Dental and surgery to remove two lumps on 14 year old

I'd like to get some opinions for my "heart kitty" who visited the vet today. We brought him in to have two lumps checked(right side of his body: one on back an inch or so away from his spine, the other on his lower abdomen) and to have his teeth examined(he recently developed bad breath and is due for a dental). It was a rushed appointment, as it often is with this very busy vet, and he said he'd like to go ahead and perform a dental and remove the two lumps at the same time. I managed to ask what kind of anesthesia would be used as he was exiting the exam room and he said isoflurane and added that he'd only be under for about 45 minutes. Obviously I have a lot of questions for him and am considering getting a second opinion from another local vet(we live in a rural area now and there aren't many to choose from). My boy is 14, blind, has had respiratory issues(upper/lower), has been under anesthesia quite a few times without problems(last time was almost a year ago for an MRI), his last bloodwork was in March and everything looked good and he's currently active, overall healthy, and happy.

So here are a few questions:
1. What questions should I ask this vet?
2. Is it unusual that he didn't aspirate the lumps to check for cancer cells? It's my understanding that it's best to do that prior to removal.
3. Is it safe to have a regular vet remove tumors that could be cancerous or should it only be done by an oncologist?
4. Should I request that the vet perform xrays for the dental or is it standard to do them? I ask because he said "only 45 minutes" under anesthesia and wouldn't that amount of time increase if he performed xrays and determined that teeth needed to be extracted? I've been eager to have a dental for him for some time now but I've been wary of the risks, as have his past vets.

Thank you for any answers.  I would never forgive myself if I didn't go about all of this in the best manner possible.

Is this the same Vet who anesthesized him last time?  Is he familiar with your kitty's health history and heart condition?  

I don't think cancer can necessarily be detected by aspirating the lumps...think you should ask that as one of your questions, because I could be wrong.

Since the needle biopsy isn't necessarily foolproof, how would you know you need an oncologist to perform the surgery?  It's kind of a catch 22.  Did this Vet suspect these lumps to be cancerous?  Sometimes they have  good feel for that, I suspect. 

I think you need to feel comfortable that the anesthesia they will be using is good for heart issues, AND you need to ask if the dental will include xrays. 

It's always a worry (for me) to have a dental, especially at his age and with a heart problem, but as long as they do the proper preliminary checks, and are WELL AWARE of the issues, there is no reason to think things won't go well.  That being said, I would certainly want a Vet who can take the time to assuage my fears and answer all my questions!  If he is rushing out the door to the next patient just during your visit, how he is going to be during surgery?

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I would ask this vet what kind of monitoring your kitty is going to get while under anesthesia, especially given that he has a heart condition.  Obviously EKG is a must, as is regular blood pressure checks.  The practice I work for does EKG, SPO2 (pulse Ox), ETCO2 (end tidal CO2), temperature, blood pressure and respiratory rate.  We also keep them on IV fluids throughout the procedure.  Does he have someone there solely for the  purpose of monitoring anesthesia?  What kind of induction agent is going to be used (avoid ketamine/valium.  I'd be much happier if he said something along the lines of torbugesic and midazolam followed by propofol.)

I would also want to know what kind of  recovery support he would receive post op.  Is there some one there to monitor them after the endotrachial tube is removed?  Are they provided with a heated cage?

45 minutes?  Really?  A good cleaning with full mouth films takes me about 30 minutes, and I am fast.  How big are the lumps?  That part, including shaving and prepping (and given that they are small unattached lumps) will likely take another 30 or so minutes.  I'm not even including time to extract teeth and we're already at an hour.  Was he planning on cleaning the teeth or just pulling the bad ones?  I wouldn't proceed with this vet if he isn't going to do full mouth xrays and post extraction films as it is pointless to pull only the obviously bad teeth.  Then you just to have to put them under anesthesia again in 6 to 12 months to take care of the teeth that should have been done last time. 

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Doing a fine needle aspirate is not a must, if you've already decided you'd rather take them off than wait for lab results it is reasonable to skip that step.  They are only around 70% accurate anyway as it all depends on how well the mass's cells exfoliate. 

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If the regular vet is competent it should be safe to have them removed with them, one of the things you can ask is how big a margin around the mass the vet is intending to take.  If he is going to trim as close as possible to the mass then consider another surgeon, since you don't know what kind of mass and are worried about malignancy it is it is reasonable to ask for fairly large margins, say, at least 1cm. 

Update:

Thank you both for the replies. I should have noted that when I said "heart kitty" I meant to indicate his high importance in my life(he's the love of my life) However, there have been concerns about his heart in the past(he has a complicated, confusing, mysterious medical history). His heart was checked after he had a neurological event several years ago; looked fine. Years later it was checked when his respiratory issues had worsened and I brought him to UC Davis. Unfortunately, he was on a medication(temporarily) at the time and they were unsure if it was the cause. Fast forward.. his last cardiology consult with a doctor I adored back home: she said there were some slight abnormalities in his heart that she didn't believe would ever be a problem for him but did note that he had a lowered heart rate(probably due to his respiratory issues). So yes.. his heart is a concern but he has been under anesthesia since then(at a teaching hospital 6 hours from us, a year ago) and he did well.

The vet we brought him to here is a favorite of many people but yes, the last appointment was the last straw for me. and I don't trust him with this. I made an appointment with another vet who was recommended to me by a few people including our neighbors(who brought a dog to him in the middle of the night for emergency surgery and were impressed). If I don't feel confident in him or he feels I should have it done (somewhere better equipped), we're prepared to go that route.  His appointment is Thursday and the receptionist basically made two appointments so we're sure to get enough time for all questions and going over his medical history.

Imbri: I noticed you were in the Chicago area. It's about 7 hours from us but I might be contacting you for a recommendation in your area, if you don't mind. It's a long drive but.. everything is a long drive from here.

Hey not a problem, drop me a private message if you have any questions or want recommendations

And good luck to both of you!