What's that lump?


Dogs and cats are notorious for developing lumps and bumps on their bodies over their lifespans. {Ferrets, guinea pigs, hamsters, rabbits, and rodents are not immune to lump (mass) formations either}. Many of these are benign growths, and often self-resolving, but some may be malignant or infectious in nature so an accurate diagnosis is warranted.

We recommend any new swelling or growth on your pet be examined as soon as possible once detected. We will examine the mass by visual inspection and by palpation. Some common growths may be identified by gross examination alone, for example, oral papillomas and sebaceous adenomas. However, the vast majority of growths need to also have a microscopic evaluation to obtain a diagnosis. This is accomplished by a Fine Needle Aspiration (FNA) of the mass.

Fine needle aspiration is performed in the clinic during most routine exams and sedation is very rarely needed. A small gauge needle is inserted into the growth and gently maneuvered within it. Gentle suction is often applied to a connected syringe. The maneuvering of the needle and the suction help to obtain a sample of the cells that make up the growth. The sample is then delivered onto a slide which is allowed to dry, then stained, and viewed under the microscope. General veterinary practitioners are able to make confirmed diagnoses a vast majority of the time. There are some instances where suspect diagnoses need to be sent to a veterinary pathologist for further identification and/or confirmation.

I try to inform pet owners ahead of time that growths may be "wall-to-wall" cells, so obtaining and observing a cell sample is relatively easy in that case. However, there are many growths where the cells may not exfoliate well or the growth may be more like a blueberry muffin and the abnormal cells are the blueberries that we are attempting to "blindly poke". In these scenarios we may not always get a diagnostic sample (even after repeated sticks with the needle) and so we'll often recommend that a surgical biopsy or complete excisional biopsy should be performed.

It's important to pay attention to any new growth/lump/bump/swelling on your pet and have it examined as soon as you can.  We will often be able to give you a diagnosis of what it is the day we check it out and then lay out a recommended treatment plan.  Many times we'll recommend "watchful neglect", but there are those lumps that may be cancerous or painful to your pet and so the sooner we diagnose the sooner we can manage it.

Is Pet Health Insurance Right for You?

When it comes to insurance, people seem to be in one of two camps: those who love it and those who hate it. For those of you who love it, prefer to pay bills in smaller monthly payments rather than occasional large chunks at a time, or for those that simply have accident/illness prone pets - keep reading!

We recently took some time to really dive into plans from the pet insurance company, VPI, to determine if it could be a worth-while investment for our clients. While there are lots of different pet insurance carriers out there, we chose to evaluate (and ultimately recommend) VPI due to its track record and notable financial underwriter, Nationwide. This said, we're happy to accept any pet insurance plan you choose and encourage our clients to shop around to find the deal that's best for them and their pets.

Before I get into the nitty-gritty of individual plans, let me start by explaining what pet insurance is, and what it is not. In the eyes of the underwriters, pets are treated as possessions and are therefore insured more like cars and less like people. While I personally may not agree with this philosophy, (my dog, Marlie, is practically human!) it does make insurance significantly less complicated. Another aspect to mention is that all pet insurance plans are by reimbursement only. This means you pay for your pet's care at checkout as usual, submit your paperwork, and then the insurance company will send you a check. Plans are available for pets of any age, but have the best coverage and are most affordable if started when your pet is young and at its healthiest.

To help our clients receive the maximum reimbursement possible, one of our receptionists, Lori, is now our official insurance guru. Before submitting your claim, she will scour your pet's medical record and confer with your veterinarian to find the most accurate and beneficial diagnosis to list. With the safety net of insurance, it is our hope that our clients will have the financial freedom to say 'yes' to our veterinarian's best medical recommendations for your furry companions.

Which VPI plan is best for you?

(This is my personal summary of each plan. Please refer to VPI's website: or call 888-899-4VPI for complete information.)

Major Medical Plan

  • Most comprehensive plan with largest reimbursement allowances (typically allows more than enough to have 100% reimbursement for our service prices)
  • Covers injury and illness including chronic conditions, multiple conditions, and advanced diagnostics
  • Covers hereditary issues after 12-month waiting period
  • New plans available for dogs and cats less than 10 years old
  • Plans activate 14 days after application
  • Average premium $15-$40/month based on deductible size, pet age, and pet breed/size.
  • Annual deductible options of $100, $250, or $500 

Medical Plan

(Similar to the Major Medical except...)

  • No hereditary condition coverage
  • Has reimbursement allowancesthat typically will cover 80-90% of our service fees
  • Monthly premium runs a few dollars less

Injury Plan

  • Coverage for accidents only (not medical illness claims)
  • New plans available for cats and dogs of any age
  • Plans activate 24 hours after application
  • Average premium $12/month
  • Flat annual deductible of $250

Cat Plan

  • Coverage for the 15 most commonly seen medical conditions
  • Reimbursement allowance of $600 per condition per year
  • New plans available for cats less than 10 years old
  • Plan activates 14 days after application
  • Average plan $12-15/month
  • No annual deductible

CareGuard Wellness Coverage

(can be added to the above plans)

  • Coverage for wellness exams, vaccines, heartworm prevention, tests, microchips, and +/- spay/neuter/dental procedures
  • Reimbursement allowances will break even for most of our patients
  • Monthly premium $12-22

As with any insurance, there are some products/services/conditions that are not covered in any plan. For VPI, this includes:

  • Food/Nutritional Supplements
  • Congenital/Developmental Conditions
  • Behavior Problems/Training
  • Breeding/Reproductive Conditions
  • Cosmetic Conditions (including declaws)
  • Pre-Existing Conditions

Please let us know if there is anything we can help you with in regards to pet insurance (or anything else for that matter!) If you decide to purchase a plan, please let Lori know and she will be happy to help you with paperwork after each visit.

What's in a Wellness Exam?


Recently, many of the veterinary specialty colleges have started recommending an increased frequency of veterinary checkups for our patients, particularly our senior dogs and cats. At Daniel Island Animal Hospital, we recommend a 6 month wellness check in addition to the more extensive yearly exams where we do heartworm tests, fecal examinations, routine blood work and vaccines as needed. Many people who are used to only doing yearly appointments may be wondering what the value of a 6 month checkup is. To answer that I’d like to go through exactly what it is we are looking for on a physical examination. Although it doesn’t take long, we get a lot of information every time we see your pet, and it helps build a solid medical record so that we can monitor for small changes.

Why every 6 months?

It’s important to remember that our pets age the equivalent of  4-7 years for every calendar year. This means that every 6 month check is about the equivalent of you going to the doctor every 2 – 3 years. This becomes very important for senior pets who may be at risk of developing serious diseases that can show only subtle signs at home. Pets who we may think are just “slowing down” with age may actually have underlying problems that, if undetected, may compromise your pet’s comfort and/or longevity.

What goes into the physical exam?

Every veterinarian has a different approach to physical examination that they are comfortable with, but in general, a thorough physical examination is generally done with the owner and covers the pet from nose to tail.  We like to have the owner present so that you can help to point out things you’ve noticed and we can ask you questions about anything we find (i.e. – have you ever noticed this lump?)

When I start a physical examination, I like to work my way from the front to the back:

  • Eyes – the doorway to the soul? Maybe, but they are also good indicators of discomfort, neurological disease and high blood pressure in addition to any primary problems such as trauma, cataracts, glaucoma, conjunctivitis or tumors of the eye or eyelid. We may use an ophthalmoscope or an indirect light and lens to further examine the structures of the eye for problems. Tests for tear production, corneal ulcers and eye pressure are also common follow-ups when a problem with the eye is observed.
  • Ears – Ears should be fairly clean and pink. If the inside of the ear is red, dirty, swollen, smells funny or if a pet is shaking his/her head frequently, this is where we find out what is going on. We also thoroughly examine the pinna (ear flap), for any injuries or masses. An otoscope is used to examine the deeper ear canals and the tympanum or eardrum.
  • Nose – Noses should be cool, clean and moist. A dry nose doesn’t necessarily mean that a pet is sick, but nasal discharge or abnormal nasal skin can be indicators of allergies, immune mediated disease, infections and some kinds of cancers.
  • Mouth – We check the teeth, gums, tongue, cheeks and back of the throat for dental disease, ulcers, masses or abnormal color. How much information we get depends a lot on how well our patients cooperate, so in some cases we may need to perform a sedated exam to really probe into the areas in the back of the mouth and throat.
  • Lymph nodes – dogs and cats have lymph nodes under the chin, in front of the shoulders, in the armpits (also called axillae), inside of the thighs (the inguinal area) and behind the knees. I usually check all of these at once while doing a good once over of the whole pet by touch to see if I feel any abnormal skin or masses.
  • Heart / lungs – Just like your physician, we listen to the heart and lungs with a stethoscope to detect heart murmurs, arrhythmias and lung crackles or wheezes.  Sometimes in heavily panting dogs or purring cats we may have to close the mouth or adjust the position of the animal to get a good listen. While listening to the heart, I often will feel the femoral pulse, on the inside of the back leg, to make sure the heart beat and the pulse are going at the same time.
  • Abdominal palpation – ideally we like to get a feel of both kidneys, the tip of the liver, the stomach, spleen, intestines and colon, and check for any abnormal masses or areas of discomfort. In overweight or very tense pets we may not be able to be as thorough. A rectal examination is commonly used for intact male dogs to evaluate the prostate, however it may be performed during any physical examination to evaluate the rectum and anal glands for masses. 
  • Musculoskeletal / Nervous system – evaluating the eyes, ears, nose and mouth can tell us a lot about the nervous system, as does watching the pet move around the room.  A full orthopedic examination, including a check of reflexes and range of motion of each joint, is necessary any time lameness appears or if there is concern about possible pain or difficulty moving. We also check closely for pain and normal reflexes in the neck, back and tail.
  • Skin – from head to toe we are evaluating the coat and skin for abnormal color, texture, lumps, bumps, cuts, bruises or smells. This includes between the toes and in the area around the genitals and anus.  

Just like in people, the key to good health is preventative care and early detection of problems. Regular physical examinations help us catch things earlier and give us a better chance of successful treatment! In addition, it gives us a chance to talk with our patient’s owners about anything from behavior training to diet to dental home care and help ensure that we’re doing all we can for your furry companions. It’s what we like to call “good medicine”!

Do Vets Have Pets?

I have many!! I can fully relate to pet owners who find vet care to be expensive – it is. As a veteran veterinarian (translation = old), I have adopted many needy patients over the years, so I own pets with complicated, chronic medical conditions.

I know how frustrating it can be to have an itchy dog who continues to have outbreaks, no matter how many visits, how many medications and how many products you try. I have lost beloved cats and dogs to kidney failure, cancer, stroke in the middle of the night, and mega-esophagus of unknown origin. Even with all the money and knowledge in the world, we still lose them to “mystery diagnoses” because we just don’t know everything yet. There is more research to do!

As one of my friends frequently says, “it is what it is.” He also points out to young people on a regular basis that life is unfair, and the sooner they realize it, the happier they will be. Sometimes, in spite of all our best recommendations and attempts at preventive care, bad things happen. But the preventive care DOES help keep them happier and healthier for longer, so that money is definitely NOT wasted on our wonderful furry friends.

I often get questions about diet and preventive care in my own household and I am happy to share this information with you. At DIAH, we study literature constantly to keep abreast of the best evidence and most current recommendations, and we do follow them in our own homes.

Revolution: my cats all live strictly indoors and get monthly Revolution – a topical medication that prevents internal and external parasites. Even indoor cats get fleas – I guarantee it! They just hide it well.

Diet: my dogs and cats eat Royal Canin, Science Diet or Purina foods. I am aware that there is a lot of public opinion about pet food ingredients, most of it quite passionate - but these are the companies I trust to purchase quality ingredients and to formulate diets using the scientific information we actually KNOW about nutrition. This is one area that needs a lot of research and these are the companies spending millions of dollars doing it. The more “natural” pet foods are based on theory, not science.

Supplements: my dogs and cats each take an Omega 3 fatty acid supplement (AllerG-3) and a joint supplement (Dasuquin) daily. These supplements are at levels far higher than food companies can put into their diets (they go rancid.) We have great evidence to show they reduce the effects of arthritis, heart disease and some cancers. These brands have been tested in pets, so we know they actually get into their systems and do have positive effects. The Costco or other generic versions are not regulated and we just don’t know even if the ingredients are listed accurately, let alone whether they are bioavailable to our pet species.

Canine heartworm and flea control: my dogs take Sentinel and Comfortis monthly because they do not have a tick risk. When I take them to my parents’ farm, I put Preventic collars on them. If my dogs were exposed to ticks regularly, I would use Sentinel and Frontline Plus.

Dental Care: the absolute best care is daily brushing, but I cannot commit to that because of the number of pets I own (don’t ask!) Dr. Rainwater is a model pet owner – she brushes regularly. Instead, I use Aquadent water additive so that when my cats and dogs get a drink of water, they are also getting an antibacterial rinse. I give them Science Diet Prescription T/D Diet as treats daily – the kibble is large and requires chewing and is formulated to clean the teeth as they eat. We now know that canned and dry diets accumulate tartar equally on the teeth, so only dental treats or diets formulated specifically to clean as pets chew actually make a difference.

My rabbit and guinea pig are fed Oxbow brand food and I even purchase my Timothy hay from Nebraska because the quality is so much better than anything I’ve seen locally. Rabbits and ferrets also need monthly Revolution; Guinea pigs do not need parasite control.

I hope this has been interesting and informative for you. I want you to know that when we make recommendations, these are things we believe and understand to be accurate based on our years of education and literature review. We also are passionate about dog and cat health, and are not in the business of selling. Daniel Island Animal Hospital is just that – an animal hospital providing medical, dental and surgical care to pets. We carry most products we recommend for your convenience, not as an income-provider for us.

We’d love to have your thoughts and feedback and are happy to answer questions!