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| Lymphedema, also spelled lymphoedema, also
known as lymphatic obstruction, is a condition of localized fluid retention
caused by a compromised lymphatic system. The lymphatic system (often referred
to as the body's "second" circulatory system) collects and filters the
interstitial fluid of the body. Lymphedema has been barely recognized as
being a serious health problem; however, this is slowly changing due to
education and awareness. The danger with lymphedema comes from the constant
risk of developing an uncontrolled infection in the affected limb. Still,
physicians and medical staff who practice in fields where this disease
is uncommon may fail to correctly diagnose the condition due to the apparent
lack of information regarding this disease. It may be primary or secondary.
Primary/congenital lymphedema is usually present at birth or by several
months of age.
. Lymphedema in Labrador Retrievers Lymphedema is more common in dogs than cats and no sex predilection has been reported. Although lymphedema can affect all breeds, dogs with a familial predisposition include Belgian Tervuren, Borzoi, English Bulldog, German Shepherd, German Shorthaired Pointer, Great Dane, Labrador Retriever, Old English Sheepdog, Poodle and Rottweiler. In some breeds, like the Labrador Retriever, the mode of inheritance has been shown to be autosomal dominant with variable expressivity. This means that only one copy of the gene, which may be inherited from either parent, is required to produce the trait. The parent with the dominant trait will pass the affected gene to approximately half its offspring, and the trait will be apparent in both the parent and the affected progeny. It also means that if either parent is affected, all puppies have a susceptibility to the disorder but not all will be affected equally. These conditions are uncommon because, as long as it is of early onset (ie becomes apparent before breeding age is reached), the disorder can be readily eliminated by avoiding the breeding of affected individuals and individuals in their bloodlines that are suspected of being carriers of lymphedema. . Causes Lymphedema may be inherited (primary) or caused by injury to the lymphatic vessels (secondary). Lymphedema may also be associated with accidents or certain diseases or problems that may inhibit the lymphatic system from functioning properly. Radiation therapy or cancer can also be a cause of secondary lymphedema. While the exact cause of primary lymphedema is still unknown, it generally occurs due to poorly-developed or missing lymph nodes and/or channels in the body. Lymphedema may be present at birth, develop at the onset of puberty (praecox), or not become apparent for many years into adulthood (tarda). Some cases of lymphedema may be associated with other vascular abnormalities. . Symptoms Symptoms may include severe fatigue, swelling of the legs that typically starts at the foot and advances toward the body, which can occur in one or multiple limbs, most commonly in the hind legs, sometimes accompanied by discoloration of the overlying skin, swelling that may affect the underside of the chest, abdomen, ears and tail, and, uncommonly, lameness and pain.The skin looks normal but has a thickened spongy feel, and if you press it, your fingers will leave dents. Skin that is swollen due to lymphedema is susceptible to bacterial infection and delayed healing after injury, but otherwise your dog will be generally healthy. . Diagnosis
Treatment There is no curative therapy, treatment is aimed at minimizing the symptoms. Mild cases of lymphedema may come and go, or persist without any adverse consequences for your dog's health. More serious cases may require bandaging to reduce the swelling due to fluid (lymph) build-up, or reconstructive surgery. Administering compression bandages to the affected area can be a problem because bandages will need changed regularly to prevent any possibility of infection on the affected skin. Treatment for lymphedema varies depending on the severity of the edema and the degree of fibrosis of the affected limb. The most common treatments for lymphedema are a combination of warm water massage, compression wraps, the use of antibiotics for secondary infections and the use of benzopyrones, a group of drugs that also may help reduce swelling. Make sure you are feeding your dog lots of high quality foods, which should be high in both protein and carbohydrate to maintain his energy levels; and that he has constant access to fresh water. In addition, make sure that his diet contains only natural foods and that his environment is free of fumes, dust and plant pollen. Keeping your dog's diet and environment will reduce the amount of work his lymphatic system needs to do and therefore improve the chances of reducing the symptoms. . Staging and severity Stages Whether primary or secondary, lymphedema develops in stages, from mild to severe. Methods of staging are numerous and inconsistent. They ranged from three to as many as eight stages. The most common method of staging was defined
by the Fifth WHO Expert Committee on Filariasis:
Home Care and Prevention Puppies with severe lymphedema may die with or without treatment. Administer all medication and follow all recommendations as directed by your veterinarian. If your pet's condition is not improving or getting worse, seek veterinary attention at once. There is no preventative care for primary lymphedema. Resolution has been seen in some puppies with pelvic limb involvement only. . Illustrations      - Fossum TW, Miller MW. Lymphedema: etiopathogenesis. J Vet Int Med 1992; 6:283-293. - Fossum TW, King LA, Miller MW, et al. Lymphedema: clinical signs, diagnosis, and treatment. J Vet Int Med 1992; 6:312-319. . Internet sources: - Canine Inherited Disorders Database (University of Prince Edward Island) - Pet Peoples Place - PetPlace.com - Wikipedia Photos:
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