"There are many causes," I said to the owner who told me that the old dog had a dental scaling 1.5 months ago at Vet 1's place and the right submandibular lymph node would be due to bacterial infection from the bad teeth.
"The lump is nodular and quite large and painful," I said. "The dog reacted to the palpation and coughed a bit. One possible cause of this early morning fit could be the sharp pain in this lump," I said. "If only dogs can talk."
I advised an X-ray. "It is best not to operate now as the lump appeared to have spread inwards," I said. "This is an inoperable tumour, likely cancerous."
"Please forgive me for asking. How do you know it is cancerous?"
"I do not know for sure, unless it has grown aggressively since 1.5 months ago. If Vet 1 had recorded the size of the lump and it is now 2 or 4X bigger, then it is likely to be cancerous." He would try to get the report from Vet 1.
"If it is just an inflamed right submandibular lymph node, then medication will reduce it considerably," I said. "We have to review in 2 weeks time. Blood test did reveal liver disorder as the enzymes are increased. However, some vets will say that the liver enzymes must be considerablv higher than today to cause fits in your dog. I mean, you ask 10 vets and you get 10 different opinions."