My Dog Has a Lump: See Something, Do Something—Cookie’s Lumpectomy

What should you do if you find a lump or bump on your dog?

Small bumps or swellings that show up out of the blue can be simply caused by stings, bites, or an infection. Cookie had her share of such little things. They were most likely caused by small wounds from her running through the bush. They went away within a short time.

That is not to say that an infection could not become a major problem. JD got an infection on his leg which did require antibiotics.

But if I were to run to a vet with every boo-boo Cookie sustains, I’d have to move in with them.

My Dog Has a Lump: See Something, Do Something—Cookie's Lumpectomy

The rule of lump

If the lump is painful, bothers my dog, or being otherwise naughty, I see a vet when I find it. If it’s a well-behaved bump, I give it a week or two to go away. Which is what they often do.

If a lump is the size of a pea and hangs around for a month, see a veterinarian and have it aspirated. It doesn’t even matter how many lumps you aspirated before and that they all turned out benign. That doesn’t mean that the new one will be the same thing.

Read Dr. Sue’s story about how even a veterinarian can underestimate a bump. Smokey’s story is why Dr. Sue started her See Something, Do Something campaign.

Cookie’s story

Just when I thought I was busy enough worrying about Cookie’s joints and muscles, life threw in a twist [as usually]. And at the least ideal moment too.

It was Thursday evening. We came home from Cookie’s last critter check and I was petting and rubbing her when I felt a bump on her belly.

What the heck is this?

Where did it come from?

Could it be some kind of a bug bite? It felt quite large and not like a bug bite. But Cookie gets so many belly rubs by the two of us, as well as by her physical therapist and vet techs and everybody, somebody would have to have felt it if it was there before, wouldn’t they?

To get a better look and feel I grabbed a flashlight and glasses and crawled under the hood. That’s what we call it when I want to check something on her belly without having to make her roll on her back in order to do it.

Like a mechanic, I get under and have a good view of what lies underneath.

It does not look like a bug bite

At least no bug bite I’ve ever seen before.

It was this fleshy, warty, blister-like type of thing. I did not like it. But here was the problem. The next day Cookie had an appointment for her physio at the other end of the world than her vet is. Making both appointments would be very difficult if not impossible. And the day after we were leaving for hubby’s work.

“You gotta make a decision,” hubby said.

What decision was the right one? A lump isn’t really an emergency even though I was convinced that it popped up out of the blue. I did not want to pass on Cookie’s physio. I did not want to just ignore the bump either. And I did not want to wait a month to see if it goes away. Everything about this one rubbed me wrong.

Maybe it IS a really weird bug bite and will disappear or at least shrink by morning … ?

It did not go away and did not shrink

And I still had to make a decision. Right or wrong, I decided to keep the physio appointment and have Cookie’s physical therapist who is also a vet tech take a peek. Perhaps she will deem it a bug bite. And if not, we had appointments to continue Cookie’s therapy lined up at the place we were going.

I decided to do the physio and try to combine one of Cookie’s appointments with a needle aspirate.

Cookie’s therapist checked it out and said that maybe it’s a histiocytoma. It wasn’t bothering Cookie. In fact, I don’t think she knew or cared it was there.

A histiocytoma?

I was hoping it was a histiocytoma too, though it was in a strange location for it. And didn’t QUITE look like one. But it kind of did.

Some further technical complications arose. It wasn’t until a week after we found it Cookie’s bump got seen. We had made the appointment for an examination and fine needle aspirate.

But when the vet saw it she said she didn’t like it and that she didn’t want to keep it there until we might find out what it is.

Getting results of an aspirate takes about two weeks around here.

That IS rather long to find out what a bump that grew overnight is. The vet wanted to remove it and then wait for pathology results.

Identify before removing

I was against that option. As much as I wanted the lump gone, I did not want to reverse the proper process.

The reason one should identify a bump before cutting is achieving clean margins. Clean margins mean that all cancerous cells are removed and there is only healthy tissue around the removed mass.

Without knowing what it is, you can either take enough tissue to make sure the margins are clean – but you might take way more tissue than is actually needed if the bump is harmless or, perhaps you wouldn’t need to do a surgery at all. Or you don’t take out enough and your dog might end up having to have another surgery.

However, because the lump was on the belly where there is plenty of skin, I eventually agreed to taking it out. We could easily get margins generous for a cancerous bump to play it safe.

Perhaps Cookie was going to lose more tissue than she had to but it seemed the most reasonable decision under the circumstances.

Cookie’s lumpectomy

Because Cookie’s last blood work was recent enough and everything looked good, she didn’t need new blood work. Otherwise, pre-anesthesia blood work is a wise thing to do.

To make sure Cookie undergoes as little stress as possible, I packed our “communal” blanket for her and we arranged hubby being there with her when she starts waking up.

She wasn’t at all concerned about being whisked away into the back; in fact, the technician didn’t have to drag her, she dragged the technician. So many things to check out, so little time.

The surgery went smoothly and Cookie recovered from anesthesia really well.

She needed a couple of hours to come to completely. But after that, she was all bouncy and hungry and ready to go. I was very relieved because I still had concerns since the sedation for her x-rays gone bad.

We decided to use anesthesia instead of sedation because there is much better control which makes it safer. With IV and endotracheal tube in place, any complications could be handled easily.

The post-op

All went well and without a hick-up and we were waiting for the pathology results.

As you can imagine, since the moment I found the bump on Cookie’s belly I was concerned. The vet’s reaction to it made my worries only worse. The wait for the pathology results wasn’t going to be easy.

Fortunately, the wait for the biopsy results was much shorter than the wait for the aspirate would have been.

When Cookie’s physical therapist looked at it just before we left on our trip, she was reasonably convinced it was a histiocytoma. I would have gone for that. The fact that it seemed to have cropped up overnight would support that. The fact that it was on the belly not so much.

The vet who examined it definitely didn’t think that’s what it was.

Another potential good option would have been a sebaceous adenoma. Again, I found a couple of photos that kind of looked like what Cookie had on her belly. I’d take either of those.

But I had to wait for the pathology results.

The pathology results

They were supposed to come in on Thursday. Since the moment I woke up, that was all I could think about. I really wanted to call the vet and find out. But I really didn’t want to find out it was something cancerous. So I decided to pretend to be patient waiting for the vet to call.

Time was passing by.

At four in the afternoon, I finally couldn’t take it and called. “The results just came in,” the vet said. “It was indeed a histiocytoma.”

It was a histiocytoma

I think I actually might have been jumping up and down at hearing that. Cookie’s PT called it! It was great news.

Theoretically, we could have left it be and see if it was going to go away on its own. Theoretically, we could have done the aspirate and spared Cookie going through the surgery. It wasn’t bothering her.

On the other hand, we didn’t know that and it did look suspicious. And, according to the report, it was already ulcerating.

We did what we thought best at the time we made the decision.

Fortunately, the surgery went really well and Cookie had no issues with coming out of the anesthesia or the incision.

She was a good girl leaving it alone. Not only she didn’t need the cone of shame but we didn’t even need to cover it with a t-shirt which we got specifically for that purpose. Compared to the horror trying to get JD to leave his incisions alone, this was a walk in the park. All we had to do was to make sure it didn’t get wet. Because Cookie continued going for her physical therapy, even though she had to skip the underwater treadmill part, it was regularly seen and also lasered for faster healing.

No pain meds?

The only issue was pain management.

The local vet who was going to do the surgery, she was asking whether Cookie was on NSAIDs. Which she wasn’t. We used it only short term for both the iliopsoas injury and then the new injury and it didn’t seem to have done much anyway.

We discussed Deramaxx versus Meloxicam. The vet felt that Meloxicam works better for post-op situations. I was concerned about the delivery, as this comes as a liquid in a syringe. Would Cookie accept it? But I was told that it has a honey flavor and dogs love it. So we agreed on going with that.

However, after the surgery, Cookie was sent home without anything at all.

By later afternoon she started showing signs of pain. She wasn’t comfortable laying down, wandering around. I knew it meant her incision was hurting. And of course, it would. Ever had a paper cut? Well, this was one enormous paper cut.

I called Jasmine’s vet. He always sends his patient home with two pain management meds, no matter how little the surgery. Since Cookie’s latest blood work looked great and we still had some Deramaxx on hand, it was decided to start her on that. I gave it to her right away.

Because NSAIDs need to be given with food, I gave her her dinner for late lunch along with it. In about half an hour since giving it to her, I could see it started making her feel better.

I was hoping that the next day I could hold off till dinner time. But the effect lasted almost exactly 24 hours when I could see signs of discomfort coming back. So instead of pushing the medication off till dinner time, I had to push dinner time up to the late afternoon.

With the addition of having it lasered regularly, Cookie only needed the pain meds for four days.

Further reading:
See Something, Do Something: Why wait? Aspirate!