Diagnostic Approach to A Case of Chronic Hind Limb Swelling: Lymphedema in A Dog

Background: Lymphedema is a rare condition that affects the lymphatic system, potentially leading to significant disability. This case report describes a rare case of secondary lymphedema in a ۴-year-old dog with a history of bite trauma. Confirming the diagnosis of this condition in veterinary medicine can be challenging, as the clinical signs are similar to those of other common causes of limb swelling. The present case highlights the value of a systematic and multimodal diagnostic approach. Methods: In this study, a systematic diagnostic protocol was developed and implemented to arrive at a final diagnosis. This protocol consisted of sequential steps, including clinical examination, hematological and biochemical tests, radiography, ultrasonography, and cytology. The diagnosis of secondary lymphedema was definitively confirmed only after excluding other differential diagnoses and considering the trauma history of the patients. Results: The results of the clinical examination revealed diffuse, soft, non-invasive swelling in the right hind limb, with thickened skin and an “orange peel” appearance. Hematological and biochemical tests were all within normal limits, ruling out any systemic disease or infection. Radiography also showed no bone or joint abnormalities, but uniform soft tissue swelling was evident. Doppler ultrasonography confirmed signs of vascular inflammation and soft tissue interstitial swelling without signs of neoplasia. Finally, cytology showed the presence of mature lymphocytes and the absence of malignant or purulent cells, confirming the definitive diagnosis of secondary lymphedema. Conclusion: This case report demonstrates the efficacy and necessity of a step-by-step, multi-step diagnostic protocol in confirming secondary lymphedema. This approach prevents misdiagnosis and facilitates the proper management of the disease. For veterinarians, this protocol can serve as a practical guide for managing similar cases with edema symptoms.

کلیدواژه ها:

Lymphedema ، Digital radiology ، Ultrasonography ، Dog