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When NOT to Remove These Scary-Looking Lumps and Bumps...

August 09, 2011 | 153,791 views
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In the second video of this 3-part series, Dr. Karen Becker talks about more benign lumps and bumps called adenomas and lipomas.

Dr. Becker's Comments:

In part 1 of this series, I discussed benign growths in general as well as viral papillomas, otherwise known as warts. Today I want to discuss yet more types of benign lumps and bumps on your dog – the kind you're usually better off just leaving alone.

Sebaceous Adenoma

Sebaceous adenomas are also a type of cutaneous wart. Unlike papillomas, sebaceous adenomas are non-viral, which means they aren't affected by the functioning of the immune system.

Sebaceous adenomas are really benign tumors. And though the word 'tumor' sounds scary, these tumors aren't, because they're benign. There's no cancer to worry about.

The sebaceous gland is an oil gland in your dog's skin. It can begin overproducing oil, causing the gland to become oversized. Sebaceous adenomas can grow quite big, and they are distinguished from viral warts by their oiliness. Often when you squeeze a sebaceous adenoma, clear-colored oil will be extruded from the pores of the skin. Sometimes there are little tufts of hair growing out of a sebaceous adenoma.

Because these growths do secrete oil, sometimes scabs can form. They are also often itchy, so if your dog scratches the growth he can make the situation worse and cause secondary scabbing. But again, sebaceous adenomas as a general rule are benign and nothing to worry about.

The only time I would recommend removing a sebaceous adenoma is if it's in a bad location and is growing large enough that it's bothering the dog. If it's on an extremity, for example, and the dog just won't leave it alone – constantly licking and chewing it -- removal may be indicated in order to return the animal's quality of life.

In my practice, I make note of the sebaceous adenoma on the dog's body chart and leave it alone.

If your veterinarian doesn't know it's a sebaceous adenoma just by looking at it, request that he or she do a fine needle aspirate. This is a procedure where cells are removed from the growth using a tiny needle. The cells are sent off to a pathologist for evaluation, and the diagnosis of sebaceous adenoma is made. I do not recommend anesthetizing your pet to remove a 'mystery growth' to see what it is. If it's an entirely benign sebaceous adenoma, it didn't need to come off in the first place.

Meibomian Gland Adenoma

Another type of benign lump I want to discuss is a meibomian (my-BO-mee-an) gland adenoma.

A meibomian gland adenoma is essentially a sebaceous cyst on or around the eyelid. The meibomian gland is a tiny gland found on the upper and lower eyelids of dogs (and cats, but this type of adenoma is rare in kitties).

Meibomian gland adenomas are benign – nothing to worry about. They are actually the most common type of benign growth I remove at my animal hospital, and let me explain why.

Even though I don't advocate removing most benign lumps and bumps unless it's absolutely necessary, meibomian gland adenomas (also called meibomian gland cysts, eyelid warts, and benign eyelid tumors) can grow large enough to irritate the cornea of the eye.

What typically happens is while looking at your dog, you see a tiny pinpoint eruption on the upper or lower eyelid, similar to a tiny whitehead. If it doesn't change in appearance and your vet identifies it as no big deal, you can leave it alone. But if your veterinarian says it's growing and/or you notice your dog is blinking more with that eye than the other, your pet has noticed there's something wrong.

If that benign cyst continues to grow to the point it rubs the cornea of the eye, your pet's quality of life can become impaired. Corneal pain can be intense, and in this situation I recommend removal of the growth. Your dog's quality of life will diminish with an open wound on the cornea, so surgical removal of the adenoma becomes important.

And to be honest, sometimes removing one of those growths is easier said than done. Sometimes, meibomian gland cysts are tiny where you can see them, but below the lid out of sight they are much, much bigger. Snipping off the superficial eruption – the part that's clearly visible – won't always solve the problem.

Removal of the visible eruption without removing the meibomian gland, which is responsible for producing oil and creating inflammation, often means the eyelid cyst will return.

Often, vets will refer patients with these eyelid tumors to a specialist like a veterinary ophthalmologist or a soft tissue surgeon who can perform finely tuned wedge resections and eyelid reconstruction in order to successfully remove the entire benign tumor.

In my practice, I don't automatically remove eyelid tumors, I watch them. In fact, I recently saw a patient, a 15 year-old Golden Retriever, with a huge eyelid growth. This old girl isn't a candidate for anesthesia due to her age.

It's obvious the growth is bothersome to her. She makes more mucous in the eye with the growth and she blinks more frequently.

What we're doing for this dog is having her owner lubricate the eye with an over-the-counter eye lubricating product called GenTeal. The owner is lubricating the eye thoroughly three to four times a day, which allows the growth to slide back and forth over the cornea without causing abrasion or pain.

Although removing the growth would be optimal, the risk of anesthetizing this particular pet for removal of a benign eyelid lump is not warranted. So instead, we're keeping that cornea well-lubricated to maintain the dog's quality of life while she endures the eyelid growth.

Lipoma

The last type of lumpy bump I want to talk about is a lipoma.

Lipomas are benign fatty masses that are incredibly common in dogs. The traditional veterinary community believes there is no breed, sex or age predisposition for the development of lipomas. And it's true any dog can grow a lipoma – young, old, spayed, neutered, obese or thin.

However, holistic veterinarians believe there's a correlation among the quantity and size of lipomas, the vitality of a dog, and how well she metabolizes fat. If a dog doesn't have a vibrant, thriving metabolism, what tends to happen is that dog lays down fat in what I call 'glumps.'

When you or I gain weight, we tend to gain it in several places on our bodies. When a dog with inappropriate fat metabolism gains weight, he adds glumps of fat in one spot. These glumps of fat are lipomas, or benign fatty masses.

Your dog can form these lipomas anywhere on the body. They can grow under the skin or they can grow in muscle tissue. The most common place they are felt is under the skin. If your dog has a lipoma under the skin, it's movable – you can actually move it around beneath the skin. They feel soft and squishy.

If the lipoma is in a muscle, it will feel very firm and scarier – like something cancerous. But chances are it's nothing to worry about.

If you feel something like that on your dog and you don't know whether it's something scary or it isn't, make an appointment with your vet – just a regular appointment, an emergency visit isn't necessary.

Ask your veterinarian to do a fine needle aspirate to determine whether the mass is something to worry about or whether it's simply a benign lipoma. If it comes back as a simple fatty mass, the vet should note it on your dog's body chart, including its size and the date. Then you can both watch it for possible growth.

If your dog's lipoma begins to grow, then depending on the location it may be medically necessary to remove it before it's big enough to impinge on your pet's quality of life.

I can count on one hand the number of lipomas I've removed in the last five years. Those that I have removed were because to do so would dramatically improve the quality of life of that animal.

Some lipomas can remain the same size throughout a dog's life. They're nothing to worry about, and it's only necessary to watch them for growth or any sort of change.

But if there's a lipoma in the crook of your dog's groin, for example, or in the armpit, or maybe a lipoma is affecting hip joint rotation, then you need to discuss the possibility of removal with your veterinarian. When a lipoma is affecting range of motion or a dog's gait, it's best to remove the mass sooner rather than later. The bigger the mass, the bigger the incision.

Surgical removal of a lipoma is called debulking surgery. Debulking means we remove the majority of the mass, but not all of it.

Benign fatty tumors are frustrating for vets because while we can remove all the visible fat, there are always (and I do mean always) fat cells that remain. They can be in the fascia, slipped down into the musculature, or on the under side of the skin. Those fat cells have a memory, and unfortunately, lipomas can reform.

So we call the procedure debulking because we can't promise we can completely remove all the fat cells or that the lipoma will not reappear in that same location.

However, despite the tendency of lipomas to regrow in the same spot, you should still consider removal under certain circumstances. If your dog's quality of life is suffering, if she's no longer walking comfortably, if there's ribcage rotation, or if she's compensating in ways that are causing skeletal problems, often removing the lipoma will dramatically improve your pet's musculoskeletal health.

Stay tuned in the coming weeks for my video about the most common type of lump found on dogs: sebaceous cysts.

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