Heres a serious question; if you had a lump growing on your arm (or leg, or head..) how big would you let it get before you thought to yourself “HMMMM, I better have my doctor take a look at this”? My guess is that it would not have to get very big, probably even so tiny that most people wouldn’t even be able to see it. We have this attitude about lumps and bumps on our own bodies because we have a healthy fear that things like that can be really bad and we need to have them checked out by our physicians so they can addressed quickly. We should have the same level of concern about our pets. This leads us to the next Top Ten Thing We Can Do To Keep Our Pets Happy And Healthy:
Let me take a minute to clear up what is often a confusing point with pet owners about what we call cancer. Cancer is cancer but not all cancer is bad cancer. We also refer to cancers as neoplasms; same thing. We break cancer into two main groups; benign or metastatic. Metastatic cancer is the bad cancer because it is the type that can spread to other parts of the body like the lungs or liver and that little bump on the skin can become something fatal. Benign cancers are the ones that grow in one place but don’t spread to other parts of the body. Some cancers have a variable metastatic potential meaning they may have a very low probability of spreading but have a small chance nonetheless. Benign cancers are usually no big deal unless they are in a place that, by their very existence in that location, cause a functional problem for the pet. For example, next week we will be removing a large lipoma (benign fatty tumor with no metastatic potential) from a dog that I adore, because the lipoma is growing in his pelvic canal and causing an obstruction which is affecting his ability to poop normally. I am bringing in a good friend who is a specialist surgeon for the procedure and we are optimistic about the outcome.
Our pets can get a countless number and variety of lumps and bumps on and under their skin that can be felt by their owners. In fact, after a certain age, it is somewhat uncommon to see a dog that doesn’t have at least one bump somewhere on its body. We commonly see age related masses and the ones we see most commonly are benign. However, certain breeds of dogs (and for this discussion we will focus mainly on dogs because cats don’t get nearly the number of skin masses that we see in dogs) are more prone to masses, and boxers in particular grow cancers more than any other breed. If you have a boxer let me tell you right now, every lump and bump they get needs to checked out immediately. Boxers are big cancer factories and they get serious cancers at an alarming rate. I have a client with several boxers and we have done multiple surgeries on their dogs to remove skin masses. The last surgery I did on one of their dogs was to remove three suspicious masses which we sent to the lab for analysis. It turned out that the dog had three distinct types of cancer at the same time, all of them significant.
On older dogs, I frequently see wart type lesions. These are benign and normally I leave them alone unless they get large, start bleeding, are in a location that the pet can irritate them by licking, or they are in a location that they are repeatedly irritated by combing or brushing. If the pet is at all cooperative I can remove them with a local anesthetic. Poodle owners take special note here. Poodles all seem to get these as teenagers.
Owners of older Labs and Golden Retrievers should be on the lookout for lipomas. Again, these are benign fatty tumors that are usually left alone but I have seen many that have gotten so large that they either cause problems with walking or can actually fracture and become infected. Any breed of dog can get them but Labs and Goldens are particularly prone to them. Folks, do not wait until your dog has a tumor the size of a cantaloupe before you bring it in for attention. I have seen tumors the size of a football that are ruptured and bleeding that the owners swore “It just came up overnite!” It is much safer and cheaper to remove a small mass than a large one.
The biggest problem with tumors that veterinarians face is that we can play the odds about how something feels, the age of the dog, the location of the mass, or the breed of the dog and make an educated guess about what it is and whether or not it is serious, but ultimately I can not tell with 100% certainty what a mass actually is without some form of biopsy. Not all masses require immediate surgery and in some cases, i.e. an old dog with a bad heart, surgery as a first option is a bad idea. In most cases we will do what is called Fine Needle Aspirate. That’s just what it sounds like. Without anesthesia, I will take a small needle and stick it in the mass and draw out some cells, put it on a microscope slide, send it to the lab and have them tell me what it is. If its benign, we can decide if we should remove it for whatever reasons, or if it is malignant, we know we have to do more aggressive surgery to get clean margins (margins with no cancer cells) all around the mass we are removing. From there, we can have a discussion about additional treatments like chemotherapy or radiation therapy.
Keep in mind that not all bumps are cancers. I see many dogs with sebaceous cysts, infections, normal anatomy that an owner discovers like a lymph node, foreign bodies (I have seen several dogs and cats that had been, at some point, shot with a BB gun and the owners could feel it under the skin), vaccine reactions, or bug bites. So don’t panic if you feel a bump but have it checked out by your veterinarian!
As I was writing this article I got called away from my desk to see an appointment. The patient was a VERY pampered Shih Tsu that the owners treat like their only child. They discovered a small mass in his groin while they were grooming and became rightfully concerned. Examining the mass I cant tell what it is and because of its location I don’t want to stick a needle into it. He is scheduled for surgery next Friday. That’s what I consider to be responsible pet ownership.