Dog
has a skin lump - cat has a skin lump -
Dog and cat articles on Pets.ca
Evaluating
and treating dog and cat skin lumps - Dr. M. Slome DVM
Skin lumps are one of the most common conditions that Veterinarians
are faced with on a day to day basis.
A general approach to lumps is to determine whether there is a
malignancy or if they are benign - is it 'black or white'. The
very big problem that health professionals are faced with is that
most of them are 'grey'.
It
is for this reason that often it is recommended to have these
lumps evaluated and rather be over cautious
than ignore the problem until it really does become a problem.
Evaluation of the skin lumps may firstly entail doing what is
known as a Fine Needle Aspirate. This is a technique which involves
sticking
in a large type needle through the centre of the lump after it
has been surgically prepared (shaved and disinfected) and using
a larger syringe to apply negative pressure (sucking up hard
with the syringe) to try and obtain at least enough material
from the
lump to place on a slide, smear the content in a thin layer,
stain it and have it evaluated under microscope. The unfortunate
problem
with this technique is that it is only 50% accurate since the
slide may be non diagnostic if the tissue is too dense and cannot
pick
up an adequate sample from the lump.
The next option is to take a biopsy of the lump which means
removing a piece of tissue from the lump surgically and
send it off to the pathologist for evaluation.
Once the result is obtained, it may be more scientifically determined which
course of medical intervention would be best.
The next option is to surgically remove the whole lump and send it in for
evaluation to determine the prognosis of full recovery. Often this latter
option is the
most preferred as it will remove the whole lump and pathology will give a
definite answer. To do a biopsy will usually require a general anaesthetic,
and if you
are going to that extent, you may as well remove the whole thing then rather
than have to operate a second time. There are exceptions though when it is
actually advised against to remove the lump before doing a biopsy first to
determine what you are dealing with and this is something that only experienced
professionals are sometimes able to determine.
My
approach to evaluate lumps involves a careful history and clinical
examination of the lumps. It is essential to find out:
1. Does the lump bother the pet. Is it painful, itchy or
tender. Is there an appearance that it has been chewed at or licked
at
incessantly and caused the lump to be traumatized and bleeding
and raw. If there is no history of the lump being traumatized,
then one has to consider that there may ulceration of the lump
which generally means a less favourable prognosis. It is for this
reason that it is important to provide as accurate information
as possible to you Veterinarian. My approach is that if it bothers
the pet, have it sorted out - either surgically removed or aggressively
managed medically and if it does not respond within a short space
of time, don't wait - remove it. I would rather removed a small
irritating lump that the pet is bothered by than a large one that
is not bothering the pet and would appear to be benign based on
experience.
2. How long has the lump been there. Older lumps that don't look
good now are less favourable. Newer lumps may be from self trauma
again - may be itchy skin from allergies, cuts, scrapes, insect
bites, injection sites from previous vaccines. Newer lumps may
be treatable with non surgical options and seeing as they arose
recently and quickly, you generally have the option of trying medication
of just observation for a determined period of time, before deciding
to take further action. My general approach to a lump that has
arisen suddenly: if it turns out to be malignant and is so aggressive
that you do not at least have 1-2 weeks to try conservative treatment,
then I don't believe there is a good chance of recovery however
soon it was surgically removed once diagnosed.
3. How old the pet is. Middle to older pets have a greater chance
of having malignancies.
4. Location of the lump - whether over the mammary tissue, lymph
glands and whether it is more deeply located under the skin in
the muscle tissues, these need to be addressed more urgently.
5. The owners play a large role in determining the next
step. Often a lump may be tiny and look like a benign pimple but
the owner
is very concerned. The Veterinarian has to recognize this and while
he/she may feel it is likely something that can be monitored for
a period of time, it may not be worth the stress of the owner to
endure and rather pick up on the feeling of the owner. To have
a benign lump removed because the owner is worried is not harmful
to the pet and as long as the owner perceives the cost of this
to be acceptable, it is prudent to rather remove the lump and be
safe. On the flip side, there are often large, ulcerating lumps
that are not healing, been there for months and seem obviously
more serious, and the Veterinarian will strongly advise to have
the lump evaluated as soon as possible. The owner may elect not
to pursue this farther but understand the future consequences to
the decision. Often the decision would be financially based. It
is quite sad and funny at the same time though, when finances are
not an issue and while recommending more immediate action, owners
may still opt to not do anything. On a 15 year old pet it is understandable,
on a 6 year old pet, I often wonder why the owner has brought the
pet in if they do not follow sound advice. I guess what I am trying
to say here, is that a client/Veterinarian is most important to
make a sound decision. You need to trust your professional health
provider.
There are no easy answers to deciding when a lump should be investigated
or removed. The above points should help you decide when it is
time to act though. Be prepared in some cases to have to spend
money to find out, but don't resent the Veterinarian if the result
comes up with something benign. If you trust your Veterinarian,
you will know he/she has merely acted out of concern and in your
pet's, a valued family member's, best interest.
There are so many different types and causes of lumps to mention
them but here are a few that are more commonly encountered in practice.
Benign: Sebaceous cysts, Hair follicle cysts, Folliculitis (looks
like measle bumps with fur falling out over the bumps), common
wart, Sebaceous hyperkeratosis (look like raised pink pimples of
different sizes and have creases in them that looks like cookie
dough), Epulis (nodular growths in the oral cavity)
Malignancies: Mast Cell tumours, Basal cell tumours, skin or lymph
gland lymphomas, melanomas
I hope this gives some general insight whether to remove or observe
skin lumps.
Martin Slome DVM
Centre Street Animal Hospital
7700 Bathurst Street
Units 40-42
Thornhill, On.
L4J 7Y3
Tel: (905) 771-9855
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2007
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