My vet suspects lymphoma in my 6 year old corgi. Biopsy will be Monday. Are there any other illnesses or injuries that can mimic this disease. She seemed normal when I picked her up from the groomers one day and the next was unable to breathe. Is this rapid development of noticeable symptoms normal?
Type of Animal: corgi
Age: not quite 6
Name of Animal: Gwennie
She recieved a shot of a steroid yesterday when breathing seems especially difficult. She has been on Lasix 2x a day since Monday. The vet wanted her on it for a week before sedating her for the biopsy. Since the shot, whe has perked up a tiny bit and is eating wet food, but is still unable to or doesn't want to eat dry.
Hi there.Few questions for you:1. Can you tell me what made your vet suspect lymphoma?2. Did she have chest x-rays or any other testing?3. What is your vet planning to biopsy?4. What other symptoms have you noticed?
She had a lot of fluid in lung/chest area. When I first explained things to him we were discussing congestive heart failure ( she IS overwwight) after listening all around, he began palpating different areas. He pointed out a thick, ropey, area under Gwennie's jaw and told me her other lymph areas were also swollen. I'd had her clipped closely for the summer the day before (we live in Mississippi). I use the excuse I hadn't noticed anything due to her thick coat. He did no xray and no blood test. He wants to biopsy the area along her neck, which seems to have also developed a different, secondary swelling since the inital visit. She has been lethargic for somewhile, I put it off to the heat and jealousy toward a new dog we rescued. She has been eating and outputting up until this week. Now she has diarrhea, but that may be because we are hiding the Lasix in anything we can think of and she really just wants to eat the cat food. I asked about something that might mimic the symptoms of lymphoma because when I was a child 45 years ago, we had a dog develop breathing diffculty with much pain. After a postmnortem, the vet told us he'd had a ruptured diaphragm- possibly being hit by a car or even a baseball bat. I just worried that GWennie might have sustained an injury at the groomers. My husband keeps thinking there must be some infection since she acts like she feels somewhat better since the steroid shot (still heavy labored breathing though).
Got it, thanks.Here are the issues:1. Fluid in the lungs or outside the lungs may be caused by many different conditions, including congestive heart failure; most cases of fluid accumulation in the lungs also cause difficulty breathing. A x-ray of the chest is absolutely essential in determining if the fluid is present, where it is (in lungs, outside of lungs, around the heart, etc), how much there is and if there is an identifiable reason for it, e.g. a tumor or heart enlargement.2. The enlargement of the areas under the jaws may indeed be due to lymph nodes and one of the most common reasons for this is lymphoma; a biopsy is typically taken via aspiration (quick and easy sample collection with a small needle) so sedation is not needed. Other possible causes of lymph node enlargement include infections and inflammatory conditions. It's also possible that the enlargement is not due to lymph nodes but something else.3. Lethargy and difficulty breathing can, of course, be caused by many different conditions including congestive heart failure and lymphoma. It is very important to have diagnostic testing done: blood and urine testing, chest x-rays and biopsy of the lymph nodes.4. Lasix is used to drain fluid from the lungs; however, in the absence of a diagnosis, this medication shouldn't be used for long.5. Similarly, steroids, especially in the form of injections (which may last longer), can exacerbate congestive heart failure; so, I assume your vet was not too convince that congestive heart failure was present. Steroids cause fluid retention and may make it more difficult for the heart to work... The steroid shot may have made her feel better temporarily due to relief of inflammation that may be causing the enlargement of the lymph nodes. Another downside of steroids is that they make lymphoma disappear temporarily from the lymph nodes; so, if a biopsy is done after a steroid is administered, lymphoma, previously there, may no longer be found.6. I don't think this is related to an injury; however, stress associated with a visit to the groomer may have caused an exacerbation of heart disease, previously un-diagnosed.I hope this helps; please let me know if you have any additional questions.
I wonder why he wants to put her under to biopsy. Could he think there might be something he can remove? If it is done with a needle, I wonder why he didn't go ahead and do it last week? He's been practicing for close to 30 years. When we were talking the worst case scenario, he said he didn't recommend chemo as a real option. Do you think I should try to find a vet whose been in school more recently or stay with the guy with years of experience? We live in a small rural area and there really aren't many options vetwise. One is large animal, another has more years than mine and I really don't like the folks at the fourth place.
I assume that he wants to biopsy something else (perhaps sample fluid from the lungs?) or wants to obtain a tissue biopsy. I would pose the same question to your veterinarian, because, from what you're describing, a needle aspirate of a couple of lymph nodes should be a quick and relatively easy procedure (needle biopsy is typically more than adequate to diagnose lymphoma, so tissue biopsy is not necessary). Lymphoma is the most responsive cancer to chemotherapy; an average case of lymphoma can expect survival times of about a year or more (this is long when talking about systemic cancers in dogs). There are, of course, multiple variables: type of lymphoma (some types, such as T-cell lymphoma are less responsive to chemo) and presence of other diseases such as congestive heart failure.I would first try to get more information. Questions you should ask are:1. Why do you think there is difficulty breathing?2. How can we confirm this suspicion? (answer should be: diagnostic testing such as x-rays)3. If there is fluid in the lungs or around the lungs, what is the most likely cause? (This should be evident from examination and x-rays).4. Why is sedation recommended for the lymph node biopsy?If you are having difficulty getting answers, I would search a second opinion, preferably one of a internal medicine specialist (find one near you here: http://acvim.org/websites/acvim/index.php?p=3). Alternatively, you can seek opinion of another general practitioner (www.vetlocator.com).
DVM degree from Ontario Veterinary College, diplomate of American Academy of Pain Management