Possible canine cancer- Oncologist has low suspicion
My 8 year chihuahua mix, UTD on vaccines and has no significant past medical history. Was only on Simparica trio and Purina pro plan H/A kibble before she started getting sick. No other meds or known sicknesses. All of this started on Monday, June 22. Sorry in advance for this being so long, but thank you to whoever reads through it!
Monday 6/22: She didn’t want to eat dinner and was scooting.
Tuesday 6/23: not eating, less energetic/lethargic, anal glands expressed at vet (moderately full). Was eating some wet food that night but having decreased appetite
Wednesday 6/24: took her to the vet- they did a CBC w/ chem, had a rectal temp of 105F. CBC (WBC 6.54, neuts 1.15, [lymphs 3.77]).Vet administered sub Q fluids and 24 hours lasting injectable pain medication. She seemed to responded well to this. Her energy was back and she was eating a little more. Vet sent her home with doxycycline and carprofen every 12 hours.
Thursday 6/25: After the SQ fluids and pain med wore off, she was not eating as much again, less energetic. UA was sent and everything came back negative. Prescribed Entyce.
Friday-Sunday: Not many huge changes, still decreased appetite & low energy. continuing with doxycycline and carprofen.
Monday, 6/29: She vomited an hour after her doxy & carprofen. Vet said to stop giving carprofen. Fever of unknown origin panel all came back negative. That night, I noticed her R submandibular lymph node was swollen. Noticed some increased work of breathing intermittently, increased thirst and increased peeing.
Tuesday, 6/30: Brought her back to the vet, did repeat CBC (Hct 33.9, WBC 30.87, [neuts] 5.05). Vet said both of her submandibular lymph nodes were enlarged. Temp 101F. Neutrophils were extremely low and lymphocytes were high, slightly anemic. Chest X ray unremarkable. Our vet diagnosed her with lymphoma and referred her to an oncologist. Sent of blood sample for cytology and to be reviewed by a pathologist. We noticed she was doing the prayer pose.
Thursday, 7/1: Met with oncologist and she said that only her R submandibular lymph node was enlarged, not any of the other ones. in-house cytology today showed a mixed population of cells (the LN may have changed between initial sampling at the primary vet and today's evaluation). Did repeat CBC and labs were still abnormal (Hct 32.4), neutropenia (WBC 5.85, Neuts 0.15, lymph 1.92, monos 3.74, eos0.03). Manual diff: 45% neuts, 4% bands, 29% lymphs, 20% monos.Mini panel: Increased LE (AST 54, AP 1018). US done. Temp went from 103F to 101F after the vet gave her PO antibiotics. Thankfully her weight has remained stable even with the decreased appetite.
Long story short, the oncologist isn’t fully convinced that it’s lymphoma because of her wonky labs and that only one of her lymph nodes is swollen. She sent us home with 2 antibiotics, famotidine, cerenia, continue entyce and probiotic. They gave her Sub Q fluids before we left. I’m sure i missed some details, but overall, the oncologist said this is a very odd presentation for cancer and has low suspicion. She thinks it’s more likely an infection of some sort.
after we got home, she was still pretty low energy, finally ate some cooked ground turkey we made her (she hasn’t wanted chicken), she’s been drinking, peeing and pooping normally. Moving slower (that’s been going on). When we give her hard treats, she’s chewing it very slowly and spits it out and breaks it into little pieces when she usually just swallows treats whole. both vets have looked in her mouth and didn’t see anything. I would like a second opinion please! There was so much information we got yesterday and have no idea how to process all of this. This week has been a roller coaster of emotions to say the very least. We were so sure she had lymphoma and were going to start treatment, but I guess not. I am very cautiously optimistic, but all the searching i’ve done online still points to leukemia/ still maybe lymphoma.