Surgical Tumor Removal in Dogs

The word tumor refers to an abnormal growth of cells that results in a lump forming. However, tumors range widely in significance from harmless growths (described as 'benign') to aggressive life-threatening lumps that seed cancer cells to other parts of the body (described as 'malignant').

For many lumps, it is best to err on the side of caution and treat them early, so as to reduce the risks should they be malignant. Depending on the type of tumor, the options include surgical removal, chemotherapy, or radiation treatment. Of these, surgical removal is by far the most widely performed and common in first opinion practice.  

For some tumors it's helpful to know what the cancer is, in order to aid planning the operation. To do this the vet may remove a few cells via a needle and send them for analysis (fine needle aspirate). 

For aggressive cancers the vet will 'stage' how far advanced the cancer is. This includes checking the draining lymph nodes for evidence of spread, radiographing the lungs for secondary tumors, and scanning the liver and rest of the abdomen. 

This information allows the vet to decide if it is appropriate to put the patient through surgery and helps when planning how much tissue to remove. 

Typically the patient has blood tests to determine their underlying health and whether supportive intravenous fluids are required during the anesthetic. The dog then receives a premed injection, including pain relief, to prepare them for the anesthetic. 

Anesthesia is induced via a catheter in the dog's leg, and maintained via anesthetic gas supplied through a tube placed in their windpipe. 

The area around the tumor is clipped and made sterile with surgical scrub. For internal tumors, the prep is made on the skin where the incision to gain access is made. 

The scrubbed and gowned surgeon then removes the lump, with wide margins of tissue around the lump. The incision is closed with sutures, and a dressing applied where appropriate. Oftentimes, the growth is then sent to the lab for analysis, to ensure it has been completely removed and to definitively diagnose what it is.

The success of surgery depends on:

• The type of tumor
• How early the tumor was caught
• Accessibility
• How much tissue was removed from around the tumor
• Surgical technique

For small benign masses, surgery will be curative. When possible, the lump should be sent away for analysis. This not only confirms what type of tumor was present, but checks that 'clean margins' were obtained, meaning that enough tissue was removed to reasonably assume the cancer has been eliminated from that area. For large malignant masses, the surgery may not be curative but may 'debulk' the tumor and buy the patient some extra time and a better quality of life. For many patients, the outlook is good, especially with prior screening to check for complications ahead of surgery. Incomplete removal of an invasive tumor can mean it recurs.

An average, recovery time from surgery is 10 - 14 days for straightforward cases. During this time the dog must be prevented from licking the operation site by wearing a cone or having the area covered with a dressing. The dog must avoid exertion, which could burst the stitches, and only go on gentle lead walks (as instructed by the vet). 

Internal stitches dissolve of their own accord but those in the skin will be removed at 10 - 14 days. Once the results of the lab report are known, the vet will decide if further action is needed. This may include regularly screening to look for recurrence, or further treatments such as chemotherapy or radiotherapy. 

In many cases, the actual surgery is just part of the cost involved in treatment. Add on costs include screening tests such as ultrasound scans ($75-$280) and x-rays ($60-$280), with the possibility of adjunctive chemotherapy or radiation treatment. The latter takes places at specialist clinics and may cost thousands of dollars. 

For a simple skin tumor removal, the cost can vary from $180 to 375, whilst more complex internal tumors run $1,000- $2,000 and upward. 

Costs vary depending on the surgical time and the complexity of the surgery. Surgeons in first opinion practice are highly competent at removing tumors, but for lumps in difficult to access locations a referral to a specialist may be needed, which can be costly. This is especially true if a skin graft is needed.

It is never wise to ignore a lump in the hope that it goes away. Not only does this put the pet's long-term health in peril, but the eventual treatment is liable to be more expensive as a result of increased complexity. 

Surgical tumor removal ranges from the straightforward to the complex. The need for surgery should always be carefully assessed so that the benefits outweigh the risks. Major surgery is painful and requires the dog to be in relatively good health in order to heal. If the cancer has already spread or the dog is generally in poor health, then whether to proceed requires careful thought and discussion. Whilst surgery is a vital life-saving tool, sometimes even the best surgeon cannot cure the patient, because of the nature of the cancer. This means the dog may either grow new tumors in a different place, the cancer may spread internally, or the tumor regrows.

Prevention is often not possible because cancers occur due to factors outside the owner's control, such as the genetic makeup of the dog. It is, however, sensible to make sure the dog has a healthy diet and adequate exercise so they are in optimal health. Then, should a tumor develop the dog is best placed to cope with the anesthetic and surgery. 

In addition, the owner can help by being vigilant for lumps and tumors. It is a good idea to check the dog's skin on a weekly basis and get any new lumps checked by the vet. In addition, carefully monitor existing lumps. This includes:

• Photographing them
• Measuring the lump and writing the size down
• Being vigilant for changes in size, shape, or texture
• Spotting changes such as the lump starting to irritate the dog. 

Lumps that grow rapidly, become attached to the underlying tissue, become red or inflamed, or bother the dog should be checked by the vet.