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Should we have a splenectomy done on our dog?

By: Dr. Jon Rappaport

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Our question this week was:

My dog had collapsed 3 weeks ago and we took him in the local ER. They highly recommended a splenectomy we took him home and he's still normal after 3 weeks. We took him in (Friday) to get senior profile, x-rays, and ultra sound of abdomen. The next day we found out the results were normal.

They scheduled for the spleenectomy. Sunday he urinates blood with clots, we call the vet they say "oh there was a little bacteria in the bladder come pick up some antibiotics" (11:30am) they were not ready until 3:45pm (they close at 4pm). They call at 3:55pm to confirm surgery at this point we are frustrated and confused so we Do Not confirm. Tuesday we take him in to another Vet to find out that the ultrasound they viewed was not of the spleen but 5 views of the liver, 2 views of x-rays, We paid $650.00 for them to not to even perform the correct ultrasound and chest x-rays.

What do you recommend at this point? Please help we are very confused and frustrated!

Elsa Gomez


Answer

Hi – thanks for your email. To be honest it is hard to give a second opinion when you don't really know all the facts. There are a few things that don't make complete sense but I'll try to answer the best I can.

It is common for some older dogs to collapse because of a hemoabdomen (Blood in the abdomen). The most common reason for older dog to have hemoabdomen is a splenic tumor It is also possible that it can be secondary to a liver tumor. Physical examination, x-rays and tapping the abdomen (placing a small needle in the abdomen to determine for presence of blood) is diagnostic for hemoabdomen.

As mentioned, the most common area for the tumor is the spleen but can also be in the liver. There is no way to know unless you have an ultrasound which may not be available at all emergency clinics. The general recommendation is to take a dog to surgery in an emergency situation when they are actively bleeding (after some medical stabilization such as fluids, and a possible blood transfusions).

It sounds like you lucked out as far as not doing the surgery and your dog was fine. I've seen many dogs go home and bleed to death because the tumor continues to bleed. In some cases the bleeding tumor can clot and dogs can recover for a period of time – generally until the tumor bleeds again.

For elective splenectomies (dogs are stable and not actively bleeding), an ultrasound and chest x-rays are recommended. The reason to do the ultrasound is basically to determine if the tumor is isolated to the spleen or looks like it has spread to the liver (which caries a very poor prognosis). The reason to do chest x-rays is to determine if the cancer has spread to the lungs (if it has it caries a very poor prognosis). If either of these are true, then many owners may elect to keep their dog comfortable as long as possible then euthanize. It the liver and lungs look good, then many dog owners will proceed with the surgery and hope the tumor is benign (which can't be finally determined until tissues sample results are back from the pathologist). The most common cancerous tumor is hemangiosarcoma

During the ultrasoundthe ultrasonographer generally looks at all of the abdominal organs. I don't know what the person did that preformed the ultrasound on your dog but they probably looked at all the organs although they may have only printed photos of some organs. It is hard to know for sure what was done based on your email. My guess the person that did the initial ultrasound looked at the liver and spleen and you don't have all the facts. X-rays may initially have only been done of the abdomen to determine if they could see an obvious tumor or looking for blood in the abdomen.

I hope this information helps. If it was my dog, I'd want to know if the liver and lungs look clean and if I could afford it and your dog is in otherwise good health, I'd proceed with an abdominal exploratory to remove the spleen.


Best of luck!


Dr. Jon






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