Overview of Canine Hemoabdomen & Hemoperitoneum: Abdominal Bleeding in Dogs
Hemoperitoneum (also commonly called hemoabdomen) is defined as blood within the peritoneal (abdominal) cavity. Most veterinarians use the term hemoabdomen in dogs. The blood accumulates in the space between the inner lining of the abdominal wall and the internal abdominal organs. Abdominal bleeding can occur in dogs that suffer from traumatic injuries, tumors, and hematomas.
Causes of Abdominal Bleeding in Dogs
- Traumatic injuries – these are most common
- Intra-abdominal tumors or tumors within the abdomen – these can rupture, slowly bleed, or invade into a blood vessel causing blood to enter the abdominal cavity
- Hematomas – these are organized, local collections of blood that can rupture and bleed
- Coagulopathies – these are clotting disorders that can cause bleeding within the abdomen as well as in other sites
Depending on the degree of blood loss, and how rapidly the blood is lost, a hemoperitoneum may be an emergency situation.
What to Watch For
- Abdominal distension
- Subcutaneous (under the skin) bruising
- Increased respiratory effort
- Pale mucus membranes (the best place to check is the gums or inner lining of the lips)
Other signs that might indicate a more chronic (longer term or gradual) blood loss include anorexia, lethargy, intermittent weakness, and weight loss.
Diagnosis of Hemoabdomen & Hemoperitoneum in Dogs
A thorough history and physical exam are critical for a prompt, and accurate diagnosis. Your veterinarian may also recommend:
- Abdominal radiographs (x-rays)
- Abdominocentesis (inserting a needle and syringe into the abdominal cavity) to obtain a sample for diagnostic evaluation
- Fluid analysis of the retrieved sample is required for definitive evaluation
- Complete blood count
Depending on your pet’s condition and initial test results, additional tests that may be required. These may include:
- Biochemical profile
- Coagulation panel
- Abdominal ultrasound
- Computed tomography (CT) or magnetic resonance imaging (MRI)
Treatment of Hemoabdomen & Hemoperitoneum in Dogs
The general approach to treatment varies on the clinical condition of the patient and the cause of the hemoperitoneum. Therapy generally includes:
- Intravenous fluid therapy
- Blood transfusions
- Belly wrap
- Oxygen therapy
- Analgesic therapy (pain medication)
- Vitamin K administration
- Emergency exploratory surgery
A hemoperitoneum may be an emergency situation. Veterinary care should be given as soon as possible. Keep your pet calm and comfortable. Minimize stress until you can get to a veterinary hospital. Keep your pet warm. If a traumatic injury is suspected, be careful moving your pet, as fractures may be present.
In-depth Information on Canine Hemoabdomen
A hemoperitoneum is a potential life-threatening situation. The peritoneal or abdominal cavity is a potentially large space that could contain a significant amount of blood. If a large amount of blood is lost into this space, the abdominal wall musculature is stretched and abdominal distension will be noted. Abdominal distension also may cause discomfort and pain, leading to increased agitation and stress. The rapid expansion of the abdomen may also cause pressure on the diaphragm, and thus, a decreased ability to breath comfortably.
Rapid blood loss into the abdomen will also lead to a decrease in blood pressure and tissue perfusion. This may lead to shock. As continued blood is lost, the decrease in circulating red blood cells may lead to acute (sudden) anemia. Pale mucus membranes are commonly observed. If veterinary care is not immediately available, rapid blood loss may lead to death. A slower blood loss is more common and will allow for more time to seek veterinary care.
Chronic (long standing) or intermittent blood loss generally occurs more slowly, and more subtle clinical signs might be present. If the blood loss is slow, the body can reabsorb (auto transfuse) the free blood in the abdomen. Thus, dogs may only have a small amount of blood present in the abdominal cavity. These dogs may not present as an emergency, but they still may have a serious underling disease process. Making the diagnosis of a hemoperitoneum is critical in establishing an underling cause.
If the dog has normal clotting parameters the bleeding into the abdomen will, many times, stop on it’s own. Blood clots form that stop the bleeding. Sometimes, an animal will collapse due to the acute blood loss, and then slowly recover due to clot formation, and the body’s own compensatory mechanisms. These animals will appear pale and weak initially, but with time, slowly become stronger and their mucus membranes will again become pink. Owners may describe intermitted episodes of weakness followed by spontaneous recovery. Blood clots can, however, be dislodged especially with increased movement or manipulations. If blood clots are dislodged, the bleeding may start again. In many cases of hemoperitoneum due to abdominal trauma, the bleeding will stop on its own.
Causes of Bleeding
There are several main causes of a hemoperitoneum. Probably the most common of hemoperitoneum in dogs cause is trauma. A lacerated blood vessel within the abdomen or internal organ trauma may lead to rapid or slow bleeding depending on the amount of organ or tissue damage. Outdoor dogs are at significantly greater risk then indoor animals. Younger dogs are more likely to be injured as well.