# Potential thymoma, maybe megaesophagus too--any advice on these symptoms/treatment?



## Katie2 (Apr 6, 2018)

Hi everyone,

For the past five weeks or so, I've been dealing with some as yet unexplained symptoms in my 10 year-old male golden, Kelly, and right now my vet is thinking the cause is a thymoma. I had never heard of a thymoma before, so I'm hoping someone here might have experience to share.

About five weeks ago, I noticed Kelly drooling from the right side of his mouth after drinking. I figured I would see if it resolved in a week or two before calling the vet, as he seemed fine otherwise, but then about three weeks ago, he also had some yellow discharge from his right nostril after coming in from his short morning "business" walk. He laid down after that short walk and wouldn't get up, and whined when he tried to get up; he stayed like that for about an hour and a half while I called the vet, and tried to get them to fit me in, and called around to find an emergency vet who could see him. Once we got him in the car, after 5 minutes he stood up, discharge was gone, and he seemed fine! The emergency vet said it could be a dental issue, but couldn't see any obvious issue or foreign body, and noticed his right lymph node seemed slightly swollen, prescribed some antibiotics and recommended follow up with our regular vet for blood work.

He continued to experience unilateral drooling after drinking, but only had yellow nasal discharge another couple of times over the past five weeks, and only for 10-20 minutes at a time. He didn't have any more issues with lying down and not being able to get up. Our regular vet did some blood work the week after his emergency vet visit, and everything was normal except that he had lost about four pounds and his white blood cell count was a little over 20,000. He gets very excited when going to the vet, but even that seemed a little too high to attribute to excitement, so they looked closer at the white blood cells and said that his lymphocytes were high--normal being 4,500 and his being 14,342. Went back for a fine needle aspirate of his neck lymph nodes, which the vet said seemed to be the same size and possibly slightly swollen, but she wasn't sure. The report indicated that (quoting from report) "expansion of small to medium lymphocytes may represent reactive or neoplastic possibly indolent t-zone lymphoma." 

While waiting for flow cytometry results from Colorado, he started to experience some more "liquidy" drooling, a much thinner consistency than before, mostly at night (not after drinking, as it initially was--the drooling after drinking is now on-and-off), paw licking and lip smacking. Not constant, but noticeable. The drool also seems to have a slightly sharp smell, which I didn't notice in the drool before, and I've noticed it out the left side too the last couple days. His breathing is also occasionally a little "throaty," or congested sounding (but he had previously been thought to be in the early stages of laryngeal paralysis). He also sometimes has foamy saliva buildup on the right side of his mouth when we go for walks. He sometimes has swallowing issues--I'll give him a piece of string cheese and he'll act like he ate it, or smack his lips for a while, and I'll open his mouth and find it towards the back of his tongue. But he has had no regurgitation or vomiting, only occasional coughing after eating. His appetite is good and he still walks, jumps, and plays--a lot of the time, he seems pretty normal.

But the results of the flow cytometry came in yesterday and indicate not t-zone lymphoma, but several other possibilities: that there are 2 different types of t-cells causing problems; an unusual t-cell tumor; thymoma; or chronic infection, like ehrlichia. I am taking him for chest x-rays tomorrow to see if there is a thymoma or evidence of megaesophagus. The vet said he didn't seem to be having myasthenia gravis symptoms so didn't think a test for that would be necessary-- I'm not sure I agree, as he doesn't have any severe weakness in his legs, but he does have drooling and difficulty swallowing.

I'm looking into treatment options for thymoma, and I'm getting so concerned that these symptoms have been going on for weeks, untreated, and maybe getting worse, as we've waited for test results. The vet said that if they do find a mass, I would have to wait a couple weeks to get an ultrasound with fine needle aspirate of the mass. Is there anything I should ask for, like prednisone, in the meantime? Could it be lymphoma AND thymoma? Are there any more tests I should be asking about? If anyone has any knowledge or experience to share, I'd really appreciate it! I'm sort of reeling from all this and just want to make the best decisions for Kelly--he's the love of my life and such a sweet, loving boy.


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## CAROLINA MOM (May 12, 2009)

I'm very sorry for what your boy is going through.

Perhaps your Vet will refer you to a specialist or you may want to check a Vet Med School in your area. They may have some other treatments options or even clinical trials.


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## NicoleGold (Dec 8, 2015)

First step - get xrays ASAP to see if there is a mediastinal mass. If there is one, it could be a thymoma or it could be lymphoma (or it could be another kind of cancer, though not as common) and your vet is correct that he will need a biopsy to diagnose. If you have not seen an oncologist yet, I would consider consulting with one.

I am so sorry you are dealing with this.


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## DblTrblGolden2 (Aug 22, 2018)

I have a 10 year old that has Megaesophagus and LP. Now that I look back the earliest signs were times that he would occasionally throw up what seemed to be an entire feeding hours after you would have thought it should be digested. This would only happen 2-3 times a year. He was very healthy, never even an ear infection. The first day I took him to the vet he was coughing after eating but not throwing up. I thought maybe something was stuck in his throat or his throat was irritated. My vet suggested we get a series of x-rays and immediately saw that he had ME. The same day we did the blood work for. MG. It took about 10 days to get the results back from UC Davis. He was negative for MG. We put him on metoclopramide 10 mg 3 times a day and I started elevated feeding and watering. I blend his food to be a thick milkshake consistency. He does drool now and One side of his face is dropped. My vet and I both believe he may have MG and tested a false negative (it’s common). We followed the protocol for MG but saw no improvement so we eventually stopped. He is stable and nothing has gotten worse. I give Pepcid AC morning and night. He’s sitting next to me as I’m typing. I heard horror stories about ME. I cried and researched. If this is what your dealing with it can be managed. If its ME and LP you may not have a surgical option but he can live a quality life. It’s been almost 2 years since Duke was diagnosed and he’s doing well. Many other health issues have popped up in the last two years. They have all been manageable. He still doing really well all things considered. I treasure every day. They didn’t give me a ton of hope in the beginning. Be careful of internet research on ME. It paints a horror story more often then not.

Prayers and positive thoughts for you. I documented some of Dukes struggles on the forum. Feel free to PM me if you like. I’m sorry I can’t be of more help with the other possibilities but ME should be a quick diagnosis with a knowledgeable vet.


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## Katie2 (Apr 6, 2018)

Thank you all for your responses! Sorry for the delay in updating--the x-rays did not come back as expected and I've been spinning my wheels a bit trying to figure out where to go from here. The x-rays did not show a mass, and it didn't show megaesophagus either. My vet said she would consult with their office's veterinary oncologist, who is only in once or twice a week, to see what he thought the next step should be, so I should hear back about that tomorrow. 

She seems to be thinking it's lymphoma or some unusual t-cell tumor that we haven't found yet and that an oncology specialist might be able to find the right diagnostic approach since so far--the fine needle aspirate, blood flow cytometry, and chest x-rays haven't shown a definitive diagnosis. I'm calling some veterinary oncologists now to see how long I might have to wait for an appointment. I'm just so frustrated at how long the diagnostic process is taking--part of me wants to just ask if they can prescribe some prednisone or an anti-inflammatory in the meantime to see if it helps with his symptoms.


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