Diagnosis In-depthDiagnosis may include the following:
A complete medical history and physical exam. Expect to answer questions about how long the growth has been there, what it looked like when it appeared and how it has progressed, how fast it is growing and whether it is hot, swollen or painful. Other tests will be needed to determine what the cause of the lump or swelling may be.
An aspirate of the mass. The aspirate is placed on a slide, stained and viewed under a microscope. Many masses can be identified in this manner. For example, fat cells are found in lipomas and mast cells are found in mast cells tumors. Pus is aspirated from abscesses and debris or fluid is aspirated from cysts. Some tumors are notoriously hard to get cells from and this test may be non-diagnostic. In addition, some cells are difficult to identify when not seen in their normal orientation.
An impression smear. In this technique, a glass slide is pressed to a moist lesion and stained for examination under the microscope. This is particularly useful in evaluating open abscesses and other infectious lesions. The slide may show not only the characteristic white blood cells, but also an appreciation for the infectious agent (type of fungal or bacterial agent).
A biopsy. This procedure is used if the problem cannot be determined by other methods. After suitable sedation or anesthesia a piece of the mass is collected by using a biopsy punch or a surgical blade. The biopsy is sent to a veterinary pathologist to determine what kinds of cells are present. A piece of tissue may also be submitted to culture for infectious agents.
Fluids from skin masses may also be submitted for culture. Based on the results, an appropriate antibiotic or antifungal can be prescribed.
Imaging techniques such as radiography (X-rays), ultrasound and CT scans may be used to assess the extent of the mass, to look for metastasis to other locations and to plan surgical procedures.
Tests to assess the clotting system may be done if the swellings are blood-filled hematomas.
Treatment In-depth
The treatment will depend on the final diagnosis.
Malignant tumors may be surgically removed, treated with chemotherapy, treated with radiation therapy or a combination may be used.
Benign tumors often are not removed unless they become a nuisance.
Abscesses are often lanced, cleaned and flushed. Once this is done, antibiotics are much more likely to be successful.
Hematomas are treated by identification and elimination of the underlying cause. Hematomas caused by trauma often heal without treatment.
Cysts may be opened, drained and flushed, treated by removal of the entire cyst or left alone if they don't bother the owner or the dog.
Hives or other allergic reactions are treated with anti-inflammatory drugs, such as steroids and antihistamines.
