Featuring Demian Dressler, DVM and Susan Ettinger, DVM, Dip. ACVIM (Oncology), authors of The Dog Cancer Survival Guide.

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Fine needle aspirates to diagnose dog cancer?

Hi everyone,

I have been getting questions about the best way to gather info about growths in dogs.  So, let’s take a look at a common technique used to accomplish this…a fine needle aspirate.

First of all, a fine needle aspirate is not a biopsy.  A fine needle aspirate is a sample of the mass taken with a skinny little needle (meaning, not much to work with).  The vet will disinfect the surface of the site to be aspirated, often after clipping the hair, to prevent infection.  Next, a needle is introduced into the area of interest, and the plunger drawn back, creating a vacuum which draws cells into the hub of the needle.  These cells are then used to make a slide for the vet or a pathologist to look at for a diagnosis.

What is good about this technique?  Well, it takes about 2 minutes to do, and your dog gets to go home without sedation, anesthesia, or hospital stay.  Quick, easy, outpatient…nice. This is a good technique to diagnose TYPE of growth (in my hands about 75% of the time you get this info from the path lab after submitting the slide).

How about downsides? A fine needle aspirate cannot tell if the cancer cells have moved inside the body or spread into neighboring areas. There is a little inaccuracy in this technique as well. My experience is that about 1 out of 4 of these come back “inconclusive”, meaning there was not enough on the slide for the path folks to give a diagnosis.  Sometimes the vet will get a big sample, but the cells are just not the right kind to make a diagnosis (blood, connective tissue, etc.). Some tumors have a good cell yield, and others do not. Occasionally, we get an incorrect diagnosis with a fine needle aspirate.

Some dog tumors easily diagnosed with fine needle aspirates:

Lymphosarcoma/Lymphoma

Mast Cell Tumors

Histiocytomas

Lipoma

Cysts

Short story, this technique is a good, non-invasive, rough screen to get initial information.  Just keep in mind the limitations…it is not guaranteed and if there is any doubt in your vet’s mind, go for the real biopsy…coming up!

Best,

Dr Dressler

About the Author: Demian Dressler, DVM


Dr. Demian Dressler, DVM is known as the "dog cancer vet" and is author of Dog Cancer Survival Guide: Full Spectrum Treatments to Optimize Your Dog's Life Quality and Longevity. Visit his blog and sign up free to get the latest information about canine cancer. Go to http://www.DogCancerBlog.com.

  • Lori Michaelson

    Keep up your informative topics/threads Dr. Dressler!

    Would fine needle aspiration give any info on sebaceous cysts? Not looking for cancer (or possibly) but any benefits to that?

    Lori

  • admin

    Hi Lori!
    Yes, you can get a presumptive diagnosis of a sebaceous cyst. Usually you need to use the physical exam findings along with the info in the path report (or that the vet gets with an in-house slide examination of the aspirated contents). With these two bits of info (the appearance, shape and feel on the physical, and the microscopic appearance of the cyst contents), you can be pretty sure of the diagnosis. Sebaceous cysts produce a typical material within them that is pretty consistent.
    Why bother with an aspirate of a suspected cyst? Well, one example is a situation you are very familiar with: mast cell tumors, the Great Imitators. You have a firm, spherical nodule within dog skin on physical. Is is a cyst?? Well, maybe. Could be other things too on occasion. So it becomes a probability game…how safe are we if say (I base this number on my personal clinical impression only…) 80% of masses with this appearance on an exam actually are sebaceous cysts. This means that sometimes these lumps are NOT, and just FEEL like they are.
    I always recommend the safest option: get it checked out. That way we are safe not just for the 80% that are confirmed, but also for the 20% that are actually something totally different. This means that one in five are not. For every 5 dogs that come along, one of ‘em will have something possibly harmful. Since I see gobs of dogs, the 20% WILL walk into my exam room and I WILL have to deal with it. So I always recommend the safest options.
    Good blog topic! Thanks!
    Dr Dressler

  • John

    how much does something like this cost?

  • ch’an

    fine needle aspiration cost $20 today in Vancouver BC,
    and the pathology lab cost $75, total with tax about $100.
    most of what was extracted was fluid. lab analysis
    results will come back in about three days.

  • Bridget

    I just literally went through that. My girl has a mass on her side. When I got her in November (she is 10) she had fleas and mites, yeast and fungus, plus three swollen lymph nodes in the same area as the mass. I did what I could to up her immunities and the three swollen lymph nodes went back down. Still not knowing what the other lump was, I brought her to the vet but got an “inconclusive” result. I was told by the vet tech that it wasn’t a cyst or a lymph node, so I’m assuming it’s a mass. I will talk to the vet later. Hopefully, I didn’t wait too late for it to have spread, which may have been indicated by the swollen lymph nodes. She’ll go in for blood work Monday and surgery to remove the mass Tuesday. I’m planning on asking the vet if at that time, an aspirate can be done on the lymph nodes surrounding that area that were swollen, or if blood tests would indicate cancer had spread.

    My other dog has a mole looking cyst in his ear (unusual site) that I was told by two different vets was a sebaceous cyst. He scratched it with his nail, now it has grown into a “cauliflower” shape, so I will have them remove that too.

    I think the best thing I have recently done is stop smoking cigarettes around my dogs. I’m sure it has made them more susceptible to cancers.

    • Dr. Dressler

      Dear Bridget,
      I think you are doing all the right things. Keep it up!
      Dr D

  • kim bergeron

    I have a just turned 11 year old weimarer with a few lumps and bumps about a week ago I noticed a lump on her top neck the doctor did a biso and found it was just a fatty deposit. Now I took her again today because I noticed she went pee alittle on her blanket so I asked our regular vet to check that same lump to see if it had grown at all it hasn’t but this time i asked her to aspirate it and she got a little blood out of it and just a little blood out of a another lump she has. the doctor sent the work out and i have to wait to see what is going on. the vet said it need be depending on the results we would remove the lump. Now my question is why didn’t they find any blood the first time the aspirate the lump and please don’t tell me this is the end she is the love of my life. thank you for any advice you can give.
    Kim

  • Paula

    Hello Dr.
    My dog (a maltese mix) has a tumor in her liver , the vet said the tumor is too big to be surgically removed , he wants to make a tru-cut biopsy of the tumor..
    My dog doesnt have symptons, she eats very well, she wants to play everyday , she doesnt vomit , she’s always so happy that i cant understand!
    I’m concerned about the risks of this procedure in my dog…
    what is the main difference between the FNA and the tru cut aspiration?
    What would you do? Thank you for any advice and i apologyze for my english (i live in Argentina)

  • Ellie

    Hello, doctor,

    I would like to know more about possible dangers of FNA. At the recommendation of our vet, we took our 8-year-old cocker spaniel to a well-respected veterinary hospital/school to have FNA done on a large mass under his spine that may have been pressing on his intestine. It was to be fast and easy, although we were told that the needle could spread some of the cells from the mass into another part of his abdomen, “but this is unlikely.” The evening after the FNA, he became sluggish, refused to eat any food, drank very little water, and was pretty much incontinent. He paced and panted the whole night through. The next full day he seemed to be slipping so we took him back to the vet hospital; they saw no fluid accumulating near the mass, so gave us prescription antibiotics in case he had a bladder infection. He died the next day in my arms– at home, thankfully. My question is: Why did he go downhill so quickly after the FNA? Even if some cells from the mass got into his abdominal cavity, would that have been fatal so quickly? The vet at the hospital said, “I told you that the needle could spread cells from the mass to other areas…” but in less than 3 days after the FNA, would he have died from that? The hospital offered to do an autopsy — at our expense — but after their other very high bills, I couldn’t afford the autopsy. I am hoping for an objective analysis of all of this, although of course I realize that you would find it difficult if not impossible to make any comments via “long distance.”

    Are there other questions I should be asking the vet at the hospital? Could it have been something else? It’s troubling not to know what might have caused his sudden death at age 8 in less than 3 days after having the FNA performed.

    Thank you for any insights you can offer — which may help me and my children fill in some of the missing pieces of this very sad puzzle.

    Ellie

  • Janet Martin

    Hi there
    We have a 3 year old Brittany Spaniel – best dog ever! We noticed a lump on the side of her neck about a month ago. We took her to the vet and the vet said to leave it a few days to see if it goes away and then it is just a swollen lymph gland. I made an appt. for a fine needle aspiration and then cancelled it because the lump went away! We were SO happy!
    A few days later the lump came back. I had her to the vet today and they did the fine needle aspiration. I questioned if it could be cancer since the lump went away and he said that it just could have been that the fluid drained out. We are really worried – she is not even 4 yet which seesm so young for cancer.
    The vet said it coudl be a cyst or an infection or cancer – we don’t know until we get the results back. If it is cancer, hopefully we can do something. He told us if it is lymphoma that there is really no use in doing anything. She has no lumps anywhere else and is acting totally normal.
    The fine needle aspiration sample was bloody – is that a good sign or a bad sign? He said that there was a fair amount of fluid as well.
    Any help?? As I said, it is going to be a long couple of days waiting for the results.

    • http://DogCancerBlog.com DemianDressler

      Dear Janet,
      what were the results of the aspirate?
      D

      • Janet

        My dog has a lump on her paw that causes her to intermittently limp. FNA results defined it as a “follicular cyst” which confirmed what the vet initially thought since the lump deflated once she inserted the needle. I have read that these can be cured using turmeric and that surgery isn’t always necessary. A vet on a website also claimed that in vet school they explained to her how cysts are a good way for some vets to make money, when the surgery isn’t really needed. My vet is charging me $900 for the removal. I have already spent $500 in pre-surgical bloodwork and urine tests. Does my dog really need surgery? I am having a hard time figuring it out, yet I see countless people curing cysts at home so I feel as if I am being ripped off. Can you help shed some light please?

        • Dr. Susan Ettinger

          Janet,
          While we cannot make specific recommendations over the internet, if the there is limp and pain associated with the lump, I think surgery to remove the mass is reasonable, for the comfort of your dog and to submit for biopsy. Biopsy is better than aspirates to determine benign vs malignant. If you are unhappy with the opinion you are getting from your vet, you could get a 2nd opinion. Good luck!
          All my best, Dr Sue

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  • Terri

    My dog had very enlarged spleen removed 4 months ago – diagnosis high grade
    lymphoma – commenced chemo few days later – vinicristin, endoxana, prednisolone. chemo weekly x 8 then every 2 weeks. Prednisolone stopped at
    7th week as she contracted ? pancreatitis/stomach problems.

    She is an eight year old lab, previous mast cell tumour on ear 3 years ago –
    one thirs of ear removed. otherwise, has been healthy. She has now shown
    some enlarged lymph nodes. First needle aspiration inconclusive, Second
    confirmed lymphoma spread. Vet suggesting changing chemo to doxyrubin.
    Finding it hard deciding whats best – concerned re the toxicity to tissue during
    administration and potential effects on heart. otherwise, want to give her best chance please help, Terri, uk

    • http://DogCancerBlog.com DemianDressler

      Dear Terri,
      might discuss DTIC and CCNU, especially for T-cell lymphomas with your vet, and don’t forget to have an oncologist supervise the chemo if possible…
      Also don’t forget the other supportive steps- diet, immune support, etc discussed in the Guide..
      Best
      Dr D

  • http://www.dogcancerblog.com Brenda Gilday

    I have been reading about lymphoma in dogs and aspirations etc. I took my 13 year old dog to a vet and he told me the needle aspiration was inconclusive but he just knew it was cancer. My dog was perfectly healthy on one day, sick two days letter, the next day he was a little better, but after the vet, he started going down hill. I’m taking him to the country vet tomorrow because the more info I’ve been reading from your website, the more I’m sure the vet (he was also not very nice) that we first saw is wrong. My dog was eating, drinking, playing etc, started feeling a bit down (still eating) and now he has “CANCER?””” I will find out tomorrow. Let’s home that guy was wrong.

    • http://DogCancerBlog.com DemianDressler

      Dear Brenda,
      I hope you are right. Keep us posted, okay?
      Best
      D

  • Dawn Mello

    Hi, I have an 11 yr old purebred Lab that we adopted 5 months ago. She has lumps all over her and we had a biopsy done on a lump that is hard around her throat. I have 3 dogs and 3 cats. For some reason I really connected with her. Her name is Sammie and she does not let me out of her sight. Since I had the biopsy, she has been a bit differnet. I am sure she knows what is going on, these animals are way smarter than people could imagine. I asked the Vet how long is the life span, he said about 11 or 12 yrs. Is this true? Do I have anything to worry about the lump or anything spreading from the biopsy? He had to jab the needle a few times because he could not get through.

  • Lyn Gardner

    MY RESCUE DOG TARA, HAD A MELANOMA ON HER INSIDE HIP. iT HARDLY GREW AND NOW SHE HAS TWO HARD LUMPS ON HER CHEST, 1 ON HER ARM AND 1 IN HER SHOLDER. THEN I FOUND A HARD LUMP NEAR HER STOMACH. IT IS ABOUT 3 FINGERS WIDE. MY VET, THAT I TRUST WANTS TO REMOVE IT SAYING IT COULD IMPACT HER STOMACH CAVIATY. SHE WANTS TO REMOVE THE TWO OTHER ONES ON HER CHEST AT THE SAME TIME AND CLEAN HER TEETH. WE ARE UNABLE TO SCHEDULE IT UNTIL NOVEMBER 22 DUE TO HER BUSY SURGERY SCHEDULE. TARA IS AT LEAST 12. SHE IS MORE THAN LIKELY PART ROTT, PART DOBERMAN AND POSSIBLY CHOW. SHE IS EATING GOOD AND HAVING NO STOMACH ISSUES WITH BOWL MOVEMENT OR SICK ON HER STOMACH. SHE SEEMS TO TIRE EASY HOWEVER BUT ALERT AND IS CAUSIOUS WHEN PLAYING WITH HER ROTT LITTLE BROTHER. DO YOU THINK I SHOULD PROCEED WITH THE REMOVAL? I AM AFRAID IF IT IS CANCER IT WILL ONLY MAKE IT SPREAD AND I MAY HAVE LESS TIME THAN IF I WERE TO LEAVE IT ALONE. THANK YOU FOR YOUR ADVISE!!

    • Dr. Demian Dressler

      Dear Lyn
      please get the lumps tested to see if they are cancerous and if so what type. This will impact what is done;
      Best
      D

  • Bobbie

    Dr D, could you please answer the question above from Ellie February 12, 2011 at 9:56 pm . I think it is very important because I too have heard that needle biopsies as well as open biopsies can spread the cancer cells into the lymph node system and other causing rapid decline and death of an animal, including humans. I had a large breed dog, not that it matters I am sure, who had a lump under one of his legs, the vet felt it was probably just a fatty tumor and that we could leave it alone and just keep an eye on it. Several months later the tumor appeared to triple in size. The vet decided to remove the tumor. One in noticed it did not look so much like a fatty tumor near the bottom side toward the bone and wanted to send it off to pathology.

    The results were returned as cancer. The lab also said they did not get a clear margin and suggest further removal until a clean margin could be obtained. The vet said that because she uses a laser in her surgeries it is common for the tissues to shrink and “sear” somewhat, which often does not allow for a clean margin according to the labs scale. The vet felt that she cut almost to the bone when removing this tumor, but would be happy to go back in and see how much more tissue could be removed. Since the dog was 10 yrs old and had just went through the surgery, and she felt comfortable that she got all tissue that looked abnormal and enough to give a clean margin, we opted to wait. Within 10 months the dog became very ill, and anemic. I took him back to the vet, they hydrated him, took blood work, did stomach x-rays and said there was something there but they could not tell what it was. Since he appeared better, gums were white upon arrival, but pink color returned, and he regained energy (wanting to leave), the vet said I could take him home keep an eye on him and bring him back if he appeared worse, other wise they wanted to re-check him in about 10 days. He never made it. He became so ill. He would not eat or drink, was weak, and couldn’t move. I immediately took him into the Emergency Vet, some 30 miles from home, and upon examination they found his stomach to be very swollen, suspected bleeding and aspirated the stomach. They found it full of blood, said he was bleeding profusely into his abdomen and told me he was dying. They felt horrible that there was nothing they could do and recommended we euthanize him to relieve him of his pain, which we did. Having discussed the possibility of cancer cells spreading through needle aspirations tissue biopsy or tumor removal even, the vet acknowledge that this can happen. I would like your opinion and I think that Ellie would as well. I know that finding out of a growth is cancer or not on a young animal would be prudent so that they may live a fuller life, but at what age do you feel the findings, surgeries and treatments would not do much good and could be harder on the animal as well as hasten their death?

    I have a 10 year old female now whom they suspect has Melanoma and feel that it has probably spread has she has other growths and lumps, both soft and firm through out her body. One vet suggest surgery, pathology and even chemo, the other said due to age, it is better left alone and just treat for pain should it begin. She eats and drinks well, still wants to play, but I have noticed she has started panting a lot at times, similar to a dog in labor, which I am afraid could indicate pain. It is not too hot in the home, she is not as heavy as the other dog, her brother who is her litter mate, and he does not pant like that. I really need to know if you agree that the biopsies of any time can indeed spread the cancer cells to other parts of the body and hasten the spread of cancer, be it human or animals.

    • Dr. Demian Dressler

      Dear Bobbie
      yes at times this is true but only under certain circumstances:
      sample collection penetrates a hollow fluid filled tumor that seeds the body cavity from the leak or incision (of course the tumor must be within the chest, abdomen, or an internal organ like the bladder)
      OR
      the meds used potentiate tumor spread
      (high anesthetic doses of ketamine, or barbituates given IV)
      Otherwise, no, I do not believe there are many cases that increase metastatic rates…
      I hope this helps
      Dr D

      • Riskyb

        I have since read that a dogs age should not be the only reason to discount an op. I also read that anaesthetic’s are much safer than they use to be especially in an older dog that has had the blood test and got a good result.

  • Kim

    Dear Dr. Dressler,
    My dog Rex, a mini bull terrier, has just had a fine-needle aspirate done on a lump that developed on his hind leg, the day before yesterday.
    We are waiting for the results…which have not come back to us, yet.
    He had licked his tumor in days prior to our visit to the vet, and he developed hives on that leg.
    Doesn’t this mean that it will most likely by a mast cell tumor? (I can’t find anything on histiocytomas releasing histamines).
    My concern is that during the aspirate, the vet did not draw fluid out with the syringe plunger – but rather just used ONLY the needle top…and I am worried about the potential inconclusive results from the pathologist.

    PS. I will add that 2 weeks ago we took Rex into the vet to check out this bump, and they (without a fine-needle aspirate), thought it was benign. It didn’t look like much back then – but it continued to grow and get “raw” and then the hives appeared.

    • Riskyb

      I have a 12 yr old Yorkshire Terrior called Tia. She had two lumps removed 5 yrs ago which due to funds we did not have tested. I took her to the vet on Christmas Eve with an ongoing skin condition and they found another lump in the mammory areaa. Following that she had a FNA 1 week ago on a lump right next to her teet. .The results came back today and were not definitive. The only positive thing I got from it is it’s not a carcinoma. Previous to this Tia had a blood test to test her organ funtion which came back as good. My vet said they could also bring her in early and put her on fluids for a couple of hours before the op and after which would move the drugs out of her system quicker. This is the labs interpretation of the results:
      INTERPRETATION – Mixed cell population: population of epithelial cells (cells forming the epithelium. epithelial tissue, epithelium – membranous tissue covering internal organs) consisted with hyperplasia (increased cell production in normal tissue) or more likely neoplasia (The formation or presence of a new, abnormal growth of tissue).
      – some spindle cell. (Spindle cells have a unique appearance and are found only in cancerous tumors) proliferation(rapid reproduction of a cell), reactive (showing a response) or neoplastic (an abnormal new growth of tissue).
      – mixed inflammation with increased numbers of large lymphocytes (white blood cells) which may indicate involvement of the lymph node in this region. See comment.

      COMMENT – the epithelial (cells forming membranous tissue covering internal organs) cells appeared to predominate here and thus this may be an epithelial lesion. Given the region of the mass then mammary tissue is most likely to be involved and this could be a hyperplastic (An abnormal increase in the number of cells in an organ or a tissue with consequent enlargement). lesion but more likely epithelial lesion (an abnormal new growth of tissue). The presence of spindle cells could be reactive or could this could be a mixed neoplasm (an abnormal new growth of tissue).. The significance of the lymphocytes lymphoid cells (white blood cells) is not clear but given that multiple masses are present then involvement of the lymph node in this region may also be possible. In any case excision biopsy of the mass(s) is advised and submission for histology for further diagnosis. Histology will also give information on the degree of tissue invasion which cannot be assessed by cytology.

      It seems very contradictory and I am left unsure of my next step, please could you offer your thoughts

  • Tracie

    Dear Dr. Dressler,
    My dog has a history of mast cell tumors. She has a bump on her back that I had a FNA done to see what it is. It looked really ugly after the aspiration was done. Also, it seemed swollen in the tissue around it. It really upset me. Is there any risk of the FNA spreading the cancer if it is a mast cell tumor? Thanks, Tracie

    • Bavani

      I have 1 year/10 months rotty mix Doberman mix hunter. He had a lump on his ear when I got him but the vet to ld me it wa nothing serious but on Xmas day it turned into a scab and we took him to the vet and they put him on antibiotic and we got some test done yesterday and they told us it is mast tumour and they have to remove his ear to do further test?? Is this the only way??? What is there any other test they can do to find out if it is malign or benign without removing his ear?? We treat like our son and we need abut more info,,, how long will be his life spent if we do the op?????

  • Aoife C

    Hi
    Thanks for the info, it s very helpful. My boxer had a cyst removed from her hind quarter last year. We did not do a biopsy with a needle, the vet just went in and took it out just in case. I did not realize that this could be done. We went to the vet last week after finding another similar feeling lump a few inches from the last spot. She didn’t seem overly concerned about getting it removed asap, but now after reading about this, maybe it would be a good thing to have done in the mean time?Both of these lumps were pea sized and you could put your fingers around it, so not attached. The hair was growing on it too.
    The day after we came home from the vets, however, I found another lump on her front shoulder. This one seems to have grown in a week, is pinkish red (kind of bubbly looking) and has little/no hair growing on it. Would this warrant some immediate concern do you think? Do you think a needle biopsy would be beneficial or should we go straight in and take it out?? It doesn’t seem to be attached to anything again and is the size of a pea. But it does look different… so worried :(
    Thanks
    Aoife

    • Barbara Leth

      I have an almost 10 yr old unspayed Papillon. Just recently a small hard nodule popped up on one of her lower mammary glands. The first doctor said she had cancer and to have it removed and have her spayed at the same time. I had planned to breed her just for a couple of puppies to keep but could only find a purebred male Pap with an underbite in my price range. So I didn’t want to do that and just didn’t spay her. This nodule is tiny, hard to the touch and is not attached to anything that I can feel. It is tender to the touch but that is it. She still plays, she still throws things at us, she still mumbles, eats, drinks and behaves just like she did before finding this nodule. I had thought of bringing her in for a FNA to see what it is, because I really didn’t want surgery because once open to the air, things spread around fairly quickly or she could wind up dead on the table from anesthesia. My friend contacted her good friend who is a Vet in Germany. He says that once a nodule shows up, it is generally cancer and has already spread. I have very little money and am trying to raise some to help me help my girl, but do not want to do anything that would shorten her life. I do not believe in chemo for myself (I am a nurse) as I don’t believe in poisoning everything to get at the main cause. So I doubt that chemo would be in her future. What do you think about this ‘hard nodule’ near the nipple area?

      Thanks for any info.

      • Dr. Demian Dressler

        Dear Barbara,
        I would get this addressed. About half of these are cancerous, and it is not actually true that once you find a lump it must have already spread. This is only true some of the time. I’ve got to say my opinion is that of your vet in the US…at least get it biopsied at the minimum so you know what you are dealing with.
        Best
        Dr D

  • Terry

    Should a fine needle aspirate be done or should the lump just be removed? My vet believes that fna are not accurate and can spread cancer and that all lumps should be removed with a wide margin. I am concerned about putting my dog under sedation or anesthesia and subjecting her to that kind of invasive procedure for several lumps without knowing what they are. What do you suggest?

    • Dr. Demian Dressler

      Dear Terry,
      fine needle aspirates are used very commonly accross the USA and internationally to help diagnose a cancer. They provide useful information and can give definitive diagnosis, but like any test they have limitations as discussed. The opinion that all lumps should be removed with wide excision without testing is rather unusual.
      Best
      Dr D

  • Christine

    Dear Dr. Dressler,
    My 9 year old basset had his senior and one year post amputation check-up last week. Last year he was diagnosed with bone cancer. He has done magnificently well this past year and is in great spirits, acts like a 2 year old. Your survival guide is our bible throughout this process, thank you!
    Our vet found a lump and an aspirate was done. X-rays, blood and urine came out fine. But the cytology test came out as “probably anal sac carcinoma”. When they say probable what does that mean? He is going to have an ultra sound next week.
    Preparing for worst case scenario, what would be your recommended palliative care? Best case scenario?
    As always, thank you!

  • Stacie

    I am in desperate need of answers……my 6 year old rottie, whom is a huge part of my families life, was diagnosed with “cancer” 4 weeks ago, the reason for the quotes was because the lab couldn’t identify what type of cancer it is. We took him to the oncologist and more aspirations were done, she diagnosed him with “suspectable” histiocytic sarcoma. Extra stains were done and the results didn’t come back with histiocytic sarcoma, just a high grade sarcoma. He is on his first dose of CCNU. His blood count did go way down and as I type, he is in the hospital getting antibiotics, hopefully he can come home today. Is it possible that he has been diagnosed with the wrong type of cancer? Is it possible that he is getting the wrong type of chemo? It seems the CCNU has made the tumor go down (visibly) but I’m not quite sure whats going on inside. During the initial extraction of a piece of tumor a chest xray was done and it showed nodules in his left lung, but none in his bones. Now, 4 weeks later, he is down 20lbs and looks like he is just withering away. So heartbreaking.

    • Dr. Demian Dressler

      Dear Stacy,
      ugh, no fun. So sorry!
      This is likely highly undifferentiated, meaning the cells lack defining appearance making it harder to classify the type of cancer. Nature does this as classifications are human, not from nature.
      Might get a second opinion pathologist report.
      I doubt the choice of CCNU is ‘wrong” under the circumstances though.
      I would very much be thinking of other tools in addition such as apoptogens, diet, immune support, antimetastatics and so on in the Guide.
      I hope this helps
      Dr D

    • Katie

      Dr Dressler,
      I have a 12 year old border collie cross. Despite his age he acts like a puppy and has never had any health problems, except recently an occasional cough which doesn’t bring anything up. I noticed 2 small lumps under the skin on his flank so took him straight to the vet. She said she thought they were lipomas but couldn’t be sure and said his heart and lungs sounded fine. After reading your articles i called the vet again and asked for samples to be taken from each lump. They said they would probably sedate him for the procedure so i asked for a pre sedation blood test and full health screening beforehand. I have agreed as i want to know definitely if these lumps are cause for concern. I know i may be over reacting but i’d never forgive myself if i didn’t check.
      I would appreciate your opinion as to what these lumps could be.
      Thanks in advance,
      Katie

  • Dee

    Dear Dr. D.,

    i am hoping that you can shed some light on out current situation. We have a 6 1/2 year old male Siberian Husky, we got him in Oct. 2008 the month he turned 3 He has generally been pretty healthy with the exception of some ear mites when we first got him, that were promptly treated, and then a stomach irritation that appeared to be alleviated by changing his diet since all labs were in order, that was in Feb 2009. Since then he has gone for all of his yearly checkups and vaccines and has been fine, his last routine checkup was April 2012 and he was fine.

    A little over a month ago, my husband decided that he wanted to change their food( Ialso have a 4 yr. old female Sibe) to a Hollistic brand of food. He mixed the old and the new for about a week, and they seemed to be tolerating it well, so he switched to the new food completely, the dog seemed ok with it for a day or 2 then it seemed he was getting picky, he started to eat much slower, but as eating everything, then he stated to put kibble on the floor, then he was leaving a little behind ( He’s always had a robust appetite, and he was a fast eater). After About 2- 1/2 weeks of this, I thought perhaps he just does not like this food, so I went and bought him a bag of his old food. When I first fed it to him, I thought that must be it because he ate all of his food with his normal rigor. And it stayed that way for a day or 2 after that. Then he started to become picky again and eating less again leaving some behind, eating slow etc. This went on for about a week, last Sunday morning I fed him he ate all of his food, and I left for the day and left the dogs with my husband. That night he called me and asked me what he needed to put on the dogs food to get him to eat. I thought this was weird, so i brought him home some canned food, and he atle a little, but very little, over the course of that week he had begun drinking and urinating alot too. a few days I figured it was ok, because we had a heat wave so I expected it, Over the weekend it became clear to us that it was excessive, so with the changed eating habits, and decrease in appetite I became concerned. My primary concern was renal failure, as i lost another dogs to this 10 years ago, she was a different breed and 14 yrs old.

    I called the vet at once the next morning (Monday, and brought him in). The vet said his examination findings were that he was dehydrated, had a 104 fever, cranial abdominal pain when he pushed on his stomach ( whatever that means), and that his heart rate as slow, although it improved lated in the visit. He reccommended blood panels to check organ function etc, those were normal.other than the signs of dehydration. There happened to be some sort of specialist there from Tufts Vetrinary Medicine School, who reccommended an ultrasound, so we went ahead with that, and the next news was heartbreaking, that my dog had stomach cancer of 90% of his stomach was inflamed, the vet told us to give him 10 mg of Pepcid AC 2x a day and 1-2 tablets of tramadol every 8 hours as needed, to minimize his discomfort, he told us that he was in some discomfort but not suffering it was not time to put him down. He said that they could do ultrasound guided FNA to definativelty diagnose the cancer and find out what kind it was, he did not think it would change the outcome any, he said it was 95 % likely he had cancer 5% that it was some other type of stomach inflammation.

    We left our dog there for the afternoon to do the FNA, and rehydrate him via IV fluids, that was 4 days ago. We took him home an his appetite and thirst remain about the same. His activity level is up and down, sometimes he seems like himself othertimes he seems very depressed.

    Last night we got a call from our vet with the FNA results, he said that he was amazed that they found no cancer on the FNA, ad he reversed his previous position, and said that at this point he would say 95 % he did not have cancer, 5% that he did instead of vice versa. Great news I think.

    However something is causing his gastric distress/inflammation that still remains a mystery. He seems quite depressed to me he has been going downstairs to be alone alot, although usually comes back on his own a little while later. And today he has started laying down at the bowl when he drinks, (he never does this)…..

    the vet said he was going to consult with the specialist who did the ultrasound and get back to us over the weekend.

    I am still extremely worried as the laying at the bowl etc, is new…

    If not cancer what else could be causng his inflammation, is it likely to cause depression, how would it be treated and how long should it be before he responds to treatment, in your experience….

    Thank you for your time.

    • Dr. Demian Dressler

      Hi Dee,
      I am sorry to hear about this.
      Fist thing- get a diagnosis. Either get another aspirate, a biopsy, or a second opinion on the aspirate from another pathologist. Get the ultrasound. You need to know what is going on.
      As to the signs, I apologize but I cannot diagnose without hands on the dog…meanwhile consider things like mirtazapine, sucralfate, and slippery elm for symptomatic care of the tummy..under veterinary supervision. Get your dog back in to the vets for further supportive care if this persists.
      Dr D

  • Sarah

    My spayed female labradoodle has a small, hard lump by left nipple #5. My vet says it’s too hard to aspirate. Measures approx. 1/4 inch X 1/2 inch. I’ve never heard of not being able to aspirate. . . Should I urge him to try the aspiration anyway? Not sure of my dogs’ age – probably around 4 years old.

    THANK YOU!

    • Dr. Susan Ettinger

      Hi Sarah,
      In my experience if a mass is a few mm, I may not be able to get an aspirate. But if it is > 5 mm, a mass is usually possible. With that said, I am not the vet looking at your pup. If an aspirate is not possible, a biopsy can be considered. The mass should be checked out since it is near the mammary gland. Good luck!
      Dr Sue

  • Jane

    I have a 3 year old Papillon and a few weeks ago I noticed a golfball size lump on his neck and a smaller lump next to that one. I took him to my vet and she did a fine needle aspiration and blood work and put him on antibotics. The bloodwork came back his white blood cells are elevated and the fna came back “incolusive” (she said the cells were dead — used a big word ) — so they did it again one slide for each lymph node. I just got the results back again and have the same results. I agreed to start him on predisone to help them reduce in size (he was coughing where I think they were effecting his wind pipe). The vet said to just wait because there is nothing else to do. So what do I do? If he has lymphoma he will die in a few months. Could it be something else or should I expect the worse? He is just so young and he is so afraid of everything my heart is breaking.

    • dav

      oh and will accidentally hitting the tumor cause it to turn cancerous?

  • waly derose

    If a fine needle aspirate was reactive for melanoma for a dog would that not be sufficient to demand a biopsy.

    • Dr. Susan Ettinger

      Waly, hard to advise you because not quite sure what the question is. Was the lymph node or tumor itself aspirated? And it was non-diagnostic or reactive?

  • Michele

    I have a 9 year old golden retriever. I recently found a hard, grape-sized mass near her abdomen, and another on her side which seems more a part of her skin. My vet looked at her today and told me that whenever the lump is hard, it should be removed. He said that when they removed them, they would look inside to see if they needed to be biopsied. My question is this: Should they try to get info with a FNA before scheduling her for surgery? Is it possible that they might find they don’t really need to do the surgery? Also, she has 2 lumps (one is baseball size) that are lipomas that are not a concern to the vet. But they gave me the option of removing them since my dog would be under for the other two lump removals. Of course the cost is more, but should I have them removed also? I would appreciate any info/advice you could give!

  • Dianne Lansden

    Dear Dr. Dressler:
    I have a male, neutered, 87 pound mixed breed, almost 9 year old dog who has been diagnosed with osteosarcoma in the left front leg bone near the shoulder, through radiographs and we just got the definitive biopsy back today. The vet tells me that he is afraid the tumor will bust through to the joint. What treatment would you recommend? There is a program at Texas A&M that uses brachytherapy in the lesion in the bone, followed by external beam radiation and then chemo. We are considering this route, but what supplements can I give him to facilitate a cure and what foods will help eradicate the cancer?
    Thank you
    Dianne Lansden

    • dav

      hi doc we had a fine needle aspirate done on my great pyr. He has had a cyst since july which has grown slightly. we did the wait and see approach until it started growing a little (and i found other lumps too) and brought him in for the aspiration. He had it on friday and now today(monday) the lump has grown ALOT. I forgot to mention that when the vet aspirated it he said there was nothing but clear liquid(he said this means it was a cyst do you agree) he didnt even send it tot he lab he was so sure.

      ifi t’s a cyst why is it growing so much and why am i finding new lumps everyday?
      he is 3.5. also why is he so itchy?

  • Andrea Phillips

    Dear Dr, i have an 8 and half yr old boxer with already ARVC since he was 2 and half. he also has arthritis and a couple of weeks ago i noticed a large firm lump on the right side of his neck above the shoulder area. Phoned the vettook him down ,needle aspiration done 3 different times and ALL came back inconclusive.He also had bloods done which showed he is severly Hypothyroid and has been put on thyroid tablets.however the lump is worrying it is about the size of a tomato.He cannpt have a biopsy as he would die on the table given his heart condition. was wondering if you could possibly know what this could be please. Thankyou.

    • Dr. Demian Dressler

      Andrea I am sorry to say a lump is just a lump. Have the vet do a local block with sedation and get a wedge or punch biopsy- easy to do.
      D

  • Sarah

    I have a nine year old Boston terrier who was spayed before 6 months. She now has a mammary tumor and slight infection. The vet looked at the secretions under a microscope and identified the infection and abnormal cells. They suggested a biopsy, but with her age and being a “brachycephalic” dog, I worry with putting her under. The tumor is larger than a marble, would it beneficial to have a needle aspiration done first? The vet did not suggest it or bring it up. Thanks for your help.

    • Dr. Susan Ettinger

      Sarah,
      An aspirate of the mammary mass will help tell you if it is mammary tumor, but you need the surgical biopsy to determine if it is benign or malignant. Still 50% are benign and cured with surgery. And 50% of the malignant ones are also essentially cured with surgery. So 75% of dogs with mammary tumors just need surgery! So I would consider it.
      Age is not a disease, and while she needs special considerations with her breed and surgery, it should be an option. I also wrote a chapter on mammary tumors in the Guide.
      All my best, Dr Sue

  • Suzanne

    Hi Dr Sue,
    My 8 year old border collie has a lump on his back. It suddenly appeard, we brought him to the vet. They did a fine needle biopsy. They got 2 vials of a bloody liquid. They sent it in to find out what it may be. If its not cancer do we need to get it removed? What could it possibly be. When the did the fine needle biopsy the lump was almost completely gone, the next day it filled back up again. I’m really worried about him,especially since he had surger 2 months ago to remove a small lump near his mouth that ended up being Basel cell tumor. Thank you for your help.

    Suzanne

    • Dr. Susan Ettinger

      Suzanne,
      If the aspirate results are non-diagnostic, I would recommend a biopsy called an incisional biopsy, where the vet removes a piece of the mass to find out what it is, before you get it removed. This pre-surgical biopsy confirms it is tumor and allow the vet/surgeon to plan for the surgery to remove the mass. I explain more of this in a recent blog about my nurse’s dog. Good luck!
      http://www.dogcancerblog.com/staying-vigilant-with-mass-aspirates/
      All my best, Dr Sue

  • Jennifer

    I have a 3 year old Newfoundland who had a FNA done of a large mass on the side of his neck. It started out the size of a golfball and within 2 weeks it is now bigger than a grapefruit and seemingly growing every day. We started him on cortisone but the lump keeps getting bigger. My vet said it was most likely lymphoma but we’re awaiting the results of the FNA. Isn’t he too young to get this type of cancer? If it is cancer and growing this fast – how long should I expect him to live? He still eats, plays, runs etc.

  • Amy

    I’m want your thoughts on the below:
    I went to a new veterinarian. I had asked this veterinarian to do a number of things, and one of them was to examine my 11 year old, canine companions’ growths on her chest. My canine is NOT obese; she is simply predisposed to tumors. My old veterinarian had aspirated these growths in years past with benign results. However, this veterinarian not only did NOT aspirate her growths, he didn’t even really feel her chest to examine all the growths. (My limited experience with him was that he would not listen to me…) I would appreciate your viewpoint on the above.
    Thanks!

    • http://www.dogcancerblog.com Susan Harper

      Hi Amy, Well done for being proactive about your dog’s health and asking for investigative check-ups. It’s frustrating to be met with a response that seems less than helpful. I know it’s been a few weeks since you wrote, and I apologize for the delay responding. I don’t know why you have gone to a new veterinarian… perhaps the previous vet no longer practices, or you’ve moved etc. However, you are your dog’s best friend and champion. If you are still struggling with this frustration, I can suggest two approaches. You could go back to this new vet and either when you make the appointment or while you’re in consultation with the vet explain that it is important to you to have these lumps checked as you have done in the past, and that you would appreciate him either taking the aspirations for you or referring you to a vet who will. Or, find another vet. You want to have a good partnership with your dog’s health care provider, so establishing that in these first appointments will help you both. Vets are truly animals lovers, but we can all have a bad communication day. I’m sure you’ll find this or another vet who will be happy to take care of your pup. Good luck. Susan form the Dog Cancer Support Team

  • Jennifer

    Can you help? I have a blue Great Dane who is 7 1/2 years old. I found a growth on the left side his neck about the size of a flat baseball. His vet did a fine-needle aspiration biopsy that came back inconclusive but did no other testing. Because of the location of the growth being so close to major arteries, throat, etc it needs to be removed…but is risky for all the same reasons. I’m not sure what to do? Should I get another opinion? What kinds of questions should I be asking?

    • Susan Kazara Harper

      Hi Jennifer, I know this is a worrying time, but hang in there. The throat is a delicate area, but you’re lucky that your big dog has a big throat. There is more room to work. If the fine needle aspirate was inconclusive, the next step is to get a biopsy by having a piece of the growth removed surgically. This will involve general anaesthesia. Because as you say it is advisable to have the lump removed anyway, it is worth considering whether to just have the lump totally removed and have it biopsied rather than having one surgery to tell you what it is, then another to remove it. The lump could be a fatty mass, an abscess, an infection, or a cancer. Is the lump interfering with your dog’s ability to eat, drink or be happy? These are all consideration for you as well. It’s up to you whether you get a second opinion, but if it sounds like your vet is reluctant to do any surgery, and you want to know what you’re dealing with, you can ask your vet if there is a surgeon you can go to who specializes in this type of soft tissue surgery. It’s not possible for every vet to have loads of experience in every department. So step 1 is to decide whether you want to move forward with this next stage of surgery to know what you’re dealing with. If the answer is no, ask your vet what treatment options, if any, are available now. If you want surgery, getting a specialist is a good move and will give you more confidence. Then it’s step 2, finding out what that lump really is. If you get confirmation of cancer, you’ll want to ask the type of cancer, and the stage/grade of the lump. This is all information to move forward, and there is much that can be done. But please don’t spend your energy worrying about a diagnosis you don’t have yet. One step at a time. Good luck and please give your dog a hug from me.

  • Susan Kazara Harper

    Hi Kelsi,
    Here’s the thing.
    If you only have the lumps biopsied, it will still involve anesthetic and surgery for your boy. The small amount of tissue taken will be tested. If either come back suspicious, or confirmed cancerous, you may then decide to have another anesthetic and surgery to remove the lumps. Now you’re on two operations (along with the cost, the stress and the healing for your boy).
    If your vet goes in to remove the lumps (either or both) the tissue can then be thoroughly biopsied, and he or she will aim to get clean margins, i.e. taking all of the mass away if possible. By taking the entire mass it’s possible to biopsy several areas of the lumps… if there is cancer, the cancer cells may not be spread throughout the whole mass evenly, so checking several areas of a lump makes more sense from that point of view.
    So it’s really down to how you feel and what you decide, based on how you know your dog, what’s in your heart, and your vet’s professional opinion. If your boy is hale and hearty and eating, sleeping and pooping well, he may be a good candidate to sale through surgery. Your vet can help you gauge this, and listen to your gut.
    I hope this helps. You are the only one who can make these decisions, but you’re doing the right thing by reaching out for information. Breathe out any fear, check your facts and talk to your dog about it too. Good luck to you both!

  • Susan Kazara Harper

    Hello Shannon,

    Fine needle aspirates are not very accurate. A full removal with clean margins, and a biopsy is really the best way to tell just what you may be dealing with.

    Equally it is a big and possibly expensive decision to make. Trust your instincts. If you want to get a second opinion and even another quote for the cost of the surgery and biopsy then by all means do that. You are your dog’s champion, and I know you want the best for your boy. You have the benefit of a young, mixed breed dog (lab x beagle sounds gorgeous!) and that gives him good odds in this. You also caught these within a couple weeks of their appearance. Another great plus.

    I urge you not to ‘wait and see”. If these turn out to be nasty you will regret the wait. Early detection and action are your best bet. You may find that there is an vet oncologist near you. If you need help locating one, do call me on 808-568-3252 and I’ll help in any way I can. Please stay positive. We’re all rooting for you both.

  • Susan Kazara Harper

    Hi Joanna,
    I understand the confusion, and you must have been worried and frightened, thinking for even a moment that amputation had not been required. Here’s the thing; aspirates are simply not a reliable method of diagnosis, and you’ll find that most oncologists will not even consider them. An actual biopsy of a portion of tissue is much more accurate. Oncology is a highly specialized subject, and when you realize that there are fewer than 500 veterinary oncologists in the USA, and a lot of them are in research facilities rather than vet clinics, one often doesn’t get to deal directly with an oncologist for their dog’s situation. The confirmation of the presence of cancer was consistent in both opinions however, and while I know you’re a bit distressed, and hoping for facts, the focus now can be simply taking care of your dog and moving on with recommended treatment. How is your girl doing after the surgery? Most dogs rebound quicker than we’d believe, and when the limb that was causing discomfort is not an issue any longer, they can get back to enjoying each day. So please don’t spend time worrying about the possibility of MCT. Learn the signs of course, (http://www.dogcancerblog.com/diagnosing-mast-cell-tumors/) and be vigilant but not anxious. Voice your concerns to your vet, and follow up with any recommended future checks. The job now is to fill your girl’s day with the best nutrition (The Dog Cancer Diet) to help keep her strong, follow the recommended veterinary treatment protocol, and please consider Apocaps as a first-choice nutraceutical to help keep her body’s cells firing in a healthy way. Also, have you seen the website http://www.tripawds.com? It’s SO helpful. Please let go of the worry of what perhaps might have been, and focus on what is. Your girl needs you at the front line with her, as a happy guardian celebrating her every tail wag. All the best to you both!

  • Chris Goodman

    Please help!! Advise…I have a 2yr old neutered male Chihuahua/Jack Russell- He had what seemed to be allergy symptoms…watery eyes, swollen lids, licked his paws, and bum & a large lumpy abbess (? for lack of better description on his left cheek).

    First visit to vet: placed him on prednisone, antibiotics and 1/4 of a Benadryl.

    -little improvement- needle into abbess- found puss

    Second visit to vet: Shot of prednisone, more antibiotic (clavamox) – everything else as directed previously- oral prednisone & Benadryl. Added eye drops.

    -Improvement to eyes, still large lump thing on side of face- now finding additional lumps (m&m sized) on body…armpit, groin.

    Third visit (different vet): Another needle into now cherry sized lump on face, again found puss, thought it might be an infected salivary gland (??) . Showed vet additional smaller lumps, said “hmmm, watch them, I think they are fatty in nature”.. told me to stay the corse with the eye drops, Benadryl, stop prednisone and changed his antibiotic to Baytril.

    No change!! eyes still icky, lumpy, — I am SOOOO worried about this lil dog. Is there anyway for you to tell me the likelihood or not of it being cancer related?? My heart is heavy, and my dog is sick. He is eating great, pooping is normal and healthy. He is tired, but so am I on Benadryl!! Any thoughts would be so greatly appreciated!!

    I have appointment number 4 in two more days!

    • Susan Kazara Harper

      Chris, This all came on suddenly and of course you are worried. You need to know what these lumps are, and you’ve already waited for some time while various meds were tried. “Wait and see” is no longer the best advice for lumps and bumps. If you aren’t happy with the response to your request, you have every right to get a second opinion, and it should probably be from a different veterinary practice. Please take photos of these lumps and their condition every couple of days, and place a coin like a dime or a quarter next to them for perspective. These photos will help any vet better understand. You can also ask your vet to refer you to a specialist. In the meantime, try to think whether your dog was exposed to any environmental changes – – pesticides on lawns or flower beds, nearby fields sprayed, a change to any chemicals within or around your home. Summertime is the worst for this type of thing, and our pets can often suffer for it. Get your information, insist on a referral or a specialist, and your pup will get relief that much sooner. Good luck!

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