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Vet lost the lump!

Species: Cat
Breed: Not sure
Age: 5-8 years
My cat had surgery last Thursday to have a cyst on his toe removed to see if it was cancerous, and today I got a call from the vet saying they couldn't find the cyst when they went to prepare it for going to the lab for testing. They said they remember putting it in the test tube, but cannot figure out what happened to it.

My cat has had this cyst for a good 6 months to a year. It is about the size of a fair sized pee on the top of his toe, pink like the tissue on the pads of his feet, and soft looking. He has never had any other symptoms, but the cyst has grown a little bit in this time.

The vet first did a fluid test but the results came back inconclusive. The cyst, even though it looks soft like its full of fluid, was hard so they couldn't get a very good sample.

The blood work they did on the day of the surgery came back normal, but am not sure whether I can really get a definitive answer as to Floyd's health since they lost the cyst.

The vet is really trying to reassure me that he is probably fine since he doesn't have any other symptoms, his blood work was normal, and the cyst came of his toe very easily; it wasn't growing deep into his flesh or bone.

I have a few questions.

How much of an indicator is blood work in determining if he is sick or healthy? Could he have cancer even though is blood work is normal and he has no symptoms?

They say the only thing they can recommend doing now is to monitor his toe to see if the cyst grows again, and to regularly check his glands for swelling. Is this the only thing that can really be done now?

At first I was under the impression that they performed the blood work before his surgery because he is getting older and they wanted to make sure he was going to be able to handle the surgery. But now it is like they are putting a lot of weight behind the blood work indicating he is probably healthy. I am starting to feel like maybe I should have just got the blood work in the first place and keep a close watch on his cyst for changes and on his health in general (glands, whatever) before doing the surgery. It would have cost a lot less potentially.

That brings up something else I am not sure about. At first they only offered to refund the money I would have paid for actually sending the cyst for testing. I told them I would like to speak with the Dr. first to figure out what we'er supposed to do now about figuring out Floyd's health and that we could figure out the money later.

So after the doctor tried to reassure me everything is probably okay I said I didn't think I should have to pay anything for the entire operation since the point of the operation was to determine if he had cancer or not, which they can't seem to determine now. They got back to me later saying they agreed, but still wouldn't give me a refund for the blood work since they say it gives some indication that he doesn't have cancer, and that he is at an age where he should be getting blood work done on a regular basis anyway.

Do you have an opinion about this money issue? Should cats who are around 7 or 8 years old start getting blood work done? I can sort of justify paying for the blood work if this is something he should be getting anyway, but I'm kind put out about them being willing to try and get me to pay for the surgery if I didn't disagree to. I'm also not even sure, since they are putting so much weight on the blood work, that the treatment approach we took was even the right one, so I don't know if I really want to pay them anything.

I really appreciate you taking the time to listen to me. I hope my questions and concerns are clear enough, and that I haven't written too much.

Kind Regards,
Kevin



Online vet, Dr. Marie

Dr. Marie replied:

Thanks for your very detailed Kevin question. It's always great for me to have lots of information to respond to rather than not enough!

I wonder what happened to the cyst? That is so strange that they lost it! But then, accidents happen and we are all human. I have had strange things like that happen at my practice too.

Let's see if I can answer your questions.

First of all, I can tell you that when I see a fluid filled lump on a cat it is quite rare that it is cancerous. It is usually a benign cyst. With that being said, I always want to remove a cyst like this for a few reasons. It get really large and then be difficult to remove. Or, it can rupture and get infected. So, I definitely would have removed this lump.

Now, to answer your questions about bloodwork. There is no specific blood test that can tell us if a cat has cancer. However, with some types of cancers we can see an increase in white blood cells. With other types we will see an increase in Calcium.

I always, always recommend blood tests before an anesthetic. If a cat is hiding something like a kidney problem, we could do serious damage with an anesthetic if we did not take certain measures to protect the kidneys. I also recommend doing blood work on any older cat which in my books is over 8 years of age.

Here's my opinion on the money issue. If the doctor has offered to refund the price of the surgery, you are getting an amazing deal. Personally, I would have charged you nothing for sending the lump away and possibly given you a discount on some of the surgery. But I really don't think the surgery should have been for free. It still had great benefit because it got rid of the lump.

I hope I have answered your questions, but let me know if you have more concerns.

Dr. Marie.



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Disclaimer: Although Dr. Marie is a qualified veterinarian, the information found on this site is not meant to replace the advice of your own veterinarian. AskAVetQuestion.com and Dr. Marie do not accept any responsibility for any loss, damage, injury, death, or disease which may arise from reliance on information contained on this site. Do not use information found on this site for diagnosing or treating your pet. Anything you read here is for information only.

Customer reply:

Hi Dr. Marie,

Thanks for responding!

You said you would normally remove a fluid filled lump to avoid the risk of it popping and getting infected. Would you normally do the same for a lump that was more hard than fluid filled, for the same reasons? The first cytology results came back inconclusive because they couldn't get enough fluid out of the cyst; it was actually pretty hard, not full of fluid.

I guess it doesn't really matter anymore if they didn't need to remove it since I'm not being charged for the surgery! I feel okay now about paying for the blood work because it probably should have been done even if they decided not to remove the lump. Even though the blood work isn't definitive, it probably would have still been a good idea to do the blood work for getting some indication of white blood cells, etc. not to mention him being at an age when he should get it done anyway.

So I guess my only question is whether their recommendation of just monitoring his health from this point forward is probably sufficient, or are there other tests that are commonly done given his situation?

Kevin


Online vet, Dr. Marie

Dr. Marie replied:

I usually want to remove most lumps, especially if I can't tell what it is.

I think their recommendations are good. There is not really much else that we can do to monitor for the possibility of cancer in this area.



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Dr. MarieDr. Marie is a veterinarian who practices in a busy animal hospital in Ottawa, Ontario. She created Ask A Vet Question as a resource for good, accurate veterinary advice online. Dr. Marie treats dogs, cats, hamsters, guinea pigs, and rats. She has been a vet since 1999.

Is an online vet visit just as good as a trip to your veterinarian? No! But, many times, asking an online veterinarian a question can help save you money. While Dr. Marie can't officially diagnose your pet or prescribe medications, she can often advise you on whether a vet visit is necessary. You can also ask Dr. Marie for a second opinion on your pet's condition.