Fine needle aspirates to diagnose dog cancer?
Dr. Demian Dressler is internationally recognized as “the dog cancer vet” because of his innovations in the field of dog cancer management, and the popularity of his blog here at Dog Cancer Blog. The owner of South Shore Veterinary Care, a full-service veterinary hospital in Maui, Hawaii, Dr. Dressler studied Animal Physiology and received a Bachelor of Science degree from the University of California at Davis before earning his Doctorate in Veterinary Medicine from Cornell University. After practicing at Killewald Animal Hospital in Amherst, New York, he returned to his home state, Hawaii, to practice at the East Honolulu Pet Hospital before heading home to Maui to open his own hospital. Dr. Dressler consults both dog lovers and veterinary professionals, and is sought after as a speaker on topics ranging from the links between lifestyle choices and disease, nutrition and cancer, and animal ethics. His television appearances include “Ask the Vet” segments on local news programs. He is the author of The Dog Cancer Survival Guide: Full Spectrum Treatments to Optimize Your Dog’s Life Quality and Longevity. He is a member of the American Veterinary Medical Association, the Hawaii Veterinary Medical Association, the American Association of Avian Veterinarians, the National Animal Supplement Council and CORE (Comparative Orthopedic Research Evaluation). He is also an advisory board member for Pacific Primate Sanctuary.
Updated: April 4th, 2019
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
Dr. Demian Dressler is internationally recognized as “the dog cancer vet” because of his innovations in the field of dog cancer management, and the popularity of his blog here at Dog Cancer Blog. The owner of South Shore Veterinary Care, a full-service veterinary hospital in Maui, Hawaii, Dr. Dressler studied Animal Physiology and received a Bachelor of Science degree from the University of California at Davis before earning his Doctorate in Veterinary Medicine from Cornell University. After practicing at Killewald Animal Hospital in Amherst, New York, he returned to his home state, Hawaii, to practice at the East Honolulu Pet Hospital before heading home to Maui to open his own hospital. Dr. Dressler consults both dog lovers and veterinary professionals, and is sought after as a speaker on topics ranging from the links between lifestyle choices and disease, nutrition and cancer, and animal ethics. His television appearances include “Ask the Vet” segments on local news programs. He is the author of The Dog Cancer Survival Guide: Full Spectrum Treatments to Optimize Your Dog’s Life Quality and Longevity. He is a member of the American Veterinary Medical Association, the Hawaii Veterinary Medical Association, the American Association of Avian Veterinarians, the National Animal Supplement Council and CORE (Comparative Orthopedic Research Evaluation). He is also an advisory board member for Pacific Primate Sanctuary.
[…] real diagnosis, a test of the actual tumor material is needed. One of the most widely used is a fine needle aspirate. Sometime though, a biopsy (either before or after removal) is the first step to get a diagnosis, […]
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.
Dear Janet,
what were the results of the aspirate?
D
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?
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
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
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)
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
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.
Dear Bridget,
I think you are doing all the right things. Keep it up!
Dr D
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.
how much does something like this cost?
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
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