A Few Lessons in This One

I realize what *I* commonly see, may be "weird" or "rare" or frankly, SHOCKING, to most of you.

One of the most common things I see is dogs or cats with late stage cancer that were showing no signs until the day or two before they came into my office. Sometimes, thankfully rarely, people ignore signs like weight loss, lethargy, vomiting and inappetence and let it go for months. Though THAT does happen. It saddens me because there are times we can help those pets.  

We have to remember our pets often deal with pain and disease better than we do. It's truly part of their "predator" nature to hide illness. Or else they could become "prey."  It's truly amazing what processes animals are going through and yet they continue to eat and greet us as happily as ever.


But remember, we too can have things going on that no doctor in the world could see and often we have tests that are negative or normal while severe disease rages on inside. 

The other day an older German Shepherd came in (7 years) for being lethargic and a distended abdomen. The owner noticed this. Now, because I know what I know and do what I do, one of the top things that came to MY mind - breed, age, signs - bleeding splenic tumor. This is very common in our GS, Goldens and Rotties as they get older. I've seen dogs come in fine and they went out for  a run and collapsed because the bleed was fast. I've seen dogs I've examined and palpated come back in 3 months later with a mass that was NOT there before. 

This is how cancer works - in us and them.

So this dog needed some tests to confirm this and also to see how good of a surgical candidate we were - always possible for other diseases to be going on AT the same time. Dogs, cats and people can live just fine without a spleen.

Other questions:
1. Was there any evidence of spread (namely to the chest)?
2. How anemic was this dog (do we need a blood transfusion)?

Dogs can have benign or malignant splenic tumors. The only way to know is to remove the spleen and send tissue to the pathologist. The most common cancer is hemangiosarcoma.

The dog was moderately anemic (not in need of a transfusion) and the x-ray confirmed a bleeding mass with loss of detail on the image in the area of the spleen. An ultrasound was done to check for any spread to the liver (other types of cancer would do that - mast cell, lymphoma).   

We do these things to see what kind of surgical candidate the dog is AND to help the owner make the most educated decision possible.  This is a serious surgery and they can die from secondary cardiac arrhythmias, blood clots, etc. 

So, we take the dog to surgery and this is what we see:

What you see is a big mass on top of the spleen, a smaller one off the front edge and then hundreds of little red/brown masses all over the omentum, and I mean, ALL over. There are more than what is even in this picture. 

This was not going to be visible on any other test other than..bingo: an exploratory surgery. Sometimes the best test is using your eyeballs! 

There was evidence that some of these "little" spleens had started to grow and bleed out. There was NO way this was resectable. The owner was notified and chose to humanely let the dog go while she was sleeping. No other choice really. The kindest but hardest one. 

We thought we could fix this one. We couldn't. We didn't know until we got in there. This is what happens sometimes.