Pet Forum / Miscellaneous / Animal Health / February 2004

Another vet had diagnosed him with

.........So there were no abnormal values in the bloodwork?  WBC wasn't
elevated?  Eosinophils weren't elevated?  No anemia?  Eyes are normal?
Liver and spleen appear normal (X-ray or ultrasound)?  Are his nails normal?
Dog is heartworm negative?  Is the dog still on Doxy?  How old is this dog?

Ehrlichiosis:
http://www.vin.com/proceedings/Proceedings.plx?CID=WSAVA2002&PID=2595

Swollen Lymph Nodes:
http://www.peteducation.com/article.cfm?cls=2&cat=1614&articleid=319

Lymph nodes in the lung/heart area are in the mediastinum.
Radiology of The Mediastinum
http://www.vin.com/proceedings/Proceedings.plx?CID=WSAVA2002&PID=PR02605
Mediastinal lymphadenopathy is one of the most common causes of a
mediastinal mass, usually involving the cranial mediastinal,
tracheobronchial and/or sternal lymph nodes. It is an extension of a disease
process from the lung, heart, spine, oesophagus, sternum or chest wall, as a
local manifestation of a generalized disease (e.g., lymphosarcoma) or as a
congenital anomaly (e.g., branchial cyst).

I don't know that this is particularly relevant, but apparently Ehrlichiosis
can cause all sorts of havoc.

J Small Anim Pract. 2003 Sep;44(9):408-10.
Portal vein and aortic thromboses in a Siberian husky with ehrlichiosis and
hypothyroidism.
Bressler C, Himes LC, Moreau RE.
Beach Animal Hospital, 208 River Avenue, Point Pleasant Beach, New Jersey
08742, USA.
A six-year-old, neutered male Siberian husky was presented for euthanasia
for end-stage liver disease. Examination of the dog raised questions
regarding the severity of the condition. It had presented to the referring
veterinarian with polyuria, polydipsia and weight loss. Blood tests at that
time revealed elevated liver enzymes and hypoalbuminaemia. Cirrhosis was
presumptively diagnosed, based on an ultrasound examination, which showed
ascites with a normal liver. The dog had a history of hypothyroidism, which
was controlled with levothyroxine. Physical examination revealed cachexia. A
second abdominal ultrasound examination was performed and revealed portal
vein and aortic thromboses. Tick titres showed a positive Ehrlichia canis
titre of 1:640. Skin biopsies showed lymphoplasmacytic vasculitis.
Doxycycline and aspirin treatment was initiated, and the clinical signs
resolved. The authors concluded that the thrombi were primarily caused by
chronic ehrlichiosis, based on the clinical findings and the response to
treatment.
PMID: 14510331 [PubMed - indexed for MEDLINE]

Vet Pathol. 1981 Jan;18(1):48-61.
Acute experimental canine ehrlichiosis. I. Sequential reaction of the hemic
and lymphoreticular systems.
Reardon MJ, Pierce KR.
Dogs with acute Ehrlichia canis infection showed the established clinical
features of acute ehrlichiosis and had thrombocytopenia, anemia, increased
serum glutamic pyruvic transaminase activity, and decreased total serum
protein and albumin concentrations during the first weeks after infection,
and increasing gamma globulin concentrations after the third week. Gross
lesions in hemic and lymphoreticular tissues were transient
lymphadenomegaly, splenomegaly, and increased red long-bone marrow.
Lymphoreticular hyperplasia in the paracortical area of lymph nodes and in
the splenic red pulp occurred during the second week of infection. Later,
small lymphocytes were replaced by medium-sized lymphocytes and plasma
cells. Activity of germinal centers increased initially, as shown by
numerous mitotic figures and macrophages, but diminished later, and the
follicles blended with interfollicular and paracortical tissue because of a
decrease in small lymphocytes in the mantle layer. We saw splenic
hemorrhages near the perifollicular sinus, and vasculitis, most often
phlebitis, in the kidney between weeks 2 and 4. Multifocal
reticuloendothelial hyperplasia occurred in the liver during the early stage
and injured adjacent hepatocytes by compression. Lesions typical of
ehrlichiosis in these dogs were interstitial pneumonia, subendothelial
aggregates of mononuclear cells in pulmonary blood vessels, renal
periglomerular and perivenular plasmacytosis, hemopoietic hyperplasia, and
perivascular cuffs of lymphocytes and plasma cells in many organs.

PMID: 7467072 [PubMed - indexed for MEDLINE]

.....Doesn't really totally fit the picture, but worth mentioning:
Visceral Leishmaniasis
http://www.vetmed.wisc.edu/pbs/zoonoses/Leishtryp/leishdog.html

CHRONIC INTERSTITIAL PNEUMONITIS IN DOGS NATURALLY INFECTED WITH
Leishmania(Leishmania) chagasi: A HISTOPATHOLOGICAL AND MORPHOMETRIC
STUDYRicardo GONÇALVES(1), Washington Luiz TAFURI(4), Maria Norma de
MELO(3), Pedro RASO(4) & Wagner Luiz TAFURI(2)
Rev. Inst. Med trop. S. Paolo
45(3) 153-158 May-June 2003
http://www.scielo.br/pdf/rimtsp/v45n3/16165.pdf.

Blastomycosis:  http://www.vet.uga.edu/vpp/clerk/mordecai/

And of course, there's always the possibility of lymphoma.

Were the biopsy tissues sent to a lab?
Lymph Node Cytology:
http://www.vet.ohio-state.edu/docs/VBS710/lymph/lymph.html

IVIS, as always is a good source of information:
http://www.ivis.org/special_books/carter/carter3/chapter_frm.asp

Best of luck, please post back if they figure out what is going on.

buglady
take out the dog before replying

*Since blood work came back normal, he took lymph tissue for biopsy.
                           ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^

what does the pathologist's report say?

*checked him out, found a mass in his mouth and nasal cavity.  Biopsy
*came back negative.  Although he is eating, playing and gaining a little

"negative" is not something a pathologist's report generally says except
perhaps as an add-on sentence at the end. What specifically were the
findings? My thinking is that "no evidence of disease x is present in the
submitted tissue" is not the same as "these findings are not consistent
with disease x at all." You know what I mean?