Characterisation and outcome of idiopathic pyogranulomatous lymphadenitis in 64 English springer spaniel dogs

OBJECTIVES

To describe the history, clinicopathological abnormalities, diagnostic imaging findings, lymph node cytological/histological appearance, treatment and outcome of English springer spaniels diagnosed with idiopathic pyogranulomatous lymphadenitis.

MATERIALS AND METHODS

In this retrospective UK-based multicentre study, 64 dogs were recruited from 10 referral centres, 32 first-opinion practices and three histopathology/cytology laboratories, between 2010 and 2016.

RESULTS

The median age at presentation was 6 years (range: 0.17 to 11.75). Neutered females were frequently affected. Pyrexia (83.8%), peripheral lymphadenomegaly (78.4%), dermatological lesions (72.9%), lethargy (67.6%), hyporexia (54%), diarrhoea (29.7%), coughing (24.3%), epistaxis, sneezing or nasal discharge (21.6%), ocular signs (21.6%) and vomiting (16.2%) were reported in dogs for which the history and physical examination records were available. Popliteal (45.3%), superficial cervical (35.9%) and submandibular (37.5%) lymphadenomegaly were frequently reported. Haematology and serum biochemistry revealed non-specific changes. When undertaken, testing for infectious diseases was negative in all cases. Lymph node cytology, histopathology or both demonstrated mixed inflammatory (27%), pyogranulomatous (24%), neutrophilic (20%) or granulomatous (11%) lymphadenitis. Treatment details were available for 38 dogs, with 34 receiving prednisolone for a median duration of 15 weeks (range: 1 to 28 weeks). A good to excellent clinical response was reported in all but one case. Ten dogs relapsed after discontinuing prednisolone.

CLINICAL SIGNIFICANCE

Idiopathic pyogranulomatous lymphadenitis should be considered as a differential diagnosis for lymphadenopathy and pyrexia in English springer spaniels. The characteristics of the disease, absence of identifiable infectious aetiology and response to glucocorticoid therapy suggest an immune-mediated aetiology.

End-of-treatment self-efficacy: a predictor of abstinence

Results of previous studies suggest that end-of-treatment self-efficacy in problem drinkers has limited predictive validity. One explanation for this finding has been the postulated existence of a ceiling effect, i.e. the possibility that subjects who rate themselves highly in terms of self-efficacy form a heterogeneous group with some subjects making inflated self-efficacy judgements based on an over-optimistic perception of their coping abilities. In the present study, end-of-treatment self-efficacy in 63 problem drinkers, as measured by the Situational Confidence Questionnaire and a newly designed Self-Efficacy Questionnaire (SEQ), was predictive of abstinence status at 3 month follow-up. In those patients who on the SEQ had expressed great confidence in their ability to remain abstinent over the follow-up period, the additional consideration of keyworkers' confidence in their patients' ability to remain abstinent as well as patients' anticipated need for future help improved the prediction of abstinence status. These results are discussed with respect to the postulated ceiling effect. A prognostic tree using just three baseline variables predicted abstinence status correctly in 88% of all cases.