Dear Dr. Forsythe: My six-year-old-dog Willie has another mass that popped up on his side. I’ve taken him to two different vets to have it looked at, and neither one can tell me what it is. The first time they said it was “inconclusive” and the second doctor just recommended a biopsy. It was really frustrating, since I don’t want anything to go wrong with him. I’m terrified about putting a pet “under” for an operation. I want his lump taken care of, I want it gone, what do you suggest - Weldon, Petaluma
Dear Weldon: I’m sorry you have a feeling of frustration over Willie’s health. I understand that lumps and growths can cause a lot of fear and worry for people. Many of us associate this with cancer and other serious life-threatening situations, and worry that we have received a “death sentence” for our beloved companion. When you couple this with fear about impending anesthesia, surgery, and top it off with the financial obligations and recovery time for your furry buddy, the stress can become overwhelming.
The challenge for doctors is that there are different approaches in terms of aggressiveness when it comes to dealing with growths that appear on the surface of cats and dogs. Generally, most veterinarians start with something called a “fine needle aspirate” which involves sucking out a cells from the mass using a needle and syringe. We can look at this under the microscope and often give you a diagnosis on the spot. Sometimes when we attempt to aspirate the cells, the growth does not “exfoliate” well, or the only cells that come into the needle are blood cells. This causes the results to be “non diagnostic” (i.e. we don’t know what the tumor consists of). In these cases, some doctors opt for taking a biopsy, which means removing a larger piece of the growth for analysis. Other doctors, like myself, will often offer the client surgery to simply remove the entire mass with margins and send it to the lab. This represents a more aggressive but often more curative approach, in my opinion.
I’ve had clients tell me they would prefer more of a “farm approach” to working with their pets. Close as I can figure, this means “wait and see” rather than “go in and fix”. Other clients tell me “please just get it off, I want it gone!” And of course, there are a myriad of clients in the middle — they want all the options presented and all the associated fees described so they can make an informed decision that suits their values, and budget.
It sounds like you may need a more aggressive approach to having Willie’s mass removed. I suggest you have the mass looked at again and let the veterinarian know how concerned you are about getting the mass removed. Explain very clearly that you have had previous doctors look at it but not really follow through with the case and be honest with your worries and concerns. Communication is the key in advocating for Willie. I’m sure you can get a medical plan that will see him through this medical challenge. My best to you!! - Dr. F