Welcome to July/August's Case of the Month!

 

DOES A DOG REALLY NEED...

 

HISTORY

Reggie was a 10-year-old Labrador Retriever who had been a little "off" for about 4 days. He'd been lethargic and just picking at his food (which any lab owner will tell you is abnormal!) for about 4 days. Nothing at the house had been out of the ordinary, and he was always supervised when he was outdoors.

 

PHYSICAL FINDINGS

On examination, Reggie appeared pretty normal for a dog his age. However, he did have a very swollen abdomen, and a large mass could be felt. To get a better idea of what was going on, we ran some bloodwork, and took x-rays. First, the x-rays:

 

X-RAY RESULTS

abdomen

A large mass was visible in Reggie's abdomen. It was pushing all of his other organs out of place, and was sitting where the bladder normally would. Since Reggie had no signs of urinary problems, we doubted the mass was bladder-related; more likely it involved abdominal fat, lymph nodes, or the spleen. I've outlined the mass below:

outlined

Reggie's blood chemistry was normal, but his blood count was not. Here are some details:
Test          Results    Normal Range    Indicator
                       LOW   NORMAL   HIGH
HCT    =    24.9%    37.0-55.0    bar
HGB    =    8.3 g/dl    12.0-18.0    bar
TP    =    6.57 g/dl    5.20-8.20    bar
WBC    =    17,500/L    6,000-16,900    bar

TREATMENT

Reggie's low HCT (hematocrit, or packed cell volume) and HGB (hemoglobin) suggested that he'd lost some blood. His normal TP (total protein) suggested the blood was still in his system somewhere, something also backed up by the slightly elevated WBC (white cell count), which happens as white blood cells "clean up" fragments of blood cells in the body. These values supported a tentative diagnosis of a tumor of the spleen - splenic tumors frequently rupture and bleed into the patient's abdomen, often with life-threatening results. Reggie's parents allowed us to perform surgery to evaluate the tumor, and remove it if possible.

As expected, Reggie had a large (about 8 pounds) splenic tumor which had bled into his abdomen. After removal, the rest of his abdominal organs appeared normal. Reggie recovered well from surgery and went back to his usual habits, even playing a little too much and aggravating his arthritis. Fortunately, the tumor turned out to be a benign type of growth, and Reggie's long-term prognosis is very good.

Here's the whole thing (there were 2 large nodules, 1 having ruptured):
tumor

Here's a close-up showing where the tumor ruptured:
rupture

DISCUSSION

Splenic tumors are not uncommon in older dogs (and ferrets). The title of this case refers to a ferret owner who asked me, "Do ferrets really need a spleen?" The answer, in many cases, is no. In pet animals, the spleen serves as a blood reservoir, a means for destroying old red blood cells, and, early in life, a source of immmune cells. Unfortunately, it's also an area readily affected by cancer, either directly or by spread from other organs (metastasis). The good news is that, if the tumor is benign and the spleen is removed, animals with splenic disease can do well.

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