swollen lymph nodes or lymphoma?

[pussycathollow]

I took 1 of my 19 cats to the vet the other day, who had what seemed like a swollen lymph node under her jaw in her neck. She is just barely 2 years old. It was not there a week ago and she has never been a cat that is outgoing and affectionate so when she started to hide 3 days before I took her to the vet I was not overly concerned. When I found her hiding she had a slight discharge from her eyes that I figured was an upper respiratory infection. I started to treat her with zithromax (as is the usual course of action in my large cat household) and her eyes started to clear up but she still was not eating, she is drinking. The vet as usual said it may be an infection or it may be lymphoma. She put her on orbax and said to look at the lump for a week. It has now been 4 days on the antibiotic and maybe it is wishful thinking on my part but the lump seems slightly smaller and she has started to look brighter and shows a bit of interest in food but I am still force feeding her. If it is cancer shouldn't she have other symptoms? Should I be asking the vet to do some other testing? My vet is pretty laid back and takes a non aggressive approach to things and I haven't had any really serious cat issues so I am rather clueless.

[Traci]

I'm so sorry haven't had the chance to respond sooner. Did your vet offer to do bloodwork, at least a CBC? Lymphoma in a fairly young cat would be very uncommon. It could be a reactive lymph node, an infection going on somewhere, but I think bloodwork would be a wise diagnostic at this point (complete blood profile plus CBC). Your vet could also aspirate the lymph node for cytology to rule out infection vs virus, etc. Were any of her other lymph nodes enlarged? What is the condition of her oral health? (any abcessed teeth, ulcers, etc?). Do any of the cats fight with each other to the extent of biting/scratching and did the vet rule out possible abcess as the result of a bite wound?

It is concerning that you are force-feeding and that she isn't eating on her own. Exactly how long has she gone without eating on her own? What are you feeding her? What were the vet's comments about that and did she offer to prescribe an appetite stimulant? Did she offer a more palatable food on a temp basis, such as Hill's Rx A/D? Did she evaluate kitty's dehydration status?

Could you elaborate: are you self-dosing your cats with zithromax without exam/diagnosis by your vet? If so, by doing so you could be treating unnecessarily with this type of antibiotic, and some infections will not respond to certain antibiotics, making them ineffective. And, with any antibiotic, there is always potential for adverse reaction (as well as ineffectiveness, expiration, exposure to light making them ineffective, etc). Please don't self-dose your cats without your vet's express direction and supervision. Also, they must be dosed by weight, and by starting dose (mg) of the tablet, there's a specific calculation involved.

[pussycathollow]

Thanks Traci for your response. The reason the vet gave me zithromax in the first place was for cost effectiveness since I have 19 cats, when several of them get an upper respiratory infection I have a formula per mg to mix the zithromax with distilled water and dose each cat based on their weight. When Natalie first got sick she had a discharge from her nose and eyes much like 2 of my other cats (who actually got sick from their visit to the vets office for routine shots). The other 2 cats did not have swollen glands. I had Natalie on the zithromax for 2 days and her eyes and nose cleared up but the swollen glands were still there. The vet said she felt a gland in her lower neck/shoulder area but no matter how many times she showed me I didn't feel it. As of today she has been on antibiotics for 6 days and the gland in her neck is half the size it was. I am taking that as a good sign. She has never been a good eater, not a fan of wet food but would eat dry food and it was near imposssible to monitor how much she ate before she got sick as she likes to hide in the day and come out at night. I have her in a large dog crate so monitoring what she eats is very easy. The vet gave her a/d and l/d but since they are wet she is not interested in them, I am also giving her nutracal. She is starting to pick at her food and doesn't fight me when I make her eat the canned food. She is not dehydrated at this point although she was slightly a week ago (I gave her sub Q fluids for 2 days). I am not self diagnosing or running off on my own to treat her I have been doing rescue work for a long time and have been through many different cat and dog illnesses just nothing that could be cancer. I was just wondering if it could be cancer wouldn't there be some other symptoms going on like weight loss, diareaha or vomiting? I am going to report back to the vet on Saturday and I will ask for blood work if there is still any sign of the swollen gland.
Thanks

[Traci]

Well, personally, I would ask for bloodwork, just as a rule-out diagnostic. Has she been tested for FELV/FIV? Do you regularly test your cats with this snap test? (I would strongly advise to do so). Did kitty have a fever before, during or after she was examined?

Is she spayed?

Do you trust your vet? You mentioned that she has non-agressive approaches, so a second opinion may be an option for you to consider.

When the other two cats were vaccinated recently, were the vaccines parenteal (injectable) or intranasal? If the latter, these intranasal vaccines can actually cause symptoms of a URI. Ask your vet about that.

There are numerous reasons the lymph nodes can react or enlarge, sometimes they are due to a bacterial infection going on somewhere, other times they are caused by a virus or systemic problem. In kittens or developing young cats, it could be due to teething, etc. Because you have a large number of cats in the home, I would strongly advise bloodwork (full blood profile and CBC) to rule out immune conditions like FELV/FIV etc because the cats may be at increased risk (multi-cat environment, exposure risks, etc). I would also strongly advise ruling out calicivirus.

Yes, cancer conditions would generally present symptoms of vomiting, inappetance, diarrhea/constipation, dehydration, pain/discomfort, weight loss, etc, but the primary complaints have been only inappetance and enlarged lymph node. If vomiting and weight loss were apparent, you'd want additional diagnostics....if the vet suspects in the least that lymphoma is concerning, she should be addressing diagnostics immediately with bloodwork, xrays, etc. I understand why she wants to see how she responds to the antibiotics, and to see if the lump recedes, but I think bloodwork would be useful at this point.

As for food, if she prefers dry food, try feeding her kitten food (i.e., Iams kitten food), oftentimes this is very palatable for adult cats when ill.

Lastly, rule out oral abcesses, diseased teeth, or even sinus problems.