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27 It should be noted, however, that some dogs with massive HCC present without metastasis, and deaths in these cases may be unrelated to HCC.1, 26, 54 Histopathologic subtype and anaplastic characteristics in general influence the prognosis and predictability of metastasis.1, 26, 55 Metastatic spread usually affects the regional lymph nodes, lungs, and peritoneum.26, 56 Prognostic factors in dogs with massive HCC include need for surgery, liver lobe involvement, serum ALT and AST activities, and ratios of ALP to AST and ALT to AST