Spleen Functions, Hematoma and Removal in Dogs
The spleen is a very useful organ in both dogs and humans. Although it has important functions, it's not essential for survival. A splenectomy (removal of the spleen) is the recommended treatment for certain spleen disorders. In dogs, one of these disorders may be the presence of a hematoma in the spleen. A hematoma is a swelling filled with blood, which may be in either a liquid or a clotted form.
One of the dogs in my family recently developed a hematoma in his spleen and was treated with a splenectomy. We had a scary time while he was being diagnosed and treated, but he's fine now. In this article I'll describe my dog's experience and also provide information about the spleen and hematomas.
I'm a biology teacher, science writer and long time pet owner, but not a vet. If your dog is exhibiting similar symptoms to the ones that I describe or has any symptoms of ill health that don't disappear quickly, make sure that you consult a veterinarian. The vet will offer specific advice and treatment for your dog's particular situation.
Location of a Dog's Spleen
A dog's spleen is located near the stomach on the left side of the abdomen (from the dog's point of view). It's dark red in color and is an elongated organ that is often described as being tongue-shaped.
The size, shape and position of the spleen vary slightly in different dogs. The spleen's position is also affected by factors in its immediate environment, such as the fullness of the stomach.
Structure and Functions of the Spleen
The spleen's functions are related to the circulatory and immune systems.
- The spleen is covered by a fibrous capsule.
- Inside the spleen are two contrasting types of tissue - red pulp and white pulp.
- The red pulp makes red blood cells in the fetus. After birth, most of these cells are made in the blood marrow inside certain bones instead. However, in dogs, the spleen can increase its production of red blood cells if necessary.
- Red blood cells are essential for life, since they carry oxygen around the body to the tissues and organs.
- The spleen stores whole blood and acts as a reservoir in case the body needs extra blood. In this case the spleen contracts and pushes the blood into the circulatory system.
- The spleen also stores red blood cells and platelets. Platelets are involved in the blood clotting process that stops bleeding.
- The spleen acts as a filter, removing old and damaged red blood cells from the blood. It saves useful substances from the cells, such as iron, for recycling.
- The white pulp contains lymphocytes, a type of white blood cell, as well as other cell types belonging to the immune system. This system protects the body from infection.
- The white pulp also destroys infectious microbes, including bacteria and viruses, and contributes to the immune system's attack against these invaders.
An Ultrasound Exploration of a Dog's Spleen
Possible Causes of a Splenic Hematoma in Dogs
There are several possible causes of a splenic hematoma (a hematoma in the spleen) in dogs. These include trauma caused by a blow to the spleen, the existence of a bleeding disorder in the dog and the presence of a bleeding tumour in the spleen. The tumour may be a hemangioma, which is benign (non-cancerous) or a hemangiosarcoma, which is malignant (cancerous). Some older dogs develop a hematoma in their spleen for no obvious reason.
Ryan is my family's Leonberger. Based on his symptoms, a physical examination, a blood test, an X-ray and an ultrasound test, our vet initially thought that a bleeding tumour was responsible for Ryan's condition. The tumour could have been either benign or malignant. We were extremely relieved to find out that the problem was "only" a hematoma caused by a blunt force trauma. This condition can sometimes be just as deadly as some types of cancer if it's not treated quickly, however. If the spleen ruptures, very dangerous internal bleeding may occur.
How did Ryan receive the blow that damaged his spleen? We don't know for certain. He hasn't been involved in any accidents that would have caused us to rush him to a vet and he hasn't shown any signs of a bleeding disorder. In retrospect, we remember that Ryan fell heavily on his left side while playing with another dog recently, but he seemed fine afterwards. It didn't occur to us that this may have injured his spleen. The fall may have been the cause of his splenic hematoma, however.
Possible Symptoms of a Hematoma in the Spleen
The symptoms listed below can be caused by conditions other than a splenic hematoma. Make sure that you see a vet for a diagnosis if your dog exhibits any of the symptoms. The dog's problem may be minor and easily cured, but it may also be more serious and require immediate treatment.
Possible symptoms of a splenic hematoma include:
- loss of appetite
- abdominal pain
- abdominal distention
- pale gums (due to blood loss)
- difficulty in breathing (if the spleen is greatly enlarged)
Some Possible Effects of a Bleeding Splenic Hematoma in Dogs
Blood loss from a splenic hematoma may be slow and intermittent, as Ryan experienced. In this case the blood can sometimes be absorbed by the dog's abdomen.
When Ryan first exhibited symptoms of ill health, we thought that it was time to make a vet appointment soon. Then his behavior returned to normal and it seemed that he had recovered from whatever was wrong with him. A few days later the symptoms reappeared and were worse, so this time we took him to the vet immediately. The vet told us that Ryan's symptoms corresponded to the times when his spleen was bleeding. When the bleeding stopped, he felt better.
There is a danger that a hematoma in the spleen could rupture instead of leak. The surgeon said that Ryan's spleen was close to rupturing when he had his splenectomy, so we are very glad that he had the surgery when he did. Severe internal bleeding caused by a ruptured spleen can cause shock, a condition in which there is a rapid and dangerous drop in blood pressure.
Removal of the Spleen, or Splenectomy
The recommended treatment for a splenic hematoma will depend on the dog's condition. In some non-emergency situations a vet may try treating a dog with compression bandages, intravenous fluids and careful monitoring. Sometimes the spleen needs to be removed, however. This is especially true in emergency situations.
Unfortunately, as in Ryan's case, it may not be possible to determine the definite cause of an enlarged and bleeding spleen in a dog before surgery or even during surgery. An examination of the spleen by a specialist is required to determine whether cancer cells are present.
My family agreed with the vet's suggestion that the spleen should be removed, even though the swelling and bleeding might have been due to a malignant tumour of the spleen that had already released cancer cells to other areas. Our goal was to give Ryan as long a life as possible. We wanted to get the spleen removed, since that was the immediate emergency, and then consider the next steps once we had a definite diagnosis for the problem.
We received the diagnosis of a hematoma only after the spleen had been removed and examined by a pathologist. The recommended treatment would probably have been the same if we had known about Ryan's hematoma in advance, since a dangerously swollen and bleeding spleen is a medical emergency.
Blood vessels travel to and from the spleen, but a vet who specializes in surgery can expertly disconnect and seal these during a splenectomy and keep bleeding to a minimum. A blood transfusion may still be necessary after the surgery, but Ryan didn't need one. Our vet told us that another common problem immediately after a splenectomy is a heart arrhythmia, which needs to be treated straight away. Ryan was monitored carefully but never experienced this problem. In fact, the vet said that he recovered amazingly well from the surgery. He's certainly happy now!
Ryan's spleen was removed in open surgery. In this procedure a relatively large opening is made in the abdomen in order to reach the spleen and its blood vessels. The opening needs to be closed by stitches afterwards, or in Ryan's case, by staples. This is the most widely used technique for performing a splenectomy in dogs.
A newer surgical technique called a laparoscopic splenectomy involves making several tiny incisions in the abdomen, which are known as ports. Special surgical instruments are inserted through each port. A camera enables the surgeon to see the inside of the abdomen.
Laparascopic surgery is said to be minimally invasive and is less traumatic for the body than conventional surgical techniques. Not all surgeons have experience in performing this type of surgery, however. Part of a laparoscopic splenectomy in a dog is shown in the video below.
Laparoscopic Surgery to Remove a Dog's Spleen - Removing Adhesions
Post-Surgical Care and Living Without a Spleen
It's important that a dog doesn't nibble an incision site and destroy the stitches or staples, which is why Ryan is wearing a cone in two of the photos in this article. The cone is also referred to as an Elizabethan collar or an E-collar.
The vet will probably recommend that the dog avoids climbing stairs for a while and eats frequent small meals rather than a few large ones. The dog won't be allowed to go for walks at first, but will soon be allowed to go for short ones.
Other organs can take over the spleen's functions after a splenectomy, so a dog can live very well without a spleen. For example, like the spleen, the liver breaks down old and damaged red blood cells and recycles some of their components. It increases this activity when the spleen is removed. Although in general a dog without a spleen lives a normal life, the dog may be more susceptible to certain infections after a splenectomy.
Pet Insurance or a Saving Fund for Pet Emergencies
The cost for major veterinary surgery is very expensive. As cute and tempting as a puppy or a dog may be, it's very important to consider the financial future before bringing the dog home. Ryan has had two medical emergencies in his life, both of which were expensive to treat. It would be a horrible situation to be unable to afford a treatment that a pet needs in order to be free of pain or to survive.
Pet medical insurance plans are available, but it's important that a person is clear about what a plan covers before signing up for it. Another technique for preparing for pet emergencies is to set aside a specific amount of money from every pay period and place it in a separate savings account.
Pets can be dear friends and deserve the best that we can give them. Assessing whether we can afford to take care of a pet and preparing for financial emergencies if we bring the pet into our family are important factors in pet ownership.
Update - In Loving Memory
Unfortunately, I have some sad news to share in this update. Ryan's diagnosis of a hematoma was wrong. He did in fact have cancer. I'm very glad that his spleen was removed. He returned to health and had a happy three months of life. Then his symptoms returned and we discovered that he had multiple tumours in his abdomen.
My advice to anyone who has a tumour removed from their dog and is told by an expert that the tumour is benign is to delight in the news and enjoy their pet's renewed health. I would also suggest that they try to give their dog as good a life as possible. If you are ever in this situation, don't wait to take your dog on that special walk that you've been thinking about or letting your dog experience a fun activity that you've been meaning to try. As is true for dogs and humans, we never know what the future will hold.
© 2014 Linda Crampton