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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 24379
Experience:  University of California at Davis graduate veterinarian with 44 years of experience
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My dog Zahara has a large lump on her nose. It is on the top

Customer Question

my dog Zahara has a large lump on her nose. It is on the top of the black softish skin of her snout. It has been there a long time and was previously biopsied for cancer but came back negative. It then seemed to reduce in size. IN recent weeks it has grown very large again, larger than it was previously. It weeps fluid sometimes, clearish in colour and she avoid us touching it.
JA: I'm sorry to hear that. Some lumps are serious and some aren't. Let's see what the Veterinarian has to say. How old is Zahara?
Customer: 7 years
JA: Is there anything else the Veterinarian should be aware of about Zahara?
Customer: she has thrombocytopenia and is on azathioprine every second day
Submitted: 2 months ago.
Category: Dog Veterinary
Expert:  Dr. Michael Salkin replied 2 months ago.

You're speaking to Dr. Michael Salkin. Welcome to JustAnswer. I'm currently typing up my reply.

Expert:  Dr. Michael Salkin replied 2 months ago.

I'm sorry that your question wasn't answered in a timely manner, Belinda. Can you upload a photo(s) of Zahara's nose to our conversation? You can use the paperclip icon in the toolbar above your message box (if you can see that icon) or you can use an external app such as dropbox.com/ I need to see if this lump has arisen inside or outside her nose. Such lumps that increase in size yet then decrease only to increase once again are usually cystic (full of fluid). The fluid forms, reabsorbs, and then forms once again. Cysts can be a primary lesion or arise secondary to infections and neoplasia (cancer). Depending upon what I see, I might recommend scoping or X-raying her nose +/- advanced imaging in the form of CT.

Customer: replied 2 months ago.
Hi Michael
Thank you for your reply. My girl is sleeping right now and it's quite dark so I'll wait until the morning to get a good photo in light. As mentioned she does have an auto immune disease so it wouldn't surprise me if this lump was a side effect or consequence of something she has picked up along the way. Poor girl is always in the wars!
Expert:  Dr. Michael Salkin replied 2 months ago.

I understand. Yes, azathioprine can predispose to infections and neoplasia.

Customer: replied 2 months ago.
Here are two photos and she's on 25mg azathioprine every second day now. She'll most likely stay on this dose for the rest of her life.
Expert:  Dr. Michael Salkin replied 2 months ago.

Thank you! *****'s nose been scoped to see if that bump originates within her nasal cavity?

Customer: replied 2 months ago.
Photo 2
Expert:  Dr. Michael Salkin replied 2 months ago.

Our messages crossed...here's what I posted: "Thank you! Has Zahara's nose been scoped to see if that bump originates within her nasal cavity?"

Customer: replied 2 months ago.
Not sure what scoped is? I took her to a local vet who wasn't sure then to a derm who did a biopsy. The results came back negative for cancer.
Expert:  Dr. Michael Salkin replied 2 months ago.

She would be anesthetized and a vet would look up her nose with either a rigid or flexible scope. Here's an image of a rigid scope:

Customer: replied 2 months ago.
Mmm can't say. I would assume that when the derm anesthetized Her for the biopsy they would have done that? What are your thoughts?
Expert:  Dr. Michael Salkin replied 2 months ago.

I think that the dermatologist didn't take a deep enough biopsy. Here's what I would do:

1) Anesthetize Zahara.

2) Scope her nose. If it looks abnormal inside her nose, biopsy that which looks abnormal. If it looks normal inside her nose...

3) X-ray that area to better understand the extent of that swelling. Does it involve soft tissue only or does it involve cartilage or bone?

4) A surgeon will need to perform an excisional biopsy. In other words, the area will be opened up surgically and deep biopsies of soft tissue, cartilage, or bone will be taken.

5) You'll finally know why Zahara's nose looks like it does. Her breed is over-represented with neoplasia (cancer). I suspect a neoplastic process particularly because she's been on azathioprine chronically. The neoplasia may be benign - a hematoma (collection of blood), perhaps, because it has gone up and down in the past.

Please continue our conversation if you wish.

Customer: replied 2 months ago.
Ok thank you I at least have a clearer way forward now. It has been very frustrating speaking to so many veterinary specialists who haven't come up with any answers. I have recently found an excellent surgeon who I'll ask help from as he has successfully treated my other dog for nerve damage in his lower spine. Thank you for your guidance I really appreciate it.
Expert:  Dr. Michael Salkin replied 2 months ago.

You're quite welcome. I'm pleased to hear of this surgeon. I can't set a follow-up in this venue so please return to our conversation - even after rating - with an update at your convenience. You can bookmark this page for ease of return.

Customer: replied 2 months ago.
I will thanks
Expert:  Dr. Michael Salkin replied 2 months ago.

I appreciate it!

Expert:  Dr. Michael Salkin replied 2 months ago.
Hi Belinda,

I'm just following up on our conversation about your pet. How is everything going?

Dr. Michael Salkin