Ask the NorthStar VETS Vet: Prednisone before Chemotherapy

Dr. Dorothy Jackson, a Veterinary Oncologist at NorthStar VETS, addressed a common question she gets from pet parents around the use of Prednisone in lymphoma patients prior to starting chemotherapy.

For many years, it has been said that any dog diagnosed with lymphoma should not be started on Prednisone until the pet parents decide on whether or not to treat with chemotherapy. The reason behind this was evidence showing that dogs treated with steroids prior to chemotherapy had shorter survival times. There are several studies that prove this concept. However, many do not detail the exact dose of steroids used nor the duration of use prior to initiating chemotherapy, two very important distinctions.

Now, I don’t disagree with the data, but I do feel there are times when this may not be the best route to take. I have seen lymphoma cases where patients have struggled with lethargy, inappetance, increased respiratory effort, etc. for up to a week prior to their consultation appointment. Knowing these cases are more time-sensitive than others, NorthStar VETS does its best to fit these patients in within a few days of diagnosis.

In my opinion, some lymphoma patients would benefit immensely from low-dose Prednisone while they wait for their consultation. I also feel that this short course of therapy does not drastically interfere with certain diagnostics (if the pet parents pursue them) nor warrants a worse prognosis. There have been plenty of cases that lived the average one year with chemotherapy despite being on Prednisone for a week or so prior to starting therapy. I also feel that some of these patients would have missed out on the chance to receive chemotherapy because of their poor quality of life.

This is only one Oncologist’s opinion. If you ask others, you will likely receive different thoughts. Bottom line: “No Prednisone before chemotherapy” may not always be the best rule. We should always assess the risks versus benefits for each patient before making the decision. If you are faced with this and not sure how to proceed, contact us to ask. We are always available to help!

Learn more about the Oncology service at NorthStar VETS

Dorothy Jackson, DVM, DACVIM (Oncology)
Originally from the South, Dr. Jackson attended Mississippi State University for her undergraduate studies and veterinary school. Following veterinary school in 2009, she completed a rotating internship at the University of Missouri followed by a specialty internship at Georgia Veterinary Specialists in Atlanta. Dr. Jackson was lucky enough to obtain both academic and private practice experience during her residency, training at the University of Pennsylvania and Veterinary Cancer Center in Connecticut. Following her residency, Dr. Jackson obtained board certification in Oncology and worked at Red Bank Veterinary Hospital for 2.5 years before joining the Northstar VETS team.

Being an Italian from the South, Dr. Jackson loves food. She loves cooking new recipes and trying new restaurants with her girlfriend…another Italian. When not traveling to new places, they enjoy their time at home with their 3 cats who keep them quite entertained.

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