Diagnosis and Conservative Management of Primary Lymphedema Resulting From Multiple Aplastic Lymphocenters in a Dog

A 6-week-old 7.4-kg (16.3-lb) sexually intact male Great Dane with a history of severe peripheral edema within the head, neck, limbs, and tail since birth was referred for further evaluation. A whole-body computed tomography examination documented severe subcutaneous edema multifocally associated with numerous hypoplastic and aplastic lymphocenters, particularly the left axillary, iliosacral, inguinal, and popliteal lymphocenters bilaterally. A congenital anomaly of the lymphatic system resulting in lymphedema was strongly suspected. The dog was managed with a combination of low-fat diet, rutin, and furosemide initially. In addition, the owner used a combination of compression socks and therapeutic massage several times daily along with carprofen and gabapentin for pain and inflammation. The patient was hospitalized to receive supportive care several times over a 2-year period for treatment of fever associated with cellulitis resulting in secondary wounds and infections. To the author's knowledge, this report represents the first case of presumed congenital lymphedema diagnosed with computed tomography and successful long-term medical management without surgical intervention.