Angel is a 14-plus-year-old feline sharing her life with her caretaker, Stefanie. Some time ago Stefanie found a small, dark and soft mass on the top of Angel's head and about six months ago it grew quite visibly to about the size of a quarter at its base and three-quarters of an inch high. It is now pink in color, soft and, as Stefanie puts it, squishy. She wants to know whether or not she should be concerned.

The simple answer is yes. At this point, we do not know what type of mass is growing on Angel's head or if it could be cancerous. The fact that it has changed character and appears to be growing is concerning.

Angel needs surgery to have the mass removed. This will require an anesthesia, but from Stefanie's description, it does not sound like it will be a major procedure. Still, Angel is 14 years old and needs to be treated differently from a 2-year-old when preparing for an anesthetic procedure and the procedure itself.

On older patients I like to check body functions first. This is tailored to each individual but usually includes blood work and testing to check for proper heart function. This more accurately assesses anesthetic risk, which then allows us to make adjustments as necessary. All patients need to be assessed for risk. Just because everything appears normal does not mean there is not some underlying problem.

After surgical removal of Angel's tumor, a biopsy will be performed on the mass. With this information, we can give a prognosis.

One important component of Angel's surgery is pain management. It is very important to control pain to further good healing. Proper pain control is based on an assessment of the likely level of pain that a particular procedure might induce. In Angel's case, medication likely will be needed before the procedure, followed with medication after and an oral preparation to be given for a few days at home.

Dr. Jeff Kahler is a veterinarian in Modesto, Calif.