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

Waiting and watching — but for how long?

Updated: September 26th, 2018

Have you been told to “just watch” a lump or mass on your dog by a veterinarian? I wouldn’t be surprised if you have. I too have advised that to my pet Guardians.  But how long is ok? What size is too big?  Are there actual guidelines?

In my veterinary training, I was taught that if a mass is not growing or changing in appearance, it is likely ok to do nothing and leave it – “just continue to monitor.” It’s been ten plus years since I started my medical oncology residency, and from my experience treating dogs and cats with cancer, that is not always the best advice.

While many skin masses are benign, some of these masses may also be slow-growing malignant tumors and it is better to remove them early, when it is more likely that the tumor can be completely removed with wide margins with the FIRST surgery.  I feel we are waiting too long, for too many masses.

This week I saw two cases that really depressed and frustrated me. Both were cats. I know this is a blog about dog cancer, but these cases illustrate exactly why it can be problematic to wait too long to take action – no matter what species we’re talking about.

Earlier in the week, I met Tiger, a big 16 year old cat with a recurrent tumor on his lower jaw, up front by the incisors.  It was first removed exactly a year ago. And now, it was back, and 3 cm wide. Think about how big a cat’s head is, and you’ll see that is a big tumor.

The tumor was a low grade fibrosarcoma, which, as in in dogs, is a malignant connective tissue cancer with tentacle-like projections that extend out from the visible tumor. It is these tentacles that make recurrence after surgery common if the surgery does not also remove a large amount of tissue around the tumor. We need a wide, clean “margin” of tissue. How big a margin? That’s what can be tricky to figure out by “just monitoring” it.

This week, as I visually inspected Tiger’s mouth with our surgeon at our practice, I was cautiously optimistic that surgery was an option. But just looking at a tumor doesnt tell the whole story, so, to be sure, we did a CT scan. Unfortunately, based on the CT scan, the tumor and its tentacles extended too far back. Surgery was no longer an option, as there was no way to get wide enough margins, and (most importantly) leave a functional mouth so the kitty could eat once he recovered. The surgery last year did not get wide enough margins. We didn’t want to do another resection (surgery), because we would end up with a minimal margin, and that would lead to another recurrence.

The second kitty I saw this week was Tulip. She also had a low grade sarcoma, a peripheral nerve sheath tumor, on the right side of muzzle. Tulip’s Guardian first visited her vet five months ago, after she noticed a small mass on the side of her face. Her vet prescribed steroids and antibiotics, which did not help for long. A month later, the mass was biopsied. At that point, the mass was still small, about 1cm, and likely still a good candidate for surgical removal.  Unfortunately, I did not see the case until this week, four months after that biopsy. At this point, the mass is greater than 3 cm.

The point I’m making here is that for both of these cases, the cancers might have (essentially) been cured if they had been treated with more assertive methods early, while they were still small tumors. Tiger’s first surgery should have had much wider margins, to reduce the risk of recurrence. Tulip should have had a big surgery with wide margins on that small, 1 cm tumor, rather than taking a wait-and-see approach.

Big surgeries, early, on small tumors, can be really helpful for these sarcomas. As in dogs, the metastasis rate is low for sarcomas, and chemotherapy is typically not recommended once the surgery removes the tumor.

Instead, I had to deliver the frustrating news that we are now beyond surgery as an option, in both cases. We now have palliative radiation, palliative pain medications, and anti-inflammatories. Palliative techniques are not designed to remove the cancer, remember. They are meant to help the dog, or in this case, cat, feel better while the cancer continues to do what cancer does.

Understandably, both guardians wept when I explained the situation. My heart was heavy, as I outlined the lack of good therapeutic options to rid these cats of their once-treatable cancers.

Dr. Dressler and I write in our book that there’s always something you can do to help your dog with cancer – and there is. You can always improve quality of life, change the diet, start supplements, and, of course, take advantage of palliative and therapeutic treatments.

But please – if you’ve landed on this page because your dog (or cat, in honor of Tulip and Tiger) has a lump or a bump, and you have been told to wait and watch it … rethink that.

In my next post, I’ll give you some guidelines for how to handle a “wait and see” situation.

Best,

Dr. Sue

Discover the Full Spectrum Approach to Dog Cancer

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  1. carol jones on May 19, 2018 at 9:00 am

    25 lb. miniature pincher, 13-1/2 years old. Large spindle cell sarcoma on back right leg. Four surgeries for removal in the last year. March 5, 2018 Vet says he can do no more. Tumor around and under leg bone, tumor now size of baseball and beginning to look bumpy and red in spots with all hair coming off tumor. We are waiting. We just have no advice other than wait. Our vet did his best but he is done with us now. We are giving our dog 9 drops of cannabis oil from druggist. We think it helps. Our dog eats everything he can with this oil…we have been advised. We do NOT know what to expect. The cancer odor is very bad and this dog is our baby and sleep with us. We wash clothes a lot. Is there anything else we can do and what will eventually happen with the tumor. Thank you.

    • DogCancerBlog on May 21, 2018 at 9:59 am

      Hi Carol, thanks for writing. Do you have a copy of The Dog Cancer Survival Guide yet? It has lots of ideas on diet and supplements that might be supportive to your baby as you try to help fight that tumor. At this point, it sounds like you need more support, too. Perhaps a second opinion or another veterinarian might have some ideas about how to keep him comfortable? You might also take a look at this post, which will help you to know what “the end” looks like — and help you to know whether you are close to it or not. https://www.dogcancerblog.com/blog/warning-signs-dog-dying/ Many cuddles to you and your little boy from all of us.

  2. Susan Kazara Harper on June 1, 2015 at 4:07 pm

    Hi Marti,
    Please give a big HAPPY BIRTHDAY to Buddy. I’m sorry this response has been delayed, and I know you may not feel very happy with this diagnosis looming. But Buddy can celebrate his 10th birthday in your loving care! and that’s something not every dog, nor human can enjoy. Do you have a copy of the Dog Cancer Survival Guide book? If so, please check out pages 36, 37 and 48 where it talks about decompensation. We know our dogs have the natural instinct from their wild cousins to hide, or ‘compensate’ for any state that is not perfect helth. When they are no longer able to do this, we call it decompensation, and sometimes that’s when we humans actually realize there is a problem. You know Buddy better than anyone, and your vet will know his medical state. Basically, there is so much you can do to help Buddy, starting with a Dog Cancer Diet (free download at dogcancerdiet.com, or it’s presented in the book), and keeping yourself as upbeat and unstressed as possible. Disease feeds on stress, and Buddy knows your heart probably better than you do yourself. If you can infuse every day with joy at being together, fantastic nutrition, play, and vigilance with your vet, Buddy may surprise you both. Please do refer to the book and work closely with your onncologist. Buddy does not have a number engraved on him, a final date, or anything like that. A prognosis only relies on statistics and don’t take into account the individual spirit of the dog. As long as he’s happy, enjoys his appetite and can poo and pee in comfort, he’s doing well. Do check out Part IV of the Book, Making Confident Choices. Every day is a gift, with or without a cancer diagnosis. Enjoy that birthday cake (or bone) and hold him close. Good luck to you both!

  3. Marti Farber on May 12, 2015 at 10:39 am

    Dear Dr. Ettinger,
    My Buddy is a beagle he will be 10 on June 01,2015 on April 01 he was diagnos. by oncologist with a sarcoma tumor it’s location between the kidneys and adrenal gland and dangerously close to a major artery they told me if I di the surgery he would only have 6-8 months to live if he didn’t bleed out and die on the table which was a 60% plus chance. So if this were me I would not have the surgery and leave this in God’s hands. My question is what signs should I be looking for as this cancer progresses & any tips for caring for my baby as every day now is a gift.
    I look forward to your response.
    Sincerely yours,
    Marti Farber

  4. Anna on July 10, 2014 at 8:31 pm

    Dr. Ettinger,

    Do you remember how long it was before Tiger’s tumor first started to return? My cat had a low grade fibrosarcoma removed from the top of his head approximately 7 months ago. It first appeared as a scar at the age of 9 months (summer of 2009) and grew very slowly until it was the size of a small pea, and was removed winter of 2013 while his teeth were being cleaned. It was around 2-3 mm in diameter and was removed with 1cm lateral margins, and as deep a margin as possible w/o removing skull (vet cut down to bone). The pathology report said that the tumor was well-differentiated and there was zero mitotic activity in the examined slices. Also, margins were reported to be clean. My vet discussed my cat’s case with the pathologist and he said that he had difficulty deciding if it was a fibroma or fibrosarcoma, but after consulting with another pathologist decided it was “just cellular enough” to classify as malignant. Due to the tumor’s low grade and clean margins, he thought my kitty might be cured. However, a second, more thorough margin check revealed a small focus of neoplastic cells. I consulted with a radiation oncologist and surgeon at the local vet school, and the surgeon said that in order to get the recommended margins, he would have to remove the top of my cat’s skull and replace it with a prosthesis; therefore, given the low grade of my cat’s tumor, he did not recommend re-resection. The radiation oncologist said that either radiation or a “wait and see” approach would be acceptable, given the lack of research on low grade fibrosarcoma in cats. However, she said if it were her cat she would do radiation. She is very confident in her team’s ability to spare his eyes and brain, and believes that the probability of radiation- induced cancer (I.e., osteosarcoma) is much lower than the probability of my cat’s tumor recurring w/o radiation, thanks to modern radiation techniques. The cost of treatment would be around $7000. I think it could be possible for me to come up with this money through a combination of donations and loans (unfortunately, I never purchased insurance…I didn’t even know pet insurance existed before his tumor was first documented by my vet in 2009, and buying it any time after that wouldn’t have been helpful because understandably, they don’t cover preexisting conditions). However, the limited research I’ve looked at suggests that for low grade fibrosarcoma, adjunctive radiotherapy does not reduce the rate of tumor recurrence in dogs and cats. Given how well-differentiated my kitty’s tumor cells are, I don’t even see how the radiation could “target” the residual cells. Radiation therapy is usually effective against cancer because it has a disproportionate effect on poorly differentiated cells (the healthy, well differentiated cells live and the cancerous, poorly differentiated cells die). It is difficult to pour so much money into a treatment that is unlikely to help, and will cause my kitty an enormous amount of stress (it would require 18 trips to the vet in one month, and my cat trembles and refuses to eat or drink while at the vet). Therefore, I’ve opted for the “wait and see” approach. That’s why I asked about Tiger. It’s been 7 months for my cat and there is no regrowth yet. I palpate once every two weeks. I found a small study which determined that the mean/median tumor free intervals for low grade fibrosarcomas in cats were between one and 1.5 years, so I’m definitely not breathing easily yet.

  5. xinch on June 22, 2014 at 5:29 am

    Hi Dr Sue, I live in Malaysia with my 5 year old American Cocker Spaniel, Shandy. Last August she had a mass grow on her upper lip and was removed and tested. The tests came back benign but just a month ago it regrew rapidly and aggressively. A 1cm margin was removed and the mass sent for testing. This time around, the mass is a malignant, Grade 2 soft tissue sarcoma! The pathology report states that while the excision margins are generally wide and the lesion fully excised, they’re also focally narrow (approximately 1mm). He has advised widening the margin to try and minimize the chances of regrowth, but even that he said may not be 100% effective. He’s also insisting that it probably has not metastasized and has declined to do an Xray to check so I’m not too sure what the next steps are in this case. She has an chronic case of malassezia which is currently being treated (it flared up again post-op). Could you please advise me on what the next best options are? 🙁

  6. Patty on April 8, 2014 at 5:12 pm

    Hi Dr. Sue, I spoke with you on your talk show about my dog Halo. She has the Apocrine ductular adenocarcinoma. Surgery on the tumor on her back was in Dec 2013. Saw an oncologist after speaking with you in February. He said it was a grade 8. Recommend praxicam for a year. Chest xray normal.all blood test normal. Ok, now he also wanted to send biopsy back to see how clear the margins were. They forgot to do this in February. They just sent it, and the margins are good but the depth is not good. Only 1 mm he said 4 mm would have been good. I’m confused on that, but now they want to do another surgery to get deeper. Or radation or metronic therepy. Halo has had this going on for so many months that I think the cancer cells are already elsewhere ready to spread, I’m concerned that since December s surgery an April surgery will be to late. I really am so sad and I don’t know what to do. She just turned 3. I wish they wouild have done all this sooner. I just wanted to know your thoughts on this. Is it really to late to do another surgery? Thank you

    • Susan Kazara Harper on April 11, 2014 at 10:17 am

      Patty, I can hear how distressed you are, of course you are. How is Halo in herself? At 3 she is very young and if she’s doing well with her appetite and her quality of every day life, she has a lot going for her. You say you’re worried the cancer has spread, but ‘worry is a prayer for what we don’t want’. I fall into worry about things too, and I know it doesn’t do a bit of good. I suspect the vet would not be recommending further surgery unless he felt that Halo was in good shape and that the surgery (or radio and metronomic chemo as you said) is worth trying. Yet ultimately all of this is your decision. And sometimes that stinks. Dr. Sue is off line for about a week, but you could email into Radiopetlady@gmail.com again and perhaps get on the show again when she returns. I know this feels like it doesn’t help right now. Talk frankly with your vet, ask what he thinks is the best option for Halo at this point. Does he have any reason to believe the cancer has spread? Take a few deep breaths with Halo and talk to her about it all. You will know the best decision in your heart. Are you using any nutraceuticals to help support her? Is she on the Dog Cancer Diet? It all helps. I’ve had two dogs who surpassed both the odds and their prognosis when they had cancer. Good luck Patty. Give Halo a cuddle from me please.

  7. julia on March 11, 2013 at 4:31 am

    Dear Dr. Sue, my wonderful Dog Cancer Survival Guide along with Dr’s D’s acopops have just arrived in London courtesy of Amazon, and I am finding the book very helpful in coping with Nutty, my 15 year old Sheltie’s recent diagnosis of squamous cell carcinoma in his mouth. Unfortunately we discovered this growth quite late and my vets do not recommend surgery as it would mean removing too much of his jaw. He is in amazingly good form, enjoying his walks, does not appear to be in any pain and has a good appetite. he is just the same as always. However the tumour is 1 and a half inches, is now growing out from his lip, and is now visible when his mouth is closed. Although I understand that it is difficult to give advice over the internet but I wonder if you know of any good oncologists in the UK who might be able to help? He is taking apocaps, shitake mushroom extract, colloidal silver and a homeopathic supplement and I have changed his diet. I must be realistic but I want to do all I can. Best wishes, Julia Stephenson

  8. Tipsy's carer on January 7, 2013 at 1:19 am

    Hi, I’ve got a big decision to make, and would appreciate any guidance. Tipsy came to live with me 3 years ago, as her original owner moved to rented accommodation, and couldn’t have pets. Tipsy is a Saluki/Border Collie cross now 11yrs old. Lovely temperament. April 2012, as we were on an evening walk, Tipsy collapsed, her back left leg gave way. She couldn’t get up. I ran home, got my car, a lady helped me get her in. Off to the Vets, were she had always been for treatment since a puppy, so they knew her history. Tipsy couldn’t stand, and was crashing about the surgery in an attempt to get her movement back. Vets initial reaction was to put her down, which I was horrified by. Vet knows I have no insurance on Tipsy, and at the time a limited budget. We agreed to give her 12 hours, she was given Diazepam to calm her, I could feel her sink into my arms and relax as the injection worked. She had a drip in her leg, too. Tipsy stayed in overnight, I got a call to say she was recovering. I went and collected her the next afternoon. She also had Epiphen tablets. Tipsy slept on and off for nearly 2 days, When she got up on the second day to have a drink, I noticed a small lump on her leg, next to the site were the drip had been. Rang the vets for advice, said I should bring Tipsy in. Lump was aspirated, results came back, a spindle cell tumour. At the time, the lump was the size of a walnut. The vet denied it could have been caused by the drip, even tho it was right next to the drip site. They didn’t suggest removal, and implied cost if I did want lump removed would be prohibitive, possibly a £1000. As the lump got bigger,(now size of a pingpong ball) I went and got a 2nd opinion. Vet said it could be removed, but as clear boundaries were needed, lump now probably too big, and could be risky. Was advised lump would eventually split, as the skin would reach a point where it would stretch no more. Tipsy is fine, eats well, can still run to chase squirrels, but the lump has got to the size of a tennis ball. It looks awful. Why the first vet didn’t remove it when it was tiny I will never know!!!!!! A friend has just told me to try a vet she uses. Went on Thursday, he is willing to try and remove lump, but told me it’s 90% likely to return, but could give her an extended time. He removed one last week that came away like shelling peas. Also did one on a dog that had come over to U.K from Greece, and lump wouldn’t come away, dog had to be euthanaised.. Bearing in mind Tipsy is 11+ years old, what should I do???? I feel helpless watching this lump grow, but feel I may condemn her to death if Vet operates and lump accelerates. Please can anyone help me make a decision? Thank you, in hope.

  9. Kasey McMahon on January 2, 2013 at 4:10 pm

    Dear Dr Ettinger,
    I am simply devastated, my 10yr old French Bulldog was recently diagnosed with MCT at the base of his back leg. This began as a cyst removal in October that was about the size of a golf ball. The vet that did the sx did not send it for testing because he did not think that it showed characteristics of being cancer. Once his post sx meds were done, I noticed fluid build up and lumps that I thought were lymph nodes at the time appear. Second vet visit, vet said “I’ve never seen anything like this before, but it doesn’t look like cancer, so more antibiotics and pred. Again he responded well but as soon as he was done with the meds, the same reaction. The third visit just like the last visit, but this vet did several needle aspirations and did not see any cancerous cells, so what a relief we thought. More meds, same as before. My final visit to the vet, I saw a different vet who quickly said this is serious and we need to remove these cysts right away. I was crushed, and decided to cantact a friend of mine who also happens to be a vet, but his practice is too far to be my regular vet and he confirmed that it was a MCT right away and was very concerned. Now my question (sorry for rambling, perhaps this is just therapeutic on my part), my friend mentioned creating a vaccine for MCT using a tissue sample from his tumors. I have never heard of this before and I wondered what your experience was with this approach? The cost is outrageous naturally, I was told that it would be somewhere between $2000-$3000. Due to the cost I am leaning more towards chemo, but I’m just so confused about what direction to go. I realize that you are limited on what advice you can give, but anything would be helpful. I am trying to deal as best I can, but everything I have read about MCT is grim, I haven’t found any success stories and I feel like I only have a few months left. Any information or insight would be helpful.
    Kasey

  10. Cheryl on December 31, 2012 at 12:01 pm

    So glad I found this website.

    My 8 year old Shadow has a peripheral nerve sheath tumor in the lumbar region – it was growing into his spinal cord. His symptoms were a limp that developed in July – vet thought it was a CCL injury but when they took in in for surgery the othro said it was not a CCL injury. Nothing was showing up on the xrays. He seemed to recover after that and then in September started limping again and having paid. Had an MRI done and the diagnosis was made. I was told surgery was not an option but I could try radiation. He had 19 radiation treatments and has improved greatly. The onocologist and neurologist and very pleased and I think a little surprised. Does radiation work for these kinds of tumors? They won’t tell me how long he has. It has been 4 months now since his diagnosis and he was given 2 weeks to a month without any treatment.

    I feel so helpless about my Shadow but he seems happy and is doing well for now. Do you have any experience with these kind of tumors? He was never biopsied so don’t know if this is a low or high grade tumor. He had been having subtle symptoms in his walk from last March on.

    Thanks for your time.

    • Dr. Demian Dressler on January 2, 2013 at 12:22 pm

      Dear Cheryl,
      well, if its working…there you go. Yes, nerve sheath tumors are one of the various ones that radiation can help with. The reason why the oncologist won’t give you survival data is probably because it is not known for your specific case.
      I would definitely start with this post:
      https://www.dogcancerblog.com/blog/an-overview-of-what-else-can-i-do/
      and I most definitely would read the Dog Cancer Survival Guide (www.dogcancersurvival.com). There are many steps that can be done that may contribute to your Shadow’s longevity and also life quality.
      Best
      Dr D

    • Dr. Susan Ettinger on January 13, 2013 at 12:51 pm

      Hi Cheryl,
      Sorry to hear about Shadow. Nerve sheath tumors are a type of soft tissue sarcoma, but the ones involving the central nervous system/spinal cord are different than the ones involving the skin and/or subcutaneous tissues. I really cannot give a prognosis without being more involved directly in the case. It sounds like you have a good team on specialists. I hope Shadow continues to improve and do well.
      All my best, Dr Sue

  11. Ruth Dixon on December 8, 2012 at 12:03 pm

    I have been reading the canine cancer blog for quite some time. I have a close to home interest in that I lost one great girl to bone cancer and my other girl has a four + year history of mast cell tumours. The first MCT caught me by surprise. It looked like a wart that had scabbed over. At the time this one was found and operated on, there were two other ones. All removed. She has lost most of her tail because of another one (looked like nothing) and she has just had two more removed. All in all she has about eight (I’ve lost track). I am now always waiting for the next. My personal advice . . . . there is really no “watch and wait” period that works. A fine needle biopsy is the only thing that will give you some peace of mind. Well not if it is “something”, but at least you will never kick yourself because you watched and waited too long. My old girl will be 13 (pretty good for a large dog) and she is still here because I have everything suspicious, biopsied. Yes it gets expensive but no one ever said that caring for your four legged children could be cheap. Something to think about when you let them into your heart.

    • Dr. Susan Ettinger on December 29, 2012 at 6:09 pm

      Great advice, Ruth! Thanks for sharing. Wishing your dog continued health!
      All my best, Dr Sue

  12. Dog Owner on November 27, 2012 at 4:54 pm

    I am fortunate that my vet aspirates every lump I find. Most have just been fatty tumors. But, one on my dog’s leg had doubled in size literally overnight (between the time I called the vet and the vet’s appointment the next morning) & test showed “funny” cells. At the time, my dog was almost 13 & surgery was scheduled immediately. Fortunately, turned out not to be cancer & he fully recovered. But then, this past summer, I felt 2 lumps under his throat – he was diagnosed with advanced lymphoma. Due to his age (now almost 14), we decided not to do chemo, instead kept him comfortable. He lasted 3 months.

    • Dr. Susan Ettinger on December 29, 2012 at 5:48 pm

      Thanks for sharing, and I am sorry about your dog’s lymphoma.
      With sympathy, Dr Sue

  13. Gillian on November 26, 2012 at 11:22 pm

    Dr,
    Can you please help me , my dog just got spayed four days ago because of ovary infection . I brought her to the vet because i found bumps near the nipples at the rear end and they gave her an x-ray. The vet said it was early stage of ovary infection and hence they spayed her . However the point is even after operation the bumps were still there. (At first there was only one). The bumps are under the skin , the biggest is 1cm in diameter. Some are visible while some can only be found when touching the area . Does she have Mammary cancer ?

  14. Chrissy on November 26, 2012 at 9:48 am

    I noticed a very small growth on the outside of my dog’s bottom lip at the beginning of November. It was whitish-pink and hard/rough. It seemed to grow so I had my vet look at it about 10 days later (11/14). She just looked at it and said it was nothing – probably a wart or cyst, and that it would go away in 6 weeks.

    By the time I went home for Thanksgiving on 11/17, it seemed to be growing even more. I went to my family’s vet on 11/19 and had it aspirated. The vet used two needles and took two samples. She wrote down that it was 2 mm at this time. The cytology report said there was “low cellularity” and noted the presence of anucleated squamous epithelial cells, mildly increased neutrophils, rare macrophages, and rare pleomorphic bacteria. The comment states, “the presence of squamous debris with the concurrent mixed inflammation could suggest that this is a ruptured keratin-filled lesion which has incited a significant inflammatory response with a secondary bacterial infection.”

    However, it also states that because cellularity is low, the sample maybe not be fully representative, and that the squamous debris could be a result of superficial contamination. The recommendation is “correlation of these findings with the clinical impression of the patient.”

    The vet’s advice was to “watch & wait.” She suspects it is a cyst that has “filled in” and that it is not malignant. She said generally mast cell tumors (her original concern) exfoliate very well on aspiration. She also felt she got good samples on her aspiration.

    Watching and waiting is making me nervous. At the beginning of November the lump was <1mm and now it is probably 4mm. It is still really small, so I feel like the vets think I'm being silly (and I can't keep paying for office visits just to get "advice"). My dog has had two surgeries in the past year (she was spayed at the shelter and then had to have a surgery to repair an abscess that resulted from that spay), and I would much prefer not to have another surgery because of how dangerous it is (the cost is less important to me). However, above and beyond that, I want my dog to be okay.

    The vet who did the cytology said that cysts do grow and that cancer typically would not increase in size this quickly (it's more of an inflammatory response?). However, the lesion is rough on the outside and is growing out of the skin (it is not below the skin). It does not look like a cyst to me.

    I don't know what to do. Like I said, I don't want to keep going to vets and spending money on office visits, but I want to take care of my dog. She is a 3-4 year old lab mix. I have only had her for a year and that is way too soon for me to lose her 🙁

    • Dr. Susan Ettinger on December 29, 2012 at 5:43 pm

      Chrissy,
      I agree with your vet that MCT typically exfoliate well, but any time the cellularity is low, one cannot be certain of the diagnosis. How is the mass now? Another option is a punch biopsy which can typically be done for small masses less than 1 cm. Sometimes our surgeon does them with a local block and sedation instead of anesthesia, which keep costs down. I cannot give you specific medical advice over the internet and this may not be a good option in this case near the lip, but I hear your concern, and it may be better to get a procedure to remove it, and if it’s benign, you’ll have that peace of mind.
      Good luck, Dr Sue

  15. Gillian on November 26, 2012 at 3:00 am

    Dr Susan,
    I bought my dog to have an x-ray as she had small little bumps near her breast .The vet said that the x-ray showed no tumor but the vet found out that she had infected ovaries. And hence my dog got spayed 2 days ago .The point is , after surgery there are still small bumps near her rear end (near her nipples). Does she have Mammary cancer ? The bumps cannot be seen , it only can be felt by touching the area ( the bumps are under the skin).At first there was only one bump but then few weeks later a few more popped up.The bumps did’nt grow in size .
    Size :about 1cm diameter

    Note : She’s 11 this year

    • Dr. Susan Ettinger on December 29, 2012 at 5:35 pm

      Gillian,
      I recommend the masses get aspirated to determine if they are cancer or not. Also, 50% of mammary masses are benign, and of the 50% that are malignant, half of those are cured with surgery. So 75% of mammary masses are cured with surgery. You cannot tell by touch or size. Good luck,
      All my best, Dr Sue

  16. Elliott Garber on November 21, 2012 at 9:40 pm

    As a general practice vet seeing little lumps and bumps and often advising to “wait and see”, this article definitely interests me! I often give clients the option of having something removed at the beginning, even if it does appear to be completely benign. However, I usually tell them truthfully that if it were my pet I would probably wait until there were more signs to worry before going through the risks of anesthesia and surgery. Thanks for the insight.

    • Dr. Susan Ettinger on November 24, 2012 at 6:07 pm

      Dr Garber,
      Thanks for reading and sharing. I too was taught the wait and see approach, but I have had to rethink this approach as I see and hear about too many pets that this approach is failing them and their tumors. Too many pets have masses that were once surgical and now there are no good options. I appreciate all the work the vets on the “frontline” do. Vets like you i general practice are the first ones to see these masses, and I am just trying to have us re-evaluate this approach. I am hopeful together we can help more dogs and cats catch those tumors earlier. Aspirate and biopsy! =)
      Thanks again for contributing!
      All my best, Dr Sue

  17. TERRY WOODS on November 19, 2012 at 9:41 am

    I understand the need for immediate action with fibrosarcomas but WHAT do you DO when there are MULTIPLE sites and they are removed and then 5 months later you have DIFFERENT multiple sites and they are removed and then 5 months later….on and on. Dog is sliced and diced every 5 months. Fibrosarcoma NEVER occurs on the same site. NEVER…..Dog is 6. Vets are now refusing to slice him up and take margins again as there are now 6 to 7 sites. Metronomic chemo was not tolerated…where do we go for help???? Cannot even find evidence that this happens in young 6 year old dogs. Nothing on internet

    • Dr. Susan Ettinger on November 24, 2012 at 5:54 pm

      Terry,
      This sounds like a very unusual case. I am sorry to hear about all the surgeries and bad reaction to chemo. For atypical cases, you are unlikely to find info on the internet. I would recommend a second opinion with an oncologist. If you dog is making new FSA, I recommend chemotherapy. Sometimes chemo can be tolerated with different drugs or dosages.
      All my best, Dr Sue

  18. Billie Sue White on November 17, 2012 at 9:11 pm

    This article really hit home with me. It brought back the tragedy that I am stilll trying to cope with every single day. Han, my big, black, handsome Newfoundland/Lab mix had a tiny dermal mass resmbling a wart suddenly appear on his right abdominal wall. I took him to an oncologist, who aspirated it as benign and advised me to just “watch” it. Several months later I took him back because the mass was getting larger; it had almost doubled in size. The oncologist again aspirated it as benign but refused to remove it, saying it was not necessary. Again she said to just “watch” it. Four months later I took Han to the same veterinary oncologist to have this growing mass re-checked. It had increased in size from 4mm x 6mm to 10mm x 12mm in less a year. I again asked the oncologist to remove the mass; again, she refused. I then asked her to at least aspirate it. She refused, saying there was no need since it was benign the previous two times she aspirated. For the third time she advised me to just “watch” it.

    Sadly and tragically I blindly, unknowingly, and naively trusted and followed this veterinary oncologist’s judgment and advice. Several months later this same dermal mass was diagnosed by a different veterinarian as an advanced grade three mast cell tumor. Eight months later (after surgery, chemotherapy, and radiation treatment), my dearest, precious Han, who was not yet eight years old, passed away. There are no words to express the pain, sorrow, and guilt I feel every day. I hope others will benefit from our tragic experience.

    • Dr. Susan Ettinger on November 24, 2012 at 5:45 pm

      Billie Sue,
      I am so sorry about Han. Thanks for sharing your story – I know it is not easy.
      With sympathy, Dr Sue

  19. Lindsay McFadden on November 16, 2012 at 10:36 am

    Our 4 year old golden, Tralee, has already had one surgery for a type of melanoma on her paw last spring. The surgeon removed two digits and obtained clean margins. At the suggestion of our vet and the surgeon, he also removed one lymph node which was found not to have been attacked by this horrible, horrible disease. Although our oncologist gave us news about a new vaccine, we were hopeful that we were in an okay place with the situation, clear margins and lymph node, and opted not to have her administer the very expensive, series of shots.
    In October, I found 2 small lumps ascending up her leg and immediately called our vet and took her in. The vet measured and aspirated both lumps. We waited through the weekend and found out the dreaded results the following Tuesday. The lab report suggested that it was different, slower growing tumor that would not spread. For some reason, the lab that analyzed the liquid removed, like to give it a name. In Tralee’s case, it would not have made a difference but I believe that a bioposy is the only true test.
    I made an appointment with the surgeon to see Tralee a day later. All the pain we experienced just 6 short months ago, came flooding back as we drove up to the hospital for our appointment. The surgeon performed a thorough examination of both her legs, finding additional lumps going up her affected leg. We had 3 views of chest x-rays done and found no dark areas.
    I realized, that as we talked through our options for potential treatment, this was more than likely the same type of cancer as originally removed. The surgeon advised me that if we did try to go ahead with more surgery, he would end up with dirty margins this time. Even with the surgery and going ahead with the series of shots, treatment might buy her 12 months.
    We have Tralee at home with us and, for now, she is doing well. She is very active and happy and knows nothing about her health.
    As soon as the cancer was diagnosed in March, I read as much as I could on melanoma in dogs. I found Dr. Dresslers book and this blog and am thankful for the information provided in both. We switched her dog food to a grain free option from HALO. We have done radon tests in our home and are waiting for the results. We do not and have not applied pesticides on our grass area. We already have our water tested annually and will continue to do so by several different companies in an effort to find out what carcinogen may lie lurking somewhere in our immediate environment. When I started researching, I was shocked at the amount and different cancer types that may exist in our beloved 4 legged friends.
    I am so sorry for any of you going through this agony. I love my girl and kiss and hug her every chance I get. If I wake in the night, I always give her a pat to let her know I am there for her. We purchased a St. Francis medal for her and pray to him for strength.

    • Dr. Susan Ettinger on November 24, 2012 at 5:43 pm

      Lindsay,
      I am sorry to hear about Tralee. Thanks for reading and sharing. And good luck to Tralee.
      All my best, Dr Sue

  20. Natalie on November 16, 2012 at 2:10 am

    My vet told me to wait and see – I didn’t I got an enlarged lymph node biopsied on my golden and was all clear – 3 weeks later my baby collapsed and we spent a rolled coaster ride of it could be this or that – then an X-ray showed an extremely large heart and then to confirm a suggested diagnosis I fared to see a specialist. Cardiologist and echocardiogram – to our dismay my poor baby had a a Tumor in his heart and finally a diagnosis of hemangiosarcoma was made- sadly due to the position of this nasty nasty Tumor my baby let md know it was time for him to go play at the bridge with his fur cousins – since this event I have spent many hours researching and have discovered the earliest sign would have been a liitle pimple like cyst on is back that I was told by the vet was a common sebaceous cyst that sometimes in older dogs burst ! Lesson learned – evey lump bump scratch deserves to be investigated – I know had it been biopsied and a diagnosis made earlier it would not have changed the outcome as this is such a horrible cancer- but I would have known in advance and maybe the pain and guilt I feel now after the diagnosis would be less – seriously guys if your gut tells you it’s not right – do t just sit on it – our babies are way too precious not too 🙁 I was blessed with my boy for 12 wonderful years and for that I am thankfully / but still it hurts like hell !

  21. darci finley on November 15, 2012 at 9:58 pm

    try vet immune tabs and consult a hollistic vet! and change your pets diet thats so important…if processed food is bad for us its bad for them!

  22. Lauren on November 15, 2012 at 2:18 pm

    Thx for the great advice. I’ve never been comfortable with “watch and see” — dor what? Get it out asap to be safe.

    Thx!

  23. Joanne Riddle on November 15, 2012 at 1:12 pm

    I was told to watch a small lump in my dog’s neck. 4 weeks later this small marble size lump is a tennis ball….and 13 weeks later my dog whom I was told was not facing anything life threatening died from hemangeosarcoma. If I could turn back the clock to the day that I found the small lump, I would insist on an immediate biopsy. My vet failed me…she failed my dog. NEVER will I WAIT again.

    • Dr. Susan Ettinger on November 24, 2012 at 5:37 pm

      Joanne,
      I am truly so sorry about your dog. I hope together we can help other dogs get aspirates and biopsies done sooner, but it does not help your dog. I am so sorry about your loss.
      With sympathy, Dr Sue

  24. Ms. Charlie W. on November 15, 2012 at 12:46 pm

    Dr. Sue, I was researching the type of cancer my precious dog, Dude, was diagnosed with, the soft tissue Fibrosarcomas oral cancer on the inside upper jaw. The suggested treatment is doxorubicin chemo 1 tx so far with piroxicam then Palliative radiation therapy (six treatments- he is on his 3rd tx) then return to doxorubicin.

    Eight days after the chemo (also started piroxicam at least a week before the chemo) Dude got very very ill with severe diarrhea and extreme lethargy and just wanted to lay as far away from the house in the back yard as possible. I had to carry him into the house. He was given medicine for diarrhea but the oncologists wasn’t sure why he got so sick 8 days after chemo. They didn’t believe it was the chemo and thought it might be the piroxicam. My fear is whatever it was seemed like it nearly killed him so I’m hesitant to return to the chemo or piroxicam.

    What has been your experience with the above treatment and side effect?

    I was reading a book “Cancer and your pet” by Debra Eldredge and Margaret Bonham and they reported some positive outcomes combining chemo with NSAIS’s and were there was excitment about great outcomes with bladder cancer and a development about a new and relatively safe treatment for dogs and tried on canine oral cancers that can’t be operated on.

    This book was dated 2005 is there more current research on this? What are more current outcomes? Also Can’t my dogs tumor be removed with surgery even if it means removing the upper jaw bone? Or leaving a dirty margine and blast it with radiation? Nobody seems to think so.

    Dude is 12 years old and show no signs of illness, he is my best friend ever and he just loves me and I him, he is the best dog ever, so I want to leave no stone unturned in finding the best possible chance of him beating this cancer!

    Your feedback would be invaluable.

    Ms. Charlie W.

  25. Therese on November 15, 2012 at 10:32 am

    I watched a pinky-finger-tip-sized flat, raised area (that apparently only I could feel) for 6 months at our vet’s direction. We treated it as if it were an insect bite or perhaps a puncture from running into something in the yard.

    The bump was on our dog’s skull, slightly to one side of the midline of the upper sinus. Since it was painful when pressed lightly, I finally insisted that we biopsy and our vet admitted that this was out of his league. Sigh. A specialist confirmed this was a squamous cell carcinoma that had originated in the upper sinus and had now come through the top of the skull. Worst day ever (to that point).

    What followed was a whirlwind of surgery, radiation and finally chemo. A fight we lost after 5 months. The bills were enormous because we had no pet insurance.

    Looking back and taking her entire medical history into consideration, there were signs that this was likely cancer perhaps as much as a year before diagnosis. Of course hindsight is 20/20, but I wish our vet had been a bit more aggressive about getting to the bottom of this medical issue. As an owner, I will be more aggressive in the future about lumps and bumps. I would rather spend the money to rule out, than have one of our dogs go through this again.

    • Dr. Susan Ettinger on November 24, 2012 at 5:32 pm

      Therese,
      I am sorry to hear about your dog. Know that you did all you could for your dog. Again, so sorry for your loss.
      With Sympathy, Dr Sue

  26. Donna on November 15, 2012 at 9:41 am

    This is very depressing as my, very special, shephard mix has several growths on his body and one has grown from egg size to palm size in about 3 years. This while we watch – now I dread to see what this could be. He has another on his side by his ribs – a fairly large one by his back knee – that got larger after he had knee surgery – even though I talked to the vet about the relatively small lump I felt behind the knee at that time. It wasn’t anything to worry about-its probably 6inches behind his knee now. But he walks okay. I feel sick. Sometimes I get the feeling, that even with the Vet/Dr. – they are just dogs. They are our so much more than “just dogs”.

    • Dr. Susan Ettinger on November 24, 2012 at 5:30 pm

      Donna,
      I hope you are able to get the masses aspirated and get some answers and options.
      Thanks for reading and sharing. All my best, Dr Sue