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Have you ever wondered what you’re supposed to do about the fatty lumps your middle-aged dog starts to sprout? Lipomas are so common and annoying — and yet so benign — that it’s not surprising we would harbor mixed feelings about them.
The most common veterinary approach for these masses is to do a fine needle aspiration to get a diagnosis. We then check the extracted cells under a microscope to make sure we don't see any oddball cancerous cells.
Most of the time, we’ll inform you that the mass is indeed a benign lipoma, and you’ll breathe a sigh of relief when we tell you that we’d rather not surgically remove it, given the high rate of complications and possibility of regrowth. All you have to do then is tolerate its unsightliness, a blemish your dog has no reason to resent — she couldn't care less what she looks like.
But if your veterinarian is the cautious type, he’ll inform you of something you may not know: A fine needle aspiration is an inexact method of assessing a mass because it tells you onlywhat the cells look like in the spot punctured by the small needle. It can’t possibly be 100 percent representative of every cell within the mass. And considering that lipomas are nearly impossible to distinguish from liposarcomas (the cancerous version) using a fine needle aspirate, the more rare cancerous form is still a possibility.
That’s why some vets are more likely to offer removal for lipoma-like masses. In my experience, most board-certified veterinary surgeons recommend it. After all, they’ll argue, you can’t know what it is without examining the whole thing. And you wouldn’t leave any mass in your own body without the same thorough treatment — unsightly or not. At least, most of us wouldn’t.
Despite this purist approach that some extra-cautious vets take, cosmetic reasons are often cited as the primary rationale behind the surgical removal of most lipomas. Owners just don’t like how they look and feel.
It's true that there’s a very low probability that a mass will turn cancerous or otherwise harmful if it looks like a lipoma under a microscope. It’s also true that lipomas are notoriously annoying to remove and result in a high rate of postoperative complications (mostly superficial infections) and delayed healing — not to mention the expense and general discomfort of surgery, as well as the risks involved with any anesthetic procedure.
All of this begs the question: Is the risk worth the reward?
Disclaimer: Some lipomas get very large and may affect a dog’s quality of life. In these cases, surgery is indicated. The good news is that lipomas most often show up on the trunk of a dog’s body, where they can be more easily removed, thanks to an abundance of skin in the region. (Fun lipoma facts: They’re rare in cats but common in parakeets. Older, obese female dogs also seem predisposed to them, which is yet another reason to keep your dogs lean.)
Luckily, there's a new, less-invasive method of lipoma removal that's gaining popularity: suck the life out of them á la liposuction.
A new study suggests that it's less painful and the healing time is quicker. However, certain complications (fewer than with surgical excision) and regrowth are still possible. And it’s not recommended for the really big ones —more than15 centimeters in diameter.
This is undoubtedly a cool innovation that’s got the vet community justifiably intrigued. Will it change our recommendation when it comes to whether these masses need to come off? Hmmm. Let me ponder that one.
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