In 2017 a German Shepard dog named Myles came in for his annual evaluation. A wonderful companion, a super athletic pet who loved his dock jumping events, he checked out in excellent health.
During the abdomen palpation he let out a little yip. It was a cry you hear many times over the years when you flex a joint just the wrong way or inadvertently pinch an ear during otoscopic exam.
I thought nothing of the incident. He was the last appointment of the night I went home thinking Myles looked as good as ever.
We ran the standard senior wellness labs with a blood panel and urinalysis and the results indicated no internal health issues.
Two weeks later Myles was dead. He was rushed to the emergency clinic where he was diagnosed with hemoabdomen from a ruptured splenic tumor, and he died during surgery.
In hindsight, when Myles cried out, I could have walked him over to the ultrasound machine, scanned his abdomen, and likely would have spotted a tumor on his spleen, and started the discussion about preventing it from becoming a life ending incident. Hindsight likes to preach about could have, should have, would have.
I learned from this terrible loss, and here is a practice tip to help you do better by your patients.
Tumors of the spleen are the most common abdominal growths in the canine. The problem is these growths can be challenging to find on exams, especially in larger dogs. These growths often go undetected until they cause illness.
Most of you know the statistics about splenic growths. Hemangiosarcoma is the most common primary canine splenic cancer in dogs, and it is aggressive and metastatic. Approximately 67% of splenic tumors in large breed dogs are malignant.
Splenic tumors have a higher incidence in larger dogs and a breed predilection for Labrador & Golden Retrievers, Rottweilers, and German Shepard dogs.
Ultrasound scanning of the spleen is a simple test and can be done as a routine screening to help avoid the devastating consequences caused by some splenic tumors.
If an ultrasound machine is available, you should learn how to scan a spleen and spot abnormalities. It is a skill that is easy to master and it can be a life saver.
For dogs all dogs over 7 years old we perform Senior Wellness Testing that includes a standard blood profile, urinalysis, and a spleen scan. We add a small fee to the standard senior lab fee to cover the ultrasound scan.
Spleen scans can also be performed as a stand-alone test during routine examination appointments since it takes very little time.
The Journal of the American Veterinary Medical Association published a study in June 2016 where splenectomy performed on dogs with non ruptured splenic growths showed 70.5% patients with benign splenic lesions and 29.5% with malignant neoplasia. The incidence of benign versus cancerous splenic growths when detected early is the opposite of the data for those with tumors of the spleen that cause hemoadomen.
When you scan and detect a non-bleeding splenic growth you can inform clients the data indicates there is a 30% chance it is cancer and discuss the option of monitoring it, or in higher risk breeds it may lead to working up the patient for surgery. Clients should be informed even benign splenic growths may eventually rupture and bleed out.
By performing routine spleen scans you will find tumors and develop baseline information to assist in monitoring these patients. One day you will discover a mature growth in danger of rupturing and you can prevent an emergency hemoabdomen in that patient.
Losing a patient like Myles will always haunt me.
His legacy helps me practice better medicine, and I hope Myles helps all of you.
-Dr Keith Hilinski
Rolling Hills Pet Hospital
SDCVMA President 2005