QUARTERLY BEAT / DECEMBER 2025
ONCOLOGY DIAGNOSTICS FOR THE PRIMARY CARE VETERINARIAN:
FOR REFERRAL
HOW TO PREPARE YOUR PATIENT
Curious how you can best support your cancer patients before referral? In this Drs. Christine Mullin, DACVIM (Oncology) and Craig Clifford, DACVIM (Oncology), share practical ways primary care veterinarians can take a proactive role in oncology diagnostics. From staging and immunophenotyping lymphoma to incorporating innovative, noninvasive screening tools, learn how everyday diagnostics can streamline care, reduce costs, and enhance collaboration with your local oncologist. 4. Abdominal: Not required for all tumors, but can be informative for lymphoma patients that are clinically ill (particularly with gastrointestinal signs), dogs with abnormal serum chemistry screens (i.e., liver enzymopathy, azotemia), and dogs with notoriously metastatic tumors on the caudal half of the body (i.e., anal gland tumors, large swollen mast cell tumor on a hind limb, etc.). Ideally this test is performed by a board-certified radiologist or internal medicine specialist with ultrasound experience, or by a veterinarian or technician with thorough training in ultrasonography that can send the images for evaluation by a radiologist.
Christine Mullin, VMD, DACVIM (Oncology) Craig A. Clifford, DVM, MS, DACVIM (Oncology) BluePearl Malvern, Malvern, PA
INTRODUCTION The average cost for a routine veterinary visit in the United States can range from $70 to $174 for dogs and $53 to $124 for cats. 1 The financial burden can increase exponentially for a sick visit, particularly when a cancer is discovered or suspected. A considerable portion of the expense incurred by an owner of a veterinary cancer patient lies in the diagnostic workup, much of which is traditionally performed at referral institutions. In order to free up client financial resources and potentially increase client access to specialty oncology care, the primary care veterinarian could play a more significant role in the diagnostic workup of these patients. Below, we outline some of the diagnostic tools available in everyday practice that can help streamline oncology care for our veterinary patients, all while promoting a more active and ongoing role of the primary care vet in that patient’s cancer journey. GENERAL CANCER PATIENT WORKUP Upon diagnosis or suspicion of a cancer, a few basic tests could be performed in primary care practice to not only expedite the staging process but also provide general insight into that pet’s overall health. Whether evaluating a patient confirmed or suspected to have a systemic cancer, like lymphoma, or one that has been diagnosed with a solid tumor that will ultimately require surgery, such as a mast cell tumor, soft tissue/bone sarcoma, or an oral tumor, the following tests are typically recommended as part of the workup when indicated.
1. Basic lab work: Complete blood count (CBC), serum chemistry, urinalysis (when indicated). 2. Pulmonary metastasis screening: Three-view thoracic radiographs with review and official report provided by board certified radiologist or AI radiology service. 3. Regional lymph node sampling: For oral tumors and solid tumors on a limb, fine needle aspirate cytology should be performed and submitted to a reference lab to screen for metastasis. This result can significantly impact treatment approach and prognosis.
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