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Big lymph nodes.

Species: Dog
Breed: Pekingese
Age: 5-8 years
My dog has swollen lymph nodes for about 15 days now and they are all over his body. He has no other symptoms, is energetic, eating fine, and in good spirits (basically his usual self). We did a blood test to reveal that his white blood cell count is 4.4 ( his red blood cell is OK his ALP is normal, but ALT/AST are elevated with ALT 155 and AST 56. The doctor said that his blood looked fine though....

He also said that it's probably lymphosarcoma but is perplexed that he otherwise OK and not exhibiting other symptoms no vomiting, weight loss, lethargy, etc....and he gave him no more than 2 months to live! I honestly don't trust his answers, because he keeps using works like "is likely" "in my experience" "it could be a tick related illness but..." I also wanted him to take an aspiration from the lymph tissue and he said he doesn't do those because they aren't very accurate and the only way to really know is to do a full lymph biopsy...although he wouldn't recommend that because it's highly invasive and not worth it if we aren't planning on doing chemo. Are there any other tests we can do to determine what's causing the flare ups?

He isn't very helpful and not giving me any other options or definitive answers...could it be a treatable infection? I'm probably going to go for a second opinion to get a more precise answer, but anything that can point me in the right direction or help with asking the right questions would be great. Thank you.


Online vet, Dr. Marie

Dr. Marie replied:

Sorry to hear that Shanson is having these issues!

I would agree that, even though there are some changes in his blood values, they are likely not significant.

There are several things that can cause lymph nodes all over the body to be enlarged. (The medical term for this is generalized lymphadenopathy).

The most common is indeed lymphoma (or lymphosarcoma which is basically the same thing). However, there are other things that it could be. Any sort of body wide infection, such as a tick borne infection or a bacterial infection could cause lymph nodes to be enlarged like this.

If this were my case I would be recommending a fine needle aspirate of the lymph nodes. If I wasn't sure if it was cancer or not then I would be sending the aspirate to a pathologist to look at. If this is not cancer, the pathologist usually can tell. They would likely then give you a diagnosis of "reactive lymphadenopathy" which means that the lymph nodes are reacting to some type of infection.

If we play the odds, cancer is the more likely diagnosis. I have seen dogs with lymphoma that had huge lymph nodes but didn't feel sick at all. Usually these dogs start to feel sick a few days to weeks after we notice that the lymph nodes are big.

If I got a diagnosis of reactive lymphadenopathy though, then I likely would run a tick titre test to see if we can determine if there is a specific tick borne disease. And, I'd probably be putting Shanson on some antibiotics.

It's always tough to judge a case without knowing all of the facts though. It's possible that your vet has some more information that points to cancer. However, it's never wrong to have a second opinion just to be sure.

I hope things work out ok.

Dr. Marie.


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Disclaimer: Although Dr. Marie is a qualified veterinarian, the information found on this site is not meant to replace the advice of your own veterinarian. AskAVetQuestion.com and Dr. Marie do not accept any responsibility for any loss, damage, injury, death, or disease which may arise from reliance on information contained on this site. Do not use information found on this site for diagnosing or treating your pet. Anything you read here is for information only.

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Dr. MarieDr. Marie is a veterinarian who practices in a busy animal hospital in Ottawa, Ontario. She created Ask A Vet Question as a resource for good, accurate veterinary advice online. Dr. Marie treats dogs, cats, hamsters, guinea pigs, and rats. She has been a vet since 1999.

Is an online vet visit just as good as a trip to your veterinarian? No! But, many times, asking an online veterinarian a question can help save you money. While Dr. Marie can't officially diagnose your pet or prescribe medications, she can often advise you on whether a vet visit is necessary. You can also ask Dr. Marie for a second opinion on your pet's condition.