Tumors of the Spleen

November 26th, 2011 by admin

Two weeks ago I received an urgent call from a pet owner at 6:30AM. His neutered Westie “DJ” had been vomiting intermittantly all night and was very weak. He also would not eat. This was very unusual for him since “DJ” was known to eat aggressively at any opportunity and “DJ’s” owner reported that he had never missed a meal in all of his 6 years until now! I hurriedly rushed in to the office right away to examine “DJ”. On the way to the hospital many possibilities ran through my mind as to what could be going on with “DJ”, but I knew whatever it was was serious since “DJ’s” Dad was not one to call without good cause! Upon examining “DJ” I found his temperature to be only 92 degrees F, his abdomen to be slightly painful and his gums to be pale. His heart rate was elevated at 220 and was pounding loudly in my stethescope. “DJ’s” pulses were thready and fast. I knew right away that “DJ’s problem was a case of acute abdomen with secondary shock. My first thought was pancreatitis due to the weakness, vomiting and shock noted on the physical exam. Also many small breed dogs like “DJ”are prone to this often fatal disease after ingesting some type of high fat or toxic meal. However “DJ”s” dad reported that “DJ” had only eaten his regular dog food prior to this sudden illness. I immediately instructed our nurses to start an IV for shock and draw blood for a pancreatitis test (lipase), CBC (complete blood count) and chemistry in our in-house lab. Also I ordered chest and abdominal x-rays to look for signs of pancreatic disease, as well as any other possible cause of a painful abdomen. Within a few minutes the lipase test came back negative and by that time “DJ” had received some IV fluids and appeared stronger. Also the CBC was done which showed and elevated white blood cell count and a slightly low red blood cell count. His chemistry revealed only slightly elevated kidney and blood sugar values. Since the bloodwork didn’t support pancreatitis as the cause for “DJ’s” problem I now turned to the x-rays for more information. Plainly visible on the digital x-ray screen was a large central abdominal mass about the size of a lemon in the region of the spleen. Surrounding the mass was a cloudy haze suggestive of a fluid such as blood. I went over our findings with “DJ’s” Dad. I recommended exploratory surgery after “DJ’s” shock had resolved from the IV fluid therapy. He authorized the surgery and we operated when “DJ” was ready. Present on the spleen was a large hematoma from a ruptured splenic tumor. The treatment for this is removal of the spleen which we did. To check for malignancy we sent a sample of the tumor to the lab for a specific diagnosis. “DJ” recovered beautifully and went home the next day. At the time of discharge “DJ” was very energetic and even kept some food down that morning! “DJ” did very well and his red blood cell count was back to normal at his 5 day recheck visit. He healed completely and had his sutures out 10 days later. The biopsy report came in a few days later and read hemangioma-benign!

The hemangioma/hemangiosarcoma complex of dogs is a fairly common cause of abdominal tumors in middle to older aged patients. Approximately 50% are benign, 50% malignant. The malignant tumors often spread to other organs of the body such as the spleen, liver and the right atrium of the heart. They arise from the cells which line the blood vessels in the body and may arise from any blood vessel, although the spleen is the most common site. Certain breeds are predisposed for this problem: german shepherd and golden retriever, however it is possible for any type of dog to get them. The malignant type has a high rate of metastasis to other organs such as the liver and lungs. Surgical removal of the tumor with follow-up medical therapy is recommended for the malignant hemangiosarcoma. Surgery is curative for the benign form. I expect “DJ” to make a full recovery with no risk of the tumor returning! Please call if you have any questions concerning this potentially life-threatening disease process!