Dog has a mast cell tumor

November 2, 2015 4:26 PM

My dog was diagnosed via fine needle aspiration with a mast cell tumor. It is on his left lateral flank. We are scheduled to have it removed and biopsied tomorrow. However, this is our regular vet. Should we halt this and consult an oncologist or specialist first? Or should we proceed and wait till we get the results of the biopsy?
posted by ChuckRamone to Pets & Animals (15 answers total)

Best answer: I would proceed with your primary vet. There's no need to pay specialist prices, especially if they are able to remove it. This is quite common at the animal hospital I work at and we even use the same laboratory as the specialist we refer people to. If the histopathology comes back with something serious I doubt your primary vet would hesitate to refer you to a specialist.
posted by smellyhipster at 4:34 PM on November 2, 2015 [3 favorites]

Response by poster: Thanks, smellyhipster. I got the same answer at a different forum. I'm really freaking out about this and needed some input badly.
posted by ChuckRamone at 4:52 PM on November 2, 2015

I had something similar happen with my dog. I'd get it removed asap by your regular vet. if the biopsy shows spreading then you can consult an oncologist but the sooner you have it removed the better. And smellyhipster is right - removing a lump doesn't need a specialist.

Very best wishes for your dog's smooth procedure and recovery.
posted by mulcahy at 6:07 PM on November 2, 2015 [2 favorites]

For what it's worth, I have known of quite a few dogs with mast tumors who had them removed and there were no further problems. I've even known of a couple who did not have them removed with no ill effects. I hope this might ease your fears a little bit and I wish the very best for your dog. It's really wonderful to see all of the fantastic pet people here on MeFi who love and care for their pets so well.
posted by WalkerWestridge at 6:29 PM on November 2, 2015 [1 favorite]

This is a very common procedure for your vet if they've been in business for any length of time. As long as you trust them generally you should let them do it. You'll get a continuity of care from them that you won't get if you go for a specialist, especially if you have wound care or other issues post-surgery.
posted by Lyn Never at 7:05 PM on November 2, 2015 [1 favorite]

IMAV/IMNYV- In this location I would let your regular vet do the surgery- if the margins are clean (no tumor cells seen near the edge of the remove tissue) and it's low grade then you most likely won't need to see an oncologist. If it'a high grade or the margin is dirty (the tumor extends to the margin) you might need follow up consultation but this really isn't very common.
posted by morchella at 9:08 PM on November 2, 2015 [1 favorite]

I am a veterinary technician who works in specialty medicine, mostly on the emergency/critical care side. I would personally consult a board certified surgeon. In my opinion this procedure should be performed by a surgeon with training in surgical oncology. The surgeon at my specialty hospital frequently revises mast cell tumor scars where there were dirty margins. Just my opinion.
posted by slime at 5:14 AM on November 3, 2015 [1 favorite]

I agree with slime. It is of utmost importance that the surgeon gets clean margins, and while it's true that your vet may have done many mast cell removals, they haven't done as many as a board certified surgeon who is in surgery all day every day. If there are financial constraints, then I would consider sticking with your regular vet, but if you are willing to go to an oncologist you might as well do it now, rather than later.
posted by Rock Steady at 5:20 AM on November 3, 2015

We had multiple mast cell tumors removed from two different dogs by our primary vet. My understanding is that these are very common, and if they are low grade very unlikely to spread. If you trust your vet and feel they have experience with this, I wouldn't hesitate to use them for the removal. Unless your vet is unable to get clear margins or feels that the tumor has already spread, I don't think an oncologist is necessary.

Best wishes for you and your pup on his quick recovery!
posted by thejanna at 7:33 AM on November 3, 2015

My dog had a mast cell tumor on her neck that a surgical specialist removed. My regular vet said that she was uncomfortable removing it since the vasculature in the neck was going to make getting the correct margins difficult.

The surgeon I went to was fantastic and she made sure to get ample margins. She also cut in such a way that the incision healed without any bumps. There's still a scar, but it's smooth.

The specialist also gave my dog an ultrasound before surgery to check to see if there was evidence of cancer elsewhere in her body.

I live in Chicago and the surgery cost about $2500. I would check with your vet on price and see if the price is similar to that of a specialist. If it's similar, I would go to the specialist. My understanding is that getting the appropriate margins is essential. I am happy my vet recommended the specialist because I feel more confident that the procedure worked. It's been 2 years and my dog is happy and healthy.
posted by parakeetdog at 8:31 AM on November 3, 2015

Response by poster: Oh boy. After reading some of the more recent replies suggesting a specialist, I feel a little nauseated. My dog is in surgery today. I'm hoping for the best but I get anxious and think dark thoughts very easily. Aaarh.
posted by ChuckRamone at 11:47 AM on November 3, 2015

How did the surgery go? I hope everything went great.
posted by parakeetdog at 4:24 PM on November 4, 2015 [1 favorite]

It's ideal to go to a specialist, but certainly not necessary. If your vet has any concerns about the outcome post-surgery, they can refer you after the fact. Thinking good thoughts!
posted by Rock Steady at 7:31 AM on November 5, 2015

Hope your dogs surgery went well, sending you positive thoughts for speedy healing!
posted by WalkerWestridge at 1:54 PM on November 6, 2015

Response by poster: I got the pathology report back today. It was a grade II tumor with a mitotic index less than one with no vascular invasion. The margins of the excision were about 6 mm deep and 11 to 27 mm laterally. It was about 1 cm in size at the time of removal.

The report says that based on the two-tiered grading system, it is low grade.

My concern is did the doctor take enough out? 11 mm is only 1.1 cm. I don't understand why she didn't take out a consistent lateral margin.
posted by ChuckRamone at 2:57 PM on November 6, 2015