Swollen Lymph Node in Neck

I discovered a swollen lymph node in the left side of my two year old Shih Tzu's neck.  I immediately took her to the vet and he checked her temperature, which was normal, and felt all other nodes, which were also normal.  After one minute of looking her over he concluded that nothing was wrong and if it was I had caught it "too early", which I didn't think was possible, especially if it is cancer.  He gave her a shot to reduce the swelling and sent us on our way.   I do not think the proper attention was given to this situation, but I don't know if I should wait several weeks to see if swelling subsides or if I should go to another vet.  The vet also didn't bother to check her teeth to rule out any possible tooth infections.  This worried mommy needs help!

[Aleda M Cheng, D.V.M., C.V.A]

Hello there,

The good news is  1. your dog is young, and,  2. only one lymph node is enlarged.  This does not totally eliminate the possibility that it is cancer but it would be farther down on the differential diagnostic list than if your dog was 12 years old, or,  if all lymph nodes were enlarged.   Lymph nodes can also be enlarged by infectious, inflammatory, or even traumatic causes.

To best relieve your worrying a fine needle aspirate (needle biopsy) could be performed immediately on the enlarged lymph node.  The needle biopsy is an excellent diagnostic tool.  This procedure does not require anesthesia, can be performed in an office visit setting, and is fairly inexpensive.   It is performed by inserting a small needle into the swollen lymph node and extracting some cells.  The cells are placed on glass microscope slides and are viewed under a microscope by a pathologist, or other diagnostician.  Good cellular samples usually yield excellent results.  Occasionally a sample is not diagnostic and the aspirate must be repeated, or a surgical biopsy must be performed.  The results of the aspirate test usually take less than one week.  

Please also request that the vet examine your pet's teeth.

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