Abstract / Summary
Abstract Background Cutaneous and subcutaneous masses are common in dogs and cats, and early diagnosis via fine needle aspiration (FNA) or biopsy is critical for guiding treatment and improving outcomes. Although guidelines recommend evaluating persistent masses ≥ 1 cm, the extent to which these practices are followed in veterinary clinics remains unclear. Objectives This study evaluated FNA use for dermal and subcutaneous masses and identified barriers affecting diagnostic decision-making in small-animal veterinary practices. Methods A 16-question survey was emailed to 10,000 small-animal veterinary professionals in the United States, including veterinarians, technicians, and practice managers. Questions addressed demographics, clinic characteristics, frequency of FNA, cytology evaluation, biopsy use, and reasons for not performing FNA. Data were analyzed to assess associations between clinic size, digital cytology use, and diagnostic practices. Results A total of 240 respondents completed the survey. Only 29% reported performing FNA on more than 50% of the examined dermal or subcutaneous masses. The mean percentage of FNAs performed was 39%. Clinicians with a high daily caseload of over 4 patients with dermal or subcutaneous masses were significantly less likely to perform an FNA than those seeing under 4 patients a day ( p -value 0.043). Digital cytology was used by 35% of clinics and was significantly correlated with decreased overall FNA utilization and in-house FNA evaluation ( p -value 0.03 and p -value < 0.01, respectively). The primary barriers to performing FNA were the perception that masses were benign (35%), cost concerns (32%), and client declination (19%). Notably, a substantial proportion of excisional biopsies were performed without prior FNA (mean 30%), potentially reducing diagnostic accuracy and complicating surgical planning. Conclusions FNA appears to be underutilized in veterinary practice, particularly in high-volume settings, representing a missed opportunity for early diagnostic evaluation of cutaneous and subcutaneous masses. Increased integration of FNA into routine workflows, along with targeted training for veterinary students and clinicians, may improve diagnostic decision-making and patient care.