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November 03, 2006

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Joey

I loved your article it has great information. I think you and your readers might be interested in another article I found about pets and dry eyes.
You can visit the website at http://whatistheeye.wordpress.com

Henry

Since you are not one of my local vets I'd like to ask for your opinion if I may: I have a Retreiver mix that is around 12 years old. She has a large growth on the side of her neck which does not seem to bother her, but it's large and solid, so I'm assuming it's a cancerous growth considering her age/breed. During her yearly, my vet made no comments about it but I wasn't the one who took her in to ask questions.

The question is, since she has shown a hyper-sensitivity to sedating drugs like Acepromazine in the past, and she's now 12 years old, should I put this dog through surgery to remove this growth, or as some might say, "let it ride out"? In other words, I have heard that older dogs have much less chance of surviving a surgery to begin with, and I'm torn between taking action on this or just letting her enjoy life until this becomes a life-choice decision. She does not seem to be bothered by it and appears not to be in pain. Below is a link to how it looks (though the hair over-emphasizes it a bit): http://i984.photobucket.com/albums/ae327/powdersprings30127/Animals/roxyside.jpg

My friends and coworkes are literally 50/50 on getting it treated vs just letting her live her life out with it. Thanks for any opinions.

Doc

Hello, Henry,

You have to look at the risks versus the benefits.

The first thing I would do would be to get a needle-aspirate cytology. It is quite possible that this is only a lipoma: a benign, fatty lump. If so, you get almost nothing but grease when you aspirate it.

This is done by placing a 20-gauge needle into the mass and putting suction on it with a 3cc syringe. You just want a little material in the needle itself; you don't pull hard enough to get anything in the syringe.

This material is then squirted onto a glass slide, stained and examined under the microscope.

You don't get any architecture this way, but you can usually identify a lipoma, an infected area, a fluid-filled cyst, or a mast-cell tumor. If it is a big solid, cellular tumor, you probably won't be able to identify the tumor without a bigger biopsy.

A bigger biopsy can be obtained with a special needle that cuts a core about the size of a pencil lead. One can also do a wedge biopsy. If the dog is calm, that can sometimes be done with just a local anesthetic.

If your dog does not do well with acepromazine, there are other sedatives. Some, like Dexdomitor, have antagonists so that they can be "reversed" if the dog is too sleepy.

I can't really manage your dog's treatment and diagnosis long distance.

The results of a needle aspirate cytology may set your mind at rest (if it's obviously benign, like a lipoma). If not, then you're back to your original question.

If your regular doctor is not comfortable with anesthetizing an older patient, you might ask for referral to a specialist. Performing pre-operative risk factor testing can help identify situations that could affect her anesthesia. I'd get chest X-rays, blood-work, maybe an ECG. This can let you know more about the risk side of the risk/benefit equation.

It is certainly true that there are things your dog is going to "die with" instead of "die from". These decisions are often not clear-cut. However, more information can make it easier.

Good luck.

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