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Dr. Joey
Dr. Joey, Board Certified
Category: Dog
Satisfied Customers: 4723
Experience:  15 yrs in practice, specialist canine/feline medicine
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Hello. Get ready for an essay: I have an 11 year old golden

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Hello. Get ready for an essay: I have an 11 year old golden retriever. Not overweight. Fed on high quality dry kibble organic hypoallergenic senior. Supplemented with chrodointin and glucosamine and salmon oil. 3 months ago my dog was constantly sneezing for about 3 days. I monitored it and it stopped. Then about a 2 and a half months ago i noticed a drastic change in her walking. She became exercise intolerant. From running around she could barely walk. Was exhausted after 10 minutes. She was panting heavily and loads of thick drool was coming out of side of her mouth. Took her to vet. Checked teeth. Fine refereed to specialist. MRI scan and e m g test. Nothing serious on MRI scan of her spine. Tests for nerve damage was substantial. No to degenerative myelopathy Blood test confirmed hypothyroid. She has been on tabs for a month and a half. No change in strength of her rear legs except now. Her rear legs cant work anymore. Rapid muscle loss. During this time i noticed she started swallowing constantly and started to cough and snoring noisy breathing. Me and the vet were thinking laryngeal paralysis. Her lymph nodes enlarged first in her throat. Vet said watch and see for a couple of weeks. Blood test done kidneys fine electrolytes fine slight anaemia Then shoulder nodes enlarged. Vet took a needle aspirate 3 days ago Vet has said lymphoma without confirmation. My question due to the rapid decrease in muscle in her rear legs and noisy respiratory breathing with gagging and dry wretching could this be a fungal infection like Aspergillosis. This could explain swollen lymph nodes and the speed at which the muscle has deterierated in her rear legs.
Submitted: 3 years ago.
Category: Dog
Expert:  Dr. Joey replied 3 years ago.

Dr. Joey :

Hello I am Dr. Joey. Thanks for trusting me to help you and your pet today. I am a licensed veterinarian with over 15 years of experience. I look forward to working with you.

Dr. Joey :

This is not typical for Aspergillosis, but we cannot rule it out since it certainly could cause some of the signs you are seeing (the weakness, lymph node enlargement) but typically a fever is associated with this infection. It most commonly occurs in younger dogs (under 6 years of age, but it could occur at any age. Diagnosis is made by finding the organism. This might be possible off a lymph node aspiration. If there are changes in the lungs based on x-rays then doing a bronchoalveolar lavage with endoscopy or even a transtracheal wash may find the organism.


But lymphoma could account for the signs being observed as well. For the hind limb weakness, there may have been a change in the spine that was on a microscopic level and not easily observed. Was a CSF tap (spinal tap) done to look for change? This may have been the only way to potenially diagnose this at the early phases. However, for the weakness, it is also possible this is unrelated to the lymph node enlargement.

Dr. Joey :

I want to comment that lymph node enlargement in this breed and age is most commonly due to lymphoma, but it may not be this. The aspiration submitted to a pathologist was the best first step. If this is negative or not diagnostic for lymphoma, then I would suggest screening for any regional tick-borne bacterial diseases and fungal diseases. And take chest xrays again to assess this area.

Dr. Joey :

I also want to confirm that when your vet took the aspiration of the lymph nodes that this was submitted to a board certified pathologist to view. There is no other way to diagnose lymphoma, and I have been fooled many times before. I think lymphoma is, unfortunately, most likely but we need confirmation before proceeding. Should you receive that confirmation from the pathologist (not from your vet looking at this slide in-house), then I do advocate consider chemotherapy since this is a problem that is highly responsive and remission rates are good.

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Expert:  Dr. Joey replied 3 years ago.

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Customer: replied 3 years ago.
Hi. Thank you for the response. Re Aspergillosis. She doesn't have a temperature. Will wait for result re lymph node aspirate and then take it from there. Also the aspirate was sent to a lab. As far as I am aware they did not do a spinal tap. It was the neurological signs. That was focused on. There have been no chest x rays The MRI was only done on her spine.
Expert:  Dr. Joey replied 3 years ago.
I do think chest xrays are indicated, especially if the lymph node aspirate does not obtain a diagnosis. It is possible that both problems are related to lymphoma, and that the spine was affected first. On an MRI unless there is obvious lesion, we may not detect infiltration with abnormal cells; that is where a CSF tap would be helpful, but at that time it sounds like there were no other indications of disease beyond the spine being affected.
This is such a tough and devastating issue to not only have the lymph node issues but to have such weakness in her hind end. Please keep me posted. I am interested to know the final diagnosis. And certainly let me know if you have any further questions.
Customer: replied 3 years ago.


Hi Re Maxi- OK its lymphoma. She is 11 years 4 months- her back legs have seriously weakened to the extent that she can only walk for about 3 mins continuously and then has to sit down. The vet has put Maxi on steroids. I am now cooking for her as she wont eat dry food anymore- the dry heaving seems to have improved because the lymph nodes have reduced in swelling due to the steroids. Thanks for answering my questions I guess I was looking to see if there could be anything else that I can do for her. I am now taking it day by day. I guess you could say it is peripheral neuropathy plus lymphoma plus underactive thyroid. The vet contacted the specialist to see if it could have been in her spine however they are saying they did not pick up any cancer sign in her spine.


 


Thanks for answering me.

Expert:  Dr. Joey replied 3 years ago.
Have you discussed doing medications in addition to prednisone (a chemotherapy protocol). There are other drugs such that are tablets, but they do require CBC monitoring. A comprehensive protocol of chemo drugs has a better chance for improvement than just steroids alone (alone we might see improvement for 4-8 weeks or maybe upwards of a few months) but then worsening.

Please keep me posted.