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This guide helps you triage; it does not replace your veterinarian's exam. When in doubt, call us at 514 223-1197.
Go now: the pictures that cannot wait
Most lumps are not tonight's emergency. They are still a reason to call us. What follows is not. Any single one of these is enough, and none of them depends on species. Settle your pet into a carrier or onto a stable surface, keep the ride calm, and call on the way. Two of these pictures mention a lump that is hot or painful: go by what you already noticed while petting them, do not press the lump to check.
- Weak, unsteady on their feet or lying on their side, gums pale, white or grey, breathing fast, belly looking bigger than it did yesterday. None of that seems to have anything to do with the lump. It does: a mass can bleed inside the body with nothing showing on the outside.
- Struggling to breathe, noisy breathing, coughing, trouble swallowing, or swelling of the muzzle, the face, the throat or the neck.
- The lump is bleeding and it will not stop, or it is open, weeping, or it smells.
- The lump turned red, hot and bigger within hours, and at the same time there is vomiting, diarrhea, dullness, or collapse.
- The lump is hot and painful, it is growing fast, and there is a fever, no appetite, hiding, or refusing to be approached.
- Welts have come up all over the body within minutes or hours, the face is swelling, there is scratching, drooling, vomiting, restlessness.
- The lump is on a limb and your pet will not put weight on it, or the leg gave out suddenly. Do not walk them.
- Bruises are appearing on the skin or the gums, the nose is bleeding, the stools are black.
Reading this at night or on a weekend?
Do not set an alarm for opening time. We have no service outside our opening hours. If we are closed, a 24/7 emergency centre takes over and you can call them right now: describing the situation over the phone commits you to nothing.
What a lump will not tell you
You are probably matching what you just felt against descriptions you found online. Soft or firm. Movable or fixed. Round or irregular. Let us save you the time: that sort of sorting does not work. It is not incomplete, it is wrong, and the reassuring half of it is the more dangerous half.
The description that reassures is the one that misleads
Soft, round, rolls under your fingers, does not hurt: that is the description of a lipoma, a fatty lump. It is also, word for word, the description a great many mast cell tumors give. Our own page on those tumors already says it: a mass that looks completely ordinary can be an aggressive one. So when you read somewhere that "soft and movable is usually fine", you are not reading information. You are reading the exact sentence that makes people wait.
Size tells you nothing
A pea-sized lump can be the one that worries us most. A golf-ball-sized lump can be nothing at all. Big does not mean serious, and small very much does not mean nothing.
Speed does not sort it either
Perfectly ordinary things appear overnight. Serious things sit unchanged for months before they move. And there is worse: some masses swell and then shrink again on their own, week to week. Hold on to this one sentence, it may be the most useful on the page: a lump that has gotten smaller is not a lump that is going away.
Our hands are not enough either
A veterinarian feeling a mass learns real things: exactly where it sits, whether it is anchored to what lies beneath, how the nearby lymph nodes feel, whether it hurts. That shapes the rest of the visit. It does not diagnose. The vet who says "this looks like a lipoma, but let us check" is not being excessive and is not selling you something. They are being accurate.
The only thing to do, and it is a small thing
One procedure answers the question, and it is a very small one: a fine needle aspirate. A few seconds, a needle the size of a vaccine needle, often during the same visit, with no anesthetic. Book that. The section "The aspirate, for real" walks you through exactly what it is like, because being afraid of the procedure is one of the real reasons people wait. And to be clear: there is no version of this page where we tell you to watch it for a few weeks and see.
What to write down, without touching it
Five minutes, done with your eyes and your phone camera. It looks like nothing, and it changes more about what we can do at the appointment than anything else you could do today.
Hands off
Our page on canine mast cell tumors already carries the wording that governs here, and we are not going to soften it: never massage, squeeze, or manipulate a suspicious skin mass before consulting a veterinarian. This is not a politeness. Some masses, when they are handled roughly, release a substance that makes the whole area swell all at once and can make a pet genuinely ill. Everything below is done without pinching it, without pressing it, and without measuring it between two fingers.
- 1
Where it is
Describe it the way you would describe it to us on the phone, because that is exactly what is about to happen. Not "on his side": "on the left flank, level with the last ribs", or "on the outside of the right thigh, halfway between the hip and the knee". If you find more than one, number them. A numbered list of three lumps is worth ten times "he has a few".
- 2
Its size, next to an object
Do not reach for a measuring tape, and above all do not pinch it between your fingers to judge it. Instead, lay a coin on the fur beside the lump, without pressing: a dime, a quarter, a loonie, whatever you have. Then take two photos. One close up, with the coin in frame. One from further back, so we can see where on the body it sits. A coin in a photo tells us more than a number does, because the number depends on how hard you squeezed.
- 3
The date
Write today's date down today, in your notes or right on the photo. "A while now" is not a date, and in two months you will remember it no better than we will. And let us be honest about what that date means: it is the date you found it, not the date it appeared. Those are two different things, nobody knows the second one, and we will never ask you to guess it.
- 4
The real shortcut: your phone
Here is the part almost nobody thinks of, and it is the most useful. You very likely already have, in your camera roll, the one piece of information that is missing: photos of your pet from three months, six months, two years ago. Open it and look for shots where the same part of the body is visible. Can you see it? Can you not see it? Both answers are gold, and the second one as much as the first. It is the only honest way to know how long it has been there, and the only one that asks nobody to wait for anything.
- 5
What has changed around it
Still without touching: is the hair over it gone or thinning? Is the skin red, crusted, open? Is your pet licking there? Did they react when your hand passed over it while you were petting them? Write down what you have already noticed. Do not provoke the reaction to find out.
What the photo is actually for
Three things. So we can compare it to the one taken at the next appointment. So anyone who sees your pet knows where to look. And so that lump number two is still lump number two a year from now. It is not there to replace the appointment, and it is certainly not there to give you a reason to wait. Take the photo today, and bring it to the appointment you are booking now.
One thing to rule out before you panic
Look closely with a light, without touching. An engorged tick looks a great deal like a small grey or beige lump stuck to the skin, and around Montreal that is not rare at all. If it has legs, it is not a mass.
What not to do, however good the intention
Every one of these reflexes comes from a good place. Every one of them costs time, muddies the information, or does harm.
- Do not press it, do not massage it, do not try to empty it, and do not have three people feel it for a second opinion. Every extra prod is another round of handling, and the first rule on this page makes no exception for curiosity.
- Do not lance it, open it, put a needle in it, or try to drain it, even if you are convinced it is an abscess. Even if you have seen one before. Even if your pet had exactly this last year.
- No hot compresses, no salt soaks, no waiting for it to come to a head.
- Put nothing on it: no cream, no ointment, no natural product. One deserves to be named, because it is sold online for exactly this: black salve, made from bloodroot, marketed on a promise to make lumps fall off. These products burn tissue. They do not choose what they burn, they leave a deep and painful wound, and they do nothing about whatever was underneath. If you have already used one, or already put anything else on it, stop and tell us when you call: it changes what we will see on the skin, and rinsing does not undo it. In the meantime, keep your pet from licking the spot.
- Do not shave the area and do not trim the hair around it. We will do that if it is needed.
- Do not give anything for pain, no anti-inflammatory and no leftover prescription, whether it was your pet's or the other animal's. That is the whole of the next section, because it is the place on this page where the most harm gets done with the best of intentions.
- Do not put a cone on and call it handled. If your pet is licking the lump, the cone protects the skin in the meantime, but the licking itself is information: tell us on the phone.
- Do not wait for the next annual exam. And do not cancel the appointment because it has gotten smaller in the meantime.
Do not give any medicine from home
This page is read by someone whose pet may have a lump that is hot, painful, or licked raw, and the medicine cabinet is ten feet away. This is the moment to be very clear: here, the move that comes from the very best intention is also the one that kills.
Acetaminophen (Tylenol)
Deadly to cats, even a single tablet. There is no safe dose. In dogs it attacks the liver. If your pet has swallowed some, that is an immediate emergency.
Ibuprofen (Advil), naproxen (Aleve), aspirin
Stomach ulcers and kidney damage, in dogs as well as cats, and cats are affected at smaller amounts than dogs. Never a human anti-inflammatory, whatever the reason. In a small animal, a single tablet can be enough.
Leftover prescriptions
The painkiller prescribed to the other animal in the house, or the one left from an episode six months ago. A prescription is worked out for one animal, one problem and one weight: it does not transfer, and a dog's tablet given to a cat is one of the most common poisonings we see.
Antibiotics left over from another time
A hot, painful lump makes people think abscess, and plenty of households have half a bottle somewhere. Starting an antibiotic blind does not empty an abscess, does not fix what is not one, and makes the sample harder to read at the exact moment we need it.
Nothing by mouth, and here is exactly why
It is not that everything is poison. It is that a pet who has been given something stops licking and stops reacting: you would lose the few signs you had, right before the visit where they count. And relieving an animal's pain is a real priority, not a luxury: it is a clinic decision, made once we know what we are treating. If your pet is in pain, what they need is not a tablet, it is a phone call.
The aspirate, for real
People put this off because they picture surgery, an anesthetic, a recovery, a pet coming home groggy and shaved. So let us describe the actual thing, because it is none of that.
How it goes
- 1
Awake, in the exam room
Depending on the case, the aspirate is done during the consultation or at a visit booked for it, with no anesthetic, your pet on the table, gently held. There is nothing for you to prepare and no need to withhold food beforehand.
- 2
A fine needle
The size of a vaccine needle, often finer. No incision, no stitches. A small swelling, some redness or a bruise can show up at the puncture site in the hours that follow, mostly with certain masses: it settles, and it is something to tell us about rather than watch on your own at home.
- 3
A few seconds
We collect a few cells, usually two or three times so there is enough to look at. Plenty of pets react less than they do to a vaccine. Some do not notice at all.
- 4
Then the slide
The cells are spread on a glass slide, stained, and looked at under a microscope. That is where the answer lives, the one neither your fingers nor ours could give.
- 5
They leave with you
Right away. They eat, they play, they get on with their day.
When a little sedation is needed
It is not always possible awake, and it is not a bad sign when it is not. A mass in the mouth, right beside an eye, between the toes, or deep in the abdomen often calls for light sedation, sometimes with ultrasound to guide the needle. So does a frightened or a painful pet. Sedation here is not an escalation: it is what makes the procedure quick, accurate and calm.
Eye exams, eye tests and eye surgery happen here, during our opening hours; cataract surgery, glaucoma surgery and retinal disease go to a veterinary ophthalmologist. An injured or painful eye outside our hours goes to a centre open 24/7.
What it answers, and what it does not
This has to be said honestly, because disappointment does more damage than waiting does.
It answers some questions very well
For mast cell tumors, for instance, the cells have a characteristic look, and cytology often confirms what we are dealing with.
It does not give the grade
Knowing which cells these are and knowing how aggressive they are are two different questions. The second one takes removing the mass or taking a piece of it and sending it for histopathology. That is a further step. Usually it comes once we know what we are looking at; when the aspirate gives no answer, it is what takes over right away.
It does not always answer
Some masses shed very few cells, whatever the technique and whoever is holding the needle. That is called a non-diagnostic sample. It is not a normal result, it is not a failure on your part, and it does not mean the lump is harmless. It means we move to the next step, and we tell you which one.
"Can the needle spread the cancer?"
This is the question we get asked most about the procedure, so let us answer it properly. For the masses we aspirate in dogs and cats, it is not a clinical concern: the worry makes sense, but it is not what we see. The best-documented exception is instructive: bladder tumors. Avoiding exactly that risk is why we do not put a needle into a bladder mass through the abdominal wall, and why those are diagnosed a different way. In other words, the question is taken seriously, it has a real answer, and that answer is not to wait.
Where the slide goes
The sample is taken at the clinic. Depending on the case, it happens during the consultation or at a visit booked for it. From there, the slide may be read here or sent to a reference laboratory that writes the microscopic description: both routes are real, and your veterinarian chooses based on what we are looking for. They will tell you which one, and why.
How long it takes
Some tests are run here, in our own laboratory, and the result sometimes comes back during the visit itself. Other samples go to an outside laboratory. How long it takes depends on the test and on where it goes: ask your veterinarian which of the two applies and how long to expect, that is the question to ask when the sample is taken.
And if the answer is the one you were dreading
Let us say this, because it is the reason some people never book. If the word cancer comes up, you will not be left alone with it in the parking lot. There is a path, there are decisions in an order, and the first one is never the one people dread. You will not have to work it out on your own, and we walk you through it one step at a time.
In cats
Cats get fewer skin lumps than dogs do. That is less good news than it sounds: of the ones they do get, a larger share turn out to be serious than in dogs. A lump on a cat deserves at least as much attention as a lump on a dog, not less.
A lump where an injection was given
Plainly: in a cat, a firm lump that appears where a vaccine or an injectable medication was given gets examined, not watched. It is rare. That rarity is exactly why injection sites are recorded in the file. And this has to be said the right way round, because the sentence can frighten people in the wrong direction: it is not a reason to skip vaccinating your cat. The diseases we are protecting against are far more common than this, and they treat far worse. It is a reason to look, and to call us when you find something. Which vaccines your cat needs depends on their life and whether they go outside, and that conversation goes very well at an appointment.
A lump on the milk line
In a female cat, a small bead under the skin along the line of the nipples, from chest to groin, is a finding to take seriously every single time. Unlike in female dogs, most of these masses in cats are not the ordinary kind. They are usually found by accident while petting, they are small, they do not bother the cat at all, and that is exactly what makes people put them off. Do not put it off. It applies to male cats too, more rarely.
Mast cell tumors happen in cats too
In cats it is most often a single firm lump, sometimes hairless, and often on the head or the neck. There can be more than one, but one is enough: do not wait to find a second before you call. As in dogs, they are not to be handled, and cytology usually recognizes them well.
The bite abscess
In a cat who goes outside, a hot, painful lump that grows quickly a few days after a scrap is often an abscess. You may have noticed that this picture appears higher up, among the signs that mean leaving now. That is deliberate. A cat running a fever who has stopped eating does not hold until tomorrow. And it bears repeating: it does not get opened at home, not even when you are certain what it is.
In dogs
Dogs tend to grow several lumps over a lifetime. That is precisely what creates this page's trap.
The dog who already has three
He already has fatty lumps, your vet has checked them, everybody knows them, they have names in the house. So when a fourth turns up, it joins the same mental file and nobody calls. Except that each of the first three was identified separately, one at a time, and none of them tells you anything at all about the fourth. "He gets lipomas" is a true sentence about your dog. It is not a sentence about this lump. That is why we ask you to number them and photograph them: because a year from now, neither you nor we will remember which was which.
The great imitator
The mast cell tumor is the reason this page needs to exist. It can look like a pimple, a cyst, a lipoma. It can sit there unchanged for a long time. It can swell and shrink from one day to the next, which gives the comforting impression that it is going away. And it is the one the hands-off rule was written for.
The places nobody thinks to look
Between the toes, on the lips, along an eyelid, around the anus, under the tail, inside a skin fold. A dog who licks one paw constantly, who scoots, or who has had one weepy eye for weeks may have a lump rather than a habit. Look, without touching, and tell us.
A lump that seems to be part of the leg
If the swelling is hard, does not roll under the skin because it feels continuous with the bone, and the same leg is lame, this is not a lump under the skin and it does not follow the same path. In a large-breed dog, that gets looked at without delay.
Lumps that are not under the skin
You came here for something you felt under your fingers. Three other places produce exactly the same worry, and a fourth produces no lump at all.
Lymph nodes
They sit under the jaw, in front of the shoulders, in the armpits, in the groin and behind the knees. In a healthy pet you can barely feel them. An enlarged node feels exactly like a lump under the skin, and this has to be said: it does not mean cancer. Nodes also swell for infection and inflammation, sometimes from something close by, in a tooth or an ear. But several nodes enlarged at once, in a pet who does not look particularly unwell, is a classic presentation of lymphoma in dogs. In cats it is less common, which does not make the finding any less serious: it gets looked at just the same. In both species, a lymph node is one of the easiest things to aspirate.
In the mouth
A mass on the gum, a tooth that looks pushed out of line, drooling, blood in the water bowl, chewing on one side, breath that changed suddenly. Oral masses are one reason it is worth looking inside your pet's mouth now and then, and toothbrushing remains the best observation post in the house.
In the abdomen
Some masses cannot be felt from outside at all. They are found by a veterinarian's hands during an exam, or on imaging. It is the least dramatic and one of the most useful reasons to have a pet who seems well examined anyway.
And where there is no lump at all
Let us follow this page's logic all the way: some cancers produce nothing you can touch. A bladder tumor, for instance, looks for months like a urinary infection that keeps coming back and responds poorly. If your pet keeps having urinary infections, a lump is not the thing to go looking for.
Frequently asked questions
Question 1 is the one you are afraid to type. Question 8 is the one people do not dare ask.
Is it cancer?
Could the needle spread the cancer?
It has gotten smaller since yesterday. Can I cancel the appointment?
My dog already has several confirmed lipomas. Does this one really need checking too?
Can I send you a photo instead of coming in?
The aspirate came back with nothing. Does that mean it is harmless?
My pet is old and I have already decided against surgery. What is the point of knowing?
I noticed it months ago and did nothing. Have I harmed my pet?
Also worth reading
The honest triage, in one paragraph
A lump cannot be sorted by eye or by touch, and a lump that has gotten smaller is not a lump that is going away. Today: two photos with a coin beside it, hands off, the date written down, a scroll through your camera roll, and a call to book an aspirate. It takes a few seconds on the exam table, and it replaces weeks of wondering.
You found a lump and you are hesitating?
Do not hesitate any longer: call, and we will sort it out together. Often one appointment is enough; your veterinarian will tell you whether the answer comes during the visit or later. If it is more pressing than that, we will tell you right away.