Have you ever been petting your dog and suddenly felt something — a lump, a bump, something that wasn’t there before? My returning guest, Dr. Randy Hutchison of Animal Clinic Northview, walks us through exactly what to do when that happens. From simple fatty lipomas to cancer diagnosis and cutting-edge immunotherapy treatments — this episode covers it all.

Improvements continue to be made in the rehabilitation department. Not all injuries require surgery. Animal Clinic Northview has a new and expanding rehab facility. Dr. Grace Schmeiser oversees canine patients in need of rehabilitation from arthritis discomfort, sports injuries and surgeries. Many different therapies are offered: acupuncture, shock wave therapy, laser therapy, and massages.

Dr. Randy also shares with us some new capabilities which improve the overall recovery process for canine patients. Animal Clinic Northview has equipped their ICU unit with central lines - an advanced way to administer medications quickly. They also reduce the stress and pain by allowing multiple treatments and drawing blood samples through one port.

Another improvement to the ICU is the addition of high flow oxygen. This provides more direct oxygen flow to canine patients via nasal cannulas who may be in respiratory distress. Oxygen can be delivered via these cannulas before, during, and after surgery. Patients can also receive oxygen via their state- of-the-art environmentally controlled Snyder oxygen cages. Recently, Dr. Randy shares with us how the high oxygen flow process aided in ensuring that a bulldog who came in for airway surgery received the appropriate amount of oxygen. He believes this accelerates the recovery process and promotes a swift recuperation.

Animal Clinic Northview employs a full time doctor, or hospitalist, whose sole responsibility is to oversee the ICU and make sure it runs efficiently. The ICU can accommodate up to 40 patients. This relieves the 34 veterinarians in the practice of checking in whenever they have a spare moment to visit their critically ill patients while also maintaining a heavy client workload. Having a hospitalist on duty is an excellent way to give the patients the attention they need. They also rely on the staff dedicated to working and assisting with cases that are admitted to the ICU. Dr. Randy says “From the technicians to the assistants to the kennel staff - they are really the heroes. They’re the ones that are in it minute by minute, hour by hour, taking care of these patients.”

Vets are expected to be jack of all trades. This can be very challenging. However, Dr. Randy’s staff has the freedom to choose what they would like to specialize in. He always tells his new doctors they are allowed “five No’s”. It is important to know the types of cases they are uncomfortable with and leave them to other vets who want to be treating them. He wants them to choose what they are passionate about so they become very good at what they do. This allows Dr. Randy to direct specific issues to vets who see these types of cases often.

“It’s all about putting patients in the hands that are most likely to give them a chance to help them.” - Dr. Randy

One common reason to bring your dog in for a checkup is when you notice a lump or bump. You may notice a lump while petting your dog. You may see it when they roll over. The lump could be as innocuous as a wart, a skin tag, or the result of an allergic reaction. Others could be a fatty lipoma, a sebaceous cyst or a mass. Some dogs have a predisposition to forming lumps and bumps. Certain breeds are prone to them. However, every dog is susceptible. Dr. Randy always recommends bringing the dog in to get it checked out.

Sometimes, groomers find lumps that the owner never saw or felt. Lumps can be in hard to see areas and places you don’t typically touch. For example, a groomer will feel inside a back leg while they are combing the dog’s fur or they have to shave the rear end and a lump is discovered. In my podcast about grooming, Sharyn Ugan has found lumps on dogs that the pet parents had no idea were there.

When Dr. Randy is assessing a lump or bump, he typically manipulates it with his fingers. He can feel if it is hard or soft. The dog usually does not seem to be in any discomfort. The texture and the look of the lump does not indicate whether it is benign or malignant. In fact, he has learned over the years - never assume anything.

Screening is necessary to determine exactly what the lump is. It is done with a fine needle aspirate of the lump. A needle is injected into it to draw a sample of cellular material. This is transferred onto a slide to be examined and will reveal two things immediately: whether it is benign or malignant.

The cells in the sample may be benign cystic junk aspirated from a sebaceous cyst. These lumps can fill up with cystic debris so much that they can burst. This can be painful for the dog. Once it bursts, the process of forming and filling up can resume as long as the lining inside them keeps secreting the debris. Surgical removal of the entire cyst, including the lining, may be recommended.

Another type of benign lumps are fatty lipomas. They have clear fatty cells inside them with no cellular makeup. They can grow to be huge and located in cumbersome spots on a dog’s body. In both of these types of lumps, the pet parent is advised to keep a watchful eye on them. If they change color or size quickly, it should be checked out as soon as possible.

Depending on the location and the size of the lump, surgery may be recommended. For example, if the fatty lipoma is located on the dog’s side and it bothers them when they lay down, then the pet parent may want to remove it. Dr. Randy has experienced the pet parent initially deciding not to surgically remove a decent sized lipoma, but then later changed their mind. After the removal of the lipoma, they noticed their dog moving around more freely and even acting a lot happier.

Dr. Randy and his staff are accustomed to looking at certain cells from the different types of lumps mentioned above. It’s when abnormal cells make an appearance that require the expertise of a pathologist. Animal Clinic Northview is equipped with one of Dr. Randy’s favorite instruments called a digital cytology unit. This instrument scans the slide of cellular material collected from a lump and sends it to a pathologist somewhere in the world. They will get results within hours! Before the digital cytology unit was available, results were sent to a laboratory somewhere in the U.S. and results were not available for days. The expediency of the digital cytology unit results provide comfort to the pet parents so they can start making decisions that are best for their dog.

When talking about lumps that may be malignant, it is important to understand the difference between what a cytology is and what a biopsy is. A cytology is squirting material from a lump on to a slide and determining what type of cells are present. It may not tell the doctor everything, but it may provide some clues as to what it is. If it is viewed by a pathologist who determines there are some cells that have changed, then a biopsy will be recommended. This is when the lump is surgically removed and the whole mass is sent out for pathology.

Sometimes the lump is from a family of tumors called a sarcoma. One of the characteristics of a sarcoma is they like to adhere to muscles, nerves or bones, making them very difficult to remove. They are not necessarily aggressive, but they are invasive. The decision to remove some of the sarcoma, or to possibly have to remove a limb affected by it, is a difficult one to make. It is essential to have all the facts in place so that the best decision can be made. Sometimes CT scans or ultrasounds reveal that the removal of the tumor is not advisable due to the location and what it is attached to. Dr. Randy has to have an open and honest discussion with the client as to what will be the next course of action.

As in human medicine, cancer has become an increasingly prevalent occurrence. Over the years, Dr. Randy has seen a rise not only with cancer in dogs, but also cancer in younger dogs.

“Cancer is not an old age problem”. - Dr. Randy

Dr. Randy often gets asked by clients looking for puppies if he can recommend a breed that won’t get cancer. There is breed disposition, especially in Golden Retrievers, Boxers and giant breed dogs. In fact, when Dr. Randy was in vet school, he would go to a park and watch the different breeds go by. When he would see certain breeds, he would come up with 3-5 diseases they were prone to get. However, all breeds have the possibility of getting cancer. He advises the clients to get the dog that fits their lifestyle instead of basing their decision on a hypothetical.

If all of the tests come back positive for cancer, then the decision will now be to treat it medically or surgically. Another option is to not treat the cancer and instead provide comfort to the dog through pain medications and other therapies. Treating cancer in dogs medically means to treat the patient with traditional modalities such as chemotherapy or radiation. Animal Clinic Northview does not have radiation equipment. If the client wishes to choose this option, university teaching hospitals or specialized veterinary oncology centers provide this treatment.

One thing Dr. Randy wants his clients to keep in mind when faced with this difficult decision is how to provide the best quality of life. His ultimate desire is to find the best treatment that allows the dog to still run and play and be a happy dog, even with the diagnosis of cancer. In human cancer diagnoses, the goal is to cure the cancer. As much as veterinary medicine would like that goal to be the same, most veterinarians agree they are giving the dog the best quality of life possible. Even though Dr. Randy believes dogs do better with chemo treatments than humans do, there are still side effects. This is due to dosages not being as strong and the frequency of treatments may be more spread out than those for humans.

The most common cancer Dr. Randy treats with chemotherapy is lymphoma. He will see dogs with big lymph nodes under their jaw, shoulder, or knee. The most common protocol for this type of cancer is the Wisconsin Protocol, often called CHOP. This determines the type of drugs, a schedule of frequency, and the amount of medicines the dog will receive. All of this is adjusted based on the side effects the dog may experience.

Another option to treating lymphoma besides the Wisconsin Protocol is two recent drugs available on the market. Scientists have conducted so much research in ways to combat canine lymphoma by identifying specific cells to target that are essential for fighting infection. They can also suppress the immune system’s response to cancer which can ultimately kill cancer cells and slow down the spread of them.

Tanovea is a drug to treat canine lymphoma. It is commonly recommended when the lymphoma has relapsed using standard protocols. It is an injection that is scheduled according to the veterinarian’s advice. Another drug is called Laverdia. It is administered in a convenient pill form which can be given at home. It is not chemotherapy, but works with the immune system to inhibit a specific protein, and ultimately prevents the spread of the cancer cells.

Dr. Randy believes that immunotherapies are the new age cancer therapy and will continue to improve. There already are immunotherapy drugs to successfully treat melanoma. One can hope that more solutions will be invented and approved to help our canine companions fight the increasing threat of this deadly disease.

In conclusion, don’t assume — get it checked. A simple fine needle aspirate can give you answers fast, and catching something early can make all the difference. If this episode helped you, share it with a fellow dog parent.

Thanks for reading From A Dog’s Eye View! Subscribe for free to receive new posts and support my work.

This post is public so feel free to share it.

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit canineconcierge.substack.com