Abdominal Lymph Node Removal in Cats

The lymphatic system is made up of vessels and lymph nodes. Its function is to transport the white cells  to where they are needed to protect the body from infection. Each lymph node drains particular parts of the body, and when that area is infected, inflamed, or cancerous, the draining lymph is often also enlarged. 

Some of the lymph nodes in a cat's belly can often felt through the body wall, whilst others need a scan to reveal their size and shape. When a cat is sick and an abdominal lymph node is enlarged, the clinician may either biopsy or remove it. The sample is sent for histology to find out precisely what disease process (infection, inflammation, or cancer) is occurring. 

Lymph node removal or biopsy is the last of several diagnostic steps. First the clinician will build up a picture of the patient's symptoms by taking a history. Then they run screening blood tests to rule out common problems such as liver or kidney disease. If the signs involve the gut, such as vomiting or diarrhea, then specific bowel function blood tests and fecal analysis may be necessary. 

If the clues point towards an abdominal problem, then imaging such as an ultrasound exam will be conducted. This helps to visualise any enlargement of organs or lymph nodes. When possible, the vet tries to avoid laparotomy (surgically exploring the abdomen) and attempt to get a sample using a fine needle guided by the ultrasound. However, if there is a reason to enter the abdomen, such as to remove a lump from the gut, then the lymph node will be removed at the same time. 

It should be understood that removing a lymph node is rarely curative in its own right, and mostly done for diagnostic purposes in order to guide the choice of treatment.

The rare occasions where it may be done to extend life include when a cat has been treated for a cancer affecting the animal's rear end which drains to the regional lymph node in the abdomen. If there is a high risk of the cancer spreading, then the regional lymph node will be the first place it travels, so removing it could prevent further spread. 

More typically, removal facilitates a diagnosis, which then allows targeted treatment to be given in order to improve the cat's chances of recovery. Typically this might mean administering chemotherapy drugs if a diagnosis of lymphoma is made, or diet change and steroid medication if the cat has inflammatory bowel disease. 

Removal of an abdominal lymph node is an invasive procedure in which the surgeon has to make an incision and enter into the abdomen. Actually removing the lymph node itself is not particularly irksome or dangerous, but healing from the actual laparotomy taking up to two weeks. 

The body needs to heal fully before any drugs that suppress the immune system are given. This means that typically the cat recuperates for 10 to 14 days before any steroids or chemotherapy drugs are given. 

During that recovery time the cat must be encouraged to rest, which means keeping outdoor cats inside, and restricting them to one small room so they don't jump on high furniture or ledges. Some cats will need to wear a cone to prevent them licking the incision in the belly or chewing out their sutures. 

Lymph node removal needs to be seen as part of the bigger picture. The lone act of removing the lymph node may cost $100 to $200 with around $100 for a histology report, but added on top of this is the cost of diagnostics, pain relieving drugs, and the general anesthetic. A basic anesthetic cost is around $99 with similar additional amounts for every half hour under anesthesia. Screening blood tests may cost $60 to $300 depending on the profile performed. Fecal tests can range from $40 to $220 depending on the breadth of the screening. Thus, it can easily be that an exploratory surgery with a lymph node removed for histology will cost in total $1,000 or more. 

Removing an abdominal lymph node is not inherently dangerous, but is an invasive procedure. Most clinicians will attempt to get a smaller sample through a less invasive technique such as ultrasound guided biopsy. However, if the clinician needs to be inside the abdomen for another reason, then surgical removal does not greatly add to the background level of risk. 

As part of the immune system, lymph nodes police the abdomen to manage infection. Once removed they do not grow back, but usually the lymph circulation will find an alternative route to permeate the structures of the abdomen. 

Prevention of abdominal lymph node removal is principally about keeping your cat fit and healthy. This means feeding a good quality diet, applying appropriate parasite treatments, and getting regular vet checkups. 

In addition, since dry FIP is one of the conditions which can cause lymph node enlargement, it is important to source a kitten from a reputable breeder or a respected rescue. Unfortunately, kittens kept in close confines with lots of other cats that are sharing litter trays carry a raised risk of acquiring FIP and so should be avoided. 

Likewise, if your cat has symptoms such as sickness or diarrhea, then get them checked out by a vet. Early treatment of health problems can often resolve the matter ahead of a stage where the lymph node becomes enlarged.