Thursday, November 13, 2014

About those lumps and bumps

If I removed every little lump I saw on my patients, I’d be wealthy!  But I don’t, and I’m not.  The reason veterinarians don’t eliminate every single blemish is that it’s usually not necessary.


You’ve probably seen an aging pet that has hairless, warty-looking bumps on his body.  Those rather unsightly lesions are most likely sebaceous adenomas, which are benign tumors of the sebaceous glands of the skin.  Because sebaceous glands secrete oil, the adenomas might be greasy and scabby.  As long as they don’t bother the pet owner or patient, and don’t get too big, they can be left alone.

But sometimes they create problems that indicate removal:   They can bleed and create a mess on rugs and furniture. They can also be itchy and an annoyance to the pet; some dogs and cats become obsessed with licking at the adenomas, which can make them red and sore.  Occasionally they are in a location that causes pain, such as between the toes.  And often our clients are just tired of looking at them!

Skin tags, which are seldom seen on cats, are another category of ugly, lumpy things.  Once in a while, their location makes them a problem.  For example, skin tags on the elbows are subject to repeated trauma whenever the dog lies down on the floor.  Sometimes skin tags are unattractive to the dog owner.   In those cases, we remove them.  Otherwise, skin tags are perfectly harmless and may be left alone.

Another benign skin mass we commonly encounter is a sebaceous cyst.  This differs from the aforementioned sebaceous adenoma in that it’s not a tumor, but a sac full of the oily secretion of the sebaceous gland.   But like sebaceous adenomas, they can bleed, itch, and aggravate the pet, and we recommend excision in those cases. 

We eliminate these small skin bumps in two ways:  Excision or tissue ablation.  When we excise a mass, we simply cut around it using a surgical scalpel or a laser beam.  The resulting skin defect may be left open or closed with sutures.  Excision of small masses might require only a local anesthetic.   Larger lumps or those in sensitive areas, such as the feet or face, will require a general anesthetic, so we usually try to remove those when the patient needs another procedure, such as a dental prophylaxis. 

A CO2 laser also can be used to ablate small lumps; the laser beam vaporizes the lump without thermal damage to surrounding tissue.   But this is painful without using local or general anesthesia, and again, we try to coordinate the removal with other procedures.


I’ve often wished we could remove some of these small skin masses right in the exam room instead of subjecting the pet to hospitalization and general anesthesia.  With the addition of a new instrument in our practice, that wish has come true.  

Cryoprobe™ is a portable and efficient cryosurgical device for the treatment of many kinds of skin lesions in small animals. The pen-shaped hand piece freezes unwanted tissue with pinpoint accuracy by using a micro-fine jet of liquefied nitrous oxide.  After the tissue freezes, it is allowed to thaw, and then it’s frozen again.  The “freeze-thaw-freeze” cycle results in destruction of the cells.  The cool thing (no pun intended) is that the treatment causes only minor discomfort and doesn’t require a local anesthetic.  

Because geriatric dogs tend to be skin-lump factories, they will benefit the most from cryosurgery, especially if they aren’t candidates for general anesthesia.  Even small mammals and birds may have lumps that can be selectively removed by freezing.   At Vernon Hills Animal Hospital, we think that this icy-cold therapy will be an asset for many of our patients!

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