Fine needle aspirates to diagnose dog cancer?
Dr. Demian Dressler is internationally recognized as “the dog cancer vet” because of his innovations in the field of dog cancer management, and the popularity of his blog here at Dog Cancer Blog. The owner of South Shore Veterinary Care, a full-service veterinary hospital in Maui, Hawaii, Dr. Dressler studied Animal Physiology and received a Bachelor of Science degree from the University of California at Davis before earning his Doctorate in Veterinary Medicine from Cornell University. After practicing at Killewald Animal Hospital in Amherst, New York, he returned to his home state, Hawaii, to practice at the East Honolulu Pet Hospital before heading home to Maui to open his own hospital. Dr. Dressler consults both dog lovers and veterinary professionals, and is sought after as a speaker on topics ranging from the links between lifestyle choices and disease, nutrition and cancer, and animal ethics. His television appearances include “Ask the Vet” segments on local news programs. He is the author of The Dog Cancer Survival Guide: Full Spectrum Treatments to Optimize Your Dog’s Life Quality and Longevity. He is a member of the American Veterinary Medical Association, the Hawaii Veterinary Medical Association, the American Association of Avian Veterinarians, the National Animal Supplement Council and CORE (Comparative Orthopedic Research Evaluation). He is also an advisory board member for Pacific Primate Sanctuary.
Updated: April 4th, 2019
Hi everyone,
I have been getting questions about the best way to gather info about growths in dogs. So, let’s take a look at a common technique used to accomplish this…a fine needle aspirate.
First of all, a fine needle aspirate is not a biopsy. A fine needle aspirate is a sample of the mass taken with a skinny little needle (meaning, not much to work with). The vet will disinfect the surface of the site to be aspirated, often after clipping the hair, to prevent infection. Next, a needle is introduced into the area of interest, and the plunger drawn back, creating a vacuum which draws cells into the hub of the needle. These cells are then used to make a slide for the vet or a pathologist to look at for a diagnosis.
What is good about this technique? Well, it takes about 2 minutes to do, and your dog gets to go home without sedation, anesthesia, or hospital stay. Quick, easy, outpatient…nice. This is a good technique to diagnose TYPE of growth (in my hands about 75% of the time you get this info from the path lab after submitting the slide).
How about downsides? A fine needle aspirate cannot tell if the cancer cells have moved inside the body or spread into neighboring areas. There is a little inaccuracy in this technique as well. My experience is that about 1 out of 4 of these come back “inconclusive”, meaning there was not enough on the slide for the path folks to give a diagnosis. Sometimes the vet will get a big sample, but the cells are just not the right kind to make a diagnosis (blood, connective tissue, etc.). Some tumors have a good cell yield, and others do not. Occasionally, we get an incorrect diagnosis with a fine needle aspirate.
Some dog tumors easily diagnosed with fine needle aspirates:
Lymphosarcoma/Lymphoma
Mast Cell Tumors
Histiocytomas
Lipoma
Cysts
Short story, this technique is a good, non-invasive, rough screen to get initial information. Just keep in mind the limitations…it is not guaranteed and if there is any doubt in your vet’s mind, go for the real biopsy…coming up!
Best,
Dr Dressler
Dr. Demian Dressler is internationally recognized as “the dog cancer vet” because of his innovations in the field of dog cancer management, and the popularity of his blog here at Dog Cancer Blog. The owner of South Shore Veterinary Care, a full-service veterinary hospital in Maui, Hawaii, Dr. Dressler studied Animal Physiology and received a Bachelor of Science degree from the University of California at Davis before earning his Doctorate in Veterinary Medicine from Cornell University. After practicing at Killewald Animal Hospital in Amherst, New York, he returned to his home state, Hawaii, to practice at the East Honolulu Pet Hospital before heading home to Maui to open his own hospital. Dr. Dressler consults both dog lovers and veterinary professionals, and is sought after as a speaker on topics ranging from the links between lifestyle choices and disease, nutrition and cancer, and animal ethics. His television appearances include “Ask the Vet” segments on local news programs. He is the author of The Dog Cancer Survival Guide: Full Spectrum Treatments to Optimize Your Dog’s Life Quality and Longevity. He is a member of the American Veterinary Medical Association, the Hawaii Veterinary Medical Association, the American Association of Avian Veterinarians, the National Animal Supplement Council and CORE (Comparative Orthopedic Research Evaluation). He is also an advisory board member for Pacific Primate Sanctuary.
Hi Dr Sue,
My 8 year old border collie has a lump on his back. It suddenly appeard, we brought him to the vet. They did a fine needle biopsy. They got 2 vials of a bloody liquid. They sent it in to find out what it may be. If its not cancer do we need to get it removed? What could it possibly be. When the did the fine needle biopsy the lump was almost completely gone, the next day it filled back up again. I’m really worried about him,especially since he had surger 2 months ago to remove a small lump near his mouth that ended up being Basel cell tumor. Thank you for your help.
Suzanne
Suzanne,
If the aspirate results are non-diagnostic, I would recommend a biopsy called an incisional biopsy, where the vet removes a piece of the mass to find out what it is, before you get it removed. This pre-surgical biopsy confirms it is tumor and allow the vet/surgeon to plan for the surgery to remove the mass. I explain more of this in a recent blog about my nurse’s dog. Good luck!
https://www.dogcancerblog.com/blog/staying-vigilant-with-mass-aspirates/
All my best, Dr Sue
I have a nine year old Boston terrier who was spayed before 6 months. She now has a mammary tumor and slight infection. The vet looked at the secretions under a microscope and identified the infection and abnormal cells. They suggested a biopsy, but with her age and being a “brachycephalic” dog, I worry with putting her under. The tumor is larger than a marble, would it beneficial to have a needle aspiration done first? The vet did not suggest it or bring it up. Thanks for your help.
Sarah,
An aspirate of the mammary mass will help tell you if it is mammary tumor, but you need the surgical biopsy to determine if it is benign or malignant. Still 50% are benign and cured with surgery. And 50% of the malignant ones are also essentially cured with surgery. So 75% of dogs with mammary tumors just need surgery! So I would consider it.
Age is not a disease, and while she needs special considerations with her breed and surgery, it should be an option. I also wrote a chapter on mammary tumors in the Guide.
All my best, Dr Sue
Dear Dr, i have an 8 and half yr old boxer with already ARVC since he was 2 and half. he also has arthritis and a couple of weeks ago i noticed a large firm lump on the right side of his neck above the shoulder area. Phoned the vettook him down ,needle aspiration done 3 different times and ALL came back inconclusive.He also had bloods done which showed he is severly Hypothyroid and has been put on thyroid tablets.however the lump is worrying it is about the size of a tomato.He cannpt have a biopsy as he would die on the table given his heart condition. was wondering if you could possibly know what this could be please. Thankyou.
Andrea I am sorry to say a lump is just a lump. Have the vet do a local block with sedation and get a wedge or punch biopsy- easy to do.
D
Dear Dr. Dressler:
I have a male, neutered, 87 pound mixed breed, almost 9 year old dog who has been diagnosed with osteosarcoma in the left front leg bone near the shoulder, through radiographs and we just got the definitive biopsy back today. The vet tells me that he is afraid the tumor will bust through to the joint. What treatment would you recommend? There is a program at Texas A&M that uses brachytherapy in the lesion in the bone, followed by external beam radiation and then chemo. We are considering this route, but what supplements can I give him to facilitate a cure and what foods will help eradicate the cancer?
Thank you
Dianne Lansden
hi doc we had a fine needle aspirate done on my great pyr. He has had a cyst since july which has grown slightly. we did the wait and see approach until it started growing a little (and i found other lumps too) and brought him in for the aspiration. He had it on friday and now today(monday) the lump has grown ALOT. I forgot to mention that when the vet aspirated it he said there was nothing but clear liquid(he said this means it was a cyst do you agree) he didnt even send it tot he lab he was so sure.
ifi t’s a cyst why is it growing so much and why am i finding new lumps everyday?
he is 3.5. also why is he so itchy?
I have a 9 year old golden retriever. I recently found a hard, grape-sized mass near her abdomen, and another on her side which seems more a part of her skin. My vet looked at her today and told me that whenever the lump is hard, it should be removed. He said that when they removed them, they would look inside to see if they needed to be biopsied. My question is this: Should they try to get info with a FNA before scheduling her for surgery? Is it possible that they might find they don’t really need to do the surgery? Also, she has 2 lumps (one is baseball size) that are lipomas that are not a concern to the vet. But they gave me the option of removing them since my dog would be under for the other two lump removals. Of course the cost is more, but should I have them removed also? I would appreciate any info/advice you could give!
If a fine needle aspirate was reactive for melanoma for a dog would that not be sufficient to demand a biopsy.
Waly, hard to advise you because not quite sure what the question is. Was the lymph node or tumor itself aspirated? And it was non-diagnostic or reactive?
I have a 3 year old Papillon and a few weeks ago I noticed a golfball size lump on his neck and a smaller lump next to that one. I took him to my vet and she did a fine needle aspiration and blood work and put him on antibotics. The bloodwork came back his white blood cells are elevated and the fna came back “incolusive” (she said the cells were dead — used a big word ) — so they did it again one slide for each lymph node. I just got the results back again and have the same results. I agreed to start him on predisone to help them reduce in size (he was coughing where I think they were effecting his wind pipe). The vet said to just wait because there is nothing else to do. So what do I do? If he has lymphoma he will die in a few months. Could it be something else or should I expect the worse? He is just so young and he is so afraid of everything my heart is breaking.
oh and will accidentally hitting the tumor cause it to turn cancerous?
My spayed female labradoodle has a small, hard lump by left nipple #5. My vet says it’s too hard to aspirate. Measures approx. 1/4 inch X 1/2 inch. I’ve never heard of not being able to aspirate. . . Should I urge him to try the aspiration anyway? Not sure of my dogs’ age – probably around 4 years old.
THANK YOU!
Hi Sarah,
In my experience if a mass is a few mm, I may not be able to get an aspirate. But if it is > 5 mm, a mass is usually possible. With that said, I am not the vet looking at your pup. If an aspirate is not possible, a biopsy can be considered. The mass should be checked out since it is near the mammary gland. Good luck!
Dr Sue
Dear Dr. D.,
i am hoping that you can shed some light on out current situation. We have a 6 1/2 year old male Siberian Husky, we got him in Oct. 2008 the month he turned 3 He has generally been pretty healthy with the exception of some ear mites when we first got him, that were promptly treated, and then a stomach irritation that appeared to be alleviated by changing his diet since all labs were in order, that was in Feb 2009. Since then he has gone for all of his yearly checkups and vaccines and has been fine, his last routine checkup was April 2012 and he was fine.
A little over a month ago, my husband decided that he wanted to change their food( Ialso have a 4 yr. old female Sibe) to a Hollistic brand of food. He mixed the old and the new for about a week, and they seemed to be tolerating it well, so he switched to the new food completely, the dog seemed ok with it for a day or 2 then it seemed he was getting picky, he started to eat much slower, but as eating everything, then he stated to put kibble on the floor, then he was leaving a little behind ( He’s always had a robust appetite, and he was a fast eater). After About 2- 1/2 weeks of this, I thought perhaps he just does not like this food, so I went and bought him a bag of his old food. When I first fed it to him, I thought that must be it because he ate all of his food with his normal rigor. And it stayed that way for a day or 2 after that. Then he started to become picky again and eating less again leaving some behind, eating slow etc. This went on for about a week, last Sunday morning I fed him he ate all of his food, and I left for the day and left the dogs with my husband. That night he called me and asked me what he needed to put on the dogs food to get him to eat. I thought this was weird, so i brought him home some canned food, and he atle a little, but very little, over the course of that week he had begun drinking and urinating alot too. a few days I figured it was ok, because we had a heat wave so I expected it, Over the weekend it became clear to us that it was excessive, so with the changed eating habits, and decrease in appetite I became concerned. My primary concern was renal failure, as i lost another dogs to this 10 years ago, she was a different breed and 14 yrs old.
I called the vet at once the next morning (Monday, and brought him in). The vet said his examination findings were that he was dehydrated, had a 104 fever, cranial abdominal pain when he pushed on his stomach ( whatever that means), and that his heart rate as slow, although it improved lated in the visit. He reccommended blood panels to check organ function etc, those were normal.other than the signs of dehydration. There happened to be some sort of specialist there from Tufts Vetrinary Medicine School, who reccommended an ultrasound, so we went ahead with that, and the next news was heartbreaking, that my dog had stomach cancer of 90% of his stomach was inflamed, the vet told us to give him 10 mg of Pepcid AC 2x a day and 1-2 tablets of tramadol every 8 hours as needed, to minimize his discomfort, he told us that he was in some discomfort but not suffering it was not time to put him down. He said that they could do ultrasound guided FNA to definativelty diagnose the cancer and find out what kind it was, he did not think it would change the outcome any, he said it was 95 % likely he had cancer 5% that it was some other type of stomach inflammation.
We left our dog there for the afternoon to do the FNA, and rehydrate him via IV fluids, that was 4 days ago. We took him home an his appetite and thirst remain about the same. His activity level is up and down, sometimes he seems like himself othertimes he seems very depressed.
Last night we got a call from our vet with the FNA results, he said that he was amazed that they found no cancer on the FNA, ad he reversed his previous position, and said that at this point he would say 95 % he did not have cancer, 5% that he did instead of vice versa. Great news I think.
However something is causing his gastric distress/inflammation that still remains a mystery. He seems quite depressed to me he has been going downstairs to be alone alot, although usually comes back on his own a little while later. And today he has started laying down at the bowl when he drinks, (he never does this)…..
the vet said he was going to consult with the specialist who did the ultrasound and get back to us over the weekend.
I am still extremely worried as the laying at the bowl etc, is new…
If not cancer what else could be causng his inflammation, is it likely to cause depression, how would it be treated and how long should it be before he responds to treatment, in your experience….
Thank you for your time.
Hi Dee,
I am sorry to hear about this.
Fist thing- get a diagnosis. Either get another aspirate, a biopsy, or a second opinion on the aspirate from another pathologist. Get the ultrasound. You need to know what is going on.
As to the signs, I apologize but I cannot diagnose without hands on the dog…meanwhile consider things like mirtazapine, sucralfate, and slippery elm for symptomatic care of the tummy..under veterinary supervision. Get your dog back in to the vets for further supportive care if this persists.
Dr D
I am in desperate need of answers……my 6 year old rottie, whom is a huge part of my families life, was diagnosed with “cancer” 4 weeks ago, the reason for the quotes was because the lab couldn’t identify what type of cancer it is. We took him to the oncologist and more aspirations were done, she diagnosed him with “suspectable” histiocytic sarcoma. Extra stains were done and the results didn’t come back with histiocytic sarcoma, just a high grade sarcoma. He is on his first dose of CCNU. His blood count did go way down and as I type, he is in the hospital getting antibiotics, hopefully he can come home today. Is it possible that he has been diagnosed with the wrong type of cancer? Is it possible that he is getting the wrong type of chemo? It seems the CCNU has made the tumor go down (visibly) but I’m not quite sure whats going on inside. During the initial extraction of a piece of tumor a chest xray was done and it showed nodules in his left lung, but none in his bones. Now, 4 weeks later, he is down 20lbs and looks like he is just withering away. So heartbreaking.
Dear Stacy,
ugh, no fun. So sorry!
This is likely highly undifferentiated, meaning the cells lack defining appearance making it harder to classify the type of cancer. Nature does this as classifications are human, not from nature.
Might get a second opinion pathologist report.
I doubt the choice of CCNU is ‘wrong” under the circumstances though.
I would very much be thinking of other tools in addition such as apoptogens, diet, immune support, antimetastatics and so on in the Guide.
I hope this helps
Dr D
Dr Dressler,
I have a 12 year old border collie cross. Despite his age he acts like a puppy and has never had any health problems, except recently an occasional cough which doesn’t bring anything up. I noticed 2 small lumps under the skin on his flank so took him straight to the vet. She said she thought they were lipomas but couldn’t be sure and said his heart and lungs sounded fine. After reading your articles i called the vet again and asked for samples to be taken from each lump. They said they would probably sedate him for the procedure so i asked for a pre sedation blood test and full health screening beforehand. I have agreed as i want to know definitely if these lumps are cause for concern. I know i may be over reacting but i’d never forgive myself if i didn’t check.
I would appreciate your opinion as to what these lumps could be.
Thanks in advance,
Katie