Testicular and splenic masses.

Dr. Marie replied:

Thank you for being so detailed in your question. I'll start off by answering your concerns about your dog's incision and staples. Here is one of the photos that you sent me:



This really looks like a normal incision to me. Now, I can't give you a diagnosis over the internet, but from the photo I don't have any major concerns. To answer your question, yes, there are several layers of stitches (usually 3). It certainly is possible that one of the knots from below the skin is poking up through the skin. When the staples are removed, the vet or veterinary technician will have a look at this and if necessary, will snip that out as well. A lump under the skin is nothing to worry about. I would be concerned though if the incision looked much more red and was really bothering your dog.

So now let's talk about the tumors that were removed. First off, this is excellent news that none of them were cancerous! I can understand your frustration and concerns that perhaps surgery was done unnecessarily, but perhaps I can explain why this had to be done.

I'm not sure why an ultrasound was done...if this is something that you hadn't agreed to you could possibly speak with your vet and ask why. However, it really is something that should have been done. When there is a large testicle in a dog, the biggest concern is for cancer. If you are going to do surgery for cancer, it is best practice to look for other signs of cancer. One possible reason to do this would be, say, for example, if they found that the abdomen or chest were absolutely full of cancer then they may have advised not to go ahead with surgery at all and to consider euthanasia.

A spleen tumor is an easy thing to see on an ultrasound. But, it is close to impossible to tell if a spleen tumor is benign or malignant without actually analyzing the spleen tissue itself. For some tumors you can do a test called a fine needle aspirate, where you put a needle in the tissue (without actually opening the abdomen) and look at cells to determine if it's cancerous. But, if you do this with a cancerous spleen you run the risk of rupturing the spleen and this could be life threatening. So, if a spleen mass is seen on xray or ultrasound it is always recommended to remove it.

I don't have my hands on the actual figures here, but I can tell you that it is much more common to see malignant spleen tumors than benign ones. And you can't tell the difference even when you've opened up the abdomen and looked at and felt the spleen. The only thing you can do is remove the spleen and send it away for pathology. I have removed a lot of spleens in my career and I would say that 95% of the time if there is a tumor it is a malignant cancer. It is uncommon to have a benign tumor....but a much better diagnosis!

Regarding the testicles, the same thing applies in that it is very hard to tell if a testicle is cancerous or if there is another reason for the swelling. Testicular cancers often don't affect the whole testicle. So, if you just put a needle in to get cells there's a chance that you wouldn't hit the cancerous part and get a false diagnosis. As such, any time there is one testicle that is bigger than the other, it's best to remove the testicles.

Your dog was extremely lucky. The two masses (tumor and spleen) likely weren't related to each other at all. In hindsight, we could say that they didn't need to be removed, but if you play the odds, there was a really high chance that either could be cancer. Your vet made the same recommendations that I would have made.


I should also note that the word "tumor" is a confusing one to some people. A mass of scar tissue can also be called a tumor. It's just that scar tissue is a benign mass as opposed to a malignant one.

I wouldn't necessarily say that your vet was lying about not having both test results. Often, we will get one pathology report and then, when the pathologist finishes the final report they'll just add on to the initial report and resend it again. I don't see any reason for your vet to lie to you about this. Again, I'm not trying to cover for your vet. It really does sound like he was very thorough and did the right things.

The only part of your story that has me a little concerned is that your dog is a little wobbly. This really shouldn't be normal this many days after surgery. There is a small chance that this could be indicative of blood loss into the abdomen which is a possible complication from splenic surgery. For this reason I would recommend that you have your vet examine your dog just to be sure everything is ok. As it is the weekend, one thing you can do to determine whether he needs to be urgently seen would be to have a look at the color of his gums. They should be pink just like ours. If they look white or extremely pale pink then this would make me want to get him in to emergency today.

I hope things work out ok!

Dr. Marie.


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Dr. Marie replied:

Ah I see...what an odd thing that abdominal mass was! It's definitely not something you would commonly see.

It is possible that his neuter stitches are bothering him. Given that he is eating well I think you're probably fine to wait until Monday to see your vet.

The enlarged prostate really shouldn't cause him to have trouble walking.

Hope he's all better soon!

Dr. Marie