Lymphoma in Dogs: Treatment Options, Palliative Care, and How to Know When It’s Time for Euthanasia

Lymphoma is one of the most common types of cancer in dogs. It typically affects the lymph nodes but can also involve the liver, spleen, gastrointestinal tract, or skin. Although it is a serious diagnosis, lymphoma is also one of the most treatable canine cancers — especially in its early stages. Still, treatment may not be right for every dog, and the disease often recurs.

This guide will walk you through lymphoma in dogs, available treatment options, how to provide comfort when the cancer is no longer responding to treatment, and when it might be time to consider euthanasia.

As a hospice and palliative care veterinarian practicing in New York City, my goal is always this: regardless of the path you choose, to make sure your dog’s remaining time here on Earth is full of love and happiness. If your options are confusing or you aren’t sure how to know when it’s time for euthanasia, don’t hesitate to schedule a quality of life teleconsult with one of our doctors.

What Is Lymphoma in Dogs?

Lymphoma is a cancer of the lymphocytes — white blood cells that are part of the immune system. It can occur anywhere in the body but most commonly presents as swollen lymph nodes under the jaw, in the neck, behind the knees, or in the chest and abdomen.

Common Forms of Canine Lymphoma:

• Multicentric lymphoma: The most common form; causes enlarged lymph nodes throughout the body.
• Alimentary lymphoma: Affects the gastrointestinal tract; often causes vomiting, diarrhea, and weight loss.
• Cutaneous lymphoma: A rare form that affects the skin.

Treatment Options for Lymphoma in Dogs

Chemotherapy

The standard treatment for lymphoma in dogs is chemotherapy, typically using a protocol called CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone).

Pros:

• 80-90% of dogs achieve remission (no symptoms at all), on average lasting 6-12 months

• If cancer recurs, a second remission can be achieved in about 50% of dogs, lasting 2-4 months

• Many dogs tolerate chemotherapy well

Cons:

• Treatment is time-intensive (weekly visits over several months) and expensive (many thousands of dollars) 

• Not typically curative – cancer typically returns in 6-12 months

Chemotherapy may be a good option for dogs that are otherwise healthy, don’t mind vet visits too much and have owners who can commit to frequent veterinary visits. 

Steroid-Only Treatment (Prednisone)

Some families choose to treat lymphoma with steroids. Steroids can make a pet feel better for a while but do not induce remission. 

Pros:

• Much less expensive

• May temporarily shrink lymph nodes and improve appetite

• Can buy weeks to months of relatively good quality time

Cons:

• Shorter survival times (often 1–3 months)

• Prednisone may make chemotherapy less effective if started later

Steroids may be a reasonable option for dogs with advanced disease or for families seeking a less intensive approach.

Palliative Care for Dogs with Lymphoma

When curative treatment is not pursued or when cancer returns palliative care focuses on comfort, appetite, and reducing suffering.

Common palliative care strategies include:

• Pain management: Using anti-inflammatories or opioids if needed
• Appetite stimulants or anti-nausea medication: Entyce (capromorelin) can be given daily by mouth to help improve a dog’s appetite and keep weight on.
• Managing diarrhea or vomiting: Medications such as Cerenia (maropitant) or Zofran (ondansetron) can help with nausea and vomiting. Probiotics, fiber supplements, bland diet, and certain antibiotics can help control diarrhea.

How to Know When It’s Time for Euthanasia

Lymphoma can progress quickly, especially once the disease returns after remission. I highly recommend making a comprehensive end of life care plan for your dog as soon as they have been diagnosed with lymphoma.

A comprehensive end of life care plan includes:

• Deciding which treatments you would or would not pursue, for example:
• Would you pursue chemotherapy or choose steroids only?
• If you did chemotherapy and your dog is in remission, would you pursue a second round?
• Would you hospitalize your pet if the disease was very advanced, or if there were major side effects from chemo?
• Would you hospitalize your pet if the disease was very advanced, or if there were major side effects from chemo?
• As the disease progresses, are you able to be home enough and present with your dog to monitor them?
• Do you want to ensure your pet has a home euthanasia and does not pass away at a hospital? This may mean making a decision a little sooner and not waiting for a crisis.
• An objective set of criteria for euthanasia. The following are some criteria I would consider in canine lymphoma:
• Persistent loss of appetite: If your dog is not eating much at all for several days in a row and appetite stimulants aren’t helping, it may be time to consider euthanasia.
• Extreme weight loss or muscle wasting: If your dog is getting very thin where you can see his/her ribs and hip bones, or they are getting very weak, it is likely time to consider euthanasia.
• Uncontrolled vomiting or diarrhea: If your dog is experiencing frequent vomiting that is not responding to anti-nausea medications, or if there is persistent liquid diarrhea in large enough quantities they are getting dehydrated, it may be time to consider euthanasia.
• Labored breathing: If lymphoma is in the lungs, or if your dog is developing fluid around their lungs causing difficulty breathing, it may be time to consider euthanasia.
• Severely infected, painful skin sores: In cases of cutaneous lymphoma, if your dog is developing painful infections covering extensive parts of their body and it is not responding to treatment, this can be very painful and euthanasia should be considered.
• Lack of interest in life: If your dog no longer responds to their favorite activities, seeks out affection, or engaged with their surroundings, their quality of life may be poor.

It is much easier to make these decisions when you are in a relatively calm frame of mind. When we are facing an immediate crisis of possibly losing our pet, it’s easy to make a decision we regret in a panic.

I also recommend keeping a daily journal of your dog’s quality of life. I recommend simply putting a smile for a good day and a frown for a bad day. The journal can also be a place where you write new memories you made with your dog each day. It is important when facing the end of life to live in the moment and cherish every single day.

Our comprehensive quality of life scale (https://pawsatpeace.com/quality-of-life-scale/) can help you assess your dog’s quality of life. This quiz can be taken once to give you a snapshot of your dog’s quality of life, or taken multiple times to assess trends over time.

Finally, the most compassionate choice is to give your dog a peaceful goodbye before too much suffering has set in. If you do this, you can give your dog the gift of a peaceful last day, and they don’t need to know the severe suffering that often accompanies end-stage lymphoma.

When you are starting to see more bad days than good days, it’s a good time to give them a beautiful send-off. When clients wait too long, they often end up having to rush their beloved dog to the emergency room for euthanasia.

When Should You Euthanize a Dog with Lymphoma?

When Should You Euthanize a Dog with Lymphoma?
Veterinarians often recommend considering euthanasia when a dog with lymphoma has lost interest in eating, has pain that cannot be controlled, struggles to breathe, or has more bad days than good days.

Euthanasia can be a loving and humane choice when a dog’s quality of life declines, and many families choose to say goodbye at home, where their pet feels safest.

Final Thoughts

A lymphoma diagnosis can be overwhelming — but it doesn’t mean the end has to come immediately. Some dogs respond very well to treatment, and others live comfortably with palliative care. Whether you pursue chemotherapy or focus on comfort care, the goal is do what you can to make sure your dog’s remaining time on Earth is full of love and happiness, no matter how long or short that time is.

If you are not sure what to do and would like guidance and support, schedule a comprehensive teleconsult with a compassionate veterinarian. We will review all your dog’s medical record and history, discuss all your options, and help you formulate the most compassionate and loving

And when it does come time, Paws at Peace offers in-home euthanasia in all five boroughs of NYC (Manhattan, Bronx, Brooklyn, Queens, Staten Island) to help your dog pass peacefully at home, surrounded by family. Home euthanasia can provide your dog with a gentle and dignified transition without the stress of a veterinary visit.