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post #1 of 15 (permalink) Old 08-31-2016, 08:58 AM Thread Starter
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I'm getting some panic

Since the end of July, Elza has a red bump under her toe nail.
Our new vet prescribed anti-biotic drug and it's never been healed. He sampled, sent it to the independent lab and it's not a melanoma.
Skin issue, allergy or tumor?
I've been searching another vet for the second or third opinions. Vet hopping will begin. I hate that! I wish our old vet did not retire....


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post #2 of 15 (permalink) Old 08-31-2016, 09:11 AM
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Oh my that's quite the bump! Did they culture it to see if perhaps a different antibiotic is needed? (cultures show you what it is and isn't resistant too)

Not much advice otherwise unfortunately, hope you get answers!

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post #3 of 15 (permalink) Old 08-31-2016, 09:16 AM
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That looks an awful lot like a mast cell tumor to me- vet shopping definitely in order, with a likely surgical removal and biopsy.

Poor Elza I have had mast tumors removed from a few of my pets over the years- and knocking wood, none have ever returned (although they can).
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post #4 of 15 (permalink) Old 08-31-2016, 09:52 AM
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hoping for the best, please keep us posted.
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post #5 of 15 (permalink) Old 08-31-2016, 10:31 AM
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Hope you find out soon and it's nothing serious!

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post #6 of 15 (permalink) Old 08-31-2016, 10:46 AM
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That’s a nasty looking sore. And right up there against the nail is not a good place for something like that to show up. It could be an infection or a foreign body (like a splinter) that has lodged up in there, but...

Since you’ve decided to go vet hopping, I would find a new vet SOON.

You might even want to start right away and go to a specialist or vet school if you have one available (your vet may need to refer you to the proper specialty to go to, since the initial treatment has not worked)--a dermatologist (who could refer you if needed) or maybe even to an oncologist or surgeon. They may recommend you remove the lump and send it in to a pathologist for a biopsy.

Often the best way to test a lump that might be a tumor is to take the whole thing off if possible, or as much as they can get of it, and send that in for a diagnosis. Sampling it by a fine needle aspirate or even a chunk of the mass *might* give you an idea of what kind of thing it is, but not necessarily whether it is the kind of lump that might grow. Sometimes, too, depending on where the lump is, the vet can miss the nasty part with the needle or the piece of a sample he picks, and end up with a negative result.

See this article for a better explanation--What is a Biopsy and When Might Your Dog Need it?

Hope you find an answer to Elza’s problem soon.

Last edited by melbrod; 08-31-2016 at 10:54 AM.
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post #7 of 15 (permalink) Old 08-31-2016, 03:19 PM
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I pretty much echo what Melbrod said--I biopsy everything except lipomas--and if they aren't dead obviouly lipomas I have those biopsied too.

And anything on the feet/toes and legs I do ASAP. There are, unfortunately, a number of things that show up on feet, especially on and between toes are close to nails that are a variety of one sort of cancer or another. And there are melanomas that show up on toes. Most of my vets don't want to do fine needle aspirations on anything that looks like it might be a melanoma since melanomas are nasty about biong disturbed and it will sometimes send them into sudden growth or worse start them shedding cells that end up producing cancers in other parts of the body (metatastisis).

It's one of those days when my computer and ISP don't want to download anything complex so I never could see what it looked like--but just because of the location I'd be pursuing a definite diagnosis.
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post #8 of 15 (permalink) Old 08-31-2016, 03:32 PM
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Quote:
Originally Posted by dobebug View Post
....And there are melanomas that show up on toes. Most of my vets don't want to do fine needle aspirations on anything that looks like it might be a melanoma since melanomas are nasty about biong disturbed and it will sometimes send them into sudden growth or worse start them shedding cells that end up producing cancers in other parts of the body (metatastisis).
Mast cell tumors can do the same thing. They often don’t spread internally and removal of the swelling with proper margins (the healthy tissue around the bump) is considered practically curative--but a mast cell tumor on a toenail bed can be invasive.

There are other treatments in addition to removal you can use with a youngish dog in good health to help make sure the tumor won’t come back--but the sooner you get an idea what that mass is, the better.
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post #9 of 15 (permalink) Old 08-31-2016, 10:16 PM
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I'm getting some panic

Otto had something that looked very similar growing from his nail bed. They originally prescribed an antibiotic and a soak, which seemed initially to work but it grew rapidly again when the soaks stopped. Given that he is a 10 year old black lab mix, and the tumor grew rapidly (first appeared in May of this year) the vet and I decided that the best course of action was to amputate the toe. They sent the entire toe and tumor to the lab. It was some sort of local growth, but not Squamous Cell Carcinoma (my fear given his breed, age, and the tumor appearance), and the vet said that the lab could find no indication that it had been aggressive elsewhere. Otto is doing absolutely great with his one less toe Barely noticed it. Definitely err on the side of caution with the nail bed tumors. I never did the biopsy because of the risk of it spreading if it was cancer. Either way it would need to be removed since it was bothering him and didn't respond to treatment.


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post #10 of 15 (permalink) Old 08-31-2016, 11:06 PM Thread Starter
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Quote:
Originally Posted by Sam1491 View Post
Oh my that's quite the bump! Did they culture it to see if perhaps a different antibiotic is needed? (cultures show you what it is and isn't resistant too)

Not much advice otherwise unfortunately, hope you get answers!
The vet stamped the glass onto the bump so it was cultured I guess. He did not use a needle. He's a bit scared of Dobermans...!



Quote:
Originally Posted by dobermama View Post
That looks an awful lot like a mast cell tumor to me- vet shopping definitely in order, with a likely surgical removal and biopsy.

Poor Elza I have had mast tumors removed from a few of my pets over the years- and knocking wood, none have ever returned (although they can).
It slowly grows to that size. Because Elza licks it gets worse I think.


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hoping for the best, please keep us posted.
Yes, I will! Honestly, DT is the comfortable site to me as I know many members and can obtain various opinions and experiences.


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Hope you find out soon and it's nothing serious!
I trully hope so, like toe skin inflammation.


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Originally Posted by melbrod View Post
That’s a nasty looking sore. And right up there against the nail is not a good place for something like that to show up. It could be an infection or a foreign body (like a splinter) that has lodged up in there, but...

Since you’ve decided to go vet hopping, I would find a new vet SOON.

You might even want to start right away and go to a specialist or vet school if you have one available (your vet may need to refer you to the proper specialty to go to, since the initial treatment has not worked)--a dermatologist (who could refer you if needed) or maybe even to an oncologist or surgeon. They may recommend you remove the lump and send it in to a pathologist for a biopsy.

Often the best way to test a lump that might be a tumor is to take the whole thing off if possible, or as much as they can get of it, and send that in for a diagnosis. Sampling it by a fine needle aspirate or even a chunk of the mass *might* give you an idea of what kind of thing it is, but not necessarily whether it is the kind of lump that might grow. Sometimes, too, depending on where the lump is, the vet can miss the nasty part with the needle or the piece of a sample he picks, and end up with a negative result.

See this article for a better explanation--What is a Biopsy and When Might Your Dog Need it?

Hope you find an answer to Elza’s problem soon.
Early of this year, my friend's Dobe was diagnosed melanoma so I knew how the owner found 'it'.
When I was told by a groomer on July 29 about the bump, you can imagine how freaked out I was.
Hoping for nothing serious, I quietly have been giving her some medications. Ugh! It exceeded my patient limit and here I am now.
Thanks for the link!

Quote:
Originally Posted by dobebug View Post
I pretty much echo what Melbrod said--I biopsy everything except lipomas--and if they aren't dead obviouly lipomas I have those biopsied too.

And anything on the feet/toes and legs I do ASAP. There are, unfortunately, a number of things that show up on feet, especially on and between toes are close to nails that are a variety of one sort of cancer or another. And there are melanomas that show up on toes. Most of my vets don't want to do fine needle aspirations on anything that looks like it might be a melanoma since melanomas are nasty about biong disturbed and it will sometimes send them into sudden growth or worse start them shedding cells that end up producing cancers in other parts of the body (metatastisis).

It's one of those days when my computer and ISP don't want to download anything complex so I never could see what it looked like--but just because of the location I'd be pursuing a definite diagnosis.
I agree. Toes or feet makes me sink. 'I' was even prescribed the sleeping pills.
I will go see another vet tomorrow.

Quote:
Originally Posted by melbrod View Post
Mast cell tumors can do the same thing. They often don’t spread internally and removal of the swelling with proper margins (the healthy tissue around the bump) is considered practically curative--but a mast cell tumor on a toenail bed can be invasive.

There are other treatments in addition to removal you can use with a youngish dog in good health to help make sure the tumor won’t come back--but the sooner you get an idea what that mass is, the better.
Thank you. As I can't stand to see it "not" better, I will take her to another bigger vet office.

Quote:
Originally Posted by sgourle View Post
Otto had something that looked very similar growing from his nail bed. They originally prescribed an antibiotic and a soak, which seemed initially to work but it grew rapidly again when the soaks stopped. Given that he is a 10 year old black lab mix, and the tumor grew rapidly (first appeared in May of this year) the vet and I decided that the best course of action was to amputate the toe. They sent the entire toe and tumor to the lab. It was some sort of local growth, but not Squamous Cell Carcinoma (my fear given his breed, age, and the tumor appearance), and the vet said that the lab could find no indication that it had been aggressive elsewhere. Otto is doing absolutely great with his one less toe Barely noticed it. Definitely err on the side of caution with the nail bed tumors. I never did the biopsy because of the risk of it spreading if it was cancer. Either way it would need to be removed since it was bothering him and didn't respond to treatment.


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Oh, I'm sorry for amputuating his toe. Do you think Elza's very similar to your Otto's case?
I was optimistic for the first few weeks. But now September, a month passed. It's time to move on!

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post #11 of 15 (permalink) Old 09-01-2016, 01:18 AM
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I think, but don’t quote me on this--if the vet simply pressed the bump itself or a piece of tissue cut off the bump against a glass slide (generally a rectangular piece of glass about the size of a stick of chewing gum), he was probably trying to get some cells from the bump to stick to the slide so the folks he sent it to could stain it and try to figure out what kinds of cells are there, a rather imprecise method, to say the least.

A culture would involve him using something like a sterile cotton swab, or even a bit of tissue cut from the bump and putting it into a fluid filled test tube, or streaking it across a dish of agar (jelly-like stuff) and then keeping the plate or tube warm to see if anything grows in it. If they find bacteria growing, they can then look at them under a microscope. Basically if they are all the same looking, then they can do another test to see what antibiotics will kill the bacteria.
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post #12 of 15 (permalink) Old 09-01-2016, 04:27 AM
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oh no! i hope it's something easily fixed!!

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post #13 of 15 (permalink) Old 09-01-2016, 07:31 AM
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Poor girl. Hoping for the best and you get this figured out.
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post #14 of 15 (permalink) Old 09-01-2016, 09:15 AM
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Quote:
Originally Posted by melbrod View Post
That’s a nasty looking sore. And right up there against the nail is not a good place for something like that to show up. It could be an infection or a foreign body (like a splinter) that has lodged up in there, but...

Since you’ve decided to go vet hopping, I would find a new vet SOON.

You might even want to start right away and go to a specialist or vet school if you have one available (your vet may need to refer you to the proper specialty to go to, since the initial treatment has not worked)--a dermatologist (who could refer you if needed) or maybe even to an oncologist or surgeon. They may recommend you remove the lump and send it in to a pathologist for a biopsy.

Often the best way to test a lump that might be a tumor is to take the whole thing off if possible, or as much as they can get of it, and send that in for a diagnosis. Sampling it by a fine needle aspirate or even a chunk of the mass *might* give you an idea of what kind of thing it is, but not necessarily whether it is the kind of lump that might grow. Sometimes, too, depending on where the lump is, the vet can miss the nasty part with the needle or the piece of a sample he picks, and end up with a negative result.

See this article for a better explanation--What is a Biopsy and When Might Your Dog Need it?

Hope you find an answer to Elza’s problem soon.
I agree. Go to a Vet Specialist. They have a lot more tools to diagnose with, and a lot more training. Since Uno's illness I've come to think of Vets more as a GP, and though they cost more, a Vet Specialist rather than "another Vet" should be utilized more.
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post #15 of 15 (permalink) Old 09-01-2016, 12:42 PM
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Quote:
Originally Posted by Elzajpn View Post

Oh, I'm sorry for amputuating his toe. Do you think Elza's very similar to your Otto's case?

I was optimistic for the first few weeks. But now September, a month passed. It's time to move on!

It looks remarkably similar and the growth pattern sounds similar. Like I said, I skipped the culture step because, after talking with my vet, it was aggravating him enough that either way he would need to have it surgically removed. The options then became:
1. Go to a specialist, wait X amount of time, and still need to have it removed, but know what I'm dealing with beforehand.
2. Just remove the tumor, send it to the lab, and amputate the toe if need be. I didn't like this option because of the possibility of it growing back, and because at his age I didn't want Otto going under anesthesia more than necessary.
3. Amputate the toe and send it to the lab to know what I should expect on a go-forward basis.

The actual toe amputation only added about $250 to the cost of what the surgery would have been to remove the tumor alone, and then the cost of sending it to the lab for diagnostics, which would have been done regardless. Overall I am really happy with the option chosen. He was cleared a couple of weeks ago to start hiking and swimming again, so we have been enjoying that.




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