vet techs thoughts on fna

I am looking for thoughts from anyone who has worked in a vet office. I know MarkInDenver is dealing with Rex's lump and the vet suggested an FNA. I have heard mixed things about how reliable these are. I am curious if any of you who have worked as techs can speak to the limitations you see. Ollie is diabetic and Mabel has kidney issues, so I am very particular about not doing unnecessary procedures, but I also do not want to miss something. I remember when I was a teacher, we always had to know the limits of our tools. What are the limits of an FNA?

I am a vet tech. FNA is great for cysts and some inflammatory lumps. The main limit is that it only specimens the cells at the tip of the needle. If the lump is fibrous or has very few exfoliating cells, you get a non-diagnostic result. It does not give the full architecture of the tissue. Sometimes the specimen is just blood or debris. It is a screening tool, not a definitive diagnosis for everything.

Thank you Eric. My Mochi is a kitten but I worry about pain. I saw a thread about if it hurts but I am still nervous. Does the vet need to do it multiple times if the first try is bad? I read that sometimes they have to poke it a few times to get a good specimen. That sounds scary for a small cat.

I have had this issue with Gordo. We did an FNA on a small bump and the result came back as 'insufficient specimen'. I am interested in the technical side. Is it that the needle is too thick, or is it just luck of the draw? I read a thread about when the slide is empty and it mentioned that some tumors just don't shed cells well. Does that mean we always have to go straight to a biopsy?

For what it is worth, Luna has hairballs so I am used to the idea that things can be messy. I think the main limitation is that it cannot tell you if something is cancerous with 100% certainty if the cells look weird. It tells you what the cells are, not how they are arranged. I saw a thread about biopsy vs fna which said that if the FNA is inconclusive, the biopsy is the next step. It is not a one-and-done test for every lump.