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Dr. Gary
Dr. Gary, Dog Veterinarian
Category: Dog
Satisfied Customers: 19324
Experience:  DVM, Emergency Veterinarian; BS (Physiology) Michigan State Univ
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I'm at a loss. My poor baby (Boston terrier) is 9 years old

Customer Question

I'm at a loss. My poor baby (Boston terrier) is 9 years old two weeks ago became lethargic. Stopped eating, wanted to sleep all the time. Last week her lymph nodes became swollen and her abdomen too, and she could barely get into the house (3" step in) and so I brought her into the vet. They ran blood tests (all normal), Aspirates of her lymph nodes and urinalysis- and all they got back from the lab was inflammation of the cells. I got X-rays done, and per their experts they saw nothing abnormal but swelling- yet I see a mass on the X-rays (or I think I do) and now today her right side limbs are swollen beyond belief and it feels like fluid. The vet wants to to a biopsy of the lymph, but I think it may be heart related. Does anyone have any suggestions for me before I have them open her up?? She isn't even able to move around anymore and I don't know what to do for her. I'm going to try to put a picture of the X-rays up for you to see...
Submitted: 4 months ago.
Category: Dog
Expert:  Dr. Gary replied 4 months ago.

Hello. I'm sorry to hear about your dog.

This sounds like Lymphoma to me. I'm surprised they didn't get a confirmed diagnosis after the lymph node aspirates. The lethargy, weakness, decreased appetite and leg swelling all fits. When a dog has Lymphoma, they will get obstructed lymph vessels and then edema in the limbs.

I would probably get a consult with a veterinary oncologist. They can re-aspirate the lymph nodes and see if they get a diagnosis. Most oncologists will read out the slides in house and start chemotherapy at the same time. Chemo is the best way to treat Lymphoma. We get a good response rate to put it into remission. Survival times are typically ~ 12 months with a good response. This is in contrast to ~ 2 months survival times without chemo.

If you can post the x-ray, I'll take a look for you and give you a second opinion. I know it's frustrating not having an answer. I just think the aspirates were probably at a time when the cells weren't shedding or they were low cellularity samples. I'd re-aspirate asap to get an answer. If still unsure, then biopsy. It's rare to require a biopsy, though, to diagnose Lymphoma.

Customer: replied 4 months ago.
I'll try to upload some pictures of the X-rays. I don't know how to send them from the disc- so I'll take photos of them. It came on so suddenly though, does lymphoma do that? She was fine one day and then bloated and lethargic the next!
Customer: replied 4 months ago.
I can take a screenshot of the results of the Aspirates as well if that's helpful. The did two on her, I would have figured one of them would show since they did front and rear samples.
Expert:  Dr. Gary replied 4 months ago.

It definitely looks like there are some enlarged nodes under the jaw and in front of the left shoulder on those x-rays. The abdomen doesn't look too bad. There could be a mass effect in the caudal right abdomen, but it may also be the bladder. I'm not totally sure without the lateral view as well. The spleen, liver, kidneys and GI tract all look normal.

If you could post the aspirate results, that would be helpful.

Customer: replied 4 months ago.
Also included the recent tests she had done
Customer: replied 4 months ago.
Additional X-rays
Expert:  Dr. Gary replied 4 months ago.

Ok. I'm only seeing one lymph node aspirate and then a mammary aspirate. I would probably aspirate a pre-scapular in front of a shoulder and a popliteal behind a knee. Those are away from the mouth so we don't get conflicting results secondary to any dental disease going on.

On the lateral abdomen, there is an enlarged lymph node above the colon. I just can't imagine that this is anything but Lymphoma based on the history, physical exam findings and x-rays. I would get an oncology consult and see if they can make the diagnosis.

Customer: replied 4 months ago.
Thank you for your help- I will see if I can locate an oncologist tomorrow and have them do what you suggested. What is my timeline with her? At her current state, do I have a few days to get her in (say Wednesday) and is there anything we can do to make the swelling in her limbs better so she is mobile? Or is the chemo all that all help?
Expert:  Dr. Gary replied 4 months ago.

I would say get chemo started within 48 hours to give her the best chance of getting a response. You can do massage on the limbs to help push the fluid up and also flex/ extend each joint from the toes to the body (range of motion exercises) to help. The chemo and getting the disease into remission is going to help the most, though.