week after her first treatment at the local Vet. In fact the road was bumpy before finding the VSH in Cary.

Finally start your puppy on fish oil. Try 3000-4000 twice a day. Worst that might happen if you give too much is a loose stool. If so then cut back. As you might imagine your Lab will just hate to take those fish oil gel caps.

http://www.hillspet.com/media/generalContent/Vet/Clinical/Monographs/en/managementOfCanineCancer_en.pdf

If you have the finances and time, don't give up hope. Try the Chemo. Chances are you will not be disappointed. You potentially still have many months ahead to share with your puppy