Dog with lymphadenitis?

Re: Dog with lymphadenitis?

Andrew Kent — Sun, 11 Nov 2012 12:28:48 GMT

Not sure i would believe that Staph infection is your primary problem - could this have been a contaminant? With pyogranulomatous inflammation a fungal or more exotic infection seems more likely. Any history of travel?

Re: Dog with lymphadenitis?

Rajat — Sun, 11 Nov 2012 07:39:43 GMT

Thanks for the update! Glad to hear O now on board (better late than never eh!)

Re: Dog with lymphadenitis?

Nicola Lawlor — Fri, 09 Nov 2012 22:31:22 GMT

Update - dog has progressed to significant breakdown of both popliteal and prescapular masses. Both sites now biopsied (as breakdown of each not at the same time as the other) and in both cases results are pyogranulomatous inflammation. Culture showed staphylococcus with good sensitivity to all antibiotics tested for. The dog has been on antibiotics since the start of the problems but only had a few days of steroids early on. Think we may now add in some steroids to see if things improve now. Thankfully the owner has been more forthcoming with additional testing than I had first believed from him.

Re: Dog with lymphadenitis?

Rajat — Fri, 19 Oct 2012 19:59:06 GMT

Hi Nicola

Good to hear re progress. My colleagues recent case also had a WBC around this region (though later it went even higher!)

Unusual to see hi wbc with lymphoma unless (obv) leukaemic or infection elsewhere and would expect response to broad sp abs re pyrexia so it is looking like an immune mediated one for just now with the info we have...

Let us know how it turns out!

Cheers

Raj

Re: Dog with lymphadenitis?

Nicola Lawlor — Fri, 19 Oct 2012 19:53:15 GMT

Oh, and WBC was around 32x10/9/l on 15/10 with a neutrophilia. Not been repeated due to costs (so far).

Re: Dog with lymphadenitis?

Nicola Lawlor — Fri, 19 Oct 2012 19:52:26 GMT

Thanks for the input - interestingly she has responded a bit to the change of meds today - I am guessing by the short timing of this it was to the steroids rather than the Baytril. Her temp has come down into the normal range and she decided to eat a moderate amount this afternoon. I wish I had the money here to spend on the case - I may yet sneak a chest/abdo film without a charge anyway for interest depending how the dog goes over the weekend.

Interesting to read about the necrotising lymphadenitis in springers...it does seem the popliteal area may be starting to go a bit that way. My first thought was neoplasia simply because the majority of seriously enlarged l/nodes I have encountered have been that, but the FNA were multiple from both sites with what appeared to be a very acceptable yield and were analysed externally and can find no evidence of neoplasia. I would very much hope they are fairly reliable results therefore knowing the limitations of FNA.

We'll keep up the steroids for now then instead of returning to loxicam and see what time brings.

Re: Dog with lymphadenitis?

Rajat — Fri, 19 Oct 2012 18:37:51 GMT

Hi Nicola

I havent treated this condition, but have seen it (colleagues case) which got referred quite recently

Lymphadenitis has been described in springer spaniels and cocker spaniels (necrotising in springers- !)

It can be infection related or an immune mediated condition and immunosuppressive doses of steroids and other drugs(eg Azathioprine )are often required

It may be worth a biopsy + tissue culture before proceeding - you could do a tru cut under local and mild (??oral to save costs??) sedation and save some money. How many fnabs were taken and were they looked at externally? Was there any 'doubt' in the path mind i.e. was lymphoma possibly on the radar (I know I know when are there no doubts eh?!)?

Might also be worth trying doxycycline vs Bartonella and other bacterial L forms if she remains non responsive to your current abs

What is the WBC?

If it comes to the last ditch decision - I would rightly or wrongly hit her hard with steroids (2mg/kg/day for min 4-5 weeks) and abs (incl doxy) and cross your fingers and hope for the best. Don't wean steroids too early and too much (I only say this because I am often tempted to do so and have been burnt before)

Maybe someone else with more experience will also comment

Best of luck!

Re: Dog with lymphadenitis?

Robin Grimmer — Fri, 19 Oct 2012 15:53:40 GMT

Lymhpadenitis is a bit unusual in more than one lymph node especially when they are so far apart. I would do survey x-rays of chest abdomen to look for neoplasia esp lymph nodes. I would do also do a lymph node biopsy although they might not be able to afford it.