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Old May 17th, 2008, 04:49 PM
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Giant Lipoma

I joined today for the first time and have two questions to ask that I will post separately. I have an 11 year old female English Springer Spaniel named Pepper, who I adopted 2+ years ago from a shelter. She is in my avatar. Unlike most shelter pets she was an owner surrender due to the fact he was going into a nursing home. When she arrived we found that she had lumps in several locations on her body that had been diagnosed as Lipomas. My vet agreed with this diagnosis and told me that they shouldn't cause a problem and they were common in some dogs.

One of the lipomas is behind her right shoulder and has grown very large. She has been examined by my vet on several occasions and each time we have discussed surgery. This particular lipoma has now grown to the size of a soccer ball and still appears to have no malignancy involved. My vet has had a lot of experience removing Lipomas but she is very reluctant to operate on Pepper because of the potential for bleeding post-op. She is afraid that with the size of this one, Pepper will bleed to death during surgery. The largest one that my vet has removed is about the size of a softball and she says she has never seen one that is as big as the one Pepper has.

Does anyone have any experience with a giant lipoma, what course of action was taken, how did your pet do after surgery. I did find one post here in the forum about a Giant Lipoma and the surgery, and if you refer to the pictures in that post, Pepper's is very similar. (I can't post URL's yet).

At the moment my vet is saying no to surgery but she is really on the fence about it. She has now decided that I need to bring Pepper in every 4 weeks to check it and knowing my vet the way I do after 17 years of caring for my pets, I think she will decide to operate (with my permission of course) after seeing Pepper a few more times. I don't want to lose Pepper, but this "lump" is getting way out of control and will impede her movement before too long, I expect.

Thanks for any information!
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Old May 17th, 2008, 05:24 PM
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Welcome to the forum!

I believe that there was a post last year that was similar to this - somewhere on here.

The largest one I have removed was an 8 pound basketball sized lipoma. The dog was a golden retriever that was about 11 years old. The lipoma was so large it was 50% the thickness of her hind end. The owner decided on surgery because the poor dog kept falling over due to the weight. The dog did fantastic. I have not ever had problems with excess bleeding with lipomas. Even without the use of a laser, typically they can do very well. (the 8lb one was done without the use of a laser).

Lipomas are benign fatty tumors. When you look at them they are almost all fat with very little blood supply. In fact if during surgery, large blood supplies are found, then the concern of malignancy would be raised. The largest complication I have had with giant lipomas is closing the space that the lipoma once filled. It takes a lot of time, often removal of excess skin and for giant lipomas, the addition of penrose drains.

As with all major surgeries, platelet count, protein level and bleeding times should be done preoperatively.

You said the tumor was behind (caudal) to the shoulder? Not under the arm pit correct? Under the armpit is a much more difficult surgical area. If the mass is behind the shoulder where the ribs are - this is actually a fairly good surgical area. Post operative exercise restriction can help with minimizing post operative swelling and drainage.

To date, I have never had excess bleeding issues with giant lipoma removals. Of course every case is different. If your vet and you are concerned about the surgery, then perhaps consultation with a local surgical specialist may help.
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Old May 17th, 2008, 08:16 PM
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Thanks so much for answering Dr Lee. I found that post you refer to and was very interested in your response to it - that is actually the reason I decided to finally join and ask about it.
The link to the other post you mentioned is:
http://www.pets.ca/forum/showthread.php?p=490965
and from the pics I see there the last picture at the bottom is almost identical to the position of the mass in January of this year and it now has dropped down so that the top of it is about 4 inches lower exposing a normal curve from her spine. It is growing quite rapidly now but my vet saw her yesterday and felt that it was still all lipoma.
If I was able to post some pics I would take them and post them but I think at present because I am new I can't post attachments. I will see about taking a few and posting them on my website with a link to them.
Unfortunately at the moment Pepper is suffering from an injury that occurred last Sunday when I fell on her and may not be too co-operative with pictures being taken. However, I will find a way to post some.
thanks again!!
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Old May 17th, 2008, 08:50 PM
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dbg10,

If you would like you can also PM the pictures to me here or directly to my email address (I can give to you). Then I can look at them and also post them on here for you and everyone else to see. I cannot PM you - I wonder if that is the reason you are having problems loading pictures. Perhaps someone else that understands the computer stuff better than I can help out. I usually just click on the button 'manage attachments' just below this box and I am able to place pictures in.
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Old May 17th, 2008, 09:32 PM
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Thank-you Dr Lee, unfortunately I haven't got an IM program active at the moment and it would take me longer to install and get it ready to use than posting them on my website. I posted them here:
Pepper and hope they are enough for you to see.

She was not at all co-operative because she is trying to avoid me when I am standing because of my fall on her and every time I went to take a picture she got up and walked away or just gave me dirty looks. She wouldn't stay standing long enough to take one of her standing but maybe I can get more later.

I think you can probably save the pictures I took to your hard drive so that you can study them.
Dodi
I really appreciate this, you have no idea how much!

thanks again

BTW I think the reason I can't post them by attachment is the restriction because I am new here. Maybe soon I will be able to use it after more posts.
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Old May 17th, 2008, 11:15 PM
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Pictures show up nicely. That is indeed a large or 'giant' lipoma. Assuming that she is in otherwise good health, that should still be removable. With the concern of your veterinarian in mind, do you have a surgical specialist in your area?
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Old July 27th, 2008, 08:41 PM
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I am sooo glad I waited for the results of Pepper's blood work before acting on my urge to have her giant lipoma removed. Pepper's results came back on Friday and she is now showing signs of Kidney disease with her creatinine elevated and other kidney blood work were all not good. Her Thyroid function is also affected with her results in the below normal range. It made me almost cry to think I would have put her through major surgery only to have her die on the table. It may not have happened, but the more bad results I hear from her vet exam and blood work the more I think I would have lost her during the surgery.

We have now put her on a kidney diet and will be retesting her thyroid function in a few months. We have also added metacam for her joint pain as the previcox made her vomit with every pill. I now hope she lives a year or two with the new diet and medication and know she will be happier without major surgery to remove her lump. Yes she might live longer with the surgery, but I also might have lost her then too. I think my instincts told me that her health was not as good as what it appeared to be and I know if her blood work had come back normal I would have sent her for the surgery without hesitation. She is a lovely dog and I am going to enjoy having her with me for as long as she lives. Hopefully she won't suffer with the size of the lipoma, but in actual fact she is now more active since it has dropped down her side and she seems to be enjoying life much more.

I would like to thank Dr Lee for his opinion and help with her Giant Lipoma. Maybe if she had been mine when she was younger I would have caught the lipoma much earlier and followed up with the surgery. I have experience with older dogs having surgery as my previous dog had surgery when she was 9 and then again when she was 12 1/2. It was my gut feeling that this would go wrong right from the start that stopped me.

I went with my gut instincts when making this decision and I believe I have been rewarded with a wonderful ESS for longer than she would have lasted if I had made the decision to have her operated on. I have always tended to listen to my gut instincts and they have usually told me what I need to do.

Thanks to everyone who gave me advise for Pepper. If anyone has any experience with kidney disease in a dog, please feel free to comment.
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Old September 18th, 2008, 05:37 PM
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Well here we go again we're back discussing surgery with my vet. Pepper had gone on an eating strike after we switched her to Hill's K/D both canned and dry and was eating very little. She seemed depressed so I started adding some homemade food and she perked up but she still wasn't eating much. She lost more weight and became almost boney so I decided to make her a homemade kidney diet, alternating between beef and chicken with rice keeping the protein and phosphorus levels in her food down.

After a week of this diet which she gobbled up because she loved it so much, I took her in to my vet for a baseline weight. She is now down to 67 lbs including the Lipoma but she has gained a few pounds after eating good food for 10 days. During the examination my vet found her heart murmur is now very mild a grade 1 to 2 at the most and she is happy and active again.

When Pepper walks now the lump moves independently from her body and is starting to affect her ability to walk properly. The great thing my vet found was that she could almost put her hands around the entire Lipoma. Her hands almost met behind the lump so she has decided that if she continues to gain a bit of weight over the next few weeks and remains happy and active, she will do the surgery to remove the lipoma! She is not going to try to get it all, but she said she will debulk it and remove as much as she can.

The only issue is whether Pepper will be able to withstand the anaesthetic, but my vet believes that we will lose her in the next few months if the surgery is not done. So we are going to take the chance as long as Pepper is still eating and healthy in a few weeks. I am really happy and excited about the fact that Pepper may be able to move around without the huge lump.

I am attaching a couple of new pictures of Pepper's Lipoma. In case you are wondering she has her toy carrot in her mouth in the first picture
Attached Images
  
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Last edited by dbg10; September 18th, 2008 at 05:38 PM. Reason: addition to post
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Old September 18th, 2008, 08:38 PM
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Quote:
Originally Posted by dbg10 View Post

The great thing my vet found was that she could almost put her hands around the entire Lipoma. Her hands almost met behind the lump .
omg that is a good news ! Can you imagine her without the lump ? She will be walking on !!! Good luck to you and Pepper and please keep us posted !

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Old September 18th, 2008, 10:19 PM
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That is good news, dgb10! More coming Pepper's way from hazel and the Pack!
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Old September 19th, 2008, 12:49 AM
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Sending some more for Pepper
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Old October 28th, 2008, 09:34 AM
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Well she's out of surgery but things are still very touch and go because she lost a lot of blood. The incision runs from her spine down to her belly with one drain at the bottom of the incision. The actual Lipoma was lighter than my vet had estimated but it still weighed 10 lbs.

My vet found that she had been right about the cause of her anemia, she found a large pocket of blood and vessels between the Lipoma and her body because as the Lipoma had pulled away, blood vessels were torn and the pocket of blood formed and Pepper had been bleeding into this pocket. We were supposed to go and pick her up between 4 and 6 pm but my vet said she now doesn't want to move her for 24 hours so Pepper will be staying the night at the vet. We may go over later to see her, but I think it is probably important not to move her or get her excited today.

So we pray and pray some more that she will make it through the night.... Pepper is now lifting her head after the surgery and seems to be holding her own.
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Old October 28th, 2008, 09:40 AM
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Now that the weight of the lipoma isn't stressing those bleeders, that they just dry up and heal! for Pepper. s for you. And s for both of you!
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Old October 28th, 2008, 09:50 AM
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Still keeping Pepper in my prayers. After a surgery like this it is best for her to remain calm, but she'll heal fast.
Keep us posted..
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Old October 28th, 2008, 10:30 AM
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Thanks everyone for your I hope to be able to post some pictures when she comes home. It will be amazing seeing her without her huge lump on her side and I am hoping that without it, she does really well. My vet also said that her kidney failure could also be from the stress of the Lipoma and her overall health may improve now that its gone. Here's hoping she's right!
I'll let everyone know once I call or visit this afternoon.
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Old October 28th, 2008, 11:11 PM
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It's a good thing that you got her in fairly quickly for surgery then, she could've bled out.
I'm glad the vet has kept her overnight, this will help her on the road to recovery a little faster and it never hurts to have her checked on during the night
More for a good recovery & this helps w/the kidneys too
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