Excision of Eyelid Tumor in Dogs

Eyelids tumors are common, especially in aging dogs. The vast majority are benign, meaning they do not spread to other parts of the body, but they can irritate the surface of the eye (cornea) or distort the eyelid. 

Removal of the mass is usually curative and may be done in first opinion practice or by a specialist. A procedure called 'V-plasty' where a wedge-shaped piece of tissue is removed is the most common surgery, although some specialists also use cryosurgery for small masses. If the tumor is small, under 2-3 mm, and static in size then monitoring for change or corneal irritation is acceptable.

The vet carefully assesses the eyelid tumor to see if it warrants removal, such as it is enlarging rapidly, bleeds, or irritates the cornea. Removal requires full general anesthetic in order to keep the patient still for what is very delicate surgery. In older patients, this means careful assessment, including blood work, so that any factors that could make anesthesia more risky can be corrected. 

On the day of the surgery the dog should have an empty stomach prior to the anesthetic. They are given a pre-med injection containing a combination of sedatives and pain relief, and a short time later anesthesia is induced via a vein in the the front leg. Then a tube is passed into the dog's windpipe through which anesthetic gas is delivered.

The surgeon is equipped with special, fine gauge instruments that are suitable for such delicate work. The surface of the cornea is protected, whilst the surgeon uses a sharp blade to cut a 'V' shaped wedge of tissue out of the eyelid, hence removing the tumor. The skin edges are drawn back together and sutured in place in such a way that not suture material is in contact with the cornea. 

The dog wakes up, and must wear a cone for 7 - 10 days to prevent them rubbing the eye and causing wound breakdown. 

Surgery is highly effective with this simple procedure, leading to a complete removal of the associated tumor. Since these lumps are benign, they are not liable to spread and so taking it away effectively cures the problem. 

However, it should be noted that there is nothing to prevent the dog developing a new lump of the same type in another location in the future. This is not spread from the first lesion, but purely a matter of the dog being prone to develop these lumps. 

For small eyelid tumors, cryosurgery is an alternative treatment. Cryosurgery uses extreme cold to damage and kill tissue. A small disposable cryo unit is used that has a delicate probe tip, suitable for highly accurate positioning. 

One obvious problem with this method is having extreme cold so close to the cornea or the rest of the eyelid. Success depends on shielding the cornea from damage and only using short freeze cycles, so the damage to the tissue is highly localized to the lump. Thus cryosurgery works best for small lumps only.

It is important the dog does not rub the eye whilst the eyelid is healing, or they could dislodge the sutures and cause the wound to open up. Wearing a cone for the duration of the recovery period is usually sufficient to prevent this. 

Given the difficult nature of the removing sutures from the eyelid, the surgeon usually uses an absorbable suture material which dissolves of its own accord. It takes around 7 - 14 days for the eyelid to heal, which most surgeons, erring on the side of caution, suggest keeping the cone on for 10 - 14 days. 

It is common for the eyelid to swell in the days following surgery, but this usually subsides uneventfully. The dog may be given pain relief to take at home for the first few days following surgery, but in most cases, antibiotics are not required. 

Once the eyelid has healed, there should be no recurrence of the lump at that site, however 'de novo' or new, unrelated lumps, may grow at some point in the future. 

The surgery itself is relatively straightforward and quick, and a big part of the cost is that of preoperative work up and the anesthetic itself. A pre-op blood panel ranges from $50 - $150, depending on how extensive the parameters are. 

The cost of anesthesia is variable depending on the size of the dog (smaller dogs use less anesthetic) and the type of anesthetic agent involved. A conservative estimate for a small dog would be $100, whilst a large dog could cost up to three times this amount. Expect to pay around $80 - $150 for the actual surgery itself. Then there will be add-on costs such as pain relief (an injection of a typical NSAID painkiller may be around $20), and a cone $6 - $12, depending on size. 

All in all, expect to pay anywhere from a low end $250 to a high end $630.

In themselves, eyelid tumors are rarely life-threatening or dangerous in their own right. However, their location can cause problems such as distortion of the eyelid or trauma to the cornea. When the dog blinks, a large eyelid tumor rubs backward and forward over the surface of the eye, which can cause inflammation or even ulceration of the surface. 

The vet may wish to send the lump away to the lab for analysis, to double check the tumor is benign, but this is not always essential. 

Surgery is not always essential for small eyelid tumors that do not cause irritation and are not growing rapidly. In the case of an elderly dog, the anesthetic risk may outweigh any benefit from removing the lump, in which case the vet may suggest monitoring its growth. 

Unfortunately, there is no known prevention for the development of eyelid tumors, so vigilance and monitoring are key to decision making.