Sebaceous cyst on 16 year old dog

Question
QUESTION: I have a 16+ year old border collie. Last summer she was put on Rimadyl for arthritis, and a fairly large mass on her rump was diagnosed as a sebaceous cyst. The vet informed me that the cyst could not be removed due to her age. She cannot be placed under anesthetic.
About 6 weeks ago, the cyst started oozing. Since then, I believe that all the inner stuff has been pretty much removed from within the cyst, however the cyst bag is still there, forming a lump about the size of a golf ball. Now the entire thing is like filling with liquid. It bursts regularly, and I have been trying to help keep some of the liquid drained to reduce pressure. With her arthritis and the location of the cyst, she cannot reach it to tend it at all. I have been cleaning it with peroxide, and try to keep a nitrofurazone salve on it.

My questions are these:
1. Is it at all possible to find a vet that may lance it with just a local anesthetic? She allows me to do anything I want with it, and most the time just lays there and sleeps. I could not do it myself.
2. As this cyst fills with liquid, it causes different weekspots in the top of it, so each new burst is from new location. Am I doing more harm than good by trying to keep the liquid removed to reduce the pressure? I am not sure if I should keep doing what I am doing, or just let it go and hope that it will burst a large enough area that I can physically remove the cyst bag. I just can't imagine the pain that will cause her though.

Any help or recommendations on how I can help her will be appreciated. She was rescued from a puppy mill, and spent the first 5 years of her life locked in a kennel. She goes totally crazy when locked in a kennel, or if I leave her at all. An overnight stay at the vet is not an option for her.

Thank you for ANY suggestions or information that can be shared!

ANSWER: Hi Patsy,

The good thing is Sebaceous cysts are benign. They're pretty common in dogs. Removal of your dog's cyst would just be cosmetic surgery. I would agree with your vet, it doesn't warrant removal on a 16 year old dog if it isn't causing discomfort or interfering with either movement or laying down.

Whether your dog's cyst ruptures spontaneously on it's own, or if you drain it, you should keep the area clean with an antiseptic rinse such as Betadine, after the skin has been broken.

Sometimes, draining these kind of cysts cause scar tissue, which can make the cyst seem larger, or the skin to become thicker.
Have you asked your vet about draining the cyst with a fine needle aspiration from time to time? That could be a non-surgical way of dealing with it. It's not odd or uncommon that the cyst refills with fluid, so draining the cyst could just be a part of your dog's yearly exam.

Depending on the size of your dog's cyst, it could be removed under a local anesthetic. Talk this possibility over with your vet. You can certainly have another vet examine your dog, if your current vet doesn't think removal of the cyst under local anesthetic is a good idea. A second opinion might make you more at ease with the choices you have.
If the cyst is really big your dog would need a more extensive incision.  That's when general anesthesia would be necessary.

I hope I've been a help.
Best of luck,
Patti



---------- FOLLOW-UP ----------

QUESTION: Patti,
The actual cyst started out to be about 3 1/2 inches in diameter. After it ruptured the first time, and I worked the stuff out of it, it was a knot about the size of a golf ball. I assume this is the actual cyst bag.

Now I think that a large portion of the liquid that is forming is actually around the cyst bag, and not so much inside it. On average, I would estimate that I am currently removing about 1/8 cup of liquid from it every day! It just squirts out like a squirt gun until it opens up a little, then the stuff will flow like a river.
The golf ball size knot never changes, but the area around that is rupturing in multiple places. There are an average of 6-7 open rupture areas at any given time, but they heal quickly, and then the next weak spot will rupture. She has gotten to where she will purposely lay almost on the wall or couch or whatever is close, in order to cause pressure on it to help it rupture.
In your opinion, will this ever rupture enough that I will actually be able to remove the cyst bag, or will it just keep doing this forever? I know that it has to be painful, especially being up on her back, just above her hind leg.
She cannot live with this forever, and general anesthesia is not an option.
I am seeking a second  opinion, however, finding a vet that would both do the procedure with a local, AND allowing her to come home the same day is very hard. I live in a very small, rural county and we have limited access to options.
:(

Any additional information or suggestions on how to deal with this will be much appreciated.

Thank you again for your time and patience with me!!

Patsy


Answer
Hi Patsy,

You've got one smart dog if she purposely is causing her cyst to drain!

I would not recommend attempting to remove the hard center of the cyst. That would be a real surgical procedure, and it's far from anything I could advise on. No offence intended, but if you're doing this yourself without any experience, you probably won't have much luck removing it properly. Draining it is the best bet.

These kind of cysts usually aren't painful.

As long as you're able to drain the cyst, and keep it at a manageable size, that might be the best solution to the problem. Also, by draining the cyst daily there's a chance it will heal from the inside out, and the hard center might go away or shrink, in time.

You can try applying warm, wet washcloths to the cyst for 20 to 30 minutes, 2-3 times a day. If you prefer, you can also use a hot water bottle or heating pad over a damp towel. The heat and moisture can soothe the lump, increase blood circulation to the area, and speed healing.
I suggest you talk over the daily draining with your vet, as he or she might have some helpful suggestions.

For a long while one of my dogs had such a cyst, only it was located in his "armpit" area. He's also elderly, so I didn't want to opt for the surgery. It got quite large and burst spontaneously one day. I helped it drain daily, as you're doing. There is still the hard center (about the size of a quarter) but it does seem to be staying at the greatly reduced size. I can live with that. You need to weigh your options.

Just keep in mind that this isn't going to kill your dog, and it's not painful to your dog. It really is just cosmetic.

Best of luck,
Patti