Veterinary Medicine Teaching Hospital, University of Buenos Aires School of Veterinary Sciences, Buenos Aires, Argentina
The aim of this poster is to communicate the association between a common neoplastic disease as the canine lymphoma and a behavioral disorder as the anxiety during chemotherapy.
Lymphoma is a malignant lymphocytes neoplasm that grows in solid organs as lymph nodes, liver, spleen or other organs that store lymphoid tissue. It's one of the most common canine malignant tumors. Although lymphoma is a systemic disease, it's important to determinate the extension of the disease to different organs and identify related secondary or not secondary conditions that need to be treated or controlled before or during the treatment.
The behavioral motor and exploratory abnormalities (increased motor activity, increased vigilance and scanning, destructive chewing), vocalizations (whimpering), autonomic hyperactivity (tachycardia, tachypnea, tremors, syncope), some kind of aggression (annoying, redirected), sleep disorders (dyssomnia, insomnia), ingestive disorders (coprophagia), substitution activities (lick dermatitis, onychophagia) and hyperattachment, are some of the most frequent signs of anxiety.
In eleven dogs with cytological confirmation of lymphoma, there were identified anxiety disorders in a clinical diagnostic criteria basis. These patients presented different locations of lymphadenopathy and most of them showed in good state.
There were performed blood tests, lymph nodes and bone marrow biopsies, chest radiographies, abdominal ultrasound, and immunophenotyping and the patients were stratified according with tests results. There were performed the COP protocol (Vincristine, Cyclophosphamide and Prednisolone) to these patients with Doxorubicin, Cytosine Arabinoside and Lomustine as rescue drugs. During chemotherapy the patients showed aggression problems, vocalization, diarrhea, hypervigilance, wandering, oral exploration, whining, tachycardia, tachypnea, tremors, lick dermatitis, coprophagia, hyperattachment, insomnia, and syncope. Based in actual criteria, this signs allows the diagnosis of anxiety disorder. The treatment consisted in behavioral therapy (educational, environmental, cognitival, behavioral, systemic, and by goals) and in some cases in the use of psychopharmacs (clomipramine, chlorazepam). The patients had a favourable response, achieving a survival time of one year and eight months with a good quality of life.
The complication of canine lymphoma with the development of an anxiety disorder worsens the prognosis and may lead to decide euthanasia.
The early zoo psychiatric diagnosis allowed a cognitive-behavioral, and in a few cases, pharmacological therapy, which achieved the complete remission of the signs.
In the oncologic patient, the accurate diagnosis and treatment of a behavioral disorder results to be such important as the confirmatory diagnosis and therapeutic protocol of lymphoma, leading to improve his quality of life and delaying the possibility of euthanasia.