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Clinical Examination of Farm Animals - CYF MEDICAL DISTRIBUTION

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CHAPTER 3<br />

<strong>Clinical</strong> <strong>Examination</strong> <strong>of</strong> the<br />

Lymphatic System<br />

Lymphatic system<br />

The lymphatic system consists <strong>of</strong> the carcase lymph<br />

nodes, the network <strong>of</strong> lymph vessels which connect<br />

them and the lymphatic parts <strong>of</strong> the spleen. Many <strong>of</strong><br />

the nodes are readily palpable in the healthy animal.<br />

Others can be palpated only when enlarged. Details<br />

<strong>of</strong> the location <strong>of</strong> the individual nodes and their ease<br />

<strong>of</strong> palpation are given below. The lymph vessels are<br />

normally palpable only if they are enlarged. Some<br />

vessels may be seen and palpated as they run subcutaneously<br />

towards the regional lymph nodes.<br />

<strong>Clinical</strong> examination <strong>of</strong> the<br />

lymphatic system<br />

Grossly enlarged lymph nodes may have been seen<br />

during observation <strong>of</strong> the patient before it is handled.<br />

Further observation and palpation is possible when<br />

the animal is restrained. The lymph nodes can be examined<br />

as a separate system or checked during the<br />

examination <strong>of</strong> the skin when the clinician’s hands<br />

run over the whole body surface. Each paired node<br />

should be compared for size and consistency with<br />

the contralateral node.<br />

Lymph node enlargement<br />

This may occur for two main reasons.<br />

(1) Enlargement <strong>of</strong> one or more lymph nodes may occur<br />

in cases <strong>of</strong> infection <strong>of</strong> the lymphatic system. This<br />

can occur in a number <strong>of</strong> diseases including<br />

bovine tuberculosis, actinobacillosis and a number<br />

<strong>of</strong> other bacterial infections. It can also occur<br />

in both forms <strong>of</strong> bovine leucosis – enzootic bovine<br />

leucosis (EBL) and sporadic bovine leucosis. EBL is<br />

an uncommon but notifiable disease in the UK.<br />

Infection is widespread in some other countries.<br />

Any animal over 2 years <strong>of</strong> age with enlargement<br />

<strong>of</strong> the carcase lymph nodes and in which bovine<br />

leucosis is suspected is blood tested for serological<br />

evidence <strong>of</strong> EBL. Positive cases <strong>of</strong> EBL are<br />

slaughtered.<br />

Cases <strong>of</strong> sporadic bovine leucosis may be examined<br />

further to determine which carcase and palpable<br />

visceral lymph nodes are involved. Gross<br />

lymph node enlargement may be seen, for example,<br />

in the prescapular lymph nodes. In most<br />

cases some enlargement is present in other<br />

lymph nodes. Ulceration <strong>of</strong> affected lymph<br />

nodes may occur. Areas <strong>of</strong> tumour tissue may be<br />

seen in the skin and in the thymus. Internal lymphoid<br />

tumours may be found in many locations<br />

including the heart base, the mediastinum and<br />

wherever lymph nodes are present. Affected<br />

lymph nodes are usually non-painful to the<br />

touch but may interfere with many body functions.<br />

Heart base and thymic tumours may<br />

obstruct venous return. Mediastinal tumours<br />

may compress the oesophagus causing bloat or<br />

dysphagia.<br />

(2) Lymph node enlargement in response to local infection<br />

or inflammation in the region <strong>of</strong> the body drained<br />

by the lymph node involved. In these circumstances<br />

the lymph node is acting as a sentinel <strong>of</strong><br />

local disease. The enlarged node may be warm<br />

and inflamed, and sensitive to the touch. On finding<br />

an enlarged lymph node the clinician should<br />

examine the area draining into the affected node<br />

for evidence <strong>of</strong> any pathological problem. As<br />

with tumour infiltration, the enlarged lymph<br />

nodes may affect the function <strong>of</strong> adjacent organs.<br />

Location <strong>of</strong> the carcase lymph nodes<br />

Many <strong>of</strong> the nodes are paired and should be compared<br />

for size and consistency. Lymph nodes are<br />

normally firmer than adjacent muscle and other s<strong>of</strong>t<br />

tissues (Fig. 3.1).<br />

12

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