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Friday, January 24, 2014

Lumps and bumps on your dog: Is a needle biopsy worth it?

If you remember, last week I talked about a bump appearing on Lulu's ear, and the vet wanted to remove it.

The lump last week when I first saw it.
At the advice of... well most people, we got a second opinion.

Hey, Mom, why am I in another big white room?

We took Lulu to Trinity Pet Hospital. The vet there sees my parents' dogs.

He asked me if the lump grew. I said no, but it has gotten darker.

Here is what he told me:
  • He thinks it's most likely benign. Possibly a lipoma of some kind. (What's a lipoma? Here's what PetMD said.)
  • He said a needle biopsy (fine needle aspirate) would likely be inconclusive and wasn't worth doing. He said most of the time there is not enough material there for the pathologist to get a good idea what it is. The needle biopsy works better with humans.
  • If it starts to grow, it has to come off.
Does this put my mind at ease? Not really.  The answer is still inconclusive. It's still wait and see. And what if I wait too long? What if it's not benign? What if it's cancer?

I think it's interesting that the vet said fine needle biopsy would be inconclusive. People seemed to think that step should have been taken, but the vet said it wasn't worth spending the money.

So Lulu and I left the vet's office and took a trip down to Dunedin.

Sometimes the best way to clear the head is a car ride with the window down.
Dunedin, Florida, by the way, is very pet friendly. It's in Pinellas County near the Gulf of Mexico. The downtown area has a lot of restaurants with pet-friendly patios, and many of the shops will let pets in.

We had lunch at the Broadway Deli and Cafe. They made Lulu scrambled eggs and bacon, and she got to sniff some doggies.

Then we visited Happy Tails Dog Park in Dunedin, where Lulu made some friends.

That's Scooby, a six-month-old Rhodesian Ridgeback. Already bigger than Lulu!
So now the wait begins. Hopefully it doesn't grow. I looked at it today. It looks different, but I don't think it grew.

Here's what it looks like today.
Have you ever had a bump on your pet? How did it turn out?

21 comments:

  1. Great piece. My dog went through something similar with a bump on her tail. One vet wanted to do expensive blood work and a biopsy so I also got a second opinion. The second vet said the same thing about the needle biopsy. I monitored it for a month and it eventually went away. Hope everything turns out Ok for your furbaby.

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  2. Thank you for posting an update! No need to take up heavy drinking yet, huh? ;)

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  3. Thank you for keeping us updated on Lulu's "bump." I'm glad that at least the 2nd opinion visit resulted in a fun-filled afternoon for just you two! Lunch together & then some playing at the park. :) I'm sure Lulu's like "Well if I knew the white office would have resulted in all this, I might have just been happier about the whole thing earlier." Lol, gotta love 'em!

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    1. She was a very good girl. She usually is at the vet. She just struggles a little when she gets a shot, or she is being put on the scale or the table. But once she's where she needs to be she is very good and docile. Vets love her.

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  4. Have you figured out how you're going to get accurate measurements? I guess you could hold up a centimeter ruler and take a picture. Like you, I don't like "watch and wait." I want to tension to be over and resolved the way I want! Kisses to Lulu; hugs to you.

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    1. I didn't think about measurements -- was just going to eye-balling it.

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  5. It's on the paw and susceptible to infection (form the ground). We recommend to do a biopsy just to make sure ... it's a hard decision but have to do what's best and what provides peace of mind.

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  6. It sounds like a case of the Three Bears, you have one doctor who is too aggressive, one doctor who is too lax, what happened to the vet who is just right?

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    1. I know... I could go for best 2 out of 3, but then spend more money I don't have. So I'm giving this until the end of the month and then making a decision.

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  7. Frankly, I would not want to sit on it and watch it. I'd want to know exactly what it is, whether it would take needle aspirate or a biopsy or just getting it off.

    http://www.dogcancerblog.com/waiting-and-watching-but-for-how-long/#.Uun7NrRyL20
    http://www.dogcancerblog.com/how-long-to-watch-and-wait/#.Uun7M7RyL20
    http://www.dogcancerblog.com/staying-vigilant-with-mass-aspirates/#.Uun7-7RyL20

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  8. I agree 100% with Jana. My vet said we had 2 options with Tynan's first tumor- remove it or wait and see. The vet recommended removal. I had also opted to have my own tumor removed a decade before. Both Tynan and I had malignant tumors that if we had taken the "wait and see" approach could have been fatal. I didn't want some mystery thing growing in me and I didn't want one growing in Tynan! The surgeries both he and I went through were not easy but... worth it!

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  9. Hmm, glad you got a second opinion. That definitely does not look like a lipoma at all to me. In fact, I don't think I've ever seen a lipoma on the ear... but I guess it's possible. All the vets I worked with would do aspirates on some things and then look at them under the micropscope themselves. They all knew how to identify fatty cells, mast cells, cyst cells... sometimes before they even put the slide on the microscope! Then, if they are still unable to give a definite answer as to what it is, they'll send it to a pathologist.

    That lump would be super easy to remove anyways. And if you just got it taken off, then you wouldn't have to spend the money on the aspirate, which could be inconclusive anyways. So much to think about... hope it turns out to be nothing either way!

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    1. I agree with the vets you worked with Ann. Looking at an aspirate in the office under a microscope is inexpensive and easy to do. However, if it looks "weird" I wouldn't send the aspirate off to the lab, I would send the dog to surgery to remove the lump and then send the lump off to the lab.

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  10. Based on my own experience, I'd have a biopsy done. If it is "something" the quicker you deal with it, the better. IMHO, waiting is false economy.

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  11. I have to disagree with your second opinion. Fine Needle Aspirates are done in most good quality hospitals because it does provide a guide on what to do next. Most are not inconclusive. It should not cost very much either as the vet should be doing it himself in his office and not sending it to a lab. If it is something that looks like it needs to be sent to a lab then it is better to spend the money to remove it and then send the entire mass into the lab.

    The problem is that you do not know what you will find unless you look and to "wait and see" on certain tumors such as a mast cell tumor would not be in the best interest of the health of the dog.

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  12. We always stick a needle in things as a first step. It doesn't take much time. It isn't that expensive, relatively speaking. Ginko had a new really weird dangling lump toward the end of 2013. We were lucky that our vet had time, and Ginko was such a good boy. Our vet used local anesthetics and removed the whole thing that day -- while we sat in the lobby and waited. It was nothing scary, but I was glad to get it off because it creeped me out, and she said if it broke open it would bleed like crazy.

    Ginko has had a whole bunch of lumps over the years. We've checked them all -- one way or another -- and removed very few.

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  13. Be sure and take a measurement for comparision... (if you haven't already).

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  14. I would get the needle aspirate. I did one with Rigby a few months ago after he had a bump that was rapidly swelling on the top of his paw. It wasn't terribly expensive, even though our pet insurance covered it. While I didn't think it could be anything serious given his age (1 year), the fact that it came on and grew so fast freaked me out. It ended up being a benign growth with bacteria present, so he was given a course of antibiotics and it cleared up and hasn't come back.

    Here's what it looked like: https://dl.dropboxusercontent.com/u/19678449/Jenn/dog-bump.JPG

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  15. Looks like a histiocytoma, should be easily diagnosed in house on a needle biopsy, they usually regress after 6-8 weeks. Can't believe any vet would say a needle biopsy is not worth while!

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