Sunday, September 2, 2012

LUMPS AND BUMPS

Here we are at Labor Day weekend.  Where has the summer gone???  Hopefully, all of you are looking forward to at least a couple of months of beautiful and comfortable weather.  Here in Flagstaff, the months of September, October, and November are the favorite part of the year for Desperado and Helpful Buckeye.  We were down in the Phoenix area this past week and the temperatures were as high as 116 degrees.  Dry heat or not, that's way too hot for any kind of comfort.  Now, we've got 3 months of really wonderful weather before our first snow and we intend to take full advantage of it.  We'll fit several day-trips and a few 2-3 day excursions into these months, in addition to just enjoying what's going on here in Flagstaff.  Hope your Fall is enjoyable as well!

Just about anyone who has owned a dog or cat has been sitting somewhere with their pet, running your hands over their body, scratching them, and pulling your fingers through their hair...when, suddenly, you feel something firm and unexpected...a lump or a bump.  Upon closer inspection, you might see something matted in the hair or some type of swelling in the skin.  Sometimes the lump is very visible and sometimes you almost have to rub or squeeze the skin in order to realize that there is something there that is not normal.

If you're really lucky, the lump might be a piece of vegetation that has become matted in the hair right next to the skin or even a tick that has become embedded in the skin and then swelled up from feeding on your pet.  Lucky, because these usually only require a bit of careful maneuvering to resolve.

However, if the lump or bump is either part of the skin or underneath the skin, your imagination will probably lead you to expect the worst...the anticipation that your pet must surely have some type of cancer.  Even though there are many different types of lumps and bumps that are not cancer, the human tendency is to be concerned...and, that's a good thing.  Most of the time, it's very difficult, if not impossible, to predict what a growth might be just by looking at it or feeling it...even for your veterinarian.

That's why it's a good thing to have your pet examined when you find a lump or bump and let your veterinarian decide what should be done in order to figure out what it is.  Hopefully, after reading this issue of Questions On Dogs and Cats, all of you will be able to approach the discovery of a lump or bump in a more practical, objective manner, without becoming too upset in the process.

What is that bump on my pet?
Dr. Elizabeth Bradt
What do you do when you find a new bump on your pet? You know from daily patting of your pet exactly how your pet feels. If you feel something unusual, it is time to take your pet to the vet.
Your veterinarian will determine if the bump is an enlarged lymph node, an abscess, a benign fatty mass, a hematoma (blood-filled pocket) or a cancerous mass. It is important to present your pet to the veterinarian as soon as you feel the unusual bump.
When you have the appointment with your veterinarian, your pet will receive a full physical exam, and the lump will be examined. Sometimes a sampling of cells, called cytology, will be recommended. Other times a biopsy will be recommended. Sometimes a full excision (removal) and biopsy of the mass will be recommended. Your veterinarian will make a recommendation based on the size, color, location, and degree of mobility, sensitivity and texture of the mass....







Lumps and Bumps on Dogs
T. J. Dunn, Jr., DVM
There are very few surprises that will startle you more than discovering a lump or bump on your dog. As your hand wanders over your canine pal in affectionate scratching or petting, your fingers just may chance upon a lump that “was not there before." 
It will scare the biscuits out of you ... GUARANTEED!  With that nagging "C" word drifting about in the back of your mind, your first fear is that your dog might have cancer. Setting in motion your search for an answer as to what this lump is you make a quick trip to the “I hope that lump isn't serious…. “
"How long has this been here?" the veterinarian asks. "Just found it yesterday, doctor," you respond.
"Let’s see if we can find any others," says the doctor as experienced and sensitive hands work the dog over.  Sure enough, "Here’s another one just like it!" says the doctor as they place your hand right over the small, round, movable soft mass under the skin of the dog’s flank.
"I think these are what we call lipomas, just fat deposits under the skin. They are very common and usually present no problems," says the doctor. Your relief at hearing the good news is cut short as the doctor continues …"However, we honestly do not know what these lumps truly are unless we examine some cells under the microscope. So I’d suggest that we do a simple needle biopsy, place some cells on a slide and send the slides to a veterinary pathologist for a definite diagnosis."
The doctor in this case is being thorough and careful. How true it is that a definitive diagnosis of "what it is" simply cannot be made without microscopic examination of the lump’s cells. A veterinary specialist in pathology is the final authority and judge when it comes to shedding light on these lumps and bumps that we too often find on our canine pals....
Skin Lumps and Bumps in Dogs
During the course of grooming, playing with, or handling your dog, you may discover a lump or bump on or beneath the skin. To learn what it may be, you should have your pet examined by your veterinarian and go with their advice.  These growths could be:
  • Abscess: A painful collection of pus at the site of a bite or puncture wound.
  • Basal cell tumor: Solitary nodule, usually on a narrow base or stalk. Round, normally hairless, and may be ulcerated. Found on the head, neck, and shoulders of older dogs.
  • Ceruminous gland adenoma: A pinkish-white dome-shaped growth in the ear canal less than 1 centimeter in size. May become ulcerated and infected.
  • Epidermal inclusion cyst: A firm lump beneath the skin. May discharge cheesy material and become infected.
  • Hematoma: A collection of clotted blood beneath the skin; often involves the ear flaps.
  • Histiocytoma: Rapidly growing dome-shaped (buttonlike) growth found anywhere on the body, usually in young adults.
  • Lipoma: Smooth, round, or oblong fatty growth beneath the skin; feels somewhat soft.
  • Mast cell tumor: Solitary or multiple growths usually found on the trunk, genital area, and legs. More prevalent in certain breeds, including Boxers, Golden Retrievers, Bulldogs, and Boston Terriers.
  • Melanoma: A brown or black pigmented nodule found in areas of dark skin. Growths in mouth and nailbeds usually are malignant.
  • Perianal gland tumor: A solitary or multinodular growth in the perineum around the anus. Occurs most often in older intact males.
  • Sebaceous adenoma: Also called sebaceous cyst. Smooth, pink, wartlike growth less than 1 inch (2.5 cm) in diameter. Most common on the eyelids and limbs. Occurs in older individuals (average age 10). Very common in Poodles and Cocker Spaniels.
  • Skin papillomas: These grow out from the skin and may look like a wart. Not painful or dangerous.
  • Soft-tissue sarcomas: Ill-defined or well-demarcated masses of varying size and location. Often slow growing.
  • Squamous cell carcinoma: A nonhealing gray or reddish-looking ulcer found on the belly, scrotum, feet, legs, lips, or nose. May resemble a cauliflowerlike growth.
  • Transmissible venereal tumors: Ulcerated, often multiple cauliflower-like growths on the genitalia of both sexes.
  • "Warble":  Can look like a draining abscess but has the larva of a fly embedded in the lump.
  • Embedded foreign body: Can be anything that has punctured the skin and festers there...a splinter of wood or metal, piece of glass or wire.
Adapted from: http://pets.webmd.com/dogs/dog-skin-lumps-bumps

Right there on the list of the "Top 20 Dog Diseases" (as far as concerning frequency of visits to a veterinarian), following #1 Ear infections, #2 Skin allergies, and #3 Skin infections, is #4...Skin growths/Tumors.

Adapted from: http://www.petplace.com/dog-health.aspx?utm_source=dogcrazynews001et&utm_medium=email&utm_content=petplace_corepage&utm_campaign=dailynewsletter

Of course, the incidence of cancer does increase as a pet ages:


In pets the rate of cancer increases with age. Cancer is responsible for approximately half the deaths of pets over 10 years of age. Dogs get cancer at roughly the same rate as humans, while cats tend to have lower rates of cancer. Some cancers, such as breast or testicular cancer, are largely preventable by spaying and neutering. A diagnosis of cancer may be based on x-rays, blood tests, physical appearance of tumors, and other physical signs. The ultimate test for cancer is through confirmation via a biopsy.

Adapted from: https://www.avma.org/public/PetCare/Pages/Caring-for-an-Older-Pet-FAQs.aspx

Many of those cancers started out as a growth or lump on or under the skin.  This is why EARLY detection is so important when you feel a lump or bump on your pet.  Have your pet examined by your veterinarian and heed what they have to say.  They will explain the logical progression of options available that will provide enough information upon which to make a decision. 

If the lump even looks like it might be a tumor, whether or not it might be something as harmless as a wart (papilloma) or a fatty tumor (lipoma), your veterinarian would be doing the proper thing by recommending further evaluation.  This would include: 

The lipoma is one of the most commonly encountered lumps seen by veterinarians during a physical exam. These soft, rounded, non-painful masses, usually present just under the skin but occasionally arising from connective tissues deep between muscles, are generally benign. That is, they stay in one place, do not invade surrounding tissues and do not metastasize to other areas of the body. They grow to a certain size and just sit there in the tissues and behave themselves.
Most lipomas do not have to be removed. Occasionally, though, lipomas will continue to grow into huge fat deposits that are a discomfort to the dog and present a surgical challenge to remove. And even more rarely, some lipomas will be malignant and spread throughout the dog’s body.
Is it a tumor?
And therein lies the true challenge in dealing with lumps and bumps on dogs -- we simply cannot predict with 100% accuracy just what any of these growths will do. So we do the best we can by removing them when indicated or keeping a close guard over them so that at the first sign of change they can be removed.
As explained earlier, not every lump or bump on your dog will be a tumor. Some superficial bumps are due simply to plugged oil glands in the skin, called sebaceous cysts. Skin cysts can be composed of dead cells or even sweat or clear fluid; these often rupture on their own, heal, and are never seen again. Others become chronically irritated or infected, and should be removed and then checked by a pathologist just to be sure of what they are. Some breeds, especially the Cocker Spaniel, are prone to developing sebaceous cysts. 
And yes, the sebaceous glands in the skin do occasionally develop into tumors called sebaceous adenomas.  According to Richard Dubielzig, DVM, of the University of Wisconsin, School of Veterinary Medicine, "Probably the most commonly biopsied lump from dog skin is a sebaceous adenoma. This does not mean it is the most commonly occurring growth, just that it is most commonly biopsied." Fortunately this type of skin growth rarely presents trouble after being surgically removed. 
So how are you to know which lumps and bumps are dangerous and which can be left alone? Truthfully, you are really only guessing without getting the pathologist involved. Most veterinarians take a conservative approach to the common lipomas and remove them if they are growing rapidly or are located in a sensitive area.
However, caution needs to be observed because even the common lipoma has an invasive form called an infiltrative lipoma. For example, when a nasty looking, reddened, rapidly growing mass is detected growing on the gum aggressive action is indicated.  Also, keep in mind that not all lumps and bumps are cancerous, and some are fairly innocent and do not warrant immediate surgery.
Types of Lumps and Bumps
Non-cancerous lumps
Cysts, warts, infected hair follicles, hematomas (blood blisters) and others do cause concern and can create discomfort for the dog, though non-cancerous lumps have less health impact than cancerous growths.
Cancerous lumps
Cancerous growths can be either malignant or benign, and occasionally even share characteristics of both.  Malignant lumps tend to spread rapidly and can metastasize to other areas of the body. Benign growths tend to stay in the place of origin and do not metastasize; however they can grow to huge proportions.
Mammary gland tumors, mast cell tumors, cutaneous lymphosarcoma, malignant melanoma, fibrosarcoma and many other types of tumors with truly scary names command respect and diligent attention on the part of dog owners and veterinarians.
Diagnosis
Below are the most common methods of finding out "what it is" … 
Impression Smears
Some ulcerated masses lend themselves to easy cell collection and identification by having a glass microscope slide pressed against the raw surface of the mass. The collected cells are dried and sent to a pathologist for staining and diagnosis. Sometimes the attending veterinarian will be able to make a diagnosis via the smear; otherwise, a specialist in veterinary pathology will be the authority regarding tumor type and stage of malignancy.
Needle Biopsy
Many lumps can be analyzed via a needle biopsy rather than by total excision. A needle biopsy is performed by inserting a sterile needle into the lump, pulling back on the plunger, and "vacuuming" in cells from the lump. The collected cells are smeared onto a glass slide for pathological examination. Usually the patient isn’t even aware of the procedure. Total excision of the mass is attempted if the class of tumor identified warrants surgery.
CT Scans
Superficial lumps and bumps do not require that CT Scans be done, so this procedure is usually reserved for internal organ analysis. If a superficial malignant tumor is diagnosed, however, a CT Scan can be helpful in determining if metastasis to deeper areas of the body has occurred.
Radiography
As with CT Scans, X-ray evaluation is generally reserved for collecting evidence of internal masses. Most lipomas are superficial and reside under the skin or skeletal muscles. There are other lumps that can be palpated by the veterinarian via manual examination; however, the extent and origin of that mass will often be best revealed via CT Scanning.
Treatment
Since every type of cell in the body potentially could evolve into cancerous tissue, the types and ferocity of tumors that develop in the dog are numerous and highly varied. Each case needs to be evaluated on its own circumstances and variables. For example, should surgery be done on a 16-year-old dog with what appears to be a 3-inch wide lipoma? Maybe not. Should that same dog have a quarter inch wide, black, nodular mass removed from its lower gum. Probably should! That small growth may be a melanoma that could metastasize to other areas of the dog’s body.
Surgery
An important basic tool in eliminating a nuisance or dangerous lump is to surgically excise it.
Chemotherapy
Chemicals that are highly toxic to rapidly dividing cells make up an important mode of treatment for fast growing tumors. A combination of surgery and radiation/chemotherapy can help the veterinarian gain the upper hand in achieving a cure. Chemotherapy is often employed as an additional precautionary procedure after a mass has been "removed" via surgery.
Radiation
For invasive tumors that do not have well defined borders and for tumors that tend to spread rapidly, radiation therapy can be a lifesaver. Available at most veterinary medical schools and some veterinary specialists in radiology, radiation therapy is appropriate for certain types of tumors. Radiation is often employed in addition to surgical excision.
According to Dr. Dubielzig, the best approach to understanding what to do about a lump or bump on your dog is to be vigilant and treat each situation individually. "In cases where vigilance for tumors is part of the animal’s care, such as in animals where a malignant tumor has been removed and the veterinarian wishes to keep abreast of the stage of disease, then every lump should be submitted for histopathology," Dubielzig said. "In other cases where the clinician is sure of a benign diagnosis such as lipoma or a wart-like skin mass then it might be understandable to use discretion. The clinician also has to take into consideration the risk of surgery compared to the risk of health problems from a particular lump or bump."
Take a good surface inventory of your dog today, then at least once a month from now on. If you find any imperfections, take heart in knowing that modern veterinary medicine has some very effective remedies for almost all of these lumps and bumps.
Maybe your pet's lumps aren't even tumors. There is only one way to find out. All together now...HAVE YOUR PET EXAMINED BY YOUR VETERINARIAN FOR EVERY LUMP OR BUMP YOU FIND.
Any questions should be directed to Helpful Buckeye at: dogcatvethelp@gmail.com  or registered as "Comments" at the end of this issue.
 
SPORTS NEWS
The LA DODGERS can't seem to get any traction toward being more consistent.  We now have the fire power to score some runs but it just isn't all clicking at the right time.  A playoff spot is definitely not out of the question but we need to make an aggressive move soon.
The Ohio State Buckeyes opened the season yesterday with a fairly tough opponent and scored an impressive win for our new coach's first win.  Since we're on probation this year and cannot go to a bowl game, I fully expect the Buckeyes to treat every game as if it were for the national championship and end up with a pretty good record for the year.
 
The NFL opens this coming week and the Pittsburgh Steelers will again be fighting the Ravens for superiority in their division.  Our skilled players are still among the best but we've got to prove it on the field.
 
PERSONAL STUFF
 
Among the various stops Desperado and Helpful Buckeye made during our several days in the Phoenix area was the Musical Instrument Museum.  We spent a whole day there (7 hours) and were very impressed.  It ranks in the top 2 or 3 museums we've toured...a fascinating history of music around the world, including instruments, videos, and various musical props.
 
We also really enjoyed the behind-the-scenes tour we took of Chase Field, the home of the AZ Diamondbacks baseball team.  Got to visit the press box, one of the luxury corporate suites, and sit in the D'Backs dugout!  While there, I struck up a conversation with a guy who happened to be Director of Traffic Support Services for the stadium and, when he realized how much of a baseball fan I am, he offered to get me tickets for any Dodger game I wanted, even into next year...how lucky can a guy be???
Desperado treated Helpful Buckeye to breakfast yesterday at a new restaurant and I had the best corned beef I've EVER eaten!  Instead of the usual chopped up corned beef, this had big chunks and pieces of corned beef pulled right from the brisket.  Outstanding!
~~The goal of this blog is to provide general information and advice to help you be a better pet owner and to have a more rewarding relationship with your pet. This blog does not intend to replace the professional one-on-one care your pet receives from a practicing veterinarian. When in doubt about your pet's health, always visit a veterinarian.~~


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