Treatment and outcomes of two pigs treated for hemoabdomen secondary to splenic disease.

OBJECTIVE: To report the management and outcomes of two pigs undergoing emergency surgery for hemoabdomen secondary to splenic disease. STUDY DESIGN: Case report. ANIMAL: Two adult pigs with hemoabdomen and suspected splenic pathology. METHODS: Pigs were admitted for several clinical signs including lethargy, inappetence, vomiting, abdominal distention, hypothermia, and tachycardia. Abdominal ultrasound and abdominocentesis led to a diagnosis of hemoabdomen secondary to splenic disease. RESULTS: The spleen was confirmed as the source of hemorrhage during midline exploratory celiotomy in both pigs. Splenic rupture resulted from splenic vein thrombosis in one pig and splenic torsion in the other. Complications included intraoperative hemorrhage and intraabdominal adhesion formation. Four years following splenectomy, one pig was euthanized because of widespread small intestinal adhesions causing luminal obstruction, while the other pig was euthanized following a diagnosis of chronic myeloid leukemia. CONCLUSIONS: A ventral midline celiotomy provided adequate exposure for splenectomy. The procedure allowed resolution of signs in both pigs. Splenic pathology, such as vessel thrombosis or torsion, may result in splenic rupture and should be considered as a differential in pigs with hemoabdomen.

Prospective observational study of dogs with splenic mass rupture suggests potentially lower risk of malignancy and more favourable perioperative outcomes.

Haemoperitoneum secondary to ruptured splenic tumours can be either benign or malignant in origin. The majority of previous studies of canine haemoperitoneum have been retrospective, which are associated with well-recognized biases, such as the potential to underappreciate the diversity of outcomes in a complex presentation such as haemoperitoneum. This study seeks to prospectively define perioperative morbidity and mortality of haemoperitoneum in dogs secondary to ruptured splenic masses. Forty dogs with haemoperitoneum secondary to a ruptured splenic mass met the inclusion criteria. As expected, the cohort predominately consisted of older large breed dogs. All dogs underwent preoperative staging and had a splenectomy performed. Histopathologic analysis was performed on the splenic mass, as well as any possible metastatic lesions that were noted intra-operatively. Perioperative care outside of splenectomy was delivered in specialty practices using current conventional approaches to care (eg, transfusions and anti-arrhythmic medications). Fifteen dogs (37.5%) had benign splenic tumours and were cured with surgery alone, whereas 62.5% had malignant disease (most often haemangiosarcoma [HSA]). Surgical outcomes were highly favourable in the vast majority of dogs. Indeed, 38 dogs (95%) survived and were discharged after a median hospitalization of 39.5 hours. Independent predictors of longer hospitalization times included receiving a transfusion and the development of an arrhythmia. Although small, this cohort defines distinctive and optimistic perspectives for dogs with haemoperitoneum from splenic tumour rupture. These favourable outcomes from this prospective study are sufficient to ask if larger prospective studies should be conducted to better inform owners during this challenging cancer emergency presentation.

Evaluation and establishment of a canine model of delayed splenic rupture using contrast-enhanced ultrasound.

The aim of the present study was to establish a canine model of delayed splenic rupture (DSR). A total of 15 mongrel dogs were anesthetized and laparotomized. The hematomas were observed following an injection of heparin. The hematomas were ruptured. The severity of the spleen rupture was evaluated and the intra-abdominal free liquid was measured. The splenic hematomas in the dogs continued to form and the hematoma area gradually increased. The hematomas were ruptured after impacting the abdominal wall. The spleens were damaged, and conventional ultrasonography showed intra-abdominal free liquid. These conditions were demonstrated via computed tomography scanning. A DSR canine model was established successfully.

High rise syndrome with impalement in three cats.

Three cats were presented for management of impalement injuries sustained following falls from second storey windows onto spiked metal railings. Two cats presented with penetrating thoracic wounds and extensive pulmonary parenchymal trauma, while one presented with abdominal impalement and splenic rupture. Following stabilisation, all three cats underwent exploratory surgery. A good outcome was achieved in two of the cats: one with thoracic and one with abdominal penetration. Impalement injury secondary to free fallis a previously unreported variation of 'high rise syndrome' in cats.

Splenomegaly in dogs. Predictors of neoplasia and survival after splenectomy.

Splenomegaly confirmed by surgery or necropsy in 100 dogs was diagnosed histologically as benign neoplasia (n = 1), primary splenic malignancy (n = 59), neoplastic metastases (n = 6), and nonneoplastic disease (n = 34). Dogs with known systemic disease, such as lymphoma and mast cell tumor, that caused splenomegaly were not included in the study. Hemangiosarcoma was the most common splenic disease (43 cases). Overall mean age of the dogs was 10.7 years, the most common breed was German Shepherd dog, and 72 of the dogs weighed more than 21 kg. Dogs with anemia, nucleated red blood cells, abnormal red blood cell morphology, or splenic rupture had a significantly greater chance of having splenic neoplasia (P less than 0.002). A multivariable logistic regression analysis found that the presence of anemia and splenic rupture in dogs with splenomegaly was up to 69% accurate in predicting presence of splenic neoplasia. After splenectomy, the median survival time of dogs with splenic neoplasia was 13 weeks. For dogs with nonneoplastic splenomegaly it was at least 36 weeks.

Use of splenectomy in the management of lymphoma in dogs: 16 cases (1976-1985).

Sixteen dogs with lymphoma underwent splenectomy to relieve signs of massive splenomegaly including splenic rupture. The most common preoperative hematologic abnormalities, anemia and thrombocytopenia, were reversed in all dogs surviving the initial postoperative period. Within 6 weeks after surgery, 5 dogs died because of disseminated intravascular coagulation and sepsis. The remaining 11 dogs underwent chemotherapy. These 11 dogs had a complete response rate of 66% at one month after surgery; the mean and median survival times were 9.3 and 5 months, respectively. In 7 dogs evaluated until death, the mean and median survival times were 13.4 months and 14 months, respectively.