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My dog has a lump on the head (between the 2 ears). It has…

My dog has a lump...
My dog has a lump on the head (between the 2 ears). It has grown from pea size to 4cm in diameter over a week. Please advise.
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Customer reply replied 8 months ago
Saw a vet yesterday. He said the lump is attached to the skin and he could move it around. Does not seem to be attached to muscle or bone. As it is growing fast and has root like extension, he recommended to do a surgery to remove. He is not keen on doing fine needle aspirate as it may not be conclusive. My dog is s mini schnauzer and he is 12 years and 1 month old (have not been under GA.
Customer reply replied 8 months ago
Why is there no response?
Answered in 1 hour by:
10/15/2017
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog
Satisfied Customers: 34,273
Experience: University of California at Davis graduate veterinarian with 45 years of experience
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I odn't know of any tumors that can grow from a pea size to 4 cm in a week. Before I opened this area up I would perform a needle aspirate. "It may not be conclusive." is not an excuse for not performing an aspirate. A hematoma or hemorrhagic seroma could be filled with clotted blood and feel as this does and in those cases the tincture of time rather than surgery might suffice to normalize your dog. Please respond with further questions or concerns if you wish.

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Customer reply replied 8 months ago
Thank you. Could I check the possible causes of hematoma or seroma? The dog does not seem to feel pain when the area is being touched. What would be seen with needle aspirate if it is hematoma? To add that the dog had an episode of body imbalance (could not walk steadily and stumble) after a few cough post dinner last Tuesday. Blood tests were fine. X-ray showed narrowing of trachea (observed previously).

I noticed that the lump is on his occiput - an area of protruding skull which is often traumatized resulting in seromas or hematomas. His "imbalance" could have precipitated a fall on to his occiput. Normal blood would be aspirated if it were a hematoma. Bloody serum would be aspirated if it were a seroma with blood in it. Please continue our conversation if you wish.

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Customer reply replied 8 months ago
Hi Dr Salkin, the vet did fine needle aspiration today and the sample contained blood and white blood cells (no other cells but did not rule out if tumor causing infection or just infection). She gave amoxiclav to treat the infection first while waiting for the sample culture. And review in 10 days' time and perform another aspirate if needed. Any advice from you would be appreciated. Thanks!

It does look like an abscess. Was there any history of a bite wound or puncture of the skin?

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Customer reply replied 8 months ago
No. Not aware of bite wound or puncture of skin. What else should I check or monitor? Thanks.

A deep pyoderma - bacterial skin infection - can cause such an abscess. Such an infection would be readily apparent, however.

Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog
Satisfied Customers: 34,273
Experience: University of California at Davis graduate veterinarian with 45 years of experience
Verified
Dr. Michael Salkin and 87 other Dog Specialists are ready to help you
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Thank you for your kind accept. I appreciate it. 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.

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Hi,
I'm just following up on our conversation about your pet. How is everything going?
Dr. Michael Salkin
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Customer reply replied 8 months ago
Hi Dr Salkin,Thanks for your follow-up. The vet shared this morning that the culture result showed MRSA. She would be changing the antibiotics to fluoroquinolone (2 weeks' treatment). The lump was also oozing blood this morning. Do you have any advice on this and the treatment? The vet has not ruled out the possibility of tumor causing this.

MRS aren't inherently more virulent that susceptible staphylococci and the prognosis for MRS infections is usually good. The key is early recognition via culture to ensure that proper treatment is initiated and the risk of transmission is minimized. Thank you for the update. I appreciate your taking the time to let me know.

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Customer reply replied 8 months ago
Could you clarify what you meant by minimizing the risk of transmission and what measures should I take?
The vet said that if the infection is not cleared after fluroquinolone, surgery may be required to remove the tissue. Your thoughts?

An abscess should be lanced and debrided (devitalized tissue removed) which should hasten resolution of the infection. Opening it will also give her vet the opportunity to see if there's a tumor or foreign body causing the abscess. Because MRSA is a public health concern and animal-human transmission can occur, good general infection control practices should greatly minimize any risk. Because this isn't an open wound at this time, there's no risk to you. Once opened (and not closed again) you would need to thoroughly wash your hands with an antimicrobial soap each time after handling the area.

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Customer reply replied 8 months ago
It became an open wound this morning when blood oozed out a couple of times and onto the floor and wall. This was before the culture result was known. Need to disinfect the floor? The wound is still oozing with little blood and is wet.

Household bleach diluted 1:10 should suffice. If you want to disinfect areas you don't want bleached, a hospital supply company can sell you a disinfecting cleanser.

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