When Benji the six-year old male Lhaso Apso was presented to the hospital for a goiter I knew I would most likely find something else. Goiters are almost unheard of in dogs and the lump would most likely turn out to be something else.
As I examined Benji, it was obvious this was true right at the start of the physical examination. The lump was actually several lumps, all of them lymph nodes on the throat, back of the legs, armpit areas and groin. I did some fine needle aspirates and the lab confirmed the diagnosis was lymphosarcoma - a cancer of the lymphatic systems. Benji's caregiver was devastated but between tears asked what we could do.
Although no one likes the word cancer, this was one type of cancer that usually responded to treatment and could be put in remission. The options were to let nature take it course and Benji would only survive a few months, use a cortisone to add a few months to that or engage in a course of chemotherapy that would try to put Benji into a remission. I explained that although people are often scared of the word chemotherapy, newer drugs have less side effects and that I had never had a dog or cat patient lose their hair from chemotherapy.
Cost often is a major factor since the caregiver themselves have to pay for the laboratory tests and expensive chemotherapy drugs. We worked out a few protocols for Benji and went over the blood tests and medication costs involved. As much as Benji was a well-loved dog, his caregiver could only afford one chemotherapeutic treatment. We had to make it our best shot and I carefully weighed Benji and then determined his treatment dose. Having only one shot at it made our chances less likely to be successful and I erred on the side of giving the maximum dose.
With a decision made to not carry on with any more treatments I did not see Benji for a few months. I decided to follow-up with a phone call a few months later not sure if Benji was even still with us. "Benji is doing great," was the immediate greeting when she knew I was the vet. "It was kind of weird though, you said you never saw any of your patients lose their hair, but all of Benji's hair fell out. After all his hair fell out it grew back in golden color instead of black."
We rarely see hair loss from chemotherapy drugs but a combination of the high dose and individual variation probably contributed to the complete hair loss in Benji's case. The hair stayed golden for almost two years before returning to the black thick coat again. We never did require another treatment for Benji as we lucked out on our initial high dose, but I no longer can say that none of my patients lost their hair from chemotherapy.
