OWEN DAVIES MA VetMB MVetMed MANZCVS (SAM) DACVIM (Oncology) DECVIM –CA (ONCOLOGY) MRCVS

Owen spent almost ten years in large and small animal first opinion practice after graduating from Cambridge, before embarking on a residency at the RVC. He is a diplomate of both the American and European colleges of veterinary internal medicine, and in the case of the European college in oncology. His extensive first opinion experience and specialist education, almost unique I think, lends itself really well with first opinion clinicians in mind.

Owen Davies is a speaker at the forthcoming Webinar Vet virtual conference 2023. To give you an idea of what to expect I have reviewed an earlier webinar on Feline Lymphoma, as detailed above. If you haven’t watched this it is very worthwhile, and it will be a very good companion to his webinar on the canine disease, which is entitled:

‘What are the latest treatment options for canine lymphoma?’ (Monday 6th. February. 2023 20.00 – 21.00 GMT).

This veterinary webinar on feline lymphoma is a very good summary of the disease, including up to date details on the diagnosis and treatment. It also has suggestions where compromises are possible to reduce costs.

The webinar begins with five cats showing different lymphoma presentations, leading to the introduction the first (of eight) points of clinical significance that feature throughout the webinar.

POINT 1. Feline lymphoma is a different disease compared to dogs and people

  1. Cats get extranodal lymphoma most commonly
  2. Cats tend to be sick at the diagnosis
  3. Clinical signs reflect the region of the body affected

Cytology is an important diagnostic procedure and a lymphoma slide is compared with a reactive lymph node. Histopathology is the only other important diagnostic test recommended in first opinion practice, although other more specialist procedures are briefly mentioned.

POINT 2. Where cytology is equivocal or non-diagnostic for cats consider the following, in this order

  1. Histopathology
  2. Look for diagnosis elsewhere
  3. Therapeutic trial? After considering the quality of the diagnostic test results, consideration of the differential diagnosis and counselling of the client.

 In practice the anatomic site tend to correlate strongly with the type of lymphoma. T cell or B cell is not directly prognostic and only two types of lymphoma are markedly different in their behaviour –these are the low grade diseases.

POINT 3. The grade and anatomic site of the lymphoma are the most important pieces of information to form a prognosis and treatment

There is a full account of the staging system for feline lymphoma from stages I to V, and a list of all tests and procedures. However, perhaps surprisingly, this leads to point four, which questions the need for staging in the first place, because:

POINT 4. Staging rarely affects prognosis or choice of drugs but is useful to:

  1. Detect concurrent disease
  2. Form a baseline for monitoring
  3. To assess whether surgery or radiation could be used

There are seven types of feline lymphoma. These are alimentary lymphomas (with 4 subtypes), renal, nasal, peripheral nodal ‘Hodgkin like’, laryngeal, and CNS involvement in abdominal lymphoma.

All are perfectly summarised with clinical findings, diagnosis, treatment statistics, and clinical cases, along with many illustrations

POINT 5. Disease very commonly occurs in multiple sites in the abdomen and frequently extends to extra-abdominal sites.

The distinction of different anatomic forms of lymphoma is often arbitrary, and many sites may be sub-clinical.

After dealing with all the lymphoma types two more points are made:

POINT 6. Surgery or radiation therapy are more likely to have a role for the treatment of feline compared to canine lymphoma

Staging is very important to make sure you don’t have occult disease elsewhere

POINT 7. Response to treatment (complete versus parcial) is by bar the most important prognostic indicator in intertmediate-high grade feline lymphoma at all anatomic sites.

Various treatment protocols including standard, ‘good budget’, cheaper alternatives, even cheaper alternatives, an empirical ‘hands off’ protocol and finally the most palliative approach are all described, and is a most useful summary of all the options.

But how about this for a pragmatic viewpoint? In Owen’s opinion there is: 

  • No conclusive benefit of any specific protocol
  • What matters is whether the cat responds to it
  • Expense, convenience, ease of administration, number of vet visits, and risk of adverse effects should be important factors in the choice of treatment. Adverse effects are different in cats as described in point 8.

POINT 8. Both response rates and adverse effects of chemotherapeutic drugs are very different in cats and dogs.

These are fully summarised and extremely useful for client communication.

As mentioned in the introduction this webinar is a very good update on feline lymphoma and also sets you up for Owen’s contribution in the virtual conference 2023 where he is speaking on Canine lymphoma. I am sure this will be a very up to date and practical account of standard treatments, new therapies but also with budget options in mind. As Owen says, ‘It’s not about CHOP or COP anymore!’