Lymphadenopathy with cytopoint?

RE: Lymphadenopathy with cytopoint?

Julie Innes — Thu, 15 Mar 2018 23:11:39 GMT

As mentioned, we have tried twice to get the notes via phone calls. I don't really want to go into it, as I'm not here to slag off the previous vet.

According to the clients (who actually seem quite clued up) the previous vet did talk about immunotherapy but nothing was done, so don't think it was that.

RE: Lymphadenopathy with cytopoint?

Emily Rainbow — Thu, 15 Mar 2018 22:00:01 GMT

I have seen lymphadenopathy after immunotherapy vaccines started - could it be that?

RE: Lymphadenopathy with cytopoint?

Rob Loxley — Thu, 15 Mar 2018 20:45:57 GMT

[quote user="Clive Ansell"]Another option would be to not accept the consultation until in possession of the clinical history[/quote]

I suspect from the OP there's some issue at play of wilfully not passing on notes?

[quote user="Julie Innes"]despite contacting the previous vet twice, we don't have any history (common occurrence, we have long since given up with this practice)[/quote]

RE: Lymphadenopathy with cytopoint?

Clive Ansell — Thu, 15 Mar 2018 19:00:15 GMT

Another option would be to not accept the consultation until in possession of the clinical history, which could be just a brief telephone call one VS to another.

I guess you could proceed to fna, or ideally biopsy, all the same.

RE: Lymphadenopathy with cytopoint?

Julie Innes — Thu, 15 Mar 2018 16:44:25 GMT

I did offer the owners a wait-and-see option, but they came to me as a second opinion, anxious because their previous vet mentioned lymphoma then "did nothing", so they have been worrying for a while, and I'd like to be able to say a definitive yay or nay, IYSWIM. Which is why I opted to go straight to biopsy instead of doing the blood test (the last and only dog I did the blood test in came back equivocal, which doesn't leave you any further forward!)

RE: Lymphadenopathy with cytopoint?

Lucy Fleming — Thu, 15 Mar 2018 16:30:57 GMT

[quote user="Evelyn Barbour-Hill"]Not being funny, but as the dog is otherwise well another option in these rather unusual circumstances would be to do nothing for a month or so. By then all traces of Cytopoint or Depomedrone should be gone from the body, and what has happened to the lymph nodes (bigger, smaller, much the same, gone back to normal) would be useful information.[/quote]

True, but if it is a generalised lymphadenopathy due to lymphoma (possibly not that likely if it has been present for 2-3 months already and the dog is still well) another month delay could be detrimental to recovery. A quick FNA would be inexpensive, minimally invasive, and probably provide some guidance.

RE: Lymphadenopathy with cytopoint?

Evelyn Barbour-Hill — Thu, 15 Mar 2018 16:11:48 GMT

Not being funny, but as the dog is otherwise well another option in these rather unusual circumstances would be to do nothing for a month or so. By then all traces of Cytopoint or Depomedrone should be gone from the body, and what has happened to the lymph nodes (bigger, smaller, much the same, gone back to normal) would be useful information.

RE: Lymphadenopathy with cytopoint?

Rob Loxley — Thu, 15 Mar 2018 16:08:00 GMT

[quote user="Lucy Fleming"]Good lord how frustrating. Have you tried ringing the clinic and seeing if someone on reception can read the name of the drug to you from the clinical record?[/quote]

And if not, I'd be having a right old grumble - particularly if this is a recurring issue - since it is now affecting patient treatment

RE: Lymphadenopathy with cytopoint?

Julie Innes — Thu, 15 Mar 2018 16:06:36 GMT

I will probably need to try that, but I'm not holding out much hope... Often the phone just rings out, or whoever answers says they are not at the surgery and will send it to you when they get there....but it never arrives.

I know, I know. Dont get me started

RE: Lymphadenopathy with cytopoint?

Lucy Fleming — Thu, 15 Mar 2018 14:25:15 GMT

[quote user="Julie Innes"]

[quote user="Lucy Fleming"]Sure it's not depomedrone? [/quote]

It did cross my mind, to be honest! Tried to ascertain if the injection was expensive, but owners are insured and vet claims direct, so apparently they have no idea! May need to try to get details of claim from insurance company...

[/quote]

Good lord how frustrating. Have you tried ringing the clinic and seeing if someone on reception can read the name of the drug to you from the clinical record?

RE: Lymphadenopathy with cytopoint?

Julie Innes — Thu, 15 Mar 2018 13:26:05 GMT

[quote user="Lucy Fleming"]Sure it's not depomedrone? [/quote]

In the meantime, zoetis advise that they only see anti-drug antibodies in 1% of dogs, so it isn't common, and they don't think it causes lymphadenopathy, but will report it in case. Interesting to see what comes back on the biopsy, I guess.

RE: Lymphadenopathy with cytopoint?

Richard Carter — Thu, 15 Mar 2018 13:22:24 GMT

[quote user="Lucy Fleming"]Sure it's not depomedrone? [/quote] add in diabetes, lymphoma, demodex and we have a pure bred WHWT !!

RE: Lymphadenopathy with cytopoint?

Lucy Fleming — Thu, 15 Mar 2018 13:01:22 GMT

[quote user="Julie Innes"]The owners report she was recently put on a new medicine where she had monthly injections. I'm guessing cytopoint, but annoyingly can't confirm.[/quote]

Sure it's not depomedrone?

RE: Lymphadenopathy with cytopoint?

Julie Innes — Thu, 15 Mar 2018 08:44:20 GMT

Thanks Rob. She is being bathed weekly with malaseb, I believe, and her skin doesn't look too bad at the moment, bit pink underneath, but will bear that in mind if biopsy all clear.

I've e-mailed zoetis, so hopefully they will be able to give me some insight!

RE: Lymphadenopathy with cytopoint?

Rob Loxley — Thu, 15 Mar 2018 08:39:34 GMT

Most common generalised lymphadenopathy we see in atopic dogs is with generalised malassezia pyoderma; worth ruling out? Lymph node biopsy sounds good. Would also call Zoetis to chat with their technical advisers.