What to do when you find a lump

96af5dbf-e38a-4216-a84c-2ece3517fc20By Dr. Sue Ettinger, DVM, Dip. ACVIM (Oncology)

When people find lumps on dogs and cats, they often panic. It’s easy to assume the worst. And then we often avoid finding out more. But really — what should you do?

Get lumps on dogs checked by a veterinarian, ASAP. Most of the time the lumps are benign. But when they’re not, the longer you wait to get them checked out, the worse the situation becomes.

Watch and wait approach

What should you do if your veterinarian wants to “watch and wait” or flat out refuses to test those lumps for cancer?

Best case scenario: the lumps really are nothing to worry about and your dog is fine, just a little lumpy.

Worst case scenario: your dog or cat has cancer and misses a window of opportunity to get early surgery. Early surgeries are smaller (so less expensive) and, depending upon the location and cancer type, can often cure cancer.

This “watch and wait” attitude is something I am hoping to turn around because it’s not good for dogs and it’s not good for dog lovers. Not even the most experienced veterinarian or cancer specialist, like me, can look at or feel a mass and know if it is cancer or not.

We must sample lumps and evaluate the cells under a microscope to determine what they are. There is no other way to know whether a lump is benign or malignant. Your veterinarian must perform a fine-needle aspirate and/or a biopsy to make an accurate diagnosis. If your vet is unwilling to do an aspirate, I suggest you find a vet who will.

Although cancer may be the No. 1 killer of dogs, there are so many things we can do these days for dogs with cancer. That’s why Dr. Dressler and I wrote The Dog Cancer Survival Guide, which is full of practical advice from all over the spectrum including not only my specialty — chemotherapy — but also surgery, radiation, diet, supplements and even mind-body strategies.

Fine needle aspirates for lumps on dogs

Aspirates are important and can help identify many types of tumours. They’re also quick, just a tiny needle inserted in the lump, and they aren’t expensive and don’t require anesthesia.

I know, it’s scary to think that the lump can be cancer. But the sooner we determine whether a mass is cancerous and should be removed, the better for your pet. Most skin and subcutaneous (just under the skin) tumours can be cured when diagnosed early, when masses are small.

Many dogs and cats have lumps and bumps, and not all of these masses are malignant (cancerous) tumours. In fact, most tumours are benign (not cancer).

So if you find a lump while petting your pet, or your veterinarian finds one during a physical exam, don’t just monitor it. If you “See Something, Do Something.”

See Something, Do Something. Why Wait? Aspirate.

“See Something Do Something” is a set of guidelines I have developed with the input of my colleagues to help owners and veterinarians figure out what to do when they find lumps on the skin or just under the skin (subcutaneous).

See Something: When a skin lump is the size of pea or larger or has been present for one month

Do Something: Aspirate or biopsy.

A pea is about one centimeter, or about half the diameter of a penny. When masses are removed early, the prognosis can be excellent, with no additional treatment needed after surgery. Most skin and subcutaneous tumours can be removed with a simple surgery if we find them early when they are small.

But to limit the number of surgeries, we must get a diagnosis with cytology or biopsy early and before removing a tumour. This will lead to an improved outcome for your pet. A single surgical procedure can cure your pet for the majority of tumours. This is especially true for benign tumours, and some malignant cancers that are only locally invasive into the surrounding tissues (those that don’t spread or metastasize to other parts of the body).

Benign tumours

Benign tumours may not need to be removed immediately. The location of the mass on your pet’s body should be considered. Will an increase in growth in this location prevent successful surgery? Is the mass causing pain, irritation, secondary bleeding or infection? Unless the answers to these questions are yes, you may not need to do surgery at all. Your veterinarian will be able to help you figure this out for each benign tumour.

Malignant tumours

If the mass is malignant, the first surgery is your pet’s best chance for a cure. Therefore your veterinarian needs to know what the tumour is before it is removed.

What is the danger of waiting too long? Larger masses are more difficult to remove! This is especially true for masses on the legs, head and neck area and for smaller pets.

If tumors are not removed, they will increase in size, making surgery to remove them more difficult and/or they may spread to internal organs. A larger mass is also more likely to need additional therapy after surgery, such as radiation therapy or chemotherapy, to prevent recurrence. With this program, the goal is to make the first surgery the ONLY surgery your pet needs.

Stay vigilant about lumps on dogs and cats

Just because your pet may have had multiple benign lumps in the past, don’t get too relaxed. Stay vigilant and have those lumps and bumps aspirated. It’s not a big deal for the pet, and it is worth knowing what you’re facing.

I made this mistake with my veterinary nurse’s dog Smokey. This amazing Pit Bull had many benign lipomas over the years. Amanda found another one, but we got complacent about doing the aspirate, because all the other ones were benign.

This tenth mass was a malignant connective tissue tumour (called a soft tissue sarcoma) and was the size of an orange (7 cm). It required a CT scan before surgery and a more complicated procedure in order to get the necessary large margins to prevent recurrence. Smokey is my inspiration for See Something, Do Something! Why Wait? Aspirate.

Remember, no one — not a vet, not an cancer specialist, and not you — can tell what a lump is just by its appearance or feel. And “watching and waiting” is not a good idea. Get the masses aspirated. Don’t assume it’s benign. The earlier we find tumours, the better.

With early diagnosis, less treatment will likely be required, and a smaller surgery may be curative. This means cost savings, a better prognosis, happier pets and owners too! See Something, Do Something! Why Wait? Aspirate.

—Reprinted with permission of Dr. Sue Ettinger. Dr. Ettinger, Dip. ACVIM (Oncology), is a boarded veterinary medical cancer specialist. Dr. Ettinger is currently the head of the Oncology Department at the Animal Specialty & Emergency Center in the Hudson Valley in NY.  Also known as Dr Sue Cancer Vet, she is a book author (The Dog Cancer Survival Guide), radio co-host, and certified veterinary journalist. Dr. Sue developed See Something, Do Something! Why wait? Aspirate to promote early cancer detection and diagnosis. She can be found on social media at www.facebook.com/DrSueCancerVet and @DrSueCancerVet on Twitter.