Abdominal Lymph Node Removal in Dogs

Lymph nodes are small, bean-shaped masses found throughout the body, working as filters to foreign materials. These lymph nodes are found in clusters, grouping together in areas such as the groin (inguinal lymph nodes), pelvis (iliac lymph nodes), under arm (axillary lymph nodes) and the neck (cervical lymph nodes). 

Lymph node removal is termed lymphadenectomy and is defined as the surgical removal of the lymph glands. The lymph nodes are part of the lymphatic system responsible for defending the body against viruses and bacteria. The lymphatic system is also in charge of returning excess body fluids to the circulatory system, but is also largely responsible for the spread of cancerous cells. As the body has an average of 500 to 700 lymph nodes, cancer cells can break away from their primary site and use the fast chain of lymph system to spread to other regions of the body. It stands to reason that the primary reason for performing a lymphadenectomy is to examine the lymph for the presence of cancerous cells. 

A lymphadenectomy can either be limited/modified or total/radical. A modified lymphadenectomy is the partial removal of the lymph node, whereas a radical lymphadenectomy is complete removal of said lymph node. A lymphadenectomy is performed by a licensed veterinarian or specialized veterinarian than works primarily with the lymphatic system of animals. 

Prior to the canine’s surgical date, the veterinarian will perform a fine-needle aspirate biopsy to evaluate the fluids taken from the swollen lymph. A cytology of said fluids will reveal abnormalities in the cells and further diagnostic testing will diagnose the present form of cancer. 

The week prior to the surgery date, the canine will be required to halt all blood thinners and pain medications. These drugs inhibit the blood’s ability to clot and place the dog at risk for internal bleeding. If a canine has been prescribed a long-term pain medication or blood thinner, the veterinarian will perform an anticoagulation test prior to surgery to ensure the active drug components have left the body completely. 

The night before surgery, your dog will not be able to eat or drink anything after midnight. As various lymph nodes can be found in the abdominal region, the following is a general step-by-step guide of abdominal lymphadenectomy surgical procedure. 

1. A pre-anesthetic, pain medication, and antibiotic are injection to the dog. 
2. The dog will be feeling drowsy from the pre-anesthetic/sedative, but mask gas anesthesia will likely follow to allow the dog to rest comfortably. 
3. The anesthetized patient is placed on the surgical table in dorsal recumbency (on back). The hind legs are tied cranially for stabilization purposes. 
4. The patient will have the hair clipped close to the skin in the affected area. The freshly clipped area will then be scrubbed for surgery.  
5. A drape is placed on top of the dog, creating a sterile field. The drape is clamped in place and an opening is made in the drape, just above the focus point of the surgery. 
6. A scalpel is used to make an incision through the subcutaneous, fat and muscle layers above the affected lymph node. 
7. The lymph node or group of lymph nodes are identified and isolated.
8. The vet will carefully separate the lymph from surrounding nerves, blood vessels, muscles, and other surrounding tissues. Fat contains a large number of lymph nodes and may be removed along with the lymph cluster. 
9. Bleeding is stopped 
10. Sutures are placed in the muscle and skin, but a small area is left open with a drain in place. A drain will allow internal fluids to leave the body rather than accumulate in the surgical area (a common occurrence of abdominal surgical procedures). 

A lymphadenectomy is a highly effective form of treatment for managing and treating cancerous cells inside a lymph node. 

Dogs that have undergone a lymphadenectomy will be released from the hospital the day of the surgery. Some canines appear drowsy and inactive, whereas other dogs return to normal behavior. In either case, the dog must be confined and restricted from physical activity to prevent sutures from coming loose. An Elizabethan collar may be sent home with the dog to prevent manipulation of the incision site. Pain medications, paired with a broad spectrum antibiotic will be administered as directed by the veterinarian. 

The cost to have your dog’s lymph node removed depends greatly on the number of lymph nodes affected, the location of the lymph node in the abdomen and the stage of cancer the canine is diagnosed with. Major surgery completed to remove deep lymph nodes are usually priced at around $1,500, but can be more depending on the veterinarian and what was required during surgery. Keep in mind that the stated price is only a general estimate for surgery and does not include additional treatment of chemotherapy and/or radiation. Ask your veterinarian about an estimated cost for your dog’s specific surgical needs. 

As with all major abdominal surgeries, complications may occur. Although rare, a dog that has undergone a lymphadenectomy procedure may develop surgery induced bleeding, infection, and organ or tissue injury. A condition called lymphocele can also occur, a condition in which lymphatic fluids collect and need to be removed. 

Abdominal lymph node removal is a procedure commonly done to prevent the spread of cancer and is a method of prevention in itself. Cancer cannot be prevented, but keeping your dog on a balanced diet, following routine veterinary check-ups, and avoiding harmful elements (air pollutants, chemicals) may aid in preventing this disease. Surgically removing the lymph nodes will permanently prevent lymphoma in that localized portion on the body. However, due to the fact that lymph nodes are found all over a dog's body, the prevention of cancer in other lymph nodes is not obtainable.