My dog has enlarged lymph nodes, no cancer, high WBC, but acts fine. What's next?

Hello, thank you for your question about Boomer. Based on the symptoms and the tests that have been done so far I agree with your veterinarian's concerns. The two most common causes of enlarged glands in dogs are lymphoma and systemic infection. Since the glands change size an infection is still possible. It could be that the initial antibiotic did not treat the type of infection that Boomer has. Alternatively, it is also possible that Boomer could have lymphoma, and the aspiration of cells could have missed the abnormal portion of the gland. In terms of the next options for testing/treatment you could try starting Boomer on a different type of antibiotic to treat potential infection. Alternatively, I would consider biopsying one of the enlarged glands as this provides a larger piece for the lab to review. Hope this helps, good luck!

With a white count that keeps getting higher despite antibiotics I would be concerned there is cancer hiding somewhere. An ultrasound would be my next test as it can look at the intestine, lymph nodes, liver and spleen. The spleen makes the red blood cells, and if it has a tumor then that can cause that count to drop. An immune disease can also cause a low red count.

Meddy likely is suffering from an infection (elevated white blood cell count). However without a clinical history, signs of apparent illness and for how long the condition has been active, there is no way to pinpoint where the infection is, and a cause. We do not just treat on account of blood test results Her liver parameters are borderline high, so that may or may not be significant or a sign of disease. Anotheer problem may be that this blood was examined in a lab for human medicine and therefore the parameter normals may just be different. Best consult with your veterinary doctor who has given Meddy an exam.

If witchy does have enlarged lymph nodes I would recommend doing a fine needle aspirate of the lymph node. This is where a vet places a small needle into the lymph node and looks at the cells under a microscope. This will tell you why the lymph node is enlarged. The most common causes are viral, bacterial, fungal, inflammation or cancer. I would not recommend using systemic strong anti-fungals without a diagnosis of fungal disease due to the affect on the liver. Hopefully between blood work ,x-rays and aspirate you can get a better idea of why Witchy is having big lymph nodes and start proper treatment.

I would recommend removal or at least a biopsy of the lymphnodes (where a little piece of the lymph node is removed). This can be done under geeneral anesthesia, which nowadays is very safe or, if your dog is very quiet, may be done under sedation and a local anesthesia (I would prefer the general anesthesia though). This could indeed be lymphoma or it could be reactive lymph nodes, swelling because they are filtering out bacteria and other material that the body does not deem healthy. Should it be lymphoma and you do not want chemotherapy , your dog can indeed be made comfortable with steroids. Rather than hoping and guessing whether it is lymphoma or not, the biopsy, whether done by taking the whole lymphnode or just part of it, will give you a diagnosis and then you can deal with the disease.

Lymph nodes can become enlarged because they are draining an infection or inflammatory part of the body, because the lymphatic flow is being disrupted, or because of cancer in the nodes. I would discuss additional diagnostics with your vet, which may vary depending on which lymph nodes are involved. Aspiration of the affected lymph nodes is easy and can often be done without sedation. The samples are sent to a pathologist for review. X-rays of the chest and or abdomen may be indicated. Ultrasound of the abdomen may be needed. Dental cleaning and removal of diseased teeth if the lymph nodes are near the head.

It may be cancer but it could also be an autoimmune disrase. More testing is going to be needed. Are the lymph nodes enlarged? If so, your vet needs to do an aspirate of the lymph nodes. That will give you a better idea of what’s going on.