Browsing tag: Surgery

Ask a vet online- ‘My 10 year old dog has a lump not sure if I should take him to the vet?’

Question from:

Sheree Lu

My 10 year old dog has a lump around the size between a 10-cent/20-cent (Australian) coin. It’s round, soft to touch and when I touch it, it didn’t seem to cause him any discomfort or pain. It’s located on one of his hind flanks, on his thigh-ish area. Like if he sits down, the lump would be on the ground but it’s not near his anus. I’m not sure if I should take him to the vet..?

Answer by Shanika Winters Online vet

Hi Sheree and thanks for your question, with any lump you find on your pet I would advise that you take your dog to be seen by your vet.  I will try and explain in my answer some of the possible causes for the lump and how it can be monitored, treated or removed.

Why has my dog got a small soft lump?

A small soft lump can be caused by an infection, reaction to a parasite/foreign body, swelling in response to an injury/allergy, a tumour or a combination of these.

Infection tends to lead to an area of reddened/hot (inflamed) skin, which may then swell up as it fills with fluid/puss.  An infected lump would usually appear over a few days, may be painful to the touch and might burst followed by crusting over.  An infected lump may be due to a skin infection, where a parasite has bitten, where a foreign body (e.g. a grass seed or thorn) has entered or is trying to exit or maybe on top of an existing lump.

Reactions to a parasite/foreign body will also lead to inflamed skin but can occur over a much longer time scale of days to weeks.  A common parasite that can lead to development of a lump like reaction is a tick.  On some occasions the lump that you see is actually the tick still attached to your pet’s skin, it could also be the reaction to a tick bite that looks like a small lump on your dog’s skin.  Tick bite reactions are more likely to lead to a firm lump (granuloma).  Common foreign bodies that can cause a reactive lump in your pet’s skin include grass seeds and thorns.  A reaction to a foreign body may also be infected and/or painful.  Grass seeds and thorns are easy to come across on walks, depending on what season it is and where you tend to walk your dog.

Allergy or injury can cause a lump to develop quite soon after encountering e.g. a stinging nettle or having a tumble.  Allergic lumps can be single or multiple and can come down themselves in time, but the concern with an allergic reaction is if it affects the airways or circulation then this becomes an emergency situation requiring urgent veterinary attention.  A lump which occurs after an injury such as falling over or bumping into something at high speed is something an owner can usually link to the incident occurring.

Tumours are abnormal growths that come about due to a mutation (change) in your pets cells causing unregulated growth and multiplication of cells.  Tumours can be benign (not cancerous) or malignant (cancerous and likely to grow/spread).  The time scale of tumour development varies from slow growth to very fast and there are some tumours (mast cell tumours) that can vary in size due to the release of Histamine (reactive body chemical).

Should I take my dog to the vet?

Definitely take your dog to the vet if you find a lump, the urgency with which you need an appointment will depend on how long the lump has been present, how well your dog is and if the lump is changing.

Your vet will ask you a lot of questions such as:

How your dog is in general, eating, drinking and toileting?

How long has the lump been present?

Has the lump changed in shape, size, colour or texture?

Is the lump causing your dog any pain or affecting its normal bodily functions?

Your vet will also ask about any changes in diet, environment, medications and general routine.

The answers to all these questions combined with a full clinical examination will help your vet to work out what the lump could be and what steps should be taken.

What happens next?

In some cases your vet may send your pet home with medication such as antibiotics if the lump is thought to be an area of infection, or pain relief if it is thought to be a reaction to an injury.

If the lump is thought not to be harmful then your vet may ask you to monitor its size, shape, colour and texture on a weekly basis and return for a check-up should there be any significant changes such as the lump doubling in size or changing colour.

If however your vet is still unsure as to what has caused the lump then further tests may be advise, from a fine needle aspirate through to an excisional biopsy with or without x-rays.

Fine needle aspirate is when a needle is inserted into the lump (usually done in an awake pet) and some tissue sucked out into a syringe, this tissue can then be put onto a microscope slide or into a bottle of liquid to enable analysis to try and work out what the lump is.

Biopsy is when a small piece or the entire lump is cut out (usually under a general anaesthetic) and is then sent for analysis to try and work out what the lump is.  If your vet finds other lumps or enlarged lymph nodes which may be related to the original lump then samples may need to be taken from these too.

X-rays of the affected area, chest and abdomen (tummy) may be performed to show how deep the lump goes and whether it has spread to other areas such as the lungs or liver.  The reason why the chest and abdomen are x-rayed is that these are common sites for the spread of malignant growths due to their very good circulation.

If the lump turns out to be cancerous then even after cutting out the lump your pet may need further therapy such as chemotherapy to treat/prevent the lump spreading or re-growing.

I hope that my answer helps to explain the importance of having a lump checked out by your vet, hopefully your dog’s lump is nothing sinister and your vet can confirm this. But due to the many possible causes of a lump it is always safer to get your dog looked at by your vet and then make a joint decision as how best to proceed.

Shanika Winters MRCVS (online vet)

If you have any worries about your pet, please make an appointment with your vet, or try our Symptom Guide.

Ask a Vet Online – ‘My vet says my poodle cross Pom, may have cushings disease what is this please?’

Question from Carol Fogerty

Hi my vet says my poodle cross Pom ,may have cushings disease whot is this please

Answer from Shanika Winters MRCVS, Online Vet

Hi Carol and thank you for asking about Cushing’s disease (HAC hyperadrenocorticism) which is a condition where the body makes too much of the steroid cortisol which can result in a variety of symptoms.  HAC is most common in middle aged to older dogs but does also affect cats, horses, hamsters and ferrets.

There are three different types of HAC:

Pituitary dependant HAC (PDHAC) is the most common type and this is when a tumour of  the pituitary gland in the brain is making too much of a hormone called adrenocotricotrophic hormone (ACTH)  this causes the adrenal glands to make too much cortisol.

Adrenal dependant HAC (ADHAC) is less common, this is when a tumour of the adrenal glands causes too much cortisol to be produced.

Iatrogenic HAC (IHAC) is when very high doses of steroid given as medication lead to symptoms of HAC.

What are the signs of HAC?

If your pet is showing some of the following signs then your vet may suspect HAC:

Increased drinking (PD polydypsia), increased urinating (PU polyuria), increased appetite (PP polyphagia), a large rounded low slung abdomen ( tummy), muscle weakness, hair loss on both sides (bilateral symmetrical alopecia), hard areas under the skin due to deposits of the mineral calcium (calcinosis cutis) and dark spots on the skin due to blocked keratin (hair protein) filled hair follicles  (comedones).

How do we test for HAC?

There are several blood tests, urine tests and diagnostic imaging tests than can be done to try and make a diagnosis of HAC:

    Routine blood tests in cases of HAC may show up increased levels of liver enzymes, increased cholesterol, increased blood glucose (blood sugar) and also changes to the white blood cell numbers.
    Routine urine tests may show an increase in glucose, white blood cells and protein.

More specific tests for HAC include:

    Urine creatinine: cortisol ratio, here a urine sample collected from your pet is sent to a laboratory for analysis, abnormal results are found in cases of HAC but can also suggest diabetes, liver disease or womb infection (pyometra).
    ACTH stimulation test, this is a set of blood tests in which a blood sample is taken from your pet, an injection of artificial ACTH is given into a vein (blood vessel) and 1-2 hours later another blood sample is collected. The laboratory results are abnormal in approximately 80% of dogs with HAC, this test is also often used to monitor dogs on treatment for HAC.
    Plasma cortisol level, this is a blood test which directly measure the level of cortisol in the blood , the blood sample has to be treated very carefully and sent to the lab quickly so as to get an accurate result.
    Ultrasound scan of the abdomen can be used to check the size of the adrenal glands (found next to the kidneys), look for a tumour and assess the other abdominal organs. IN PDHAC the adrenal glands are usually normal size or slightly enlarged with ADHAC the adrenal glands are usually different sizes, the large irregular gland being the one with the tumour.
    Low and High dose dexamethasone suppression test (LDDST & HDDST) are blood tests where the effect of artificial steroid on the adrenal glands is measured, the results can sometimes help tell apart PDHAC form ADHAC.
    Magnetic resonance imaging (MRI) scans and computed tomography (CT) scans can be performed at referral centres to help in the diagnosis of HAC and also tell which type it is.

How is HAC treated?

Trilostane is a tablet with blocks a step in the production of cortisol in your pet’s adrenal glands therefore decreasing the amount of cortisol in your pet’s body.

Mitotane is another tablet which works by destroying the parts of the adrenal glands that produce cortisol.

Surgery to remove the actual tumours can be performed usually at referral centres.

Trilostane and mitotane are the most commonly used treatments for HAC, they are effective on both PDHAC and ADHAC and your pet should have regular blood tests to monitor that the dose given is correct for your pet. Too much medication for HAC can lead to symptoms of Addison’s disease (Hypoadrenocorticism) where there is not enough cortisol which includes dehydration, depression, diarrhoea and lethargy (weakness).

I hope that my answer has given you some useful information about HAC, the exact test done on your pet will need to be discussed with your vet. The aim of treating your pet is to reduce the signs of HAC to improve your pet’s quality of life and is best achieved by working closely with your vet.

Shanika Winters MRCVS (online vet)

Getting ready for an anaesthetic at the vets

At one time or another we all have to face our beloved pets having an anaesthetic which can be a scary process if it’s not properly explained. Fortunately most veterinary practices have a fantastic team of nurses that can help you understand the procedure. (NB. I have used “he” in the article for continuity but this goes for all dogs a

Labrador crop

and cats regardless of gender).

To give you a head start, here are some top tips:

1. The number one golden rule for preparing for an anaesthetic is no food after midnight (this does not apply to rabbits or guinea pigs). Also, some practices may give you an earlier time say nine or ten o’clock but the principle is still the same, basically no midnight feasts and no breakfast. The reason for this is two fold. The main reason is to stop your pet vomiting and potentially inhaling it. This can also prevent nausea on recovery. Another reason is to try and prevent any ‘accidents’ on the operating table which increases the risk of contaminating the surgical environment although to safe guard against this, some practices routinely give enemas and express bladders before surgery. So, while it breaks your heart to tuck in to steak and chips with Fido giving you the big brown eyes treatment console yourself with the knowledge that you are actually acting in his best interests to help minimise the risk of anaesthetic.

2. Give your pet the opportunity to relieve himself before coming into the surgery. Obviously this is easier with dogs but while we advise taking dogs for a walk before coming in we don’t mean a five mile hike on the beach with a swim in the sea, we mean a nice gentle walk around the block to encourage toileting. If you bring your dog in covered in dirt and sea water, you’re increasing the anaesthetic risk as we have to keep him asleep longer while we prep him. (See my previous article about how we prepare your pet for a surgical procedure).

3. Tell the nurse when she is admitting him whether you have noticed any unusual behaviour. Vomiting, diarrhoea, coughing or sneezing can all be indicators of problems and may need to be investigated prior to anaesthesia. Also tell the nurse if your pet is on any medication, when he last had it and bring it with you if you can. This way, if your pet needs to stay in after his operation, they will have everything he needs without adding extra to your bill.

Harvey blanket1. Some pets get a little worried when in a new place so it may be helpful to bring in a jumper of yours or a blanket that smells like home. Be prepared for this to come home dirty! Some animals have accidents on recovery and with some of the larger practices getting through over fifteen loads of washing a day (with different people doing the laundry) it may not be possible to locate your blanket once it has disappeared into the washing room abyss. It does help tremendously if the blanket is labelled with your name. That way, if it does enter the washing room, it can be found again. Eventually. Obviously with smaller practices it’s much easier to keep track of individual items.

1. Give the practice a phone number that you can be contacted on. This is something that has surgeons and nurses tearing their hair out on a regular basis. All too often we’re given a phone number only to call it and hear a message saying that the mobile phone has been switched off or to hang on the end of a ringing phone. The reason behind this is sometimes we need to contact you during surgery because we have found something unusual or that we weren’t expecting and need to gain your consent to a change of procedure. It’s your pet and your decision and we want you to be involved every step of the way but we need to be able to speak to you to do that. I’m not saying you need to be sat by your phone from the minute you drop your pet off but please give a phone number that you or someone who can get hold of you will answer. Or at the very least, a answering machine that you check regularly.

1. Have faith in your veterinary team! If they suggest extra procedures such as intravenous fluids or blood sampling it’s because they think it would benefit your pet. I had one incident where a long haired cat was coming in to be sedated and lion clipped (shaved basically as his hair was matted). As he was over eight years old and hadn’t had a blood test I suggested a basic profile just to check what the liver and kidneys were doing. The blood tests revealed elevated kidney values which meant that there was some degree of kidney disease present. Finding this early meant that we were able to recommend a special diet to help slow the degeneration down (it’s never reversible) and the cat is now more likely to be monitored before he gets too ill. 70% of the kidney needs to be affected before clinical signs appear, wouldn’t you want to know before it gets to that point? Also, if we can see there’s an irregularity before we do the surgery, we can provide additional care to further minimise the risk.

1. Ask questions. We would much rather sit with you and explain away your concerns than have you sit at home or at work worrying. Also, if you are going to search the internet for information about the procedure your pet is having, please use reputable sources such as this one or ones written by the veterinary profession. The last thing you need to be reading is a blog by Joe Smith (fictional) about his one off experience about x, y or z and scaring yourself silly. The whole process is stressful enough, don’t torture yourself!

Indie1. Bring your pet in suitably restrained. A cat needs to be in a cat carrier and a dog needs to be on a lead. A cat wrapped in a towel can easily become dinner for nervous, hungry German Shepherd. Don’t laugh, I’ve seen it happen! Yes this is a minority case but why put your pet at risk? We can’t predict how our pets will react in stressful situations (and coming to the vets certainly counts) so keep everybody safe by having control over your animal. Putting a cat in a carrier usually minimises their stress anyway as they feel safer and more secure and having your dog on a lead means that you can prevent him from bolting out of the door and on to the road.

9. That’s it! You are now fully prepared! Give your pet to the nurse to settle in and walk out the door. That’s actually easier said than done but in order to make this a smooth transition for your pet you need to be calm about it. Animals are very good at picking up stress and will become more worried about the situation the more worried you are. Obviously if your pet is aggressive the nurses may ask you to pop him in his kennel for them but the majority of veterinary professionals are more than capable of handling any type of animal and if you hand them the lead and walk out the door, nine times out of ten the dog will stare out of the door after you for a second or two then follow the nice sounding nurse who is being very enthusiastic and telling him what a good doggie he is through the door to the surgery. Don’t forget that we nurses are masters of cajoling and soothing. We have to work with vets as well after all!

If you are worried about a problem with your pet, please talk to your vet or try our Interactive Symptom Guide to check how urgent the problem may be.

More Useful Information

Examining your pet

Simple ways to check the health of your pet. Vets use these techniques as part of their clinical examiniation.

Medicating your pet

Arming you with the same simple techniques for stress free pill giving.

Worming & Flea Treatment

Information and advice in treating your pet for worms and fleas.