epidermal inclusion cyst

My friend Jen's dog has been diagnosed with a epidermal inclusion cyst.
They want to do surgery and she's worried about this. She said she just noticed another one on her elbow. Both of these areas are where she tends to obsessively licks a lot.
They also said she had a high white blood count. Gave her anti-biotics and an anti-depressant to make her stop her constant licking.
But the websites we saw report these as non-cancerous cysts. But the vet said he wouldn't know if it was cancerous or not until they remove it.
The vet said if it burst then if it was cancerous it could spread.

Should she go for a second opinion??
Respond to this topic here on forum.oes.org  
I don't know specifically about this problem but I suppose the bigger question is, how much does she trust her vet? Do they have a good relationship and a good track record of her making good diagnoses in the past? Is there something, other than internet research making her uncomfortable with the dog having surgery? If she obsessively licks those areas a lot and they are a problem for her, even if they are non-cancerous, maybe they're making her uncomfortable.
Did the vet do a needle biopsy on them, that can be done before considering surgery to see if they are dangerous ones or not and if they really do need to be removed or just left.

Kelsey gets Fluid Filled cysts on her, due to her old age now and the vet always does a needle biopsy on them firstly to see. All so far are OK and they don't have to be removed and have her go through the risk of surgery.

I'd get a 2nd opinion. Most lumps and bumps can be assessed by the needle to ascertain if they are cancerous or not.
Hmmm, I suspect Jack has one on his toe as he licks it every night. Now I'm thinking he should have that taken off.

There's just no way of knowing if they are cysts or tumors. I suspect most often they are cysts......that's what my dog's have always been. If they were cancer would you leave them? Of course not. If it makes her feel better, get a second opinion. I don't know if they can aspirate a cyst to determine it's content or would that cause it it rupture. Rupture would be bad.
Other than the internet research and the fact of having to put her dog under sedation... Jen is a bit superstitious. It is currently Mercury Retrograde and for her it's usually a bad time. So she would like to at least hold off the surgery for until retrograde is over.
She's had these cyst for while and they haven't burst yet. Most of the websites don't even talk about treating these cysts until they burst. So she was hoping she could hold off on the surgery until at least March 7th.
I said I would be a worried about the white blood count being high.
I did tell her she should call another Vet and ask their opinion.
Just hoping someone one here had some experience with these cyst and could give a little more info too.
Thanks Lisa and Susan I was typing my reply to Jill when you posted.
Yes, she did have a needle biopsy, but told her they wouldn't get results unless the removed the actual cyst and send it in for biopsy.
They should get some results from a needle biopsy or else why else do a needle biopsy? Removal and biopsy of the tissue will give more complete results, yes, but there should be some preliminary results: fluid filled, normal cells, abnormal cells, etc.

High white blood count can be indicative of infection of some sort.

Cysts can be fluid filled and harmless, can contain bacteria (and spread infection) or could be cancerous.

My first dog, Merlin, had a cyst on his front ankle that was biopsied every year for several years via needle biopsy. They never found any abnormal cells until he was 12 years old and my husband called me at work because he came home and Merlin had chewed the lump and it was bleeding badly. I sent him off to the vet and the cyst had become cancerous--or had always been cancerous and the needle biopsy had missed the bad cells . The tumor was removed twice--I would not have done it a third time, nor would the vet because it was so close to tendons, and because of his age.

I understand her worries about sedation. I was worried at having Merlin put under at his age, too. My vet requires extra labs to make sure that the dog is healthy enough (aside from the need for surgery) to withstand anesthesia, but Merlin did fine. It is something to discuss with this vet--or another vet if she feels unsure. Also if the cysts are growing or are staying the same size can indicate how urgent it is to have the cyst removed. How long does the retrograde last? I'm not up on my astronomy.
If I am getting this right the needle biopsy showed the high white blood cell count.

Retrograde ends on March 7th. I don't follow astrology myself, but Jen always lets me know when we are in one. Things do seem a little bit crazier than usual in the retrograde periods.

Here is some info on Mercury Retrograde if anyone is interested.
http://astrology.about.com/od/predictiv ... yretro.htm
If the needle biopsy showed a lot of white blood cells, that means it's infected--which doesn't mean that there are no cancer cells. But if a blood sample showed elevated white blood cells, it means there's infection somewhere in the animal.

If it's infected, it might not be a good idea to wait. If the dog is leaving it alone, and she's that nervous, she should ask if it can wait 3 weeks. Personally, I'd either trust the vet or find one I did trust.
I think if the vet wants to remove it there must be a good reason, because I find most vets tend to take a let's watch it approach.

I am highly against keeping any growth that you weren't born with. Our experience of cysts and tumors on Hannah are they only get larger over time and cause a lot of problems.

I would be concerned about the high white blood cell count. I would ask about the risk of pancreatitus and what a high count could mean. And get a second opinion if she can afford it. About how quickly it has to happen if she's stressed about Mercury Retrograde.
Thank you all for your prompt response regarding Star and I have taken it all into consideration. I guess I am just pretty stressed about it since it is the first time I ever had to deal with anything like this before. Star is a 3 year old Shepard/Retriever mix. She tends to like alot and I originally had thought this was just a scab. Finally took her in to be sure and they did pull some fluid from the cyst and said the white blood counts were high and that if these rumpture, they can be very serious. I guess, the worried Mom I am, I am just going to go ahead and go with the surgery to be safe..I wouldn't want something to happen to her. Thanks again for all your responses
More info....I actually just talked to the doctor at my vet and she stated that it is not that necessary to do the surgery right away. The pathologist did suggest surgery and that is why she had said that. So, I went ahead and cancelled. The previous doctor had noted that it looks like a lick lesion and so I just need to try to keep her from licking. Anyone know of some good non-lick medicine?
Jen, Have you tried bitter apple?
Your dog may have non inhalent allergies. You can usually give them a 1/2 a Claritin a day and/or fatty acid caps at your Vet. There is also a new medication, though pricey, that may be able to treat as well (ask the vet). Just came back from my vet - my baby, Radu, had a cyst that ruptured due to his licking. Thankfully it was just a cyst and received antibiotics but it could get infected again if he keeps licking his toes. He is a constant toe licker
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