Investigation and management of splenic disease in dogs

Abstract

Splenic disorders are a significant cause of morbidity and mortality in middle‐aged and older dogs, and a spectrum of presentations is possible, from chronic non‐specific clinical signs to a rapidly fatal haemoabdomen. Splenomegaly is commonly recognised during clinical examination or imaging in practice, but it can be difficult to decide whether the primary problem is within the spleen itself (eg, a focal mass, in which case a splenectomy is generally the treatment of choice) or whether the splenomegaly represents systemic disease (eg, a lymphoma or immune‐mediated haemolytic anaemia, in which case a biopsy may be useful but a splenectomy may be contraindicated). Splenic surgery requires an appreciation of the vascular anatomy, and adequate monitoring as well as supportive treatment may be critical to the outcome of surgery. This article discusses the anatomy of the spleen and how to investigate splenomegaly, as well as how to perform a (partial) splenectomy and the possible complications involved.

Role of strain elastography in differentiating malignant hypoechoic splenic lesions in dogs: Preliminary results

“…The prevalence of benign versus malignant lesions in our sample (frequency respectively of 67% and 33%) is consistent with other studies about the same subject (Rossi et al, 2008;Christensen et al, 2009;Watson et al, 2011;Cole et al, 2012;Hayes & Ladlow, 2012). Nodular hyperplasia was the most represented lesion (13 of 24 lesions, 54%), while haemangiosarcoma was the most represented between between malignant lesions (6 of 8, 75%).…”

“…The fine needle aspiration can be considered as the first step towards an accurate diagnosis representing a low risk procedure that can be performed without sedation. This technique presents an high sensibility for the diagnosis of extramedullary haematopoiesis or round cells neoplasia but is less sensible for connective tissue tumours that tends to exfoliate cells poorly (Hayes & Ladlow, 2012). However in some cases the location or the appearance (high risk of rupture) of the lesions makes it very difficult if not impossible the ultrasoundguided percutaneous sampling.…”

Doppler ultrasonographic evaluation of brachial and femoral veins, and coagulation and lipid profiles in dogs following open splenectomy

“…Such leukocytosis may be due to transient non-specific infection as a consequent of splenectomy and/or the stress of operation. As reported elsewhere 18 , the spleen is a member of the reticuloendothelial system that contains local macrophages responsible for phagocytosis and lymphoid tissues involved in immunosurveillance and the production of B and T lymphocytes. Furthermore, increased corticosteroid caused by fear or other stresses of anesthesia or laparotomy may also be associated with a moderate increase in WBCs 25 .…”

“…Such decrease in erythrogram indices could be attributed to the loss of red blood cells reserve in the spleen after the operation. As listed in a previous study 18 , the spleen is essential for extramedullary erythropoiesis and acts as a reservoir for about 20% of erythrocytes. Another explanation for such drop was described in a recent study 27 , the authors attributed the anemic state after splenectomy to the reduction of serum iron concentrations.…”

“…In dogs, open splenectomy is mandatory as an emergency following splenic rupture with resultant hemoperitoneum and hypotensive shock 18 , as well as it may be indicated in canine with diffuse (hemangiosarcoma, splenitis, amyloidosis) or nodular (hematoma, abscess, hemangioma) splenomegaly 6 . In the current study, to avoid the large blood vessels in the subcutis and muscle 15 , the abdomen was opened along its ventral midline.…”