Underutilization of Fine Needle Aspiration for Canine and Feline Superficial Masses- Survey Results

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 current trends in FNA use for dermal and subcutaneous masses and identified barriers affecting diagnostic decision-making in veterinary practices. Methods: A 16-question survey was emailed to 10,000 veterinary professionals, including veterinarians, technicians, and practice managers. Questions addressed demographics, clinic characteristics, frequency and methods of FNA and 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 242 respondents completed the survey. Only 29% reported performing FNA on more than 50% of masses, with a mean utilization rate of 39% (range 5–88%). High-volume clinicians (≥ 4 masses/day) were significantly less likely to perform FNA than those evaluating 1–3 masses daily (p = 0.0431). Digital cytology was used by 35% of clinics and correlated with decreased overall FNA utilization and in-house FNA evaluation. 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 biopsies were performed without prior FNA, potentially reducing diagnostic accuracy and complicating surgical planning. Conclusions: The study highlights the underutilization of FNA in veterinary practice, particularly in high-volume clinics. Time constraints, decision fatigue, and underestimation of mass significance likely contribute. Educational initiatives, workflow optimization, and strategic integration of digital cytology may improve FNA utilization, diagnostic accuracy, and patient outcomes.