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Dr. Lee
Dr. Lee, Dog Veterinarian
Category: Dog
Satisfied Customers: 5355
Experience:  8 years of experience in veterinary medicine and surgery
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Hi my dog was dignosed with swollen lymph nodes on her neck

Customer Question

Hi my dog was dignosed with swollen lymph nodes on her neck last wednesday as she had an iritated trachea was placed on baytril there was no improvement and was later changed to stomorgyl as she has bad teeth( this was started on monday) she had an aspiration done locally on saturday but as on monday i was told results could take a week I took her abroad to another clinic that could have results at the latest 48 hrs I have now recieved both results and bothe vets and labs are a bit baffled. The first FNA ( multiple samples) came back as normal salivary gland tissue. The second aspiration done abroad ( 4 samples) came back as no indication Of malignancy normal neutrophils etc mostly neutrophils though. This second lab asked for a different kind of aspiration to be 100% sure of what exactly I dont know as they asked for a no needle aspiration. This was done today and all thy managed
To extract was 2 neutrophils? I
Asked for a biopsy but they are all concerned as my dog has addisons and dosnt do well with anaesthesia
Submitted: 3 years ago.
Category: Dog
Expert:  Dr. Lee replied 3 years ago.

Dr. Lee :

Hi. I'm Dr. Lee and will do my best to help.

Dr. Lee :

Can you tell me are there any other lymph nodes that are enlarged aside from the ones near the neck?

Dr. Lee :

Also, does she have a fever? And is she still eating and drinking normally? And otherwise doing well?

Dr. Lee :

It appears that you are unavailable at the moment. If you can please provide the information above so I can better understand the situation and help. Once you reply, I will return to this chat as soon as I can. Thanks!

Expert:  Dr. Lee replied 3 years ago.
Hi. Sorry you are having trouble with the chat session. I have switched it over to Q&A session. Hopefully you are now able to see the page and provide further information so I can better help you. Thanks!
Customer: replied 3 years ago.
Hi no fever seemed
To have a slight one last week. No other inflamed nodes
Only bith sides of her neck bilateral
Customer: replied 3 years ago.
Shes eating drinking pooping lole
Normal
Expert:  Dr. Lee replied 3 years ago.
Thanks for the info.

Base on your description, I would be most concerned that it is a bad infection, possibly related to the oral cavity (bad teeth). The second FNA would support this.

As for the first FNA, the vet most likely aspirated the salivary gland, which can happen as it is in extreme close proximity to the submandibular lymph nodes. In other words, that FNA was not useful.

To know with higher certainty, you are correct that biopsy should be done. And in all honesty, with Addison's disease, assuming it is well regulated, it is safe to go under general anesthesia.

If you are able to move forward with anesthesia, I would suggest to ask your vet to fix the oral cavity at the same time, along with getting a biopsy of the lymph node.

I hope this helps. Please let me know if you have any questions or concerns. Thanks!
Customer: replied 3 years ago.
She had blood results done too all was well within normal ranges lymphocytes and eosophils on the lowest part of normal neutrophils high end of normal. My concern is and that of the lab that there dosnt seem
To be an abundance of cells in the first place on both samples . Also the first aspiration was done on both
Sides too holding the actual lump
Aswell the vet dosnt understand how he could have not aspirated the lymph gland on all 4 samples and on second samples non of the 4 samples showed abnormality either would an ultrasound be able to show which gland it actually is?
Expert:  Dr. Lee replied 3 years ago.
Ultrasound isn't going to help for this case.

The blood test results you mentioned is normal. Nothing of concern at all. This is called a stress leukogram. Absolutely normal.

As for the lump and aspirates, I can't tell you how or why the results came back as such. I would believe the results from the pathologist.

I would highly suggest to get a true biopsy done (not another aspirate) and have the teeth fixed at the same time.
Customer: replied 3 years ago.
Hi both aspirates were done by vets and analyzed by pathologists . I took both reports to the pathologist at hospital for another opinion. Hes told me that the neutrophils etc found in the second FNA can be consistent with an infection in the saliva gland as there are no epitileal cells and possibly
Why second lab asked for a non suction aspirate to get hold of some and check which gland it was. The first aspirate doant seem too deep and has a lot of epitileal cells found in saliva gland and shows healthy saliva gland tissue the third aspirate shows one single neutrophil and mucosal tissue typically found in saliva gland. Would this make any sense? Also went back to my family vet and he " lifted" the lump out of the way and showed me where to feel her lymph nodes which were tiny. Would those little bumps " small pea size" be her lypmh nodes? Right t the back below the jaw?
Expert:  Dr. Lee replied 3 years ago.
Those smaller bumps are likely to be lymph nodes. If that is the case, then there might not be any problems at all. The reason is that, the "larger" masses would be regular salivary glands. If your vet feels that the salivary glands are enlarged, you need to ask him to ask a colleague to double check. It is rather rare to have both left and right side of the salivary tissues to be enlarged. We normally only see one side (unilateral). When this occurs, we are likely to be dealing with mucocele or sialocele, which might requires antibiotics and/or surgery.

With both sides being "enlarged" or "swollen", this can be subjective and if the vet doing the examination is not experienced, often times can misinterpret the normal size salivary gland to be enlarged lymph nodes.

With these new information, I would suggest to ask your regular vet to be certain the "swollen" glands are indeed bigger than normal. If so, then try another FNA, but make sure s/he is aspirating the "swollen" mass(es). Doing this is assuming that you do not want to have the teeth cleaned and fixed.

Overall, I would still recommend to have general anesthesia performed, and cleaned the teeth, fixed the oral cavity, AND get an actual biopsy of the "swollen" mass/gland for pathologist to review. This will avoid any further guessing game on did we get the right sample, was the sample too small, etc.

Hope this helps. Please let me know if you have any further questions or concerns.
Expert:  Dr. Lee replied 3 years ago.
Hi,


I'm just following up with you to see how everything is going.


Let me know,

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