Owners have very high expectations of one’s ability to diagnose a condition based on their description, what they read on the internet, and (to a lesser extent) my physical examination. Don’t get me wrong- taking an accurate history and doing a physical examination are instrumental skills. But they are not 100%.
“What is it, doc?” the owner asks as I poke at a lump. I can give you some guesses with a good amount of accuracy based on its appearance, how it moves on or under the skin, that sort of thing. “90% of the time this sort of mass turns out to be a benign lipoma,” I might say. “But I’d still like to verify that.” 10% doesn’t seem like a lot, unless of course you are that 10%.
Koa had a mass on her shoulder that I was 90% sure was a lipoma. I performed a fine needle aspirate, which is the least invasive and most common first-line diagnostic that I use for masses under the skin. I am aware of its limitations- 25% of the time you don’t get a diagnostic sample, especially if you are dealing with the type of mass that sticks to itself tightly and doesn’t like to be sucked into a needle. Perhaps you don’t get the needle into the right portion of the mass. False negatives happen.
Koa’s aspirate was full of fat, just like your typical lipoma. So I watched it.
Last week, I revisited the mass and decided that it might be bigger. In my fingers, it behaved just like your typical lipoma- squishy, easily moving around in the subcutaneous fat without digging into the muscle beneath. But maybe it was just a teeny bit firmer than I would like? So I stuck a needle in it. Fat cells, again.
At that point, I had reached the limitations of the aspirate. I could do a more extensive biopsy, but in this case I decided to just remove the blasted thing. And guess what? It was fatty. Fatty tissue surrounding a smaller, firm, ugly ball of something decidedly not-fat.
I will let a pathologist slice it, look at it under a microscope and tell me all the things my eyes and fingers cannot: the type of cell, the margins, how likely it is to grow back. I know that many of these types of tumors can be cured with one surgery, if you happen to remove them before they do nasty invasive things.
So I wait for the results, keep my fingers crossed, and remind myself to be glad I don’t rely on numbers. After all, the median survival time for a lymphoma patient on chemo is 12 months, not two. I trust cancer not a whit.
Sending positive thoughts for Koa’s “lumpectomy” results.
More positive thoughts from the Peach State…Hang in there, Doc.
S%*#@%!!! 🙁 I’m keeping you and Koa in my thoughts and prayers and keeping a positive attitude that Koa will have twelve more YEARS with you. Having lived the horror of canine cancer, I can tell you that my worst fear is what you’re going through right now. {{{hugs}}}
Hugs to you and Koa — I hope it turns out well. Doggy prayers going out for her long and continued happy life with you and the Brodester.
(And BTW, I had not read the post from last year to which you linked — tears were shed. Heck, Bailey didn’t even get chemo, since everyone thought the mast cell issue might, just possibly, maybe, recur in a year or two. And she was 12. And we lost her about a month after the surgery. Yeah, sometimes these things just suck more than words can express….)
*fingers crossed*
Thank you so much for removing it for analysis. I have fallen in love with Koa via this blog and want her to have all the best in the life she has left. She’s a brave girl with lots of love left for your family!
Thoughts & prayers!
I am playing a different numbers game at my house. Charlee, my 12 year old chronic pancreatic, messed up thyroid dog has a nasty red lump between her hind toes. Aspiration came up negative, but we are pretty sure it is cancer by the looks of it. My vet wanted to biospy and take 2 toes, and maybe go back a second time for sider margins. I said no. I am playing the quality of life game and the what will kill my dog first game. So far me and the dog are winning. Quality of life excellent. Good Healing thoughts to Koa.
Oh, man. We’re hoping for the best at our house too. What’s that old saying … Eyes are not microscopes. Hands are not x-rays. Better indeed to put the diagnostic tools you have available to use.
Glad your intuition nudged you to remove it. Thoughts & prayers 2 you both.
Thinking of you and Koa.
Blue has had a lipoma that is slowly growing, and we also had the FNA and have probably reached its limitations. I think I want it out.
My heart goes out to you. I hope Koa realizes what good hands she is in.
Thinking good thoughts for Koa girl. Hang in there!
Thinking good thoughts… my heart goes out to both of you.
fingers and paws crossed in this household. never would occur to me something bad could be hiding in a lipoma…something i’ll think twice about since i have a dog with a few on him. any idea how common it is for something else to be inside?
she certainly is lucky that she has landed in your great hands, and you never know – maybe it is a mass of nulo that she has saved for rainy days. 🙂
It’s actually pretty uncommon, fortunately! It’s just a reminder that ‘when in doubt, chop it out!’ 😀
That is scary to find something inside a lipoma. Our diabetic dog had a small one for a number of years that fortunately never got any bigger. But he also died of cancer… so late in life that we didn’t expend any effort to find out where the cancer came from once it was diagnosed from lung nodules.
Toes, fingers, whiskers, and paws crossed for good news.