4017. A rare case of a 5-year-old male German Shepherd suffering from two swollen hind limbs. Myanmar case.

 10 Sep 2021: A very rare case. Two swollen hind limbs in a 5-year-old German Shepherd dog seen at the Royal Asia Veterinary Surgery, Yangon, Myanmar. I have had seen only one similar case in a German Shepherd in my over 30 years of practice. 

The veterinarian will also need to perform some diagnostic tests, such as a chemical analysis, complete blood count, blood urea nitrogen (BUN), urinalysis, packed cell volume (PCV), liver panel, heartworm test, and a biopsy of the fluid from the affected area. 

Also, a lymphangiography will be done by injecting dye into the lymph nodes before x-rays are performed. This is one of the most accurate tests in determining the reason for the lymphedema after the normal blood tests fail to find the cause. Additionally, the veterinarian may need to do an ultrasound, CT scans, or MRI for a
more detailed view.

Differential diagnosis:

1. Degenerative myelopathy is a nerve disease that starts in a dog’s spinal cord. If your German Shepherd suffers from degenerative myelopathy, you’ll begin to notice them losing motor function in their hind legs. But their hind limbs are not swollen.

2. A heart affected by dilated cardiomyopathy is inefficient at pumping blood, and oxygenated blood is not adequately distributed through the body. The heart becomes enlarged, and its ventricular walls get thinner. In some cases, changes in heart rhythm will also be a result of the thinned chamber walls. Also, dilated cardiomyopathy can cause fluid to build up in the lungs. But their hind limbs are not swollen. If there is swelling, it will be both 4 limbs and body. 

3. Lymphedema is a condition described as a collection of lymph fluid in certain tissues in your dog’s body because of obstructions in the lymphatic system (lymph nodes, vessels, and organs).

Most of the time, the cause of your pet’s lymphedema is caused by another illness or injury. For example, swelling of the abdomen or chest may be from cancer or heart disease, while swelling of the face, neck, or tongue could possibly be an allergic reaction.

Types

There are several types of lymphedema. The most common are:

• Congenital aplasia – Defective or missing tissue or organ

• Hyperplasia - Organ enlargement

• Hypoplasia – Abnormally small tissue or organ

• Neoplasia - Tumor

• Radiation therapy – Cancer treatment

Higher occurrence in: 

• Certain breeds (Borzoi, Rottweiler, Bulldog, Poodle, German Shepherd, Tervuren, Labrador Retriever, Old English Sheepdog, German Shorthaired Pointer, Great Dane)
• Injury or burn
• Tumors
• Infections
• Heart disorders
• Compromised liver function

Treatment depends on cause. Obstruction of lymphatic flow in the pelvic area, injury, neoplasia (cancer), chronic illness.   There is no cure for lymphedema, but if the underlying cause is found and treated, the condition may simply go away as well.

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