The Power of Collaboration: Tackling the Toughest Cases with Zoetis Specialists By Your Side
See how a vet and a Zoetis Virtual Laboratory specialist worked together to treat lymphoma
Sponsored by Zoetis
Adam Christman, DVM, MBA
So, tell us a little bit of the clinical signs of why Zahara presented to the veterinarian initially.
Lisa Bono
So honestly, we didn't have a ton of heads up given for her diagnosis. What happened was, she was getting ready to go for her one of her regular checkups, and it was scheduled on Thursday. And on Sunday, I noticed that I could feel her lymph nodes a little bit when I was just, you know, checking her up in the morning, putting on her collar. And I said, how that's interesting. Maybe she has an infection. I'm going to see the vet anyway, this week, we'll check it out. And they actually, you know, became more distinct over the course of those few days, go into the vet have a normal checkup. And quite frankly, everybody thought that she was doing great. She, you know, she looks like she's in good condition overall. I mentioned she said, "Yeah, I see that you want to get those aspirated to check." And I said, "Yeah, let's, let's do that." So, she takes an aspirate while we're there at the clinic; they check it. And she's, you know, used to her...she was able to take a quick look using the various diagnostics that they've brought in recently and see that there were abnormal cells. So, when she came back, she was like a 180. You know, she came in very optimistic initially, comes back and very somber and said, "You know, I think that she may have lymphoma, and that you should go get a consult with Dr. Wolfe to figure out what is the next thing to do for her." And within just that short period, she went from just detecting them by just palpating them to actually being visible, within a very short period of time. So, my assumption is that this was a very aggressive form of lymphoma. And that when I did get a chance to actually talk to Dr. Wolfe, she asked me if I wanted to start chemo that day. And I said, yeah, you know. I realized that this was dire, and that this was kind of a now or never situation. And I said, "Well, let's give it a shot." And Dr. Wolfe, with her extensive experience, really made me feel comfortable and confident in this decision.
Adam Christman, DVM, MBA
That's wonderful. So what was that experience like then when she referred, knowing that you had a diagnosis of lymphoma, then what happened from that point forward, then the treatment plan?
Shelli Wolfe, DVM, MBA
From that point forward, then we went ahead, and we discussed different options, presented data to her knowing, again, her career background there. And we talked through the different protocols with the most aggressive protocol being CHOP, and what that would entail, and what the visits that would be required in the labs and my expectations for adverse events and financial constraints. And we talked through other options. We did talk through other options that were available, other protocols that were available, but we made a decision together that we were going to pursue CHOP. We had a long in-depth conversation about that I'd never done chemotherapy on a Basenji and so there was a healthy apprehension there and she wasn't your traditional Pitbull/Terrier/Boxer type of case there. And so, we kind of worked together to anticipate any adverse events that we might have. And together, we made a decision that we were going to move forward with CHOP, and we started that day.
Adam Christman, DVM, MBA
Did you use a consultation service at all, too?
Shelli Wolfe, DVM, MBA
I didn't initially with CHOP, I went ahead and elected the 19-week protocol. But after week four, when we had the doxorubicin event, which ended up being a severe hyperproteinemia, hypoglycemia, severe diarrhea, she had to…she actually spent two weeks in our clinic, receiving supportive care throughout this. We knew that we had to change, and that CHOP was not going to be what would be in her best interest. And so at that point, then I did submit a case consultation to the oncology service. I was able to do that online. I was able to schedule an email. That worked better for me. And so she had access to all of the labs. She had access to the images to into the labs, and then my clinical description. And so she gave me different options. And she did it with a little humor as well. There is a funny little sentence in there that made it seem very personalized to me. I could tell that it wasn't any kind of cut and paste consultation. She started by saying, Dr. Wolfe, I think that chemotherapy protocols for COP are a lot like chocolate chip cookie recipes. We each have our own and we each believe that our chocolate chip cookie recipe is the best but at the end of the cooking process, what we have is cookies. And so she gave me different options, but we elected to do COP after that based upon that consultation service. And I did go ahead and respond to her is there one that you have is a favorite and so there's that availability to have dialogue back and forth. So we use the oncology service and decided together that we would move forward with COP, and we are currently on I believe round four.
Adam Christman, DVM, MBA
Oh, That's great. Lisa, having that collaborative approach with the oncologist through the reference lab through Dr. Wolfe. That must give you that confidence to know like we're all in you know on the same page and doing what's best for Zahara, right?
Lisa Bono
Absolutely. Absolutely. This was you know, again with given my background I really do appreciate getting other expert advice. I really value expertise and so that we had access to just talk to somebody get a consult quickly, really helped make me feel more comfortable and confident in our decisions for her care.
Adam Christman, DVM, MBA
Right. Thank you so much. Thank you so much. Lisa Bono and lots of love to Zahara. We love you.
