Peer-reviewed veterinary case report
Dog with lymphoma-like signs linked to phenobarbital epilepsy
By Lampe, R et al.·Published in Journal of veterinary internal medicine·2017·Canada West Veterinary Specialists, Canada·View original on PubMed →
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Original publication title: Suspected Phenobarbital-Induced Pseudolymphoma in a Dog.
- Species:
- dog
Plain-English summary
A 2.5-year-old male Shepherd mix was brought to the vet after showing signs of ataxia (uncoordinated movement), confusion, fever, and lethargy for three days. During his stay, he developed swollen lymph nodes and continued to have a fever. The dog was on phenobarbital and levetiracetam for epilepsy, but after tests showed inflammation in his liver and spleen, the vet switched his medication to zonisamide. Within 24 hours of stopping phenobarbital, the dog's fever went away, and he started to feel better, with all symptoms resolving within a week.
People also search for: dog ataxia treatment · phenobarbital side effects in dogs · dog fever and swollen lymph nodes
Abstract
Pseudolymphoma is a drug reaction to anti-epileptics that is well recognized in humans; it has been reported in one cat but not dogs. In this report, lymphoma-like clinical signs are suspected to be secondary to phenobarbital administration in a dog. A 2.5-year-old male, neutered Shepherd mix presented for a 3-day history of progressive ataxia, dazed mentation, pyrexia, and lethargy. While hospitalized, the dog developed generalized lymphadenopathy and sustained pyrexia. The dog was receiving levetiracetam and phenobarbital for epilepsy, and serum concentrations of both were within standard therapeutic ranges. Abdominal ultrasound revealed hepatomegaly, splenomegaly, and generalized lymphadenopathy. Cytology of the peripheral lymph nodes was consistent with reactive lymph nodes, and aspirates of the liver and spleen revealed histiocytic-neutrophilic inflammation. Phenobarbital was discontinued and replaced with zonisamide. Within 24 hours, the dog was normothermic, and other clinical signs resolved within a week. This case highlights a potentially serious yet reversible adverse reaction to phenobarbital in a dog. This idiosyncratic reaction could be mistaken for neoplasia and is an important differential for lymphoma-like signs in any dog administered phenobarbital.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/28865097/