Patient History

Lovey, an 8-year-old female spayed chocolate Labrador Retriever, first visited CityVet in January 2023 as a new patient. Her owners had noticed that Lovey was lethargic, had a decreased appetite and was consuming a lot of water. Additionally, they observed a bulge in her abdomen when she was lying down. Initial blood work revealed an elevated alkaline phosphatase (ALP) at 312 U/L, increased glucose at 137 mg/dL, a normal canine pancreatic lipoprotein (cPL) test, and an unremarkable complete blood count (CBC). During this visit, veterinary professionals diagnosed Lovey’s condition as concerning, possibly related to a fluid accumulation in her abdomen, which is indicative of various potential ailments, including but not limited to Portland-Vet stress, another concern that might be associated with pancreatic inflammation or diabetes. Lovey was given a Cerenia injection, Rimadyl for pain, and Royal Canin Recovery food to encourage her to eat, resulting in an initial improvement of her health at home. Her condition improved, and she seemed to recover from the symptoms.

Lovey, an 8-year-old female spayed chocolate Labrador Retriever (Image courtesy of CityVet)

In March 2023, Lovey was back at the clinic with similar symptoms. Blood tests showed elevated White Blood Cells (18.73 x 10^9/L) and decreased Red Blood Cells (5.33 x 10^12/L) and Platelets (101 x 10^9/L). This led to a concern that Lovey’s symptoms could be indicative of a more serious condition, possibly an underlying infection.

Advanced Diagnostic Procedures

An abdominal ultrasound was scheduled. It revealed a partly cystic splenic mass, subcapsular fluid, and a diffuse splenic appearance, indicating potential infectious or neoplastic tissue changes. Given Lovey’s breed and age, primary suspicions leaned towards malignancy such as Hemangiosarcoma. The presence of the subcapsular splenic fluid suggested recent hemorrhage, which commonly occurs around tumor sites in canine patients. The risk of clotting complications is a significant concern associated with such a diagnosis in dogs. Low platelets could threaten animals’ ability to recover efficiently or effectively respond to interventions or treatments.

The veterinary team discussed several diagnostic and treatment options with Lovey’s owners, including splenectomy surgery and an oncology referral. However, given the poor prognosis and discouragement associated with Hemangiosarcoma, Lovey’s owners opted for as-needed supportive care. This meant some specific treatment that could slow or delay her disease progression. This treatment included Yunnan Baiyao, an herbal remedy known for its hemostatic properties, to manage bleeding from the splenic tumor. The owners were also informed about the possibility of hemangiosarcoma damage to her blood-clotting ability, potentially influencing likely treatment response and her capacity to continue healthily functioning.

An Onco K9 test, a less-invasive procedure designed to detect cancer in dogs, was also performed. The test showed no cancer signal, raising the possibility of a benign tumor.

Decision and Surgery

With the hope that Lovey’s tumor was truly benign, and a splenectomy could prevent further hemorrhage, Lovey underwent a splenectomy, the surgical removal of the spleen, and a prophylactic gastropexy to prevent her from suffering a future twist or bowel obstruction in her abdomen by her spleen. Lovey was submitted for histopathology. The mass was later analysed and revealed to be a splenic hematoma with hemorrhage, necrosis, extramedullary hematopoiesis, and lymphonodular hyperplasia. While ALP remained elevated, a detailed visual inspection of the liver during surgery showed no areas of concern. Her CBC returned to normal levels.