Lumps and Bumps

THINGS THAT GO BUMP OVERNIGHT

Your pets lumps and bumps – when should you worry?

Skin ‘lumps’ are one of the problems we see your pets for very regularly. They are always a matter for concern, and you should always get your vet to check them, but luckily most prove harmless. This article should increase your knowledge on what these ‘lumps’ could be, how we diagnose them, and which ones you really need to worry about!

Firstly what could that bump be?

Here are most of the options:

  • Infection – e.g. Abscess, particularly cats.
  • Inflammation – e.g. Cat bites, bee stings.
  • Haematoma – e.g. Blood blister due to trauma, especially dogs with ear infections.
  • Foreign body – e.g. Grass seed/thorn in foot.
  • Seroma – collection of tissue fluid under skin, normally due to trauma.
  • Hernia – abdominal area.
  • Cyst – fluid filled sac, this is not cancer associated.
  • Neoplasm – e.g. Tumours. Typically ‘fatty lumps’.
  • Combination of the above – e.g. Cat bite or foreign body that has become infected.
 This strange little mass with associated nodules was proven to be a mast cell tumour and subsequently was successfully removed

So as you can see there are huge number of possibilities, the majority may require treatment but are not a huge threat to your animals health.

Now, how do we decide which of these your pet has got?

History from you about the mass is very important:

  • How old is the pet? Older animals are much more likely to have tumours.
  • Has the mass always been there?
  • Has it grown and if so, how quickly has it grown? If it is fairly static it is probably a benign tumour and nothing to worry about. If it has suddenly arrived and is now noticeably growing it may be due to many of the above causes.
  • Has it been discharging? Cysts, abscesses etc.

Examining the mass can tell us some very useful information:

 Where is it? Entire females are inclined to get mammary tumours. Anal glands can become very infected and abscessate. Ears can have haematomas when infected (caused by the dog rupturing blood vessels within the ear flap when shaking/itching).

  • Is it freely movable? Possibly suggestive of a ‘fatty lump’.
  • How dense is it? Hard or soft? Does it feel fluid filled?
  • Is the skin broken or infected? Abscesses/cysts/tumours.
  • Is it painful? Many of the above, but painful tumours are normally more worrying.

Generally palpating the mass will allow us to rule out hernias and take a good guess at what is going on. To confirm our tentative diagnosis we can do several things:

If we suspect a cyst, abscess, haematoma or seroma we can use a large bore needle to investigate the contents of the mass.

FNAB Diagnosis This Golden Retriever had several large masses on various parts of his body. FNAB allowed us to accurately diagnose what they were. If we are concerned that it could be a tumour we will perform a ‘fine needle aspiration biopsy’ (FNAB). Normally we can do this then and there. The procedure involves inserting a very fine needle into the mass and withdrawing a very small number of cells. These cells can then be looked at under the microscope to decide whether the mass is indeed a tumour and if so what type and therefore how aggressive it may be.

Occasionally, normally if we can’t get a good FNAB sample and don’t want to just resect the mass, we may opt for a biopsy. This involves a general anaesthetic and the surgical removal of a small area of the lump. This then gets sent off for histopathology. (A nice laboratory man makes a slide from it and checks it under the microscope).

The other option if we can’t get a FNAB is to simply remove the mass. If taking a biopsy involves a full anaesthetic any way it often makes more sense to just remove it and then send the whole mass for assessment. (Why send it for assessment if we’ve removed it? Because the pathologist can tell us what type of tumour it is and whether we have resected enough surrounding tissue. This tells us how likely it is to be a problem in the future. Very useful).

These diagnostic aids will pinpoint the cause of you animals ‘lump’ and ensure the most appropriate treatment and advice can be given. You will know how serious a problem it is, what should be done for it and most importantly whether there will be any long term issues.

A Healthy DoggyA quick note on tumours. This is the one we all worry about. Why? Tumours are simply the uncontrolled growth of a particular type of body cell. One of the most important things to realise about them is that they vary enormously in their potential to cause trouble. Some, including the common ‘fatty lump’, are really very passive. Generally these may stay the same size for years and it is very rare for them to spread to other body organs. The only reason for removing them is if they grow to a size that affects the animal, or are in an awkward place such as in the way of a limb. At the other extreme we have a nasty growth such as the ‘Mast Cell’ tumour. These are very aggressive, spread quickly around the skin but more importantly, they will spread to other body organs such as the liver and lungs. Not nice. These we must remove asap.

The golden rule? ALWAYS GET US TO CHECK ANY LUMPS AND BUMPS!! It is far better to be safe and not sorry.