Lumps and Bumps

Given the opportunity to examine an older dog, I’ll very likely find at least one or two cutaneous (within the skin) or subcutaneous (just beneath the skin surface) lumps and bumps. Such growths are common by-products of the aging process. In this regard, I liken them to the brown spots that appear on our skin as we get older.

The good news is that most cutaneous and subcutaneous canine tumors are benign. It’s that small population of malignant masses that keeps us on our toes. They are the reason it’s important to have your veterinarian inspect any newly discovered lumps and bumps your dog develops. The smaller a cancerous growth is at the time of treatment, in general, the better the outcome.

Pet your dog!

In terms of “lump and bump patrol,” your first order of business is to pet your dog. No doubt you and your best buddy already enjoy some doggie massage time. What I’m asking you to do is a more methodical petting session. Once a month, slowly and mindfully slide your fingers, palm sides down, along your dog’s body. Move systematically from stem to stern while inspecting for any new lumps or bumps.

Also, look and feel for changes in the size or appearance of those previously discovered. Any new findings should be addressed with your veterinarian who relies upon your help with this surveillance. Imagine your vet trying to find a tiny growth on a shaggy Sheepdog or Sheltie during the course of a single exam. Some lumps and bums are bound to be missed without your assistance.

When to see your veterinarian

Does finding a new growth mean that you must see your veterinarian right away? Not necessarily. Say that you’ve just spotted a new bump in your dog’s skin that is the size of a small pea. She is due for her annual physical examination in three months. Must you go rushing in this week with this new finding, or can it wait the three months? The answer depends on the behavior of this newly discovered growth.

My recommendation is that you continue to observe the new lump once a week. Examining it more frequently can make it difficult to accurately assess change. If the mass is growing, or otherwise changing in appearance, best to have it checked out sooner rather than later. If no changes are observed, waiting to address it at the time of the annual physical exam makes perfectly good sense.

In contrast, say that in the course of examining your best buddy you discover a prune sized, firm, subcutaneous growth that feels attached to her shoulder blade. Based on the larger size and deep attachment of this mass, better to have this one checked out right away. If in doubt, contact your veterinarian to figure out the best course of action. As with most things medical, better to be safe than sorry.

In advance of your veterinary visit, be sure to mark the location of any lumps or bumps requiring inspection. You can clip some hair over the site or mark the fur with a ribbon, hair band, or marking pen. Growths discovered at home when an animal is lying down in a relaxed, comfortable position have a habit of magically disappearing when the dog is upright and uptight in the exam room.

Fine needle aspirate for cytology

If a newly discovered growth is large enough, the usual first step your veterinarian will recommend is a fine needle aspirate for cytology. The purpose of this step is to attempt to noninvasively clarify the cell type within the mass, and whether it is benign or malignant.

Collection of a fine needle aspirate is a simple process that is easy on the dog and rarely requires any sort of sedation. Using a needle no larger than the size of a vaccination needle along with some gentle suction, your vet will remove a smattering of cells from the growth. These cells are then spit out onto a glass slide and evaluated under the microscope.

Some cytology interpretations are a slam-dunk, and can readily be interpreted by your family vet. Others require the eyeballs of a specialist- a clinical pathologist who works in a veterinary diagnostic laboratory. Remember, the goal of the cytology testing is to determine the underlying cell type, therefore whether the growth can be left alone or requires more attention. Fine needle aspirate cytology is often (but not always) definitive. If the results do not provide clarity, a surgical biopsy of the mass may be recommended.

If your veterinarian recommends surgical removal of a mass as the very first step (chooses to forego the fine needle aspirate), I encourage you to consider getting a second opinion. It is always disappointing and frustrating when a veterinarian foregoes cytology, proceeds with surgery, and the biopsy report reveals a malignancy with cancer cells extending beyond the margins of the tissue that was removed. In other words, cancer cells were clearly left behind. Had the veterinarian known in advance from the cytology report that the tumor was malignant, a different approach (much more aggressive surgery and/or radiation therapy) would have been undertaken, almost certainly resulting in a better outcome.

A second “bad news scenario” that can arise from forging ahead with surgery without benefit of fine needle aspirate cytology is failure to identify a cancerous growth that may have already spread elsewhere in the body. If the cytology reveals a malignancy, screening the rest of the body for metastasis (spread) is the logical next step. If metastasis is discovered, removal of the originally discovered mass is unlikely to provide any benefit. Rather, such surgery will only subject the patient (and the client’s pocketbook) to a needless procedure. Leaping into surgery to remove a mass without the benefit of cytology is risky business.

The importance of histopathology

If your veterinarian surgically removes a growth from your dog, do not, I repeat, do not let that tissue sample wind up in the vet clinic garbage can! A far better choice is to have the mass submitted to a veterinary diagnostic laboratory for histopathology (biopsy). There, a veterinary pathologist will evaluate paper-thin slices of the mass under the microscope to confirm the identity of the mass.

Even if a fine needle aspirate cytology indicated that the growth was benign, histopathology is warranted. On occasion, the pathologist discovers something quirky such as a malignant tumor within the center of one that is benign.

If histopathology is not affordable, ask your vet to place the growth that was removed in a small container of formalin (preservative) that you can take home for safekeeping. This way, should multiple masses begin growing at the surgery site or should your dog develop a tumor at another site, you will still be able to request histopathology on the original sample. Formalin is toxic stuff, so keep the container lid sealed tightly.

Lumps and bumps are a very normal part of the canine aging process. Teaming up with your veterinarian to assess them on a regular basis is the very best way to insure that they never create a health issue for your wonderful dog.

Does your dog have any cutaneous or subcutaneous masses? If so, have you had them evaluated by your veterinarian?

Best wishes,

Nancy Kay, DVM

Diplomate, American College of Veterinary Internal Medicine
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Author of Your Dog’s Best Health: A Dozen Reasonable Things to Expect From Your Vet
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot and Your Dog’s Best Health.   There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot and Your Dog’s Best Health are available at www.speakingforspot.com, Amazon.com, local bookstores, and your favorite online book seller.

 

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8 Responses to “Lumps and Bumps”

  1. The speakingforspot dog pictured on the Lumps and Bumps article by Dr. Kay has the most beautiful blue eyes we have ever seen! They talk about Frank Sinatra’s blue eyes — they never saw the blue eyes of Dr. Kay’s dog!

    We are writing a story about our departed dachshund Lalita and were stuck in her lumps and bumps section. This Lumps and Bumps article came at a perfect time and was excellent, but blue eyes stole the show! Where’d he get those eyes?

  2. KT says:

    Thanks for a well written primer on lumps and bumps. I appreciate your advice on how to flag the oddities for vet follow up especially now that i have 2 seniors and it seems like I discover a frightening oddity almost weekly.

    It was also a timely article to share with a friend, whose dog developed a mystery bump that is suspicious. She sends her thanks as well

  3. speakingforspot says:

    Dear Cindy,

    Thanks for sharing your heartfelt experience in response to my blog post. I suspect that what I wrote likely hit quite a nerve for you given all you and Chanel recently experienced. Know that my heartfelt very best wishes are with you during this difficult time.

    Take good care,

    Dr. Nancy

  4. Cindy Pina says:

    I just lost my 12 yr old Toy Poodle on April 10th. Her name was Chanel . Chanel has had a few rough yrs . When she was 8 went blind , then when she was 10.5 she lost one of her eyes because it “ruptered”, at that time she had a fatty tumor removed on the right side of her butt. The Vet said it was a fatty tumor. A few months later she got another one , which we didn’t think was to serious but we kept our eye on it. A few months later the lump got infected and we were told it had to be removed. But since Chanel had been thru so much with her eye removal and other tumor we hesitated. Then all of a sudden 2 more lumps appeared, they were all on her spinal bones.
    So we took her in to see the Vet since she was due for her annual exam anyway. He suggested we have her operated on right away. I was hesitant because she already had a partial Trachnea collapse and coughed a lot plus she was on Phenobarbital for seizures. The day we brought her in she acted very anxious, it should have been a sign. Chanel went in for her operation and before it was completed her little heart gave out and she died. I always kept up with her check ups I always thought I was doing the right thing . The last two lumps were different then the originals. They were more reddish in color and grew a lot faster. I just wish I had gone with my instincts and waited longer, but I was so afraid of her getting infected again. Since Chanel lost her eye her quality of life changed dramaticly even tho she had gone blind she still managed to go for walks and play in the yard. I would often tell her I wasn’t giving up on her just because she was 12 yrs old, that she had a lot of time left. I was wrong.

  5. speakingforspot says:

    Thanks for sharing your experience with your own dog in response to my blog post. No fun, and I’m sorry you and your Sadie are having to deal with this. Making good decisions in a situation like this is always difficult. If you happen to have a copy of Speaking for Spot I encourage you to read the chapter called, “When the Diagnosis is Cancer.” It might help guide you through this challenging decision making process.

    I hope all goes well and I will be thinking good thoughts for Sadie.

    Best wishes,

    Dr. Nancy

  6. Jane Eagle says:

    When I first moved here (30 years ago) I went to a new vet, who insisted that all the small benign fatty tumors on my first dog needed to be removed. After the 3rd surgry on my healthy dog, I finally went to a different vet, who told me it was unnecessary to remove them. Guess that vet had a boat payment coming up. I still bad-mouth that unconscionable vet. I watch my dogs lumps and bumps carefully; as as I always say, my motto is “when in doubt, go to the vet!”. I have found that the rare lump that looks like a wart does in fact need to come off ASAP.
    I have a friend in my women’s group who spoke about her elderly ill cat, and all the treatments they were putting her through. I gently asked why she didn’t just put her down rather than let her go through all that suffering, and she said the vets were hopeful (about what? That she would magically get younger???). She later learned that the vets at that “hospital” get a bonus for every test and treatment they order. When she took her cat elsewhere for a second opinion, they reccommended euthanizing her immediately. In my opinion, those vets at that hospital should be horsewhipped. I have avoided that place for years, after they refused to treat an emergency case until I came back and paid them the cash first!!! In an emergency, I go to the local VCA, which is expensive but excellent.

  7. Sky Benoit says:

    My 10 year old Schipperke had a lump I discovered on him that was about the size of the palm of my hand. I’ve had him about 3 years and never really noticed the lump before, so don’t know how long it had been there. The lump was kind of flat kind of like a cookie (like a raised area with a flat top) which may be the reason why I didn’t notice it before. My vet recommended having it removed and sent to a lab. This was done and the lump turned out to be benign which was a big relief. My vet did mention to me that I could have her do an aspiration, but said that wasn’t always accurate and that she highly recommended the surgery. I’m glad I went with the surgery. So far I have not found anymore lumps on him anywhere. One thing that I have noticed though is that his coat has grown back in where the lump was removed, but has not grown back in on the area surrounding that spot. I’ve never seen that happen before in any dog. The lump was removed in December 2013. Bloodwork and a thyroid check were done before his surgery.

  8. This is very timely as we are dealing with the discovery of a neurosheath sarcoma on the left wrist of our 11 year old lab mix. It was removed but with very narrow margins (less than 2mm) and the pathology report indicated that it would most likely return unless Sadie have readiation treatment. We have had a consult with Oregon State Veterinary School oncologist. It was informative and yet still has us wondering what the best course of action would be. Radiation is out, not only expensive, it would require 3 weeks of daily radiation with Sadie being anesthisized. That would be hard on a dog her age. Another option is low-doseage chemo to slow the grownth of another tumor and the third choice is to take a wait and see if it grows back and then have it surgically removed by a specialist in soft tissue. There are a couple of options the surgeon could explore which would allow for greater margins but longer recovery from surgery. There was a complication from her first surgery, an infection developed and the incision did not heal. So we have been doing wound therapy, changing a dressing every other day and applying menucha honey on the wound along with antibiotics. Our delimna, do we go ahead with chemo or take a wait and see approach? We have received much advice from both ends. At this point we are thinking about quality of life and not necessarily quantity so may just plan on providing a lot of good times these next years and not subject her to the chemo although it is low-dose. These decisions are very hard and we waffle every day. We cannot begin treatment if we decide on that until the incision properly heals.