also see Cancer and tumors also see dog lumps Infiltrative lipomas in German Shepherd Question: Please

I could use some input. I have a five year old female GSP. She had hernia surgery a year and a half ago. In about seven months the bulge came back. Our vet had said at the time of her surgery that it as a very fatty mass and it as very difficult to repair. Since the time of her surgery e atch and took !"rays hich gave us no reason it ould be anything else but the return of the hernia. On #$%&' she under ent surgery again because e felt the bulge as getting bigger and e did not ant any complications. (he treatment confirmed hat this ne surgeon had said in an e!amination of )onnie before the surgery. *n infiltrative mass. (he mass originated in the inguinal region and e!tended cranial bet een the muscle bellies of the body all to the rib cage. It also e!tended medial to midline and lateral mid ay to spine. (he mass as resected along ith a portion of the body all. there is residual tumor remaining. +e also goes on to say that e feel this is an infiltrative lipoma and ill re,uire ancillary radiation therapy to prevent recurrence and treat residual disease. -y ,uestions to you is please hat ould your recommendation be. I can/t seen to find to much information of this lipoma and e ant to give her the best possible care so e can all en0oy each other for the years to come. (hank you1 Sherry )y the ay the pathologist report agreed 2id say prognosis is favorable. *ns er: Sherry" Infiltrative lipomas can be a difficult problem. In follo "up studies of dogs that have these tumors surgically removed but no other treatment 34*5-* 4uly #61 #7789 the median time until recurrence of the tumors as $:7 days. ;adiation therapy appears to e!tend this interval significantly1 but this is based on anecdotal reports only. I couldn/t find a study that supported this claim. <e have had one patient ith this condition ho e did surgery on three times before the clients finally agreed to radiation therapy1 hich orked to prevent future recurrences entirely1 as far as e could tell. (he dog lived at least eight years after the last surgery and radiation therapy. Good luck ith this. -ike ;ichards1 25- #%:%$&&# =ipomas Question: +ello1 2r. -ike1 <e have a #$ year old German Shorthair ho has numerous lipomas. *s they appear1 e have them needle biopsied by our vet and all have been benign. Currently1 he has a fist"si>ed 3and gro ing9 lipoma on his neck%chest area1 0ust belo his collar1 and another not ,uite so large at the 0uncture of his rear leg and flank. ?either are impeding his mobility at this time1 but if they get larger1 they might. +e has had large lipomas surgically removed in the past1 but given his age and the fact that these $ are here skin constantly moves hen he alks1 our vet doesn/t ant to remove them unless it really becomes a problem. ith the diagnosis of the surgeon.

Our vet says he recently heard of a treatment that involves in0ecting saline into the lipomas and thus causing them to shrink ithout surgery1 but he can/t remember here and hasn/t been able to find more info. I/ve also searched the <eb ith no luck. I ondered if this as something that you either have heard of or might kno here e could find information about. (hanks for any help. @our eb site has been very useful to us in the past1 but this is the first ,uestion I/ve had for you. Grace *ns er: Grace" I hate to disappoint you on your first ,uestion1 but I can/t find any references to treating lipomas ith saline. I can find articles on treating mast cell tumors ith deioni>ed ater1 though. (his treatment as reported in the 4uly #77& issue of the 4ournal of 5eterinary ;esearch and it as used as an ad0unct treatment to surgical removal of the tumors. It reported that dogs having both surgery and deioni>ed ater in0ections did better than dogs ith surgery alone. I am not sure if this is hat your vet is thinking of but it as all I could find. Since this is the only article I can find on this therapy1 I am assuming that follo "up studies have not been successful in supporting this treatment but that may not be true. -ike ;ichards1 25- 8%#6%$&&& Sebaceous cysts and =ipomas Question: Champ is ill be #$ in 4une +e is a black =ab and not nuetered. +e eighs in at #&A lbs. +e has al ays had enlarged nipples and sometime they have gotten crusty but no real problems. *bout : months ago a lump1 about the si>e of a ,uarter appeared. @ou could feel all around it and the vet send it as a fatty cyst and not to orry unless it changes. I checked a eek ago today 1 ith no change. On the follo ing -onday $ days later it had gro n to an oval shaped about :"8inches long and maybe $": inches across and firm. On (uesday e took him to a ne vet 3 e have relocated9 he did a tab and said it as mostly fat cells and some bacteria cells. +e said probably a sebaecious cyst. +e put him on antibiotics1 CBP+*=BCI?1 :&&&mg a day. I as also to soak in t ice a day ith arm ater. +e said if it did not go do n surgery should be done. +e has been on the antibiotics for four full days no ith no significant change. (here had been some fluid that formed in from of and behind the lump but has since been absorbed 1 at least most of it has. 2o you feel surgery is necessary at this point1 if not ho long should I give the lump to go do n1 if it even ill. Is one eek of antibiotics enough. I really ould like to avoid surgery if possible. I also give Champ #&&&mg of 5it.C and D&& iu of 5it B and A8&mg of Shark Cartilage. +e has been on this 5it. plan for about # year.

+e is eating ell and playing and acting fine in every other ay. <e do live on a mini farm and he is al ays rolling in the dirt and horse manure. 3could this have caused the infection9. *ny help you can give me ould be greatly appreciated. (hank you also for helping ith the BEmail problem. I did use the reply. I also have a 2ob%Shep ith a similar lump on her belly 3shes ##9 but it has been there for : yr. also a fatty lump 1 and you can fell around it. <hat causes them. (hank @ou =inda *ns er: =inda" I usually do not surgically remove either lipomas 3the fatty cell tumor your first vet suspected9 or sebaceous cysts. +o ever1 under some circumstances e do recommend removal of these lumps. <e remove lipomas hen they occur in a place that they cause irritation1 such as in an FarmpitF or on the sternum right here the pressure point is hen a dog is laying do n. Sometimes these ill make a nipple sensitive and they have to be removed to get the dog to stop bothering the nipple. I used to remove a lot of sebaceous cysts1 trying to avoid letting them rupture. Over the years I noticed that hen clients refused to have these removed most of them didn/t rupture and some of them resolved ithout treatment. So no I 0ust ait to see if they are going to rupture and remove them only if that happens1 or if they occur in an irritating spot similar to the ones described for the lipomas. <e see an occasional patient ho has a persistently irritated or infected nipple and e do sometimes have to remove these to resolve the problem. (hat doesn/t really sound like hat is occurring ith Champ1 though. (he other concern here is hether or not this is really 0ust a lipoma or sebaceous cyst. It isn/t really possible to be absolutely certain ithout removing the lump. I am pretty comfortable if I get a couple of consistent smears from aspiration that are supportive of a diagnosis of either lipoma or sebaceous cysts. (he problem here is that you have gotten conflicting reports and that is a little bit orrisome. I think I/d probably ant to do another aspiration from the lump to recheck the previous findings in this instance. (he description makes a lipoma seem more likely. If there is still any doubt about the lump/s nature after the third fine needle aspirate1 sending the smear from aspirate to a pathologist for revie ould be a good idea. If it does finally seem important to remove this lump1 it is often possible to do this ith a sedative and local anesthetic in an older patient. <e do this pretty fre,uently and have been able to remove even fairly large skin lumps ithout using general anesthetic. I don/t kno hat causes lipomas to form but =abradors and dobermans both seem to get a lot them1 based on our patients. -ike ;ichards1 25- :%#$%$&&& =ipomas

Q: +i: I have an D year old )lack =ab that started getting lumps all over it/s body. -ost are very close to the skin surface and feel very loose. +o ever1 some recently occurring lumps seem to be less loose. (he vet took a small biopsy ith a syringe about a year ago hen they first started occurring and determined that it as all fat tissue. <hat are these lumps. Should I be orrying about them. Is this something more common in =abs than other breeds. *: 2ogs develop fatty tumors called lipomas. =ipomas are normally diagnosed ith aspiration of the lump and this is pretty reliable. -ost fatty cell tumors are not malignant but a very small percentage of them are either locally invasive or do have metastatic potential. * very small percentage. 2ue to this1 the standard of care is usually to leave these lumps alone unless they are causing some sort of functional problem "" like gro ing in the FarmpitF region and restricting motion of a leg. I don/t kno if =abradors have a particular sensitivity to these tumors but they do get a lot of them. -ost dogs ith these tumors ill have more than one. =ipomas can be removed but the risk of anesthesia1 even though it is small1 out eighs the risk of leaving the tumor alone and most vets are reluctant to remove them do to this. +ope that helps. -ike ;ichards1 25Gatty (umors " =ipomas Q: Over the last t enty years1 e have had four lovable mutts and one persistent problem: three of them have had substantial numbers of Ffatty tumors.F Our vet has been unconcerned about these...and over the years e have never really had any reason to orry since the only problem has been one of cosmetics. Our lab1 though1 no has t o that are about the si>e of tennis balls1 and one is under her front leg...and e anticipate e/ll probably need to have them removed. <e undertook this course of action once in the past 3 ith another dog91 and I found it pretty orrisome trying to keep a big active dog restrained for three eeks hile all the stitches healed. (o make a long story short1 that dog ended up pulling all the stitches out...and I as a basket case. So here/s my ,uestion: Is there any minimally invasive techni,ue for removing%shrinking these tumors. I ouldn/t mind the e!tra cost if a vet"school or other professional could save my dog...and me...a lot of pain and 3mental9 anguish. -any thanks. *: I have often ondered if some variation of liposuction ould ork for these tumors. <e have a surgical suction machine and I have even been tempted to try it but I keep aiting for someone to rite a study on it first. I also onder if more speciali>ed suction e,uipment may be necessary. *ny ay1 I kno of no other techni,ue for removing these tumors other than surgery at this time. *ll dogs are different and it is highly likely that this dog ill leave the stitches alone. -ost dogs do. I sure hope the odds ork out for youH -ike ;ichards1 25-

(reatment -edical (herapy I -edical therapy includes endoscopic e!cision of tumors in the upper gastrointestinal tract 3ie1 esophagus1 stomach1 duodenum9 or the colon. I Colonoscopic snare removal has been described but may be associated ith perforation if

the base is broad. I 4apanese authors reported a safe techni,ue in hich a bipolar snare as used and the mucosa of the defective region as clipped.#$ Other ise1 surgical removal is indicated. Surgical (herapy Complete surgical e!cision ith the capsule is advocated to prevent local recurrence1 hether the lipoma in ,uestion is subcutaneous or intracardiac in origin. (hese lesions may be lobulated1 and it is essential that all lobules be removed. Specific therapy depends on the location of the tumor. Subcutaneous lipomas are removed for cosmetic reasons1 and hence1 a cosmetically pleasing incision should be used. (he incision is usually placed directly over the mass and is oriented to lie in a line of skin tension. =iposuction is an alternative that allo s removal of the lipoma through a very small incision1 the location of hich may be remote from the actual tumor.#:1#81#61#' (he lesion may also be approached ith advanced1 minimal"access tissue dissection methods1 using a dissecting balloon.#A (he latter $ methods allo the incision to be placed in an inconspicuous location. Gor e!ample1 a!illary incisions may be used to remove lipomas from the back. Gor more unusual locations1 the method of removal must be tailored to the site and may re,uire the e!pertise of a consultant. I =ocal removal is indicated in intestinal lipomas causing obstruction or hemorrhage. Jncertainty of diagnosis for an intramural intestinal mass also arrants resection1 because liposarcomatous disease of the bo el has been described. I If esophageal lipomas cannot be endoscopically removed1 surgical e!cision is indicated1 hether by a transhiatal or transthoracic approach. I =ipoma"related narro ing of the ma0or air ays arrants removal of the instigating mass. =ike ise1 intraparenchymal lipomas of the lung may re,uire thoracotomy and the e!pertise of a thoracic surgeon. I )reast lipomas are e!cised if their nature is in doubt1 hether by means of ire or ultrasonographic locali>ation or by means of direct palpation. I 5ulvar lipomas may be locally e!cised. I =ipomas in critical locations1 such as the heart1 may re,uire a more physiologically and technically demanding procedure for removal1 including median sternotomy ith bypass. I Intraosseous lipomas may be removed utili>ing endoscopic means in combination ith orthopedic e!pertise. ;elated e-edicine topics: )enign 5ulvar =esions =iposuction1 (echni,ues Preoperative 2etails )ecause all lipomas are radiolucent1 findings on soft"tissue radiographs can be diagnostic but are only indicated hen the diagnosis is in doubt. Intraoperative 2etails I (umors can usually be enucleated. (hey may recur if not properly removed1 and this includes removal of the capsule. I +ibernomas tend to be highly vascular. I =ipomas in other locations may present uni,ue difficulties during removalK for e!ample1 in a person presenting ith a frontalis"associated subfascial lipoma as a protruding mass on the lateral forehead1 the lipoma may be difficult to dissect because of the highly vascular muscle that

invests it. I =ipomas of the gastrointestinal tract can fre,uently be shelled out of their submucosal location. (he duodenal lipoma sho n in Images #"$ as e!cised ith a disk of overlying ulcerated mucosa. Gollo "up (he patient should consult a physician if signs of recurrence appear. Complications Subcutaneous lipomas are primarily cosmetic issues. =ipomas in other locations may cause luminal obstruction or hemorrhage. Images #"$ illustrate a duodenal lipoma that caused gastrointestinal hemorrhage and re,uired removal.

=ipoma ;egimen Summary: Jse Guture)iotics Silymarin Plus plus Bn>ymatic (herapy -ega"Lyme or ( inlab Pancreatin or Source ?aturals Pancreatin D! 3see Bn>yme (herapy for a more complete discussion of en>ymes9 and a lecithin supplement. If there are not impressive results ithin one month1 add (he <ater Cure1 (he Lone 2iet1 and (o!ic -etals *voidance. If a liver supplement other than Silymarin Plus is used1 ensure it contains as much choline1 inositol1 beet1 and silymarin. If an en>yme other than -ega"Lyme or plain pancreatin is used1 ensure it is non"acidic and contains as much lipase activity. Jse the Silymarin Plus as directed. Jse the -ega>ymes # to : ith each meal1 and # to : bet een each meal or more as desired to speed results. If there is any acid indigestion as a result 3 hich can occur hen cleaning the liver or taking en>ymes9 increase ater consumption and use fennel seeds. Jsing (he <ater Cure is a good idea from the onset of most therapies any ay. It is probably one of the best1 and certainly among the most cost effective1 methods of removing to!ins from the body. =ecithin is one of the best supplements available to break apart fatty deposits1 although en>ymes ith lipase activity actually digest the fat. =ecithin can be a valuable addition to the regimen1 especially considering it is very ine!pensive. Jsually1 large amounts of lecithin are used1 such as 8 capsules at a time. It also helps remove arterial pla,ue and fatty deposits all over the body. =ipomas are non"malignant fatty tumors that can occur in various places in the body. (hey can occur if there is a lack of en>ymes or other nutrients hich assist the digestion of fat1 or they can merely be se,uestering to!ins1 particularly to!ic metals1 if the liver/s function is impaired. Once the supplements are being taken1 and if the lipoma is close enough to the surface1 it may be helpful to stimulate the circulation in the lipoma by massaging it1 or using a ater therapy such as sitting in a 0etted bathtub or +ot and Cold <ater Immersion. ;osemary oil1 diluted ith a carrier such as castor oil and rubbed on topically once or t ice daily1 may speed results. 2o not use rosemary oil on or near mucous membranes1 but plain castor oil can be used any here and may provide some benefits by itself. (o avoid further problems1 consider using the General -aintenance ;egimen to provide ade,uate nutrients to allo the body to function more optimally1 creating its o n en>ymes1 and keeping the liver in good function. If there has not been significant progress in the reduction of lipomas ithin one month1 dietary

means are probably necessary. *ny diet hich limits carbs and allo s ade,uate protein and oils is fine. (he Lone 2iet is probably best for long term1 but *tkin/s can be used for fast results short term. Gor dogs1 note that a prey diet 3eating only hat dogs ould in the ild " meat1 fat1 no carbs9 is a ,uick and effective cure for lipomas in dogs. +ulda Clark states that some lipomas may be caused by to!ic metal accumulation1 and it is a good idea regardless to limit absorbing or ingesting to!ic metals1 so follo (o!ic -etals *voidance as ell as possible. =ipomas 3Gatty =umps9 *uthored by: )ecky =undgren1 25* lipoma is a soft1 round1 moveable lump or bump of fatty tissue under the skin. )ecause they do not cause pain1 infection1 or hair loss1 theyMre usually spotted by o ners hen petting or grooming their pets. =ipomas are common in dogs and are seen occasionally cats. =ipomas are usually harmless. (hey gro slo ly and stay in one place. (he lipomas that tend to cause problems are the ones that are large1 or that interfere ith movement. 3If the lipoma is in an area such as an armpit1 it can hamper movement or become irritated by movement.9 =ipomas occur more often in middle"aged dogs1 over eight female dogs1 and old cats1 but some younger dogs can get lipomas. 2og breeds that are more likely to have these include cocker spaniels1 dachshunds1 poodles1 and terriers. <e donMt kno hat causes lipomas1 but e do kno that cats ho have feline leukemia are a bit more likely to get lipomas than cats that do not. Once a dog or cat has had a lipoma1 it is likely to develop others. +o ever1 each ne lump should be e!amined by your veterinarian to ensure that it is a lipoma and not a malignant gro th. * fine needle aspirate 3G?*91 in hich a thin needle is used for a ,uick in"clinic microscopic look at the lumpMs cells1 should be done for each lump. * biopsy may still be necessary if the results of the G?* are e,uivocal. =ipomas can be removed surgically. +o ever1 if your petMs lipoma is only a cosmetic issue1 your veterinarian ill likely take a ait"and" atch approach. 3@our veterinarian ill check the lump on a regular basis to make sure it hasnMt changed.9 (he lipoma can be removed hen your pet is scheduled for anesthesia for another issue. +o ever1 if the lipoma interferes ith movement or is so large itMs irritating or bothering your pet1 your veterinarian ill probably recommend that the surgery be scheduled sooner rather than later. Infiltrative =ipomas Occasionally1 some lipomas ill NinvadeO the surrounding tissues1 such as muscles and bones1 and cause functional compromise 3depending on the anatomic location9. (hese are called infiltrative lipomas. (hey are more common in the e!tremities 3limbs91 but other sites have been reported 3including the thoracic and abdominal body alls1 the head1 and the perianal regions9. (hough infiltrative lipomas are locally invasive and more difficult to control than standard lipomas1 they do not metastasi>e 3spread9 to other areas of the body. (reatment1 ideally follo ing advanced imaging 3e.g.1 C( scan91 includes surgery or surgery plus radiation therapy. (he use of radiation therapy improves long"term local control in cases of incomplete resection 3removal9. 3If the infiltrative lipoma is not completely removed1 it ill regro in over 6&P of the patients.9 Chemotherapy is of no use ith infiltrative lipomas. =iposarcomas

=iposarcomas are uncommon malignant tumors of fatty tissue. (hey behave like other soft"tissue sarcomas1 and are locally invasive in the surrounding tissues. (hey can affect any area of the body1 and are not necessarily the progression of a previously benign lipoma. <ith biopsy and histopathology 3analysis of the tumor tissues under microscope91 the grade of the tumor can be determined. <ith lo " or intermediate"grade liposarcomas1 the risk of dissemination 3spread9 to other parts of the body is lo 1 less than $&P. <ith high"grade liposarcomas1 the risk is much greater. (he main method of treatment is surgical resection. (his is sometimes follo ed by radiation therapy to improve local control and to decrease the risk of recurrence. Chemotherapy is occasionally used on high"grade liposarcomas. 2ate Published: 8%:&%$&&A 7:8#:&& *2ate ;evie ed%;evised: &#%&$%$&&D * lipoma is a benign tumor composed of fatty tissue and occurs in about #P of the general population1 usually being found in adults from 8& to '& years of age. (hey are soft to the touch1 movable1 and usually do not cause pain. <hile they can be found any here there is fat1 they are most common in the forearms1 trunk1 and thighs. (hey generally are small 3less than one centimeter9 but can be ,uite large as isolated masses. *s a plastic surgeon1 I have seen many lipomas and the standard treatment is to e!cise them. 3cut them out9 <hile small ones /pop/ out ,uite easily1 large ones do not do so and re,uire a more substantial incision and resultant scar to remove. Plus1 large ones ill need a drain after surgery as they tend to develop fluid collections. 3seromas9 Given that they are benign tumors composed of dense fatty tissue1 it is reasonable to consider the use of =ipo2issolve in0ections as a method of non"surgical treatment. =ipo2issolve is ell chronicled as a cosmetic treatment for un anted small collections of fat. <hile lipomas a bit more dense1 they should still respond to the in0ection therapy. =ipodissolve solutions are usually a mi!ture of phosphatidycholine and deo!ycholic acid 3PC2C9 that orks to break do n the fat cell alls1 causing release and resorption of the released fat. Over the past three years1 I have treated A adult patients 36 female1 $ males9 that had fairly large lipomas 3bet een 8 and #' cms91 mainly on the back and shoulders. (hey did not ant surgery nor did they ant scars1 particularly on or around the shoulder areas. *ll responded to an in0ection series in obtaining significant shrinkage of the lipoma. In some cases1 it as clear that there as either residual lipoma or scar left hich felt like nodules. (he average number of in0ection treatments as ' 38 to 79 to get the lipoma to the point that the patient did not ant any further treatment. <hile some patients are more than one year after treatment1 it is too early to say hether any lipoma recurrence may develop. =ipo2issolve in0ections do ork in both small and large lipomas in my e!perience. +o ever1 the patient must accept that it is not a fast process and may take up to ' months ith numerous in0ection sessions to get the best result in larger lipomas. Bach in0ection session is associated ith s elling and some pain that lasts about one eek after the in0ection session. It is likely that lipomas may respond faster ith combination therapy such ultrasound and in0ections. Or one can treat them ith liposuction and use =ipodissolve in0ections to treat any residual tumor. 2r )arry Bppley is a board"certified plastic surgeon in private practice in Indianapolis1 Indiana at Clarian +ealth Systems. 3http:%% .eppleyplasticsurgery.com9 +e rites a daily blog on plastic surgery1 spa therapies1 and medical skin care at http:%% .e!ploreplasticsurgery.com *rticle Source: http:%%B>ine*rticles.com%.e!pertE2rQ)arryQBppley

Cosmetic Cure Of =ipoma

Posted on: <ed1 #6 *pr $&&71 ##:6# *-

* lipoma is a slo "gro ing1 fatty tumor situated bet een your skin and the underlying muscle layer. Often a lipoma is easy to identify because it moves readily ith slight finger pressure. It/s doughy to touch and usually not tender. @ou could have several that persist for years. =ipomas can occur at any age1 but they/re most often detected in middle age.

(he cause of lipomas is not completely understood1 but the tendency to develop them is inherited. * minor in0ury may trigger the gro th.

Symptoms of a lipoma

B!cept s elling or mass hich causes cosmetic disfigurement1 no other symptoms are usually seen. I *re small R&.8 in. to #.$ in.S and felt 0ust under the skin. I *re movable and have a soft1 rubbery consistency. I 2o not cause pain.

+omeopathic *pproach on lipoma

=ipoma is a cosmetic illness. 2oes surgical e!cision cure the condition. ?o.

So1 never go for surgical options to get it removed. Jsually surgical removal causes it to spread to other places for unkno n reasons. So surgeons never assure non"recurrence in the same or other places.

Some people think that the lipoma is due to e!cess fat content of the body or obesity and so they keep on doing e!ercise and diet restriction to reduce eight. Bven after reducing eight considerably1 there onMt be any change in the lipoma.

Bven though nobody thinks of +omeopathy for lipoma1 considering it as a pure surgical disorder1 +omeopathy can treat lipoma.

+omeopathy treatment can also surely arrest ne lipoma formation. *lso there ill be reduction in si>e of the lipomas to residuals i.e.1 s elling gets softened and flattened1 so that visibility can be reduced and then vanish. )etter results can be attained if treatment is started earlier. If it is in initial stages1 it ill disappear completely. +omeopathy treatment can abort this tendency by improving the immune system.