Gosh Dr. K - between yesterday's post and today's I would think you were shadowing me or rubbing some point in....let me explain. About 2 weeks ago I removed a lipoma like mass from the axilla of a dog. It had grown to its pre surgical size over the course of a month and while not affecting the dog yet, I believed that if given time to grown this would fall into one of those areas that it could affect the dog. Secondly, it would become something that I would not want to remove. So remove it we did - it ended up being about a pound in weight, but shelled out nicely, owner declined to have it sent in for pathology. The back side of it was right next to the brachial plexus and vessel bundle - but thankfully no problems/bleeding, etc.... The dog went home and amazingly between the two drains I had put in I managed to avoid any seroma formation and the incision healed beautifully and I thought I was home free. However around the two week mark and suture removal the dog began to have this 'burn like area' on the back develop. It was first hard with a few ulcerative areas, then became softer and draining puss. Initially thought it was a drug eruption but then when another patient presented at same time (and about 2 weeks post its surgery) it was more apparent that the heating pad we were using to help keep patients warm during surgery must have been becoming faulty and developing hot spots that resulted in the burns. I felt (and feel terrible) as this is something I would have never caused on purpose. I was trying to do the right thing and prevent problems related to hypothermia (as you had also pointed out in a previous blog) and anesthetic related complications, etc. However, it is also apparent that had we not done the surgery the animals would not have developed the post surgical complications. We have been honest with both owners, not charged them for any follow up rechecks, medications, or anything. Felt this was the fairest thing we could do given the circumstances. I hope they don't consider this sloppiness on my part or neglect (we were there with them in surgery the whole time!!) Haven't had any problems with anyone else so not exactly sure why these two had issues. But heating pad is gone to trash and we will work on getting something different and better to avoid the possibility of any issues in the future. Anyway just felt like you were speaking to me this week.....and in sharing I hope that no one else will deal with same issues.

J.C. December 6th, 2008 11:17:54 AM

sorry for run on paragraph, I can't see/figure out how to get page breaks, even though I try and put them in.

J.C. December 6th, 2008 11:18:59 AM

J.C. Sorry about the paragraphs (what browser are you using?) but thanks so much for sharing your story. i guess i was talking to you this week. I feel for you, especially after a chryptorchid neuter came back last night with a 105 temp and a nasty suppurating infection of his suture line. Youch. It's on my dime this time, regardless of how it happened. (btw, axilla=underarm for those of you who don't already know that.)

Dr. Patty Khuly December 6th, 2008 12:16:41 PM

I also thank you for this timely (for me) post. My 9 year-old Lab Sadie has been growing collection of lipomas for the last couple years, at first aspirated and then left alone and watched at each office visit. This week, she developed swelling in the right rear leg over the outer thigh, which over the long Thanksgiving weekend (of course, when else?) seemed to become painful, more swollen and tender. On Monday afternoon it seemed more like an abscess and was becoming pointed. By then I had already been given a Tues. AM appointment due to heavy volume in the office after the long weekend and no vacancies till Tuesday. (My bad I guess---maybe should have gone to the emergency hospital, but chose to wait till the next morning and see my own vet). Tuesday AM the area opened on its own, poured out purulent stuff at first, then sero-sanguinous drainage. Kept the 9 AM appointment, at which time my vet unsuccessfully attempted needle-aspirate but got only serum, no cells; and suggested treating the infection first (poor Sadie had a slight fever at 102.9) and excision and biopsy when the infection is cleared. She feels that the location of the lump in question makes a lipoma seem less likely than a liposarcoma or other tumor such as mast-cell tumor (though she feels the location makes mast-cell a less likely candidate). So next week, after the 10-day antibiotic course, Sadie will go under the knife for a mass removal and biopsy, and we'll take it from there regarding any further treatment needed. Anyway, thanks for the crash course in Lipoma 101; it reassures me that my decision to risk anesthesia and surgery is probably the right one.

Shellie December 6th, 2008 01:59:52 PM

As not so common lipoma's are in cats, I opted to have one removed from my cat's front shoulder and sent to UofP for a biopsy....it was just a fatty tumor and I didn't have it removed for looks, but certainly for my piece of mind. Who knows what it would do if left in such a spot on a cat....

if you feel better that it's gone, have it removed. Especially if it is in a spot where the animal might regularly bump or bother it.

LorriM December 6th, 2008 05:43:24 PM

Dr K - I am going to show my ignorance here about which browser I am using and say Windows Explorer....would that be correct or is it something else

J.C. December 6th, 2008 06:50:54 PM

I knew a dog whose lipoma, which was located on her side, grew so large, that she was having a hard time walking.  It must have weighed several pounds.  It looked like a fur covered bike couriers bag.  Her owner was very conscientious and I guess in concert with the vet they'd decided not to remove.  She ended up getting cancer years later, I don't think it was related to the lipoma.

Stefani December 6th, 2008 07:13:15 PM

One of my cats has a fatty lipoma by his tail.  Our vet said to watch and see if it changes, then we'll remove it.  She took the "watch and see" after an aspirate was done.  So far it's the same.

Raven's Mom December 6th, 2008 07:51:18 PM

My dachshund Ralph had a lipoma that was attached to his torso on one side, sort of at his hip joint. It popped up and grew over a 2 year period (at what in retrospect was an alarming rate. to about the size of a big oval grapefruit. My vet warned me that the surgery would be tough, because of  the blood supply and how it was attached.  However, Ralph had had surgery several times for bladder stones, and he always bounced back quickly from those, so I sort of discounted her warning (figuring having a bladder cut open was probably worse that a lump removed.) I was completely wrong (of course) and his recuperation after the lipoma removal was far tougher than any bladder surgery. If another one pops up  I intend to have it removed asap. On a positive note, as soon as he had the lipoma removed, everyone kept complimenting me on his weight loss. I guess that's one way. 

shopgirl December 6th, 2008 08:07:17 PM

My old Bonnie Belle had what looked like a lipoma but as it grew it was more firm. Turned out to be a follicle tumor and despite having a base about the size of a quarter, her scar after surgery was several inches long. I was shocked at first, but I guess it was done to excise all the tissue and take tension off the wound.

<br>I know nothing about the "tailoring" aspect of wound closure, but I guess you can't just pucker a circular wound closed, this requiring a much larger incision.

<br>In retrospect I'd have taken her tumor off earlier despite the recommendation that we could wait. The foul smelling white cheeze that erupted from the tumor was reason enough to spend the money and have it removed prophylactically instead of waiting for a "change" or complication. I was a young adult at the time and it was my parent's decision, but I've learned from the experience and have every new bump needle biopsied on my dogs now.

<br>Giving the dogs a bath and a massage is a great way to check for burrs, ticks, and any new growths. I found one on Dublin that was only the size of a grain of rice, but in we went for the needle. Don't regret it for a second. The needle biopsy and the stool exam are excellent for peace of mind and getting a jump on anything.

Christopher December 6th, 2008 08:51:07 PM

Double Lipoma Dilemma:

Patient: 2 mos. shy of 12 yrs. old Scottish Terrier, hypothyroid, lab work normal except slight decrease HCT, alk phos. running 500-600 for last 2-3 years, mammary adenomacarcinoma (biopsied) removed w/ wide margins 5/08 along with teeth cleaning, removal of 2 premolars (look gorgeous!).

Has slow-mod. growing lipoma (?) needle-biopsied 3x---appears to be lipoma behind rt. front leg (same side as removed mammary gland), as of this week noticed 2nd growth opposite side behind left front leg, about 1/2 the size of other. No discomfort, pain, or interference with movement.

Dilemma: had considerable post-op pain from mammary removal though healed nicely, out-lived average age of Scottie (10.9 yrs), breed pre-disposed to cancer, has some underlying issue with ^alk phos, living good quality with activity, normal eating & elimination habits, aged coat.

I'm inclined to not mess with them (her), Any thoughts? Almost damn if you do or not.

Barb Albright/NH

Pocket's Story from NH December 6th, 2008 09:39:02 PM

i personally find the lipoma removal thing kind of agonizing in a weird way. I don't really want to take most of them off and yet I know I probably should if I'm to practice the "best" medicine I can. Cosmetics don't enter into my decisionmaking at all, though I do give owners the opportunity to express their opinion on this and I think it's OK for them to enter this criteria into their personal list of pros in favor of removal. I guess I wouldn't put my 11 year old brain tumor patient through it, though that's hard to say for sure (after all, her step daddy is a surgeon and he'd likely push me to have him do it).

All of this is by way of a long explanation on why I can't answer any of your personal questions on whether your dog's lipoma should be resected or not. On a cat, however, my rationale is different. Cats don't usually get lipomas. If there's a lipoma-like mass on a cat I'll strongly recommend removal.

JC: I'll look into your browser's potential issues.

Dr. Patty Khuly December 7th, 2008 07:40:03 AM

Okay, can someone explain the difference, if there is one, between a lipoma and what my oldest bitch gets?

This is an 8 1/2 year old English shepherd SAR dog who gets small superficial growths, generally on her flanks, that last for months, even more than a year -- but eventually "crown" or show a tiny hole in the center and can be squeezed out like zits.  Nothing seems to speed this process, they are just ready when they are ready.  She's been getting them for about four years.  None of her offspring (one litter aged 5 years, one aged 19 months) get them.

The largest she ever got was on her tail (dorsal surface) and was eventually the size of a large shooter marble; when it finally "ripened" we squeezed out some really skanky stuff.  They do not come back after being expressed.

The vet did a needle aspirate on that one, and said it was fatty cells -- but is this different from a standard lipoma, which I've always thought of as soft/solid?

Complicating matters, she had a squamous-cell carcinoma removed from right between her eyes in October 2005.  This came up fast immediately after an extended deployment to do Katrina recovery work; we assumed it was fatty, but obviously wanted it off given the location and how fast it was growing.  It was about regular marble-sized when removed.  Everyone was gobsmacked when it came back malignant, and we immediately had several pea-sized growths taken from her flanks.  This second surgery was a fiasco, with poor Pip sliced up like Frankendog and shaved near-naked in the cold winter wind, picking out her staples, learning to escape an e-collar by all means possible.  Of course they were harmless little fatty zits.

So now we're torn between the wait and see approach and an aggressive response to each bump.  She's got a new one on a front leg for us to fret about.

Fatty tumor, zit, or malignancy?  Damn.

H. Houlahan December 7th, 2008 08:53:57 AM

Thanks for the comment on Lipoma's in cats.  I've been trying to decide on just having it removed from my cat for a little while now.  You've just given me the information I needed to make the decision to remove it.  Usually I prefer to remove lumps when we find them.  The "wait and see" has been bugging the heck out of me.

Raven's Mom December 7th, 2008 09:40:31 AM

JC: I'm running Microsoft IE and put a p between to break the paragraphs. Someone at your clinic should be in charge of QC to test all equipment for malfunctions daily/weekly. It is a bummer that you got stuck on the heating pad case when someone should be in charge of discovering all defective equipment.

I know Dr. K, that no one can really decide the best option on a lipoma, with its pros and cons on particularly a compromised or elderly patient---mine being both, this time.

It was a no-brainer of removing a lump on one of my others at 8yrs., healthy, plasmacytoma next to the nose.

Also with the above cited case, I felt mammary lump was important, because I had just cared for a dog that had one grow & ulcerate at the age of 14, and it wasn't pretty nor easy to keep up with. This one also had a lipoma spread to the center of her chest, but had other issues & I truly believe would not have done well post-op.

Somehow, I don't feel as lucky, should I decide to tackle removal of these 2 particular lumps, and almost wonder if she will be sprouting more??!!

Hence the dilemma of each case. Age is definitely a factor for me, along with other concurrent health issues. B. Albright

Pocket's Story from NH December 7th, 2008 12:42:41 PM

JC: put p between less than and greater than signs

Pocket's Story from NH December 7th, 2008 12:44:35 PM

Do different dog foods affect how dogs get cancer?

Shreela December 7th, 2008 01:43:45 PM

Shreela: Interesting question. The short answer: We don't know. Though there's some relationship between wet commercial diets and hyperthyroidism in cats, no other studies have convincingly revealed anything more than a correlation here, not causation. The problem is that there's very little work being done in nutrition in general--though that's changing. As I mentioned, though, lipomas (though benign) are correlated with obesity. Thanks for the Q.

Dr. Patty Khuly December 8th, 2008 08:38:08 AM

I have a 13 pound, 7 year old miniature Dachshund, Austin, who is in good health except for the fact he's developed a small lipoma within the last 6 to 8 months. The attending veterinarian's notes describe the mass as "SQ mass #1 on the left ventral thorax about 5 cm from manubrium". A cytology was preformed in-house which revealed "adipocytes and lipid globules consistent with a lipoma". I feed Austin a raw diet in combination with Honest Kitchen and Wysong Archtype. I supplement him with 1/2 teaspoon of Sea Pet EFAs (Sea Pet Omega 3 Fish Oil 2000 with Natural vitamin E. Provides the biologically available forms of omega 3 EFA with 200 IUs of Vitamin E per tsp. ) I use this product because all Sea Pet omega-3 fish oils are completely tested for heavy metals, PCBs, furans, dioxin and other toxins. Sea Pet oils surpass all national and international standards for purity. I also supplement his diet with CoQ10 and acidophilus. Austin goes for a mile walk every day, sometimes twice. I brush his teeth regularly with Petzlife and it has done wonders for his gums and plaque build up. I consider myself a "hands on" pet owner and take my dogs health very seriously. It is for this reason that made an appointment to meet with a Homeopathic Vet tomorrow to see if there is any holistic treatment available to treat his lipoma. I do not want to stand by and watch this growth get larger and larger to the point where it impedes his movement.

Greg December 8th, 2008 11:46:50 AM

Greg: I've never heard of a homeopathic treatment for lipomas but this is not my arena--I refer my patients to a well-trained holistic vet in my area for acupuncture, TCM and homeopathics. I do, however, doubt very much that a lipoma might be amenable to non-traditional approaches--but please let us know what you try and how it works. Thanks!

Dr. Patty Khuly December 8th, 2008 12:18:03 PM

Thank you for your reply Dr. Khuly. today we have an appointment to with a Certified Holistic Veteranarian. I may have miss-spoke by refering to him as a Homeopathic Veteraniarian. In addition to being a DVM, his qualifications are: Certified in Veterinary Acupuncture International Veterinary Acupuncture Society Certified in Veterinary Homeopathy Academy of Veterinary Homeopathy Advanced Training in Veterinary Homeopathy, AVH Member, Academy of Veterinary Homeopathy Member, National Center for Homeopathy Member, American Holistic Veterinary Medical Association I will let you know how things go. Thanks Greg

Greg December 9th, 2008 09:19:31 AM

My older dog (about 14 yrs), small 23 lbs, started acting different and not wanting to eat.. I took her to the vet and she was diagnosed with a heart murmur and CHF (congestive heart failure). She was put on medication, but I'm still having a problem getting her to eat.. I was giving her sensitive stomach canned food and she was eating twice a day and going to the bathroom (BM) in the AM walk and PM walk... all of the sudden she stopped eating her wet food all together... My vet said to try boiled white rice and cooked ground beef with only a little garlic powder (not, garlic salt) to make it smell better.. The first day I made it she ate a little bit, now she hardly wants to eat anything.. she seems hungry and runs to the plate of food, but smells it and walks away... I don't know what to do.. the only thing she'll eat are the little chicken sausages (baby food) but I can only give her one or two the most b/c of the high sodium content. She hasn't been going to the bathroom everyday... when she does, the poop it's very small, about a couple of inches... I guess since she's not eating she has nothing to eliminate.... PLEASE, IF YOU HAVE ANY SUGGESTIONS I would appreciate it... I'm desperate! It's been about one week. Thanks!

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kudostechnet2 January 9th, 2009 12:42:42 AM

Hello, I have a 12 year old Dachshund female and she has a fatty tumor on her right side above her back leg. 2 months ago it was almost gone, like a scab the size of a dime maybe. Three weeks later she came back and it is bigger than a golf ball and bleeding and oozzing puss all the time. I have tried everything, if someone has any suggestions please let me know!!

Jen

jennifer Manfredi February 1st, 2009 01:00:01 AM

I have a 11.5 year old cockapoo rescue who has several large lipomas that have all been diagnosed with fine needle aspiration. The largest has doubled in size in the past three months and is located in his left inguinal area extending distally along the length of his femur. Just that past two days he has had difficulty sitting but can lie flat on that side. He has another large lipoma on the same side but up near his scapula. Two vets that I trust have seen him and advised waiting and I am wary of anesthesia at his age. Two years ago he had anesthesia for a perirectal adenoma and just last year had a dental exam and two teeth pulled and has done fine each time. He has multiple allergies most recently to rice- but his allergies are stable. This lipoma began to grow much faster than the one on his scapula area after we started him on 3,000 of Fish Oil daily. I can't find any reference that this could accelerate the growth of this lipoma. His next grooming appointment is 2/28 and I know the groomer will pitch a fit at the size of this thing. Now that his back leg is beginning to angle out some and he has difficulty sitting am I wrong to push for this lipoma to be removed? The vet I trust the most is semi-retired and only works 2 days a week and he hasn't seen this lipoma since April when he had the dental exam. I am concerned because he will most certainly have to wear NBT collar and he is a bugger about worrying at any little imperfection. His only other meds are Bendaryl daily. I had always had labs prior to this guy and I had one lab with an invasive lipoma that was eventually the cause of her death and another lab that never had so much as one lump or bump.

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ffb March 6th, 2009 06:26:49 AM

Help - my 12-year-old Sheltie has a lipoma found by the groomer last week Friday.  It's on the back of his right back leg and now wraps around 3 sides, and extends from hip almost to ankle. Monday I rushed him to the vet as it was growing practically as I watched. Today was in again and it's bigger - 4 aspirations show fatty cells. Vet doesn't recommend surgery. I don't know if his skin can stretch any farther. Is there liposuction for dogs? Surgery would surely mess with his muscles and tendons given the scope of this tumor. Vitamin E massage? Acupuncture? I'm going to try everything. We have a teaching vet hospital here but I don't think I can afford it.

Chris March 6th, 2009 03:20:27 PM

Lipomas typically are just balls of fat that don't infiltrate. They shell out most of the time. My 11 year old dog had one the size of a grapefruit removed with no issues.

Peggy March 11th, 2009 08:31:53 AM

QUESTION: I am a human with many, many painful lipomas throughout my body. All I can find are studies done on dogs. What type of medical doctor would you suggest I see? Sally Larsen Pelico62@hotmail.com

Sally Larsen March 28th, 2009 08:43:00 PM

I too have discovered a large mass on the back leg of my cockapoo, actually found by his groomer. I rushed him to the vet and was told that it is probably a lipoma. The vet said due to the location on the inner and outter aspect of the leg it wasnt something that could be surgically removed. Does this sound right? My dog didnt even budge at her palpating the area, so it seems painless to him. Although I've noticed a difference in his gait. The strangest thing is my cockapoo is acting very weird...he wines all the time, wants nothing to do with our other dog, and is almost "pacing" back and forth like hes nervous. I dont know what to think. Any suggestions? Has anyone else experienced behavioral changes with their dogs and lipomas??

Tina April 2nd, 2009 10:56:02 PM

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dvdv April 12th, 2009 08:24:21 AM

I have a 9 year old Dalmatian, Maverick.  My husband and I live overseas since he's in the military.  I noticed last summer a lump on his rear hip/thigh area.  We took him to the local German vet, who in broken English told us it was a lipoma.  When we took him back after finishing some medicine to help his ears (our female loves to lick inside his ears), I asked her to aspirate the tumor to make sure.  Only we had a vet tech who thought the lump came from a shot.  We had to explain the whole situation again and were told that they would need to put him completely under just to aspirate the tumor and that would cost us around 200 Euro. 

When we got home, I made an appointment with the base vet.  After the appointment, I noticed a smaller tumor on his chest.  We had both aspirated and were told that both were fat tumors.

However, the tumor on his hind end has grown double in size in less than a year.  In Feb. 2009, I took some wax paper and drew a circle on it and dated it.  When my husband returned a month and two weeks later, the tumor had grown about 2 more inches.  It grows up before it grows out.  I have also noticed more tumors on his body.

We plan on taking him back to the base vet but I was wondering if there is anything in particular I should be asking the vet?  Should I insist on them taking a small biopsy from the large tumor?  I don't want to find out when it's too late to do anything that I could have prevented it. 

Kathleen, "Mom" to Maverick and Piper

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