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Dr. Laura Devlin, DVM, DABVP
Dr. Laura Devlin, DVM, DABVP, Small Animal Veterinarian
Category: Dog
Satisfied Customers: 1752
Experience:  DABVP, Specialist in Canine and Feline Medicine, Veterinarian since 2000
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Approx 4 to 5 weeks a go my dog had a swollen lymph node on

Customer Question

Approx 4 to 5 weeks a go my dog had a swollen lymph node on his neck with the opposite one being slightly swollen. He was put on antibiotics and they both went down. A week after he was off the antibiotic the left one swelled again. He was then given a biopsy from 3 nodes to test for cancer, the initial results came back inconclusive and the lab is going to do further testing next week.

My question is if it was cancer would the antibiotic of had any effect what so ever? Also from what I've been reading lymphoma is a very fast acting disease in dogs, almost 5 weeks have gone by and the dog has shown no signs of sickness at all. Does this sound likely to be Lymphoma? If the further testing comes back inconclusive the vet recommends cutting out the node completely, not sure if I like that idea if I'm just dealing with a infection.
Submitted: 5 years ago.
Category: Dog
Expert:  Dr. Laura Devlin, DVM, DABVP replied 5 years ago.
Thanks for your question.

I do hope that your dog does not have lymphoma, too!

Can you tell me if the initial diagnosis was made on a needle aspirate, or was part of the lymph node removed and biopsied, or the complete node removed and biopsied? I was just a little confused and want to be able to help you as best as I can.

You are correct, you would not expect lymphoma to respond to antibiotics. That does make me think that either it was a coincidence, or that the enlarged node responded partially or completely to the antibiotics.

Just to complicate things, with lymphoma, it is possible that because the node is compromised, it was more susceptible to secondary infection, and the infection could have responded while there is still lymphoma present.

If you can let me know about the initial diagnosis, I'll be able to help you more.

Sincerely,
Dr. Devlin
Customer: replied 5 years ago.
The initial diagnosis was a biopsy, not an aspirate. The vet took a few sections from the most enlarged node (left neck), he also did smaller biopsies on the node in the right shoulder and left rear leg to get as many samples as possible. A partial of the lab results has come back so far as inconclusive, they are doing more detailed lab test (i guess more detailed anyway) on monday.

Before any biopsy was done the dog was given an antibiotic and the glands returned to normal, then a week after the antibotics stopped one swelled quite large, that's when the biopsy was done. The glands now are starting to go down agian, but the one that was cut the most is still swollen somewhat. The biopsy was about 5 days ago and the dog is on antibiotics again because of the biopsy, but I have a feeling those antibiotics are what's causing the glands to go down again. If the remaining lab work is still inconclusive I would rather not have the whole lymph node removed for testing if lymphoma is not likely in this senario.

The dog seems completely healthy and the last thing I want is to make him sick by repeatedly putting him under anesthesia and cutting parts out of him but on the other hand we need to know if he has lymphoma or not.
Thanks.
Customer: replied 5 years ago.
I should also mention that so far only the nodes in the neck have been swollen on both visits, the left one quite a bit, the right one just slightly and he mentioned the left shoulder one was possibly very, very, slightly swollen (this was only on initial visit before biopsy was recommended the left shoulder was normal ever since first course of antibiotics) the other ones were normal on all visits.
Expert:  Dr. Laura Devlin, DVM, DABVP replied 5 years ago.
Thank you for the additional information. It is very helpful.

At this point, it sounds like waiting for your biopsy results to come back would be the best course of action. You can also request that these samples be submitted to a different lab or review. It is not unusual for pathologist to disagree about a sample - it happens quite often at the lab we use at our local vet school.

With cases of well-differentiated small cell lymphoma, it can be difficult to diagnose lymphoma. Unfortunately, a complete lymph node biopsy can be more diagnostic than wedge resection or core sampling.

If the sample is still non-diagnostic, I would probably recommend an additional biopsy, even with the anesthesia. Your vet could also take a liver/spleen aspirate and even a bone marrow to stage any potential cancer. (If it is lymphoma, then this will be your next step to stage and to obtain a prognosis.)

While it is true that some dogs progress very quickly with lymphoma, I have seen other dogs do well, even without treatment.

However, the shrinking of the lymph nodes does not seem straight-forward, but I would not use that to rule out cancer. It does make me more hopeful it is something else.

Have you had full bloodwork and chest or abdominal films taken to rule out other possible infections or nodules/masses?
Dr. Laura Devlin, DVM, DABVP, Small Animal Veterinarian
Category: Dog
Satisfied Customers: 1752
Experience: DABVP, Specialist in Canine and Feline Medicine, Veterinarian since 2000
Dr. Laura Devlin, DVM, DABVP and 8 other Dog Specialists are ready to help you
Customer: replied 5 years ago.
Bloodwork, chest or abdominal films have not been suggested by the vet yet. If these further lab results come back inconclusive, would this be a good course of action before undergoing further biopsies?

I was also wondering, in your experience, how long does it usually take for most dogs to show any symptoms other than swollen glands with lymphoma?

Thank you very much for your help.
Tony.
Customer: replied 5 years ago.
Just for an update I checked his glands this morning and none seem swollen at all anymore.
Expert:  Dr. Laura Devlin, DVM, DABVP replied 5 years ago.
That is wonderful news. Absolutely I would recommend blood work and probably the chest x-rays at a minimum (to look for cancer, but also other infections).

I'm a little surprised blood work hasn't been run, especially prior to anesthesia.

You may want to consider seeing another vet for second opinion.

Typically once the lymph nodes become enlarged, it continues to progress unless chemo is started. Pred even can cause a dramatic reduction in size. However, I have had 2 patients wax and wane for months, and know that more are described in the literature.

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Dr. Laura Devlin, DVM, DABVP
Dr. Laura Devlin, DVM, DABVP
Veterinarian, DABVP Canine/Feline
353 Satisfied Customers
DABVP, Specialist in Canine and Feline Medicine, Veterinarian since 2000