Dr. Angie Krause (00:00)
Welcome back to Tails of Truth where we tell the truth about veterinary medicine. I'm Dr. Angie. I'm a holistic veterinarian and this is my co-host and veterinary nurse extraordinaire Jojo. And today we're talking about lumps and bumps and what you should do about them.

JoJo (00:19)
Yes, this episode comes to me via my mom who watches on YouTube so hey mom and Yep, Jody she has Got designer kitties little ragdoll cats and one has a mask right on the top of its head It's like I really just wish I knew When to test it or what to do with it? And I thought this is a great episode because people ask this all the time because all of our pets dogs and cats

Dr. Angie Krause (00:25)
Shout out to Jody Mom.

Hmm.

JoJo (00:45)
seem to grow lumps and bumps.

Dr. Angie Krause (00:47)
Lumps and bumps cats less often than dogs. Anytime I see, so Jody, let's answer your question. Anytime I see a bump on a cat, I do something about it and I stick a needle in it first, usually.

JoJo (00:50)
Mmm.

Mmm.

I you so, Mom. Can I say that? I told her. We've got to aspirate that.

Dr. Angie Krause (01:03)
Jody, do it. You do it. Yeah.

Sometimes masses are so small, like you can't aspirate it. But is it big enough that we could stick a needle in? OK. So we want to stick a needle in it, pull out some cells, we put it on a slide. I don't know, will this kitty need some sedation, or is it going to be?

JoJo (01:13)
It's big enough. Definitely. Yep.

It's a ragdoll it seems to just be a floppy do whatever

Dr. Angie Krause (01:26)
There's, yeah,

they're so lovely. So we'll just stick a needle in there and we just, we pull back on the syringe and basically pull some cells out. We stain them, we put them under the microscope and we take a look at them. Now there are some limitations to aspirating a mass. And one is that we don't always pull out the cells we want to pull out. And sometimes they're not.

JoJo (01:29)
Yeah.

Dr. Angie Krause (01:51)
diagnostic, but when they are, it's quite helpful. So if we were to find cancerous cells or cells that don't quite look right, then what we would do next is remove it. It sounds like it's small enough that the whole thing could be removed. Okay. Yeah.

JoJo (02:04)
It is yeah, it is it's it's

in an odd spot. It's right on the top of his head. I Would say five or six Yeah, he's young Jose on kidding Yeah, which they they are special Yeah, they they tend to produce more every things I feel Yes, it's like skin colored and

Dr. Angie Krause (02:11)
How old is he?

he's young, but he's also a purebred cat. So I feel like.

We worry more about them for sure.

Yes.

JoJo (02:31)
I love the way that you measure this because you know, her vet told her let's just watch it. You know, does it change in size, which is often the thing. But most of us don't have calipers sitting around to measure in millimeters. So you like to measure in fruit size.

Dr. Angie Krause (02:46)
Or

any kind of food. Sometimes it's a bean. Yeah, often it's fruit in dogs, but like it might be or it could be money. Like a dime. Yeah. So I like to measure in things that are kind of universal because even, ⁓ my gosh, I have a cat on me that's playing with hold on for just a sec. I just had a stab. ⁓ Even with calipers, it's easy to kind of distort the measurements.

JoJo (02:49)
Yep. Yep.

Good money.

couldn't see him.

Dr. Angie Krause (03:12)
And so I'll use them sometimes. I am big into food, big into the bean or the grape or the blueberry. Because it's, I don't know.

JoJo (03:12)
Mm-hmm.

Yeah.

Well, I would say this is pea-sized. Pea-sized. Mm-hmm. Yep. But, okay, so let's talk about when, well, let's talk about, maybe let's talk about what types of bumps exist. Bumps and lumps. So we have lipomas, which are fatty, tumors. Tumors is a scary word, by the way. Let's just, yeah. Yeah.

Dr. Angie Krause (03:26)
Okay. Yeah. ⁓

Okay.

Yeah, could... tumor is a scary word. That's why you say lumps and bumps.

But we do our mass. Sometimes we'll call them masses. Does that feel a little bit less scary? Okay.

JoJo (03:53)
Hmm. Yeah, it's a little less scary.

Why do tumors sound scary?

Dr. Angie Krause (03:56)
I feel like I, I, if we zoomed out, we'd think about like what's on the skin and then what's below the skin. So we call them dermal masses. ⁓ my gosh, this cat. I know, I don't know what you need, but something. She's like, I'm going to take down everything around you, Angie. ⁓ this is, no, this is Fiona and she's like in her villain era right now because she does not like the food I'm feeding her. And that's all I have for the week.

JoJo (04:14)
is that one not Fritz? is who do you have? Not Fiona?

was gonna say, she doesn't usually show up for, she's usually fritz.

Dr. Angie Krause (04:26)
I know.

Yes, she's mad. ⁓ Okay, so we have what's on the skin and what's below the skin. so dermal masses usually kind of stay in place. They're not very mobile, can't move them. And subcutaneous or subdermal masses usually are ⁓ mobile, like you can move them. Maybe they're soft, maybe they're hard, but they they're under, they would call it the subcutaneous space and they can move around. And so ⁓

When I subcutaneous masses, I worry less about sometimes there are a lot of dogs that produce lipomas, which are fatty tumors. And it's just a collection of fat. It's benign. Usually they all get more than one and we don't need to do anything unless it's impeding movement. and sometimes there could be underneath like a sarcoma or a mast cell tumor.

And we usually know that's happening because we stick a needle in there and we pull out cells that aren't fat. And so when we are pulling out cells and we're like, it's a lipoma, but then that lipoma grows or changes drastically. Have that checked out again, because maybe it means that we just pulled out fat cells around a cancerous tumor. Cause that happens too. And then so going back.

JoJo (05:44)
So it's

fair that you may have to retest the same mass if there are changes.

Dr. Angie Krause (05:48)
Yes.

If there are changes and for the dermal masses, I worry more about dermal masses in general, unless it looks like a little skin tag. Like people get skin tags, like they look like little wart things and usually they're either dark or like kind of flesh colored and so they can be all kinds of colors, but they just look like a little wart and those I don't worry about.

But if there's like a round tumor or something that looks strange and it's just associated with the skin, I want to aspirate that. I want to know because they're oftentimes mast cell tumors, which do spread and they are usually more aggressive if they are on the back end of a dog or a cat.

JoJo (06:35)
And I would say mast cell tumors are common, more common, not meaning that they are prevalent, but in terms of tumors that we see, would say mast cell tumors are ones that we do see. Do think that's fair?

Dr. Angie Krause (06:47)
yeah.

I see them all the time. Yeah. Yeah. I, it's probably one of the most common types of dermal cancers.

JoJo (06:48)
Yeah.

We just

did this with Bodhi, which we'll talk about, because Bodhi had a dermal mass on his front leg that he was just so irritated by, and it kept changing, and it kept changing, and it kept changing. But it came back as nothing to worry about, that it was a lick granuloma But I was so, so convinced that it was a mast cell.

Dr. Angie Krause (07:03)
Mm-hmm.

⁓ yeah, yeah.

JoJo (07:17)
The vet was convinced that it was a mast cell, it so I wonder and then we took it off and we just caused more problems Right so there's that and now he has two new masses And I'm just like I don't know that I want to cause more problems, and I wonder if other people hit up against this too just

Dr. Angie Krause (07:24)
I know, yes.

I don't see that very often. Like what you're experiencing, I think Bodhi is an outlier. I really do. I'm so sorry this is happening.

JoJo (07:39)
Right, he's so I feel bad for him. He wore

a cone you guys he wore a cone for almost three months because he just kept chewing his incision site and Chewing his incision site and so I don't want to remove other masses because for him. I think the quality of life of Wearing a cone for months at a time Is not not fantastic

Dr. Angie Krause (08:00)
Yeah. No, I get it. And I think in his situation, I think there are other things going on with him that feel like these other, you know, dermal masses are not a priority. And so I would say for the most part, what's happening to him is pretty rare. I hardly ever see a dermal mass removal turn into such a problem. Like that's, that's so unlikely. And like, so I had a pug.

JoJo (08:23)
such a saga.

Okay.

Dr. Angie Krause (08:28)
Pugsley and he developed a little dermal lesion on his kind of like his gluteal area and I freaked out and I took him to a surgical oncologist.

JoJo (08:44)
you did? That is like... Yeah, that was a freakout. ⁓

Dr. Angie Krause (08:47)
I was like, boom, because

I knew if it was a mast cell tumor that it carried a poorer prognosis because it was on his back. And so I originally took him up to this surgeon in Longmont who's no longer there. And she was like, do you want to just aspirate it? And I was like, no, I want you to take it off. And then they quoted me something I couldn't afford. I went down to Denver.

JoJo (08:58)
Yeah.

Yeah.

Dr. Angie Krause (09:13)
And ⁓ I saw the surgeon, I was like, I want you to take it off and I want you to get margins, like it's a mast cell tumor. So you had to like cut into his muscle and it was a totally benign tumor. But...

JoJo (09:27)
That's right where we cut it all off with margins.

Dr. Angie Krause (09:30)
with margins and

he was painful for like a day or two. But I was like, I did not want to mess around. And so I think I definitely overreacted. But if it had been a mast cell tumor, I would have been so happy to have just immediately taken care of it because mast cell tumors can and do spread. So.

JoJo (09:51)
And they get irritated by us messing with them, don't they?

Dr. Angie Krause (09:55)
You know, not always, not always. So yeah.

JoJo (09:59)
That's good. Okay,

this shows because I'm like, wait, this episode came about the pets in Jojo's life.

Dr. Angie Krause (10:05)
So Dr. Sue, the cancer vet, if you don't know her, you should follow her. She's lovely. She's an oncologist and she has a social media presence and she teaches other veterinarians. She always says, if you see something, do something, which I know isn't coined by her, but I think she's a good person to follow. And so if you see a mass, you know, do something and that doing something might be, you know, taking your dog or cat to the vet.

And I usually like sticking needles in things and pulling out cells. Now, that being said, if I have a 12-year-old lab that's covered in lipomas and we've established that most of them are lipomas, probably not going to say, every single one needs to be aspirated. The other thing I think is really important to ask before you do something is if you found out that it was cancer, would you take it off?

Because if you wouldn't, then why poke it? Why spend any money? Why do anything if it's not going to change what you do? So that's another conversation I'll have with people sometimes is like, hey, I'm so happy to aspirate this. If I find out that it's a mast cell tumor, would you want to do surgery?

JoJo (11:01)
Right.

Right, and that, think that is a great question is what will you do with it? And I don't know that we always know, right? Until we know, like I know with Bodhi, but had he been five years younger, I'd probably be chasing these lumps that he's growing or these masses that he's growing.

Dr. Angie Krause (11:23)
Yeah.

Right. Yeah. I think it's important to have context. And while we're talking about lumps and bumps, there's a lump that are like a tumor. I'm going to call it a tumor. It's scary, but puppies get these tumors called histiocytomas. And so those are important. And a lot of people really freak out and think, my gosh, my puppy has cancer. And they look like round little button tumors and they can be anywhere.

JoJo (11:48)
Mmm.

Dr. Angie Krause (12:00)
and they're hairless, give it a Google. You can see, you know, use Dr. Google and your veterinarian can help diagnose it too.

JoJo (12:08)
Well, I want to say don't be embarrassed. This happens all the time. People come in and say, found this bump, and it turns out it's a nipple. Happens all the time, and it's so... I mean, we just laugh about it. You can laugh about it. It's okay. I'd rather you find the nipple and worry and bring it in.

Dr. Angie Krause (12:17)
It's true.

Hahaha

I mean, I would say that happens at least once a month in practice for me. At least once a month.

JoJo (12:32)
Yeah, really. it's

and it's just newly discovered nipple. It's always been there.

Dr. Angie Krause (12:37)
Well, it's weird.

you know, humans have two nipples usually, you know, and dogs and cats have like a chain of nipples going all the way down to like in between their back legs. And so like, it's, it's so understandable. But people are mortified.

JoJo (12:55)
so understandable

They're so embarrassed when they find that out. I mean, I thought a nipple was a tick before, so there, there you have it. And I was like, is that a tick? Is that a tick? yes. Other lumps and bumps. There are so many. I can think of so many different types of lumps and bumps. Like these are not technically tumors, right? But the oral hematomas that dogs get from shaking their head, you know?

Dr. Angie Krause (13:02)
Yeah.

⁓ yeah.

JoJo (13:20)
I think of that as a lump in a bump. So if your dog has an ear infection or they're really scratching in their ears or they're shaking their head a lot, they'll get these pockets of blood. mean, There's pockets of them and their ears will swell and that's scary when it happens. And people find those.

Dr. Angie Krause (13:36)
Yeah. Yes.

Yep. Totally treatable when that happens. Yeah. Kind of frustratingly, but ⁓ they are treatable. even if you do nothing, they'll just like kind of scar down. But yep, that's treatable. Yeah. What else?

JoJo (13:41)
totally treatable.

⁓ Hemangios,

like ⁓ Bodhi had one on his eye. You remember that? Yep. So that.

Dr. Angie Krause (13:57)
hemangioma. Yeah. Yep.

⁓

or you know another really common one is the myibomian gland adenoma, which are the little eyelid tumors that are... I'm just going to show everyone on my...

JoJo (14:07)
Man.

the eyelid tumors. like, I've not really heard it called by its medical

name. That's sad. Yeah.

Dr. Angie Krause (14:18)
I I walked

into a room like an exam room. was a couple of weeks ago and they're like, my dog has a tumor on its eye. And was like, that's a meibomian gland adenoma. And he's like, that's what I thought too. No, he just made fun of me. He was just making fun of me. I was like, I know I'm, I'm a dork, ⁓ but that's what it's called. And that's what they are. And they're easy to take off and they can affect your dog's vision and they can start rubbing against the cornea. So I do recommend taking them off.

JoJo (14:27)
⁓ go her! That's amazing. ⁓ okay. I didn't know.

Yeah, I can't think of another one now, but I just feel like it's so common, especially in senior dogs. We just started seeing more and more and more of them. But like you said, don't think in cats we have the, we have the vaccine sarcomas, which we talk about in length.

Dr. Angie Krause (15:01)
Yep, have vaccine. Yep, related

sarcomas. I think on a cat, if you see something, do something. Cats just are not lumpy and bumpy. So I don't like it. Whenever I see something on a cat, ⁓ am not a wait and see. But here I have a story. Have I talked about my mom's melanoma story yet in the dermatologist?

JoJo (15:08)
Okay.

They aren't.

Okay.

No, and I

was gonna ask you about melanoma in dogs, so go with this story.

Dr. Angie Krause (15:28)
Yes. Okay.

So when I was my first semester in vet school, my very first week, my mom was diagnosed with melanoma and unfortunately she was diagnosed with stage four melanoma. But so I flew back home and I, she was not diagnosed by her dermatologist. Like she had had a, basically what someone thought was a lipoma removed, but it had melanocytes. Like it was like purple. And so they removed it and they're like, wait, this is melanoma.

So I flew home to be with her and I went to the dermatologist with her and he said, you know, they were trying to find the primary melanoma, like where it started. And so I remember sitting with her and she pointed down at her leg and she was like, this mole has changed. And he looked at it, he's like, this looks totally fine, but because you've just been diagnosed with malignant melanoma,

I'm going to look at it. So he shaved it off and it came back as melanoma. Now it wasn't her primary melanoma, but that changed how I feel about looking at something and diagnosing it. Cause here's very experienced dermatologist, like he had been practicing for decades and he looked at it and he's like, I think that's fine. And it wasn't. And it taught me my first semester in veterinary school. Like your eyes are not microscopes.

And so when something changes, just do something about it. So I probably take things off biopsy more because of that experience. And that's like, you know, with my pug, that's why I'm like, get it off, do it now. and I do that with my own body. My dermatologist is like, you really want me to hack this off? I'm like, it changed, hack it off, do it right now. Because I'll never forget that moment when that dermatologist was so sure it was nothing. And sure enough, it was a melanoma.

JoJo (17:04)
Right.

And isn't that isn't that the truth of how we approach medicine with ourselves and our dogs is from our own personal life experiences, which Makes so much sense. I mean that what a traumatic experience for you that Yeah

Dr. Angie Krause (17:26)
Yes.

Yeah, yeah.

And so I just saw it firsthand. Now, him missing that wasn't going to make a difference for her. But I think about it in my patients of like, what kind of difference am I, could I be making by saying, let's wait or let's not wait on that. And so I am very much

shave things off. do, you know, I'll do biopsies, punch biopsies under local anesthesia. Like I tend to just get it off unless I feel like, that's a skin tag. You know, I do have a lot of years of practice seeing things and, ⁓ or lipomas I tend to not worry about.

JoJo (18:08)
Alright, and when we aspirate a lipoma, often times, I mean it's pretty obvious that it's a lipoma when it's aspirated. I mean, we'll still look under a microscope, fatty cells are very obvious, but that doesn't mean there can't be something else hidden in there.

Dr. Angie Krause (18:13)
Yes. Yes.

Exactly. And that's why I always tell people like, okay, I've aspirated this, I pulled out fat, I looked at it into the microscope, and either washed away or I saw fat cells. And, but if it changes, that doesn't mean there wasn't like a mast cell tumor hidden in there, which, listen, that is so rare. I think 90 % of the time, these fatty tumors that feel like fatty tumors are really fatty tumors. And then every once in a while, it's, it's something else. So

JoJo (18:48)
And there are dog breeds that are more prone to developing boxers.

Dr. Angie Krause (18:52)
boxers, Frenchies, pugs, Bostons. Who else? no, mast cell tumors, sorry. Yeah. ⁓ like the boxer and then... And you should always assume it's a mast cell tumor.

JoJo (18:57)
Yeah, they get lipomas, just so many lipomas. mast cell tumors, I was thinking lipomas. like, boxers are just lumpy in general.

because they get those really, really round, hard masses on their bodies. Heard loud and clear. You know what I'm hearing? Boxers get mast cell tumors. ⁓

Dr. Angie Krause (19:15)
that are mast cell tumors.

Like if there's a dermal

mass on a boxer, everyone's like, and I mean, not to say that they don't get lipomas too, but there is a moment where you're like, this is a boxer. I'm going to take this seriously because they just have more cancer and they have more dermal cancer. Yeah. Yeah.

JoJo (19:30)
Yeah.

Yeah, that is true. And it's

nice because they have that short hair, so it's really obvious. Yeah.

Dr. Angie Krause (19:42)
It's obvious, yeah. And I think once

someone takes off a mast cell tumor from their dog, then they're like watching every little lump in the butt,

JoJo (19:50)
everything. And

that's exactly where I was going to go. It's just, they had those maps of your cat or dog where it's like, it's just a little piece of paper and it's got like the front side of your cat and the backside where you can just document. Cause some of these, some of these animals get 15, 20. And so to remember that this one was pea size and this one was apricot and this one was, you know,

Dr. Angie Krause (20:02)
Mm-hmm.

JoJo (20:15)
Some other kind of size you're not gonna you're not gonna retain that so just make a map keep track. Yep Okay, so there were some really key things if your cat has it if your cat has a bump get it checked out Yep, if your boxer has something Do something yeah, and just map it

Dr. Angie Krause (20:20)
Make a map. Yeah, it can be really helpful.

Do something.

do something.

Yes. Yeah. Don't be afraid to stick a needle in. Well, you don't stick a needle in it. Let your veterinarian do that.

JoJo (20:40)
I'm glad to clarify

that. like, no, be afraid. Don't stick a needle in it. Bad advice.

Dr. Angie Krause (20:44)
Don't stick a needle. That is bad advice. No, let your

veterinarian do an aspirate and just be surveilling. You are way better than we are. know, sometimes, especially like if I have a Berner come in, like I'm trying to run my hands through the fur I'm trying to, or like Goldens, like you're trying to get everywhere, but you can't always find everything.

and especially like mammary tumors, those are really important to keep an eye out for, especially if your, dog was spayed later or still intact. So I think that's really important to just really be your dog's kind of medical advocate there, or if your dog, is aggressive at the vet. And sometimes we're like, we're like putting our stethoscope on, we're like trying to feel for lymph nodes.

And then we can't do much more. so that's when you really have to advocate for your dog and just put your hands on them if they'll let you.

JoJo (21:44)
I was just going to ask you too, because you recently found in one of your patients the anal gland carcinoma. And were there symptoms for that, or that was just found on examination?

Dr. Angie Krause (21:51)
Mm-hmm.

Yeah, there were some symptoms where things like kind of smelled different. I think he was like licking more. There was like some staining around the anus. So there were definitely symptoms that tipped us off. Yeah.

JoJo (22:08)
Hey, lumps and bumps, like there are a variety, which we didn't talk about. Dogs can also get melanoma. But I don't see it very often. Have you seen it very often?

Dr. Angie Krause (22:13)
Dogs can get melanoma, but it's not like

from, it can be from sun exposure, although like so on dogs with white fur or pink, like in hairless areas, they can get like squamous cell carcinoma and less frequently melanoma. So we worry about that less in dogs that it usually it's going to come from a melano cyte like somewhere else with the melanoma. Like we see a lot of oral melanomas, but it's not as

related to UV exposure as it is in people.

JoJo (22:45)
Right, okay. So it just sounds like keep your hands on your dog and cat, always looking, and then bring it to the attention of your veterinarian. Yeah.

Dr. Angie Krause (22:50)
Yes. One more. Look in your

dog and cat's mouth whenever possible. Oral tumors like lumps and bumps in the mouth can be important. Under the tongue, especially in kitties, which I mean, cats don't want you to look in their mouth, but here, let's see. hold on. I'm going to grab my cat. Yeah. Okay. I'm not going to grab a cat, but I'm going to grab a cat mouth.

JoJo (22:56)
possible.

Yeah, under the tongue.

And that's a kitty one.

Yeah, I was going say, can you show us how?

Dr. Angie Krause (23:16)
wait, no, this is a dog mouth. Okay, let's pretend it's cat. I know, but let's pretend it's a cat mouth. It's a very large cat mouth.

JoJo (23:17)
Yeah, I don't think you have a cat mouth.

Yeah,

I do not want to meet that cat.

Dr. Angie Krause (23:28)
so what I do is I take my hand to, and I put it right here under the incisors and I go like this to look in and they're going to go, you know, and they're going to try to shake their head, but just try to get a look under the tongue and then at the roof of the mouth. That could be helpful. So

JoJo (23:46)
Okay, so it sounds like eyes on your pet. If you find something, call your vet. look, we're gonna make a rhyme. Eyes on your pet, find something, call the vet. I would rap it for you, but totally not. Yeah, I think we've lost our minds, Angie. Yeah.

Dr. Angie Krause (23:49)
Eyes on your pet.

Do something, yeah.

Thank

Yes. I think we have, I think we have,

but before we go, I just want everyone to know that I do online consultation. So if you want to talk about a lump or bump, maybe the biopsy results of a lump or bump or anything else, I can consult with you online. You can go to boulderholisticvet.com and we have a book consultation button in the top right corner.

and you can grab some time on my calendar. We'll collect records, it'll be recorded, and I can help you create a plan. We also have a lot of online courses that we are giving away for free to our podcast listeners. And you can use Truth Tales, right? Did I get that right? And you can spell it T-A-L-E-S or T-A-I-L-S. And you can get that.

JoJo (24:52)
You got it right?

Dr. Angie Krause (25:00)
For free, we're always making new courses. So even if you're getting this, you know, listening to this episode years from now, check it out.

JoJo (25:09)
All right. Next time. Bye bye.

Dr. Angie Krause (25:10)
Talk to you soon. Bye.