The Spleen

Dr Mc Blog


July 19, 2016
“Tank” was adorable. An enormous Golden Retriever puppy, he had moved into the long-legged gawky teenage stage most pups go through and was ripe for the adjustments necessary to bond with his foster family, who had volunteered to train and socialize this puppy for Guide Dogs for the Blind. Guide Dogs for the Blind has been around since 1942. They place service dogs each year with blind and low-vision people who benefit from renewed activities and lifestyle once accompanied by their “Seeing Eyes” dog.

In order to prepare a puppy for his or her future responsibilities and to bond with people they benefit from leaving a kennel situation and moving into a home. A youngster needs to learn basic manners, basic obedience training, be properly housebroken and above all, be loved. Many future guide dog puppies are placed in homes through 4-H programs. They may live with their foster family for over 12 months, when they are returned to the Guide Dogs for the Blind school for temperament testing and suitability as a Companion Service Dog. A puppy that passes this test will be enrolled in further training, at the end of which they are matched with their Human. The foster family is invited to attend the Graduation Ceremony and meet the new Team (Guide Dogs may remain the property of the School). Dogs that do not pass an entry test will first be offered back to their foster family before being placed in a pet home.

Thus it was that Tank came home to roost. Large and ebullient, he was deemed a little too frisky to take his job seriously and flunked out of the program. Far from hanging his head in shame, Tank was overjoyed to be reunited with his first family and never looked back. He demolished hoses, lounged in the swimming pool and ate them out of house and home. On his visits to the Clinic we put on our “calm” faces – when pleased to see you (and Tank was pleased to meet everybody!) Tank could literally knock you over with his enthusiastic greetings. Subtlety was foreign to Tank, but his doggie charms were irresistible and he was so cheerful that we all loved him.

That was 11 years ago. Today Tank is nearly 12 years old. His owner has brought him in because he is very quiet, too quiet even for a dog that has calmed down with maturity. His weight has dropped, though not because of a diet. His gum color is a little pale, suggesting the possibility of anemia. Most horribly, I can feel a large mass in his abdomen. I keep my head down for a moment, bent over the dogs’ back as I consider what I shall say. Before I have to look his owner in the eyes. That first moment when unspoken fears are acknowledged.

We discuss tests, his age. Tanks’ owners agree to pursue a diagnosis.

The blood tests deliver both good and bad news. Tests confirm that Tank is anemic. But his liver and kidney function are good, other internal organs good. X-rays demonstrate a large undefined mass in his abdomen. We continue to an ultrasound examination of his abdomen, which helps to identify the spleen as the mass. We are breathless as the machine’s probe moves up to explore Tank’s liver. One of the most horrible cancers a dog can get typically involves both liver and spleen. Tank’s liver appears to be clean; we cannot identify evidence of cancer spreading there. We must now consider the option of other disorders of the spleen.

The spleen is an interesting organ. Looking like an elongated red-purple colored tongue, it sits near the stomach. The spleen is the largest filtration system of old blood cells in the body. In addition, it produces a portion of the new red blood cells the body needs and cells for the immune system. That said, a spleen can be removed and the animal can live a perfectly normal life, no special medications or supplements needed. Because it is filled with blood, the spleen can develop large blood clots called hematomas, which can burst open. The dog will bleed to death. It can twist upon itself or develop tumors. Any disease or trauma that causes a ruptured spleen may lead to death by rapid bleeding out into the abdomen. It is splenic cancer that is the most feared; because of its close connection to the bloodstream this cancer spreads rapidly.

We discussed the options. Tank might have hematomas of the spleen. Removed surgically, his prognosis would be excellent. But we might open him up and find evidence of a spreading cancer that had gone undetected by our other tests. Worse, in the early stages, cancer might have spread at the cellular level but not be evident until long after surgery. Often the trained eye of the surgeon cannot visually differentiate between a hematoma or cancer, so we could go to surgery, remove the spleen, performing a splenectomy, only to find out days later that the results of the biopsy test at the lab were cancerous. The family needed time to confer. Ultimately they agreed upon proceeding to an exploratory abdominal surgery, where we found a gigantic spleen. It was bulbous and lumpy, an angry dark purple color that spread from one side to the other and, once removed, was found to weigh over 3 pounds (when healthy it had probably weighed less than 6 ounces). Tank came through surgery fine. In less than 24 hours he ate a healthy breakfast. He went home the day after the surgery, wagging his tail at being relieved of that tremendous weight. Within 2 weeks Tank was rapidly putting on weight (sigh) and appeared restored to his old self. We all rejoiced when the pathology report could not detect any cancer, but pronounced the cause : splenic hematomas. Tank’s future appears bright and we all look forward to his cheerful greetings to come.

Christine B. McFadden, DVM

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