Tests and Monitoring in Canine HCC: What to Expect

Core Bloodwork That May Be Used in Monitoring Canine HCC

Complete Blood Count (CBC)

A complete blood count (CBC) is a commonly used blood test that evaluates red blood cells, white blood cells, and platelets. It can help identify conditions such as anemia, inflammation, or infection by measuring changes in these blood cell populations, providing valuable information about overall health and possible underlying issues.^{Barnes et al.}

A CBC is frequently part of routine monitoring because changes in blood cell counts can signal a wide range of health concerns that may warrant further investigation. It is often one of the first tests performed during the diagnostic process and remains a useful tool throughout the course of care for dogs with suspected or confirmed HCC.

CBCs may be repeated over time to establish baselines and observe changes, rather than to drive decisions based on a single result.

Serum Chemistry Panels

Serum chemistry panels, also called blood chemistry panels, are another cornerstone of both routine wellness care and ongoing monitoring.

These panels typically include liver enzymes, kidney values, electrolytes, and other markers of metabolic function.^{DiVita and Singler}

In dogs with HCC, chemistry panels may be used to track liver-related trends, assess overall organ function, and support decision-making as care evolves.

Imaging and Monitoring Over Time

Ultrasound

Ultrasound may be the initial diagnostic tool that reveals liver tumors, but it's important to keep in mind that imaging alone cannot determine whether a mass is benign or malignant, or identify the specific tumor type. Even when malignancy is suspected, ultrasound cannot reliably distinguish HCC from other cancers.

Repeat imaging is commonly used to observe changes, such as tumor progression, over time. Frequency varies and is influenced by stability, symptoms, and overall care goals.

Biopsy and Cytology

Fine-Needle Aspiration (FNA)

Fine-needle aspiration is less invasive than surgical biopsy but may not provide a definitive diagnosis.

Surgical Biopsy

Surgical biopsy can provide more tissue for analysis, but results may still be inconclusive. In some cases, care decisions are made based on the most likely diagnosis rather than absolute confirmation.

Kidney Monitoring: Urinalysis, UPC Testing, Blood Pressure, and SDMA

While HCC affects the liver, longer-term care may sometimes bring attention to other systems, including kidney health.

Urine testing may be introduced as part of this broader monitoring, even when cancer is located in the liver. In many cases, urinalysis is part of routine wellness care or periodic screening, and findings such as proteinuria may be identified incidentally rather than through targeted investigation.

If signs of early kidney changes or protein loss in the urine emerge over time, particularly with increased monitoring or as dogs age, additional assessments may be used to better understand kidney health and systemic effects. These may include urine protein-to-creatinine (UPC) measurements, blood pressure monitoring, and, in some cases, blood-based kidney markers such as SDMA. Together, these tests can help provide a more complete picture of kidney function over time and support thoughtful, whole-dog care alongside liver-focused monitoring.

Monitoring During Treatment or Supportive Care

Monitoring approaches may differ depending on whether chemotherapy, targeted therapies, immunotherapy, or comfort-focused care is part of the plan.

Across care paths, testing is generally used to support quality of life, identify side effects, and guide thoughtful adjustments.

When Longer Survival Changes What Needs Monitoring

Some tests that are not considered standard at the time of an HCC diagnosis may become relevant later, particularly when tumor progression is slow and a dog lives longer than initially expected.

As time passes, other health considerations may come into focus simply because the dog is living longer. Kidney disease, proteinuria, or metabolic changes may be identified over time, prompting additional monitoring.

In these situations, testing expands not because the cancer has worsened, but because care has shifted toward long-term, whole-dog support rather than short-term disease management.

Integrative Assessments

In some integrative care contexts, caregivers may choose to explore additional, noninvasive assessments as part of supportive care. These tests are not considered standard oncology care and may be performed through third-party services rather than veterinary clinics.

Because these assessments are exploratory, results are best used to inform discussion rather than guide decisions independently. Caregivers may review findings with their veterinary team, including an oncologist, to determine whether any supportive changes are appropriate or safe.

In this way, testing can offer insights and ideas while medical decisions remain grounded in veterinary oversight.

Making Sense of Ongoing Testing

Testing is meant to support care. It is always appropriate to ask what a test is intended to assess, how results will be used, and whether repeat testing is necessary.

As circumstances change, monitoring strategies may change as well. Thoughtful preparation and open communication can help ensure testing remains aligned with care goals and quality of life.

For additional context, you may find it helpful to explore our pages on Preparing for HCC Appointments, Understanding Canine HCC, and the Canine HCC Glossary. Relevant research is available on our Studies and Articles page.