Many things in life are unavoidable – and ageing has got to be up there at the top of the list. Sometimes the signs of ageing are subtle – a little bit of grey hair here, a little less spring in the step, a little twinge in the bones as we bend over past our slightly bigger bellies. And then there are other changes associated with ageing that literally stick out like a sore thumb. For our pets, one of the most obvious age related changes we see is an increase in the appearance of new lumps and bumps in the skin and below the skin. But let’s make it clear up front – worrisome lumps and bumps are MORE COMMON in older animals, but they CAN HAPPEN to young dogs too.
Vigilant owners who spend a lot of time with their animals are usually quick to pick up these changes and report them to us. However, in dogs with longer coats it can be quite difficult to feel the smaller lumps and bumps and sometimes even the bigger ones slip by unnoticed too.
It’s a great idea to get into a routine of doing a quick check of your dog’s and cat’s body on a weekly basis. You don’t need to do a detailed up-close inspection. Just run your fingertips lightly over the head, back, sides, chest and belly then down each leg. The more often you do it, the more likely you are to get used to where the normal bony lumps and bumps belong, and you’ll quickly recognize when something feels different.
So if you find something unusual – is it always something to worry about? Cancer specialists and pathologists will answer that question with a “yes” every time – the lump may not be cancer, but it IS worth worrying enough to find out! If cancers of the skin or associated subcutaneous tissue (tissue below the skin) are detected early enough, they are frequently curable with surgical removal. If left too long, some cancers of the skin can metastasise (spread) to internal organs and inevitably become fatal. We have a better chance of curing the malignant lumps if we get them early in the course of disease and can remove enough tissue around them to “catch” any stray cells before they head off to other areas.
What should I do?
Therefore, the logical first step in planning what to do when you find a lump or bump is to find out exactly what the lump or bump is. Obviously we start by looking at it. Some lumps have a “typical” appearance. For example, young dogs commonly develop a tumour called a histiocytoma. These are benign tumours in the skin which usually look like a small flat “button” of tissue. Older dogs commonly develop benign glandular adenomas, which are wart-like nodules. HOWEVER – we can never be 100% certain of the identity of a lump just by looking at it. Some of the sinister lumps appear in many shapes and sizes and these “great pretenders” are not to be overlooked. If we feel reasonably confident that a lump is likely to be “harmless”, we will sometimes recommend that owners watch and see what the lump does over the course of a few weeks. If there’s any doubt then we don’t hesitate to recommend prompt removal.
In most cases if the lump is a reasonable size our next step is to try to take a sample of cells to look at under the microscope. This involves inserting a needle into the lump and collecting enough cells in the needle to spread out over a slide, which we stain to show up certain characteristics. This is a procedure which can usually be carried out in a normal consultation – yet it’s invaluable in helping us work out what to do next.
Malignant or what?
The 2 main categories that most lumps and bumps fall into are either tumours (cancer) or inflammation (eg infections or inflammatory responses to trauma or insect stings). When we look at the type of cells on the slide and the characteristics of those cells (colour, size and shape) we can usually decide which of the 2 categories the lump belongs in. If we believe that the cells are typical of tumour cells, we often can’t say much more about it than that. Sometimes we get lucky and are immediately able to put a specific name on the lump. If not, this is when we hand over to the experts for their input. The slides that we look at in the clinic can be sent to specialist Veterinary Pathologists who are able to further categorise most samples as being either benign or malignant and will often be able to tell us the exact tissue type involved.
When we know what tissue is involved and the type of change happening, we can reasonably predict the likely behaviour of the tumour and better plan our next step. In most cases we move on to surgery, knowing from the pathology the type and extent of surgery that we’ll need to do to give us the best shot at curing the disease.
If in doubt…
If the results of our aspirate clearly indicate that the lump is benign then surgery is not always immediately necessary. If the lump is only a moderate size and is in a position on the body where it’s not likely to be traumatized or interfere with daily life then it may be a reasonable decision to just leave it alone and watch it. However if a lump is benign but big and likely to be difficult to remove if it gets bigger, or is bleeding or annoying your pet, then common sense says get rid of it now while we can.
Fortunately, in the vast majority of cases we can cure most malignant skin cancers with surgery alone if we catch them early. If we find that surgery is unlikely to be curative there are chemotherapy protocols available in many cases that may be suitable for your pet. We will always discuss future management and likely outcomes with you so that you can make decisions based on facts and what you feel is the best approach for your pet.
So when it comes to lumps, knowing what we are dealing with is most of the battle. We all tend to bury our heads in the sand when we know things aren’t quite right because we’re afraid of what we’ll find out. But really, this is a fantastic opportunity to use knowledge as power – it may even save your pet’s life.