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

How to Get A Diagnosis Before Surgery

Updated: October 19th, 2018

There are several different ways of finding out if a lump is a cancer.  Each involves having some of the growth tested, but which is best?

There are several ways to collect a sample.  Often a biopsy is done.  A biopsy involves collecting a piece of the growth for analysis.  Sometimes the growth is removed and the entire mass is send off.  This is also called a biopsy.

Other times a needle is used to collect some cells from the area in question.  These cells are then placed on a glass slide, and the slide is sent for review.  This is called a fine needle aspirate.

Finally, cells can be harvested from fluid collected within the chest, abdomen, lungs, or sinuses.  This specimen can be sent off as well.

Different pets have different growths in various locations. Which is the best?

For growths on the skin, under the skin, in the spleen, liver, prostate, and some bladder or mouth tumors, often the best first step is the fine needle aspirate.  The reason for this is a fine needle aspirate can usually be done without any anesthesia and the procedure itself is over with quickly.  Dogs recover almost immediately and there is very little trauma.

Fluid analysis is useful for tumors in the abdomen, chest cavity, and nasal sinus.  This fluid can yield a diagnosis, sometimes without invasive surgery.

Fine needle aspirates and fluid analysis are good first steps to plan later surgery and work-up.  If a vet removes a cancerous growth for a biopsy without knowing if it is cancerous, a second surgery is often needed to remove more tissue.  This second surgery aims at removing more cancer cells that may be left in the area surrounding the growth.  A second surgery can often be prevented by knowing what we are dealing with first.

Another reason getting a diagnosis before a surgery is that, sadly, sometimes the tumor has already spread to other areas in the body.  If the fine needle aspirate report suggests that the growth has a high likelihood of spreading, often your veterinarian will do tests to determine if spread has already happened.  If there is evidence that spread has already occurred, surgical removal of the growth may not make sense.

In some cases doing a surgery is not the best treatment.  Cancers that have spread may need chemotherapy, radiation,  diet changes, apoptogens, immune supplements, anti-metastatics, and other treatments beyond surgery.

Sometimes a minor biopsy procedure can be done as a first step.  The advantage of a biopsy is the pathologist will be able to give a definite diagnosis almost 100% of the time.  Occasionally the less invasive tests yield hazy or inconclusive information, which almost never happens with biopsies.

One of the ways a minor biopsy is performed is by taking a small piece of tumor tissue using a biopsy punch or a scalpel.  This requires only a stitch or two, and the recovery is usually not bad at all.  These tests are often done for growths on the surface of the body, in the mouth, ear canals or genitals.

The bottom line is  a diagnosis should be sought before jumping right into surgical removal of growths that may be cancerous.  If surgery is the right approach, the right surgery can be done, and appropriate work-up can be performed beforehand.  For cancers where surgery is not the best option, other treatments can be started.

For more information on cancer testing as well as a comprehensive road map for the dog cancer journey, see The Dog Cancer Survival Guide.

Best,

Dr D

Discover the Full Spectrum Approach to Dog Cancer

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  1. Christine Taylor on October 5, 2013 at 11:28 pm

    My dog is a 10 year old Siberian Husky/Shep mix. He has a mass on his left lateral side near the end of his rib cage. It seems to be swollen and is as big as the palm of my hand. The vet did 3 needle biopsies for a cost of $240 but when the results came back all they could tell us is that this is a very aggressive form of Cancer and the lab recommended surgery to remove it. Apparently the lab cannot tell us what type of Cancer it is but that it doesn’t spread to other organs.

    When I asked the vet for statistics regarding length of survival rates for dogs with and without surgery but I was told there is no research done. I think this is completely unacceptable and actually neglectful. There is absolutely no reason why Veterinarian Colleges cannot request results and timelines from vets who have treated cancer and the ages of the dogs.

    Another issue I have is that doctor’s, when treating humans have guidelines in place about whether or not to do surgery depending upon the size of the tumor. I was told that they will do surgery as long as they do not have to remove more than 50% of his skin and muscle. How can any dog recuperate well when so much tissue is removed? If such a dog did heal just fine how would he move?

    We have checked with other dog lovers who experienced something similar and all who went with surgery lost their dogs shortly after. We are talking under 6 months. One of the dogs recouped just fine (he was 10 as well) but then one day 6 months after surgery he went to his owners whimpering in pain and just dropped dead.

    The life span of our dog is apparently 10-12 years and recommending surgery without being able to supply us with statistics has put us in a terrible position. We originally decided to just let our dog live out his life enjoying his walks etc for as long as he can before he becomes uncomfortable because we were told the surgery is very traumatic (similar to a radical mastectomy in a woman) and he has reached the bottom range of his life expectancy.

    As a result of our decision our daughter has cried continually almost for 4 days. When she does stop crying it is for a brief time only. She thinks that because the vet recommended it that we should do it as my daughter sees this as a sign that he WILL live another 2 years. The family has been stressed seeing her suffer along with our dog having terminal cancer.

    Our dog has separation anxiety and just being at the vets makes him stressed. When he had to be sedated (had a hot spot and didn’t like the collar) he didn’t sleep, all he did was lie there whimpering until the sedation wore off. My daughter thinks that we should do all we can when it fact there may be little chance he will live past 6 months and even less of a chance living longer. Statistics would help us decide the course of action that best suits our dog.

    If you know of any would you kindly post them. I left a message to book the surgery as this was the only way I could relieve my daughter’s suffering.She is in University and cannot tend to her work due to her wondering what the right choice is. If chances are he will only suffer and die soon after than I would like to just manage the condition best we can until we can no longer relieve his suffering.

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