Any idea what is wrong with ddog?

[CMOTDibbler]

Yes, he has been to the vet, 4 times so far, back on Friday - but they don't know what is going on.
A month ago, his (lurcher, 12 yo) lymph nodes came up under his chin and a temperature. Off his food (he is a total snowflake with food and it takes very little to put him right off).Vet thought salivary gland infection or a tooth maybe, prescribed antibiotics. Lymph nodes went down.
2 weeks ago, lymph nodes right up, back to vet, she found even more lymph nodes enlarged, biopsied for lymphoma
Biopsy came back with no concern, just inflammatory response. Vet says to wait and see what emerges
Last Thursday, noticed a scab on his snout, by Friday (back at the vets) he had lots of pustules on his snout and on his sides at the back, couple on a leg.
Blood tests all normal apart from raised WBC. Slide of exudate only shows pus. On antibiotics again. Vet has no idea what it is though.
No new pustules since Saturday, but original one is still draining. He's brighter in himself, but still only eating exactly what he fancies at that moment (has lost 4kg since October).

Any ideas hive mind? Or things that would make him feel brighter. I asked the vet if I should be bathing him in hibiscrub, but she wasn't sure, so have just been using sterile saline to wash the really manky one so far

Have the vets considered Alabama rot? It’s very rare but it is seen.

I did ask about it, but its not described as lymph nodes first, and his kidneys are working fine

Did your vet do a salivary gland washout? Our lurcher girl's neck was swollen a few years back and vet washed it out under LA followed by antibiotics. I'd never heard of this condition before. She's been fine since.

Strangles? Rare in an older dog but can happen.

No, after the generalised lymph node swelling they felt it was unlikely to be just a localised infection - but partly why he didn't get antibiotics at the time of the biopsy as well was to try and see where anything was - looking for a nice big juicy abscess to come up was the vets words

If it was just on his face, it would sound a lot like strangles. But the lesions on his back (but only from the end of his ribcage to the start of his tail, none on his tummy) don't fit. But I guess as puppy strangles is auto immune if he is weird enough to get it as a senior dog, theres no reason why something else weird could happen. He's on the right antibiotics anyway, and we discussed some steroids to try this week, partly just to give him a boost, so I will bring it up for sure

Does the biopsy done cover cutaneous lymphoma as well as normal lymphoma as that is rarer but sounds like it may fit .

It was an FNA of the lymph nodes only, so not cutaneous. But the skin lesions don't look like lymphoma (I've seen a range of human cutaneous lymphomas up close and personal, the vets had never seen them in real life), and most are healing now which wouldn't fit. They were coming up, bursting, and then scabbing - you didn't see the skin thing, just the scab/ exudate in his hair. No hair loss around them, no raising of the skin
There were also no weird lymphocytes visible on a slide of the oozy one - which isn't definitive of course.
His lymph nodes are right down now btw, only one neck one palpable

For anyone interested, ddog started very high dose steroids on Friday, and is looking (and feeling) much better. His really nasty skin lesions have all dried up, and he only has two which are open wounds now. The vet is still mystified, but wonders about pemphigus folcieus.

It does sound similar to my dog that had pemphigus foliaceus. His was confirmed by a skin biopsy.

It may have been coincidence but he had had his second dose of librela. Then started to come up with these horrid blister wounds starting on his nose and then spread over his body.

He had a course of high dose steroids (which caused other issues!) but the pemphigus foliaceus has never returned and he is no longer on steroids- much to our vets surprise.

As it is meant to be auto immune not sure how that works. Personally I will always blame the librela for kicking it off as he has been fine since stopping the librela!

It’s great news that he is feeling better , steroids are wonder drugs !

@IngGenius how long was your dog on steroids? Nothing had changed for ddog before this, though actually we were thinking of trying librela as his joints were getting more painful.

A lovely Lurcher you say??

@CMOTDibbler I cant remember exactly but several months. We began to cut them down and that took ages as he was on such a high dose to start with.

The steroids made him pile on the weight and he lost a lot of his fur. He was pretty off on the steroids. When we began to decrease them he got his love of live back again and his fur all grew back. 18 months on he is great and pretty good for a 14 year old collie.

Vet and I agreed not to put him back on librela (although no documented evidence that this was the cause). He is on galliprant and loving life again. He was out herding the geese this afternoon

The steroids made his sores go pretty quickly though.

That's great to hear that he's done so well. Weirdly, my dad had pemphigus vulgaris, diagnosed after one big flare in his 80's, and once it had been brought under control with steroids, he never had another one even though its supposed to keep going once started.
@Xmasisoffsantahascovid as his face is a bit manky still, heres a photo from a couple of years back which is suitably cute and festive

Oh that is interesting re your other dog.

Love the picture and hope he gets better soon

Ime Lurchers love clothes!!.

Our lurcher has just been diagnosed with lymphadenitis and put on steroids. He was really very poorly, could not walk etc but steroids have made a huge difference. He is starving on them though! Been on them 5 weeks so far and reducing every few weeks depending on blood results