Laurie's Blogs.

Going down the lymphatic drainage / lymphedema rabbit hold has led me to some interesting articles.  Here’s one to dive into, and it’s very fitting to go with Part One of my Training Video on Lymphatic Drainage Manual Therapy!  

Poláková N, Lederer KA, Richter B, Panáková L. A Case Report of Presumptive Primary Lymphedema Localized to the Face of a Dog. Vet Sci. 2023 Jun 22;10(7):409. 

Lymphedema is an uncommon and often overlooked cause of chronic swelling in dogs. Most veterinary reports describe primary lymphedema affecting the limbs of young dogs, usually associated with congenital lymphatic abnormalities. A recent open-access case report, however, expands this understanding by describing what appears to be the first documented case of primary lymphedema localized to the face.

Case Overview

The reported case involved a 1-year-old German Shorthaired Pointer with persistent, non-painful unilateral swelling of the muzzle. Common differentials such as infection, neoplasia, trauma, and parasitic disease were excluded through cytology, histopathology, microbiology, and PCR testing.

Advanced imaging using indirect CT lymphography revealed absent lymphatic drainage and hypoplastic lymph nodes on the affected side, supporting a diagnosis of presumptive primary lymphedema. Histopathology demonstrated marked dermal and subcutaneous edema with mild chronic inflammation but no evidence of malignancy or infection.

Why This Case Matters

Previously, canine primary lymphedema had been described almost exclusively in the limbs. This case highlights that localized facial swelling may also be lymphatic in origin, even in the absence of limb involvement. As with other forms of primary lymphedema, the diagnosis remains one of exclusion.

Diagnosis and Management

Diagnosing lymphedema can be challenging. Imaging—particularly CT lymphography—plays a key role when lymphatic dysfunction is suspected. There is currently no curative treatment; management is largely supportive.

In this case, manual lymphatic drainage and physiotherapy led to long-term improvement, while glucocorticoids provided only partial, temporary benefit. Antibiotics were ineffective in the absence of infection.

Clinical Takeaways

•     Primary lymphedema can present outside the limbs, including the face.

•     Chronic, painless swelling with negative diagnostic findings should prompt consideration of lymphatic disease.

•     Physiotherapy and manual lymphatic drainage may improve comfort and function even when lymphatic abnormalities are congenital.

•     Reporting rare presentations is essential to improving recognition and understanding of lymphatic disorders in dogs.

This case broadens the clinical spectrum of canine lymphedema and serves as a reminder to include lymphatic disorders in the differential diagnosis of unexplained facial swelling.

And now you know!  Cool, eh?!

Until next time,

Cheers!  Laurie