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Category: Dog Veterinary
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My 8 y/o English Bulldog has enlarged lymph nodes under her

Customer Question

My 8 y/o English Bulldog has enlarged lymph nodes under her jaw and front right shoulder. First trip to the vet, test negative for tick borne illness and given Prednisone 15mg twice a day ongoing and clindamycin teice a day for 10 days. Two weeks after first consult, nodes are noticibly smaller and CBC done. ALT & AST 452 & 1990 U/L respectively. Low platelet (29 K/ul) and high Lym (4.32, 23.7%). Doctor still suspects infection. Do I give the new antibiotics (minocycline 100 BID x10 days) or will I shut her liver down?
Submitted: 2 years ago.
Category: Dog Veterinary
Expert:  brisadog replied 2 years ago.
Hi, I can help you with your question today.
I'm worried that the enlarged lymph nodes may also be caused by lymphoma. It is no surprise that the lymph nodes would reduce in size with prednisone if she has cancer - prednisone is one of the chemotherapeutic drugs that we use to treat lymphoma.
The elevated liver values are very concerning as well. Has she had x-ray or ultrasound of her abdomen yet?
Customer: replied 2 years ago.
No imaging tests of yet. Doctor wants to try the antibiotics and prednisone. I worry about the processing and metabolism of the antibiotic with the high liver enzymes causing total liver failure. Is this a legitimate concern? Or will the abx process without liver involvement?
Expert:  brisadog replied 2 years ago.
Minocycline is metabolized by the liver. I don't think it is a good idea to start that medication without more information about his liver function. I recommend that you do not start the minocycline yet. Ask your vet about a liver function test called "pre and post prandial bile acids", and an abdominal ultrasound.
I would also have recommended aspirating the lymph nodes to diagnose the condition (these are not always diagnostic, but in some cases we can tell specifically what condition she has). Unfortunately, since they have already started her on prednisone, this could cause us to miss a diagnosis of lymphoma.
Please let me know if you have further questions. I am happy to continue until I provide the service that you seek.
Expert:  brisadog replied 2 years ago.

I'm just following up on our conversation about Joseph Scognamiglio. How is everything going?

Dr. Susan

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