Owner
Veterinarian
Surgical Oncology Under Real-World Constraints
"Buddy"
Start
The “Remove It Today” Mast Cell Tumour
Buddy is a 7-year-old neutered male Labrador Retriever. He has a 2 cm raised, erythematous cutaneous mass on the distal forelimb, close to the carpus. The owner reports it has changed in size over the last week and seems occasionally itchy.
They have a fixed budget and are anxious about referral. You are concerned about the location, the ability to achieve appropriate margins, and the risk of an unplanned excision.
Fine needle aspiration performed today is consistent with a mast cell tumour, the owner is leaving the country tomorrow, they insist on immediate surgical removal to avoid “losing time to cancer.”
Next
Veterinarian
Clinical objections
Next
Veterinarian
A colleague says, “It’s confirmed on cytology, so just take it off now.”
Discuss your differentials and how confident you are in committing to mast cell tumour as the working diagnosis, including what might still surprise you and why that matters for planning.
Veterinarian
Outline a stepwise plan for today
From what must be clarified before surgery to initial management and surgical intent, including proportionate staging and imaging and perioperative risks specific to suspected mast cell disease.
Veterinarian
A colleague argues that not operating today means doing nothing.
Explain what active management looks like when you defer excision and how you would keep the patient safe while planning next steps.
Veterinarian
Describe the escalation triggers
Or stop rules that would lead you to postpone surgery, change surgical intent, or recommend referral, including how you would respond if oncologically appropriate margins cannot be achieved at this anatomical site.
Owner
What would you do if it were your pet?
Next
Owner
Empathy
Start with an empathy statement that acknowledges the owner’s urgency and fear, without endorsing a rushed plan.
Owner
Explain what the needle sample has achieved today
And what it has not achieved, using plain language. Clarify why the location of the mass affects what a “good surgery” looks like.
Owner
Offer options that match different levels of urgency and budget.
Include a pathway that prioritises safe planning before surgery, and a pathway that proceeds more quickly but clearly explains what is being traded off and why that may reduce the chance of a clean first surgery.
Owner
If it were your pet?
Answer: “What would you do if it were your pet?” in a way that is honest about uncertainty and focused on outcomes you can defend, without promising cure or using absolutes.
Well done
You successfully completed the challenge and addressed all of our questions, both from a professional perspective and as a pet owner
STS_M3_CDSC_01_The “Remove It Today” Mast Cell Tumour
Improve International
Created on December 23, 2025
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Transcript
Owner
Veterinarian
Surgical Oncology Under Real-World Constraints
"Buddy"
Start
The “Remove It Today” Mast Cell Tumour
Buddy is a 7-year-old neutered male Labrador Retriever. He has a 2 cm raised, erythematous cutaneous mass on the distal forelimb, close to the carpus. The owner reports it has changed in size over the last week and seems occasionally itchy.
They have a fixed budget and are anxious about referral. You are concerned about the location, the ability to achieve appropriate margins, and the risk of an unplanned excision.
Fine needle aspiration performed today is consistent with a mast cell tumour, the owner is leaving the country tomorrow, they insist on immediate surgical removal to avoid “losing time to cancer.”
Next
Veterinarian
Clinical objections
Next
Veterinarian
A colleague says, “It’s confirmed on cytology, so just take it off now.”
Discuss your differentials and how confident you are in committing to mast cell tumour as the working diagnosis, including what might still surprise you and why that matters for planning.
Veterinarian
Outline a stepwise plan for today
From what must be clarified before surgery to initial management and surgical intent, including proportionate staging and imaging and perioperative risks specific to suspected mast cell disease.
Veterinarian
A colleague argues that not operating today means doing nothing.
Explain what active management looks like when you defer excision and how you would keep the patient safe while planning next steps.
Veterinarian
Describe the escalation triggers
Or stop rules that would lead you to postpone surgery, change surgical intent, or recommend referral, including how you would respond if oncologically appropriate margins cannot be achieved at this anatomical site.
Owner
What would you do if it were your pet?
Next
Owner
Empathy
Start with an empathy statement that acknowledges the owner’s urgency and fear, without endorsing a rushed plan.
Owner
Explain what the needle sample has achieved today
And what it has not achieved, using plain language. Clarify why the location of the mass affects what a “good surgery” looks like.
Owner
Offer options that match different levels of urgency and budget.
Include a pathway that prioritises safe planning before surgery, and a pathway that proceeds more quickly but clearly explains what is being traded off and why that may reduce the chance of a clean first surgery.
Owner
If it were your pet?
Answer: “What would you do if it were your pet?” in a way that is honest about uncertainty and focused on outcomes you can defend, without promising cure or using absolutes.
Well done
You successfully completed the challenge and addressed all of our questions, both from a professional perspective and as a pet owner