I lost a patient while on emergency duty this weekend. We diagnosed a sweet Australian Shepherd with a suspected tumor on his spleen. It wasn't what his mom was expecting to hear. His symptoms seemed to have come on gradually, but then suddenly worsened. The hardest decision was made to avoid any further suffering for this brave boy. We all know how mom felt. It's sad every single time I help a family through this moment. One of the ways I deal with that sadness is to learn from the experience. Learning from each case helps me to honor that pet and that family by being even better for the next family that comes in. I want to share that with you by telling you about splenic tumors.
Tumors of the spleen (splenic tumors) are one of the more common tumors we see in veterinary medicine. This condition can affect dogs or cats, but for different reasons. We diagnose dogs more often. Among dogs, the most common types of tumors that form on the spleen are hemangioma (noncancerous or benign) and hemangiosarcoma (cancerous). To better explain, let me tell you more about the spleen itself.
The spleen sits on the left side of the abdomen, just behind the stomach. It serves multiple functions, including filtering out red blood cells that are old, damaged, or marked by the immune system for disposal. The spleen also acts as part of the lymphatic system, monitoring the body for infection, etc. At any given time, there are many red blood cells making their way through the spleen's vast circulation. When a dog becomes anemic, the spleen releases a supply of red blood cells to try and make up for the loss. So, the spleen is important and holds a lot of blood.
The two types of tumors we are discussing, hemangioma and hemangiosarcoma, both originate from the blood vessels of the spleen. Hemangioma tumors are like large blood blisters. The threat they pose to our patients is bleeding. A great deal of blood loss can occur and these tumors can be life-threatening even though they are not cancerous. Hemangiosarcomas also are dangerous due to the potential for blood loss, but they also are aggressive and can spread throughout the body.
Splenic tumors can be undetectable in the body, with no symptoms to our patients. Most of our clients have no reason to suspect anything being wrong with their pets until the tumor ruptures or begins to bleed. At that point, depending on the rate of blood loss from the spleen, we can see sudden death or collapse, or lethargy and belly pain. Vomiting can occur, body temperature can decrease, gum tissue can appear pale, etc. At this point, clients know there is a problem and quickly take their dog to their veterinarian.
Splenic tumors are diagnosed based on exams, X-rays and/or ultrasound, and blood work. If a splenic tumor is suspected, your veterinarian might also take chest X-rays or perform extra tests for signs of cancer spread (possible hemangiosarcoma). Then, he/she will talk to you about options for treatment. The first step in treatment is the emergency surgical removal of the spleen. This surgery carries risks related to bleeding, rupturing of the spleen during surgery, and anesthetic risks that are associated with blood pressure and the body's shock response. Blood transfusions are often necessary, sometimes even before surgery can begin. The risks continue during recovery depending upon how stable the patient is, how much blood loss was experienced, etc.
Once the spleen is removed, tissue can be submitted to a pathologist to determine whether the tumor is benign or cancerous. If the tumor is benign, then removal of the spleen results in a cure of the dog's condition! However, if the tumor is cancerous, moving forward with treatment involves chemotherapy with referral to a veterinary oncologist. Newer treatment options mean hope for patients, and they can experience a symptom-free time.
Sometimes, it is in the patient's best interest for their owner to consider humane euthanasia. Patients who have obvious signs of cancer spread to other organs, patients who are battling multiple health conditions, who are not stable enough for surgery, and patients who are just not up for the fight can be relieved of their suffering. It is not advisable to allow "nature to take its course" without intervention.
It can be devastating to find out that your dog or cat has a disease of any kind. The symptoms and quick decisions that come with splenic tumors make this disease especially heart-wrenching. We may not be able to detect splenic disease in the early stages of all patients, but regular checkups and blood work are recommended as our best preventive measures.