Lymphedema

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Lymphedema in a young pup[1]
Lymphedema in a Whippet characterized by extensive non-painful pitting oedema and purpura extending from the thoracic wall to both forelimbs and the ventral abdomen[2]

Lymphedema, which may be primary (idiopathic) or secondary, is a clinical symptom rather than a disease per se and is usually caused by a blockage of peripheral lymphatic ducts of the limbs.

This condition may occur as a congenital disease due to developmental abnormalities and is characterized by soft, non painful edema of one or more extremities. Generally the disorder is recognized by the breeder between birth and 12 weeks of age.

Affected dogs present with visible swelling of limbs and pitting edema which may be localized to the limbs or involve the ventral trunk as well.

Diagnosis is usually based on presenting clinical signs and hematological analysis to determine a cause of this clinical symptom.

Primary lymphedema can appear histopathologically either as lymphatic hypoplasia or lymphatic hyperplasia and dilatation. While mild extravasation of erythrocytes can be a feature of primary lymphedema[3], marked purpura associated with edema is more commonly described in association with vasculitis syndromes[4].

Secondary lymphedema has also been reported due to hematological disturbances associated with lymphangiosarcoma[5], chylothorax[2], following mastectomy after removal of mammary tumors[6] and thoracic duct ligation[7], as well as infections with the parasite Brugia pahangi[8].

Omental transfer treatments have been effective in dogs with lymphedema due to thoracic duct obstructions[9] and prednisolone has shown to be effective in remedial therapy of this condition in dogs with other causes[10].

References

  1. Laboklin
  2. 2.0 2.1 Schuller S et al (2011) Idiopathic chylothorax and lymphedema in 2 whippet littermates. Can Vet J 52(11):1243-1245
  3. Scott DW et al (2001) Muller and Kirk’s Small Animal Dermatology. 6th ed. Philadelphia, Pennsylvania: Saunders.
  4. Cogar BD et al (2005) Chylothorax in Henoch-Schonlein purpura: A case report and review of the literature. Pediatr Pulmonol 39:563–567
  5. Williams JH et al (2005) Lymphangiosarcoma in a 3.5-year-old Bullmastiff bitch with vaginal prolapse, primary lymph node fibrosis and other congenital defects. J S Afr Vet Assoc 76(3):165-171
  6. Kang JH et al (2007) Secondary malignant lymphoedema after mastectomy in two dogs. J Small Anim Pract 48(10):579-583
  7. Farnsworth R & Birchard S (1996) Subcutaneous accumulation of chyle after thoracic duct ligation in a dog. J Am Vet Med Assoc 208(12):2016-2019
  8. Orton S et al (1998) Association of elevated lymph node cell release of histamine and tumor necrosis factor with genetic predisposition to limb edema formation in dogs infected with Brugia pahangi. Am J Trop Med Hyg 58(6):695-704
  9. Knight KR et al (1991) Combined coumarin and omental transfer treatments for canine proximal obstructive lymphoedema. Int J Exp Pathol 72(5):533-542
  10. Galkowska H & Olszewski WL (1992) Spontaneous cluster formation of dendritic (veiled) cells and lymphocytes from skin lymph obtained from dogs with chronic lymphedema. Lymphology 25(3):106-113
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