Is It Cancer? Never Assume

Many pets get the wrong treatment because a mass is assumed to be cancerous.

Benign sweat gland cyst in the tail of a 9-year-old Labrador.

Photos Courtesy of Dr. Phil Zeltman

Many patients never get the surgery they need or are euthanized because veterinarians or owners assume that a mass is cancerous.

It’s not uncommon for a referring veterinarian to call me to perform surgery on a patient with a “splenic tumor.”  I tend to call it a “splenic mass” until proven otherwise by my pathologist. Understandably, clients often don't want to put their pet through surgery if it's likely to be cancer. But that’s obviously a decision based on their family vet’s assumption.

The truth is, it sometimes doesn't really matter if a mass is benign or cancerous. A benign mass can cause some very annoying signs depending on where it is located: a large mass in the rectum preventing a dog from defecating; a large cervical mass pushing on the trachea and causing severe dyspnea; a large axillary mass preventing a dog from using the leg normally.

Benign intestinal mass in a 9-year-old Golden (jejunal leiomyoma).

These masses might have been benign, but they still caused some significant signs that dramatically affected the pet's quality of life.

We recently did surgery on three patients; all the names used here have been changed. "Everybody" just knew they had cancer. But their owners just loved their pet too much and couldn't put them to sleep without at least the benefit of surgery.

Max is a 13-year-old male Sheltie. X-rays revealed a large splenic mass. Based on the way it looked on ultrasound, we believed the mass to be malignant. Taking an ultrasound-guided biopsy of the spleen is possible, but it can be risky; the mass can rupture and the biopsy can cause "seeding."

Despite the odds, John, Max's owner, was interested in surgery, which was performed the next day. The mass was the size of a cantaloupe (in a Sheltie!), and looked really ugly–i.e. vet code for "Man, this oughta be cancer." Max recovered uneventfully.

One week later, the biopsy came back as … benign! The mass was a myelolipoma. Max is now expected to have a normal quality of life and a normal life expectancy.

Jake is a 12-year-old male cocker who had difficulty urinating. Ultrasound showed a large mass in his bladder. Bladder masses are much more often cancerous than benign. Linda, the owner, elected to have the mass excised anyway.

We took Jake to surgery a few days later and removed about one third of his bladder.  One week later, the biopsy came back as … benign! The mass was a leiomyoma. Jake should have a normal life expectancy and a normal quality of life.

Praline, a 9-year-old Labrador, had a pretty big mass under the tail. She was referred for a tail amputation, because the mass was thought to be cancer. For some reason, call it a gut feeling, I wasn't too thrilled to do that, and of course neither was the owner.  So we decided to remove the mass only. 

Upon section postoperatively, the mass appeared dark, so I was concerned it could be a malignant melanoma. One week later, results came back: the mass was benign!  It was a cyst in a sweat gland.  Again, this mass will not affect the patient's life span, and Praline got to keep her tail.

The list could go on.

The moral of the story: Never assume.

I am perfectly aware that the diagnosis could just as easily be bad. In fact, it was supposed to be, based on experience and statistics. But here are three older dogs, some would say in the last part of their lives.

They all were statistically "supposed" to have cancer. But these loving owners, willing to provide the best possible care for their pet, were not going to give up without a fight. In fact, out of countless patients who did have cancer, I don't remember a pet owner ever regretting choosing surgery over euthanasia, no matter how much extra time we bought.

The goals of tumor removal are to obtain a diagnosis, improve the patient's quality of life (e. g. being able to urinate or defecate or breathe), increase life span, and decrease future risks (e.g. by preventing a hemoabdomen secondary to rupture of a splenic mass).

Over the years, I have become much more cautious when a pet owner asks me whether I think a tumor is benign or malignant. I simply say, "I don't have microscopic vision," and that I just don't know.

Some clients hate this answer, but I would rather say that than give a client unnecessarily poor odds or false hopes.

In the case of Max*, Jake* and Praline*, three extremely dedicated owners were rewarded with an excellent diagnosis, an outstanding prognosis, and hopefully many more happy years with their dogs.

Dr. Zeltzman is a mobile, board-certified surgeon in Allentown, Pa. He is the co-author of “Walk a Hound, Lose a Pound.”


20 thoughts on “Is It Cancer? Never Assume

  1. I very much enjoyed these happy ending stories. Our twelve yr young labrador, Roxanne-Love, had two masses on her spleen. We opted for surgery…results came in benign! Our prayers were answered. This all took place in the last month. I was asking the vet at the hospital, where our Roxy had her surgery, what happens when pet owners come in with sick pets and they want to save them, but can’t afford surgery?? Roxy’s surgery cost us $4300. For some that is a drop in the bucket and for others it might as well be $100k. I can only imagine how helpless pet owners must feel if they can’t afford to try and save their pet’s life. ๐Ÿ™

    I can’t imagine life without puppy dogs!

    1. My dog roxy was diagnosed with a mass on her spleen today! She goes in for surgery tomorrow! I can’t believe our dogs have the same name and both have a splenic mass…can I ask what your roxy’s symptoms were? Was the mass affecting her heart at all? Or causing her to be anemic?

  2. Thank you for this article. Most have told nightmare stories and scared me to death!! My 11 year old springer mix had a cantaloupe-sized mass on her spleen and it was removed yesterday. Now we wait for the results…Wishing for the best, and so thankful there are surgeons who can help. To all who have a dog with a mass…keep up the hope and spirit and give plenty of love!

    1. We are bringing our 8 year old lab in tomorrow morning for spleen removal and this is the first article Iโ€™ve read that has had anything leaning towards good news so we are praying for the best. Good luck with your fur baby

  3. My cat is 6 years old and just had a mass removed from her spleen two weeks ago. The results came back and they could not say for sure 100% what it was. I know I don’t want to put her through chemo. She has been back in the hospital for 8 days now due to anemia and the cause is not 100% determined either, even after lots of tests. So far she has had 3 transfusions…1 before the surgery and 2 after. Now that she is on steroids her HCT levels are staying up. It’s all a mystery.

  4. Our labrador Chloe was diagnosed a couple of weeks ago with a HUGE splenic tumor, the size of a watermelon. It was crowding out all of her other organs and the vets only used the word tumor to describe it. Euthanasia was the recommended course of action as Chloe is 16.5. I sought a second and third opinion and all vets said euthanasia should be performed that day. They actually told me that to put her through surgery would be cruel as her prognosis was so poor, the cancer had probably spread and we would only gain a few weeks with her, but at what cost to her with the anesthesia and surgery recovery. We opted to operate anyways as I just couldn’t part with her and I knew she wasn’t ready to say goodbye. Chloe had surgery the next day and all went well, her recovery was swift, and the results of the histopathology came a week later – it was BENIGN!!!!
    We are well aware that she will not live very long anyways as she is already quite old but we are so happy that we followed our hearts and saved her life!!! Just like this article says, don’t ever assume the worst and always keep hope and faith in your animal. Think what they would do for you in the same situation and do that for them. Always give them a chance and do not give up, even against ALL ODDS. You never know!!!

    1. A fantastic note. Many thanks for writing it.
      Our beloved 13 year old black labrador Zorro is on the operating table as I write, having a large mass on his spleen removed. Fingers crossed the growth is benign. Your note has encouraged me to push hard for a biopsy when the vet calls (if they suggest otherwise).

  5. I know this article is old but the comments are newer and all of it gave me hope.

    My cat just had surgery to remove what turned out to be two large masses in her abdominal area. The vet said her organs look great and her lungs were clear and he thinks it is related to some leftover ovarian tissue that the vet who spayed her left in. She has exhibited signs of heat twice a year since I got here so it makes sense. We’re waiting to get the results of the histopathology to see if it’s benign or malignant.

    I’m so glad I found this article because it gave me encouragement to get this thing taken out of her and not just let it go.

  6. My 13 1/2 year old cocker just had a spleenectomy….removal of spleen and a baseball sized ugly tumor…
    One vet said to euthanize, the other…knew my heart had to know for we opted for
    Like everyone else….all I have read are death sentence stories…and I hold my breath as
    I wait for Buddy’s histopath report!
    He has no other lesions, no bleeding into the abdomen….blood tests are all normal!
    I am praying my gut is right….BENIGN….but if not….I will do everything in my power to make him comfortable…

    thanks all!

  7. Hi …my Chandler …shihtzu…has a spleen mass also. His symptoms were not eating…or eating very little for a doggie who always loved his food for 12 years. We had unltrasound on Friday that showed he has a mass on his spleen. It is the holidays now. So I am waiting on our vet to return and hope to get a call tomorrow to set up probable surgery to remove this mass whether benign or not. The ultrasound said there were 2 masses one was 2 inches the other was smaller. He is mildly anemic. I have been living on pins and needles waiting for xmas and New Years to pass so that we can move forward to make him feel better. He is drinking and eating small portions of (I made him filet minon steak). He really has no interest in the food though unless you hand feed him. Prayers this is benign and removal makes him feel better and eat.

  8. My 13 year old German Shepherd Diesel is booked in tomorrow for splenic mass removal. Fingers and paws crossed it’s benign. He is my best friend….

  9. Our 7 year old toy fox terrier just has her spleen removed. A 5cm tumor in it. We are awaiting biopsy results. Oct 2016, we lost another TFT, 6 year old, hemangioscarcoma in the jaw.
    Just praying we donโ€™t lose our other little girl…

  10. Yesterday at emergency vet our 7 year old Brittany Spaniel was found to have a large, unruptured, splenic mass. We elected to hold off on surgery until we could talk to our family vet today. His recommendation was to not do surgery. I’m torn! I want to give him that chance, but I don’t want to put him through surgery if the outcome is grim ๐Ÿ™ My mom doesn’t want to do the surgery, I do, but I don’t want to push her into doing something she is not comfortable with…

  11. Our German Shepherd has had trouble going to the toilet and tries several times a day our vet showed us an xray and thinks there is a mass preventing him from going to the toilet he has on occasions passed normal stools he shows none of the symptoms of cancer he has not lost his appetite and runs like a pup he is 5 years old, he is seeing a specialist on monday

  12. My friends’ beautiful dog was diagnosed with a spleen tumour last September, following a major bleed, which he survived. His owners opted not to have surgery. Now it is nearly March and he is still alive and acting like a puppy still, there are days when he is a little slower but overall he is amazing…he has had two minor bleeds, where he is clearly not feeling great, one can see the colour of his gums is pale, but he comes back. I took care of him for four weeks and eliminated the dry food, preparing every day meat with some veggies and quinoa. During that time he had no bleeds. His owners have now changed his diet so he is eating more meat, I do not know about the dry food. As my dear friend had Ovarian cancer and had trouble with digesting food, I reasoned that this dog’s digestive system might be compromised and hence I gave him easily digestible food. The mass is very large, he was a very slender dog and now looks like he is a little overweight, probably the mass is the size of a cantaloupe. He is 10 or 11 years old, a mixed breed of setter and pointer (I think). I wonder how long he can continue, he is much loved, he has outlived the original thoughts by 3 to 4 months. Has anyone had a similar experience? Does anyone think the food might be helping?

    1. Tell your friends to research Yunnan Baiyao. It is a Traditional Chinese Medicine supplement that helps with bleeds. There are several great groups on Facebook – one is the Ketogenic Dog Group (special high fat diet for dogs with cancer) and Hemangiosarcoma Diet & Supplement Protocols for dogs – A holistic Approach.

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