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

How Important Are All Those Expensive Diagnostic Dog Cancer Tests?

Updated: April 13th, 2021


You could easily spend over $1,000 just to diagnose your dog’s cancer. Are any of those tests worth it? Which ones?

Veterinarians have been telling us for years that there are some bumps and lumps that pose a problem, and others we can “watch and see what happens.”

This “watch and wait” attitude is now being called into question – big time. And not just by our veterinarian authors, Dr. Demian Dressler, and Dr. Susan Ettinger, oncologist, who co-authored The Dog Cancer Survival Guide.

Ack! Do Something!

With the relatively recent understanding that cancer has indeed become the number one killer of dogs, many cancer experts are starting to recommend that veterinarians test EVERY lump and EACH bump. Or, as Dr. Ettinger says: “See something, do something!”

But tests cost money. And if your dog has cancer, money might become tight, quickly.

So how far should you go when it comes to all those diagnostic tests? Are they really worth the money?

Argh. As is so often true with cancer, there is no clear-cut answer to those questions.

Sometimes, yes, those tests are worth it.

Sometimes, they aren’t.

The answer mostly depends upon you, and only you can decide for yourself what’s right for you and your dog.

Read Chapter 9 and Listen to This Webinar

This is such a tricky area that Dr. Dressler and Dr. Ettinger dedicated an entire chapter (chapter 9) of The Dog Cancer Survival Guide to the subject. Dr. Dressler also addresses this topic in several of his Ask Dr. Dressler webinars, including one called 19 Most Common Mistakes We Make When Dealing with Dog Cancer. (Both the book and access to webinar recordings come in The Dog Cancer Kit.)

Get the Dog Cancer Kit

Inexpensive and Probably Necessary: Fine Needle Aspirate

Some cancers can be diagnosed with a very simple test called Fine Needle Aspirate. This is a really common test, and you may already have experienced it. Your vet takes a very thin needle, inserts it into the mass, and draws up a sample of the cells and fluids inside the mass. Most dogs barely flinch, and there is no anesthesia necessary.

Next, the sample is looked at under a microscope and examined for cancer cells.

A fine needle aspirate can easily diagnose lymphoma, mast cell tumors, and benign cysts.

Unfortunately, other cancers usually can’t be diagnosed with a fine needle aspirate, either because the cells inside the mass are too clumped together to draw up through the small needle, or because the cells don’t come up the needle at all.

Sometimes the test doesn’t tell us anything we can rely upon. For example, if the vet just sees fluid, and no cells, it doesn’t mean there is no cancer in the tumor. Maybe there are cancer cells in there that didn’t come up the needle. This result is usually classified as “inconclusive” – as in, it didn’t tell us anything concrete.

More Expensive, Probably Necessary: Biopsy

If a fine needle aspirate is inconclusive, another test called a biopsy is needed to determine if there is a malignancy. And sometimes, a biopsy is necessary even if a fine needle aspirate has already been done. Especially if your dog’s mass is eligible for surgery.

A biopsy is a small surgery to remove a portion of the tumor (or in very few cases, the entire mass). Because it’s a surgery, anesthesia is required, and your dog will usually have stitches and some recovery to deal with afterward. The biopsy is sent off to a lab, and you have to wait for several days to get the test results back.

Avoiding a biopsy is pretty much impossible if you have hopes of removing your dog’s tumor using surgery. After all, this is how veterinarians plan the surgery!

Here’s a video you can watch where Dr. Dressler and Dr. Ettinger discuss diagnosing with a fine needle aspirate and/or a biopsy.

diagnostic-test-dog-cancerMore and More Tests

Depending upon your dog’s symptoms and what type of cancer the vet suspects, he or she may also want to do X-rays, ultrasounds, MRI’s, or even CT scans.

And don’t forget blood panels and urinalysis, and other miscellaneous tests. And none of these cure the cancer. They just tell us what we’re actually dealing with.

Oh, and by the way, there may be more tests needed to stage the cancer – to find out how much or if it’s spread. You can easily spend $1,000 just on tests for some cancers.

And that’s often when the decision needs to be made: how much of this testing should we do?

How Much Testing Should You Do?

Well, the answer to that depends a great deal upon you, and upon how you want to treat your dog’s cancer. In Full Spectrum cancer care, which is the approach Dr. Dressler created, we take charge of our dog’s health team and consider ourselves “the boss.” Dr. Dressler calls this being a Guardian.

In Full Spectrum cancer care, we take as many steps as possible to increase our dog’s ability to fight cancer:

Step 1: Conventional Treatments

Step 2: Nutraceuticals

Step 3: Immune System Boosters and Anti-Metastatics

Step 4: Diet

Step Five: Brain Chemistry Modification

There are many things you can do in each step, whether you have a confirmed diagnosis or not.

You can implement the last four steps even if you don’t know what type of cancer your dog has – because steps two through five apply to every single cancer case.

Testing for Conventional Treatments

However, if you want to use step one – conventional treatments like surgery, chemotherapy and radiation – you should probably do the testing your veterinarian recommends.

According to our oncologist co-author, Dr. Ettinger, conventional treatments require planning, and the more information your vet has about your dog’s cancer, the higher their chances of success will be.

Should an Oncologist Do Your Testing?

But hold on – because Dr. E. also cautions that sometimes Guardians show up at her desk with reams of tests she wouldn’t have ordered had she been consulted earlier in the process.

Not every cancer needs every test.

And if you spend $1,000 on tests she doesn’t really need, that’s probably $1,000 less in your budget for treatment. Talk about a heartbreaking situation.

This is why Dr. E. recommends that if you know you’re going to use conventional treatments, you should think about getting an oncologist on board just before you do your first biopsy, or just after you get the results back.

That way, if more tests are needed, you have someone who only thinks about conventional treatments supervising and advising your decisions.

What If You’re Not Interested in Conventional Treatments?

On the other hand, Dr. Ettinger tells us that if you already know you’re not going to treat with conventional treatments (chemotherapy, radiation, and surgery) you may not need to do as much extensive testing.

From what we can tell here at Dog Cancer Vet, most Guardians fall into this category, whether it’s because of financial constraints, or just not wanting to put their dogs through surgery, chemotherapy, or radiation.

Other Ways to Help Your Dog

Whether you choose to use conventional treatments or not, you should focus on the things you can do at home in steps Two through Five:

  • Step Two: Nutraceuticals —  Nutraceuticals like Apocaps (which you can get on Amazon or from your vet) and in some cases Artemisinin or Neoplasene may be of help. Please read chapter 12 to understand when these might be appropriate and ask your veterinarian about their use with your dog.
  • Step Three: Immune System Boosters and Anti-Metastatics — Supplements such as beta glucans offer a boost to the immune system, and other supplements may also help keep cancer from spreading. These are covered in chapter 13, and some may help your dog in your dog’s case.
  • Step Four: Diet — Changing your dog’s diet to foods that don’t feed cancer and actively fight the disease is one step almost everyone can take. This is thoroughly covered in chapter 14.
  • Step Five: Brain Chemistry Modification — In chapter 15, Dr. Dressler outlines how to deliberately increasing your dog’s life quality by doing things that change his brain chemistry. Believe it or not, your dog’s natural happiness is a cancer fighter!

(We should note that even though you can do these things at home, you still consult with your vet about their use. It’s always important to make sure you’re getting that supervision. Just because something is “natural” doesn’t mean it isn’t powerful. Every step Dr. Dressler includes in Full Spectrum care is there because there is evidence that it could help.)

What’s Next?

If you already have a confirmed diagnosis, that’s great. It will really help you and your team to make informed decisions about how to treat the cancer.

And as you can see, even if you don’t have a confirmed diagnosis, there are still many, many things you can do to help your dog.

To get an overview of diagnostic testing and what’s involved in each type, please see Chapter 9 of The Dog Cancer Survival Guide.

If you already know your dog’s diagnosis, you can also see what additional tests Dr. Ettinger specifically recommends (or avoids) in the chapter dedicated to your dog’s cancer type.

You can also use chapter 20, Treatment Plan Analysis, to help you make testing decisions. It’s best to read that chapter after you’ve read the rest of the book, of course.

And to learn more about conventional treatments, don’t forget to read chapter 11, Step One.

And everyone – whether you choose conventional treatments or not – should implement Steps Two, Three, Four and Five.

We don’t have a silver bullet (yet) for cancer. So every step can help. We can’t ever know what will or won’t work for any particular dog, but feedback from former readers – some of which is included in The Dog Cancer Survival Guide – has shown us, over and over, that every step should be considered.

Dr. Dressler actually suspects that it’s the combination of steps that produces the best results. Well, obviously he does. It’s why he included all five steps … even though some contain things that his colleagues think are pretty wacky!

If you’re interested in learning more, the most effective way to immerse yourself in research is to get The Dog Cancer Kit, which you can register for here:

Get the Dog Cancer Kit

Best Wishes & Doggy Kisses from Our Homes to Yours,

Dog Cancer Vet Team

Leave a Comment

  1. Cindy Maxion on December 14, 2021 at 11:11 am

    Dr. Dressler:

    I am overwhelmed with gratitude with your dedication for dogs who have cancer. I ordered the Apocaps and next on my list if the Cancer Survival Book.
    A million thank yous.

  2. Paul Crone on November 24, 2018 at 5:42 pm

    My dog is part Saint Bernard and retriever. he has developed large lumps and a fever that comes and goes. I have been giving him cephalexin and have started 1 81mg aspirin a day. some days the fever is gone and others he seems to be so hot he can hardly stand it. The lumps started about six weeks ago and there were just a few under his jaw. with no fever. now he has a mass of lumps across his jaw from ear to ear and a fever more often than not. He’s lethargic and acts as if going up and down steps is hard and painful. At times his breathing is labored and heavy, as if he’s been running. He’s about eleven or twelve. I rescued him in 2010 and found out from the people in the neighborhood that he was left as a puppy. He’s been healthy his whole life until now. I can’t afford expensive testing and treatment. Is there anything I can do that will lesson his symptoms?

    • Dog Cancer Vet Team on November 26, 2018 at 9:18 am

      Hello Paul,

      Thanks for writing. We’re not vets here in customer support, so we can’t offer you medical advice. However, we can provide you with information based off Dr. Dressler’s, and Dr. Sue’s writing 🙂

      As Dr. Sue writes in the article below, if a lump is 1cm or larger, or has been there for over a month, get it checked by a vet ASAP. This might mean getting a fine needle aspirate (or a biopsy in some cases) to determine what the lumps are– it’s better to know sooner rather than later. Here’s the link to the article where Dr. Sue goes into more detail on this:

      You may find this article to be beneficial in learning how to tell if your dog is in pain, pain signals (limping, vocalising, unusual panting), and pain management options:

      You may also want to take a look at what Dr. D calls the Full Spectrum Care– this involves taking into consideration conventional treatments, nutraceuticals, anti-metastic and immune boosting supplements, diet and mind-body strategies. Here’s the link:

      Your veterinarian will be the best person to consult as they know you, and your dog, and they will be able to tell you what the lumps are, what you can do to help manage your boy’s pain, and what might be causing the symptoms that your boy is experiencing.

      We hope this helps!

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