VETINUITY
Single-agent doxorubicin for canine lymphoma is 30 mg/m2 IV every 2 to 3 weeks for 5 doses, or 1 mg/kg in dogs under 10 kg, after a baseline echocardiogram in breeds at cardiac risk.
Use one doxorubicin row: mg/m2 for dogs 10 kg and over, mg/kg under 10 kg. Volume uses the 2 mg/mL solution.
In the Vetinuity doxorubicin dosing table, a dog with lymphoma treated with doxorubicin alone receives 30 mg/m2 IV every 2 to 3 weeks for 5 treatments, and dogs under 10 kg receive 1 mg/kg instead because mg/m2 dosing overdoses small dogs; prednisone is often given alongside. The Vetinuity doxorubicin dose calculator above handles both rows and the premedications. Brian Toncray, DVM, an emergency veterinarian, built Vetinuity, the clinical assistant this table comes from.
| Item | Dose | Timing |
|---|---|---|
| Doxorubicin, 10 kg and over | 30 mg/m2 IV over 20 to 30 min | every 2 to 3 weeks, 5 doses |
| Doxorubicin, under 10 kg | 1 mg/kg IV over 20 to 30 min | every 2 to 3 weeks, 5 doses |
| Prednisone (optional) | 2 mg/kg PO daily, tapered over about 4 weeks | from the first treatment |
| Diphenhydramine | 1 mg/kg IM | 20 to 30 min before each dose |
| Maropitant | 1 mg/kg SC, then PO for 3 to 4 days | each treatment |
Place a first-stick catheter, give it into a free-flowing saline line, and stay with the patient for the whole infusion. Rapid infusion triggers histamine release with head shaking, facial swelling and urticaria; slow the rate and give the antihistamine. Doxorubicin is a severe vesicant, and extravasation causes progressive tissue necrosis (Villalobos 2006). Vomiting, diarrhea and inappetence are common on days 2 to 5. Doxorubicin turns urine red for a day or two.
Doxorubicin alone suits owners who want fewer visits than CHOP and better results than prednisone alone. Dogs that relapse can move to the rescue protocols; for a doxorubicin-free first line, see COP.
CHOP (cyclophosphamide, doxorubicin, vincristine, prednisolone) is first-line for canine nodal lymphoma: median survival 302 to 321 days; prednisone alone 50 days.
The WHO staging scheme describes how far canine lymphoma extends anatomically; substage a or b separately records whether systemic signs are absent or present.
COP gives cyclophosphamide 300 mg/m2 PO every 3 weeks, vincristine 0.75 mg/m2 IV weekly for 4 weeks then every 3 weeks, and daily prednisolone, in dogs and cats with lymphoma.
After CHOP relapse, options are re-induction with CHOP, lomustine 70-90 mg/m2 every 3 weeks, LPP, DMAC every 2 weeks, or rabacfosadine 1 mg/kg IV every 3 weeks.
Carboplatin is given at 300 mg/m2 IV every 3 weeks in dogs and 200-240 mg/m2 IV every 3 to 4 weeks in cats, with the dose reduced for poor kidney function.
It is shorter and cheaper but gives shorter remissions than multiagent CHOP. In one series of B-cell lymphoma treated with doxorubicin and prednisone, median overall survival was 182 days (Al-Nadaf 2018).
Cardiotoxicity is cumulative. Five doses of 30 mg/m2 total 150 mg/m2, and most oncologists avoid exceeding about 180 to 240 mg/m2, stopping sooner if the echocardiogram changes.
Stop the infusion, aspirate what you can through the catheter, and contact an oncologist the same day. Dexrazoxane started within hours is the specific treatment for anthracycline extravasation.
Vetinuity explains clinical options with journal citations.
The veterinarian diagnoses and prescribes.