Splenectomies

RE: Splenectomies

Emily Rainbow — Wed, 17 May 2017 22:25:11 GMT

Of the 8 I can remember doing personally in the past 3 years I have had 2x benign masses (one bleeding, one not), 1x secondary to trauma, 3x HSA, 1x lymphoma and 1 that died as I GA-ed it.

RE: Splenectomies

Martin Atkinson — Wed, 17 May 2017 18:59:30 GMT

[quote user="David Mills"]A grown man in his 70s crying about stars[/quote]Hold on I'm not 67 for a couple of months. Anyway, growing old is compulsory, growing up is optional. You should know!

RE: Splenectomies

David Mills — Wed, 17 May 2017 18:45:01 GMT

[quote user="Martin Atkinson"]

What I want to know is why someone one starred/low starred my post but Lou who said almost the same got 5? There's some sad people on this forum.

[/quote]

A grown man in his 70s crying about stars

RE: Splenectomies

Martin Atkinson — Wed, 17 May 2017 18:25:25 GMT

What I want to know is why someone one starred/low starred my post but Lou who said almost the same got 5? There's some sad people on this forum.

RE: Splenectomies

Thomas Johnson — Wed, 17 May 2017 12:23:33 GMT

[quote user="Lou Dawson"]On a different note, I'm often surprised by the number of splenic masses I get sent that are not HSA. Presumably it's a biased sample population because we are unlikely to get samples from dogs with an abdomen full of mets, but a fair proportion of masses that look quite horrible grossly are ruptured haematomas, myelolipomas or haemorrhagic benign hyperplastic nodules. [/quote]

I know we've mainly been talking about bleeding splenic tumours, but this paper looks at splenic masses that were found incidentally and hadn't ruptured, and 70% were benign:

https://www.ncbi.nlm.nih.gov/pubmed/27172343

RE: Splenectomies

Lou Dawson — Tue, 16 May 2017 22:38:49 GMT

I went to a lecture by Guillermo Couto at BSAVA a few years ago. He was of the opinion that HSA dogs did quite well with CHOP; he was more concerned about the cardiotoxicity from the doxo rather than mets. Obviously this was his own opinion/experience and I'm not in clinical practice so it's difficult to comment when there are owners, finances etc that I don't have to deal with but I remember thinking when I left the lecture that I would be happy to try chemo on my own dog if she were to have a HSA diagnosed ever.

On a different note, I'm often surprised by the number of splenic masses I get sent that are not HSA. Presumably it's a biased sample population because we are unlikely to get samples from dogs with an abdomen full of mets, but a fair proportion of masses that look quite horrible grossly are ruptured haematomas, myelolipomas or haemorrhagic benign hyperplastic nodules.

RE: Splenectomies

mariette asselbergs — Tue, 16 May 2017 21:09:58 GMT

But I did surgery on a 10 year old labrador with a bleeding splenic mass (haemangiosarcoma) and no visible metastases, and he survived in good state for a year. Owners were very happy with this.

I found a splenic mass by accident when my own dog was being scanned in an ultrasound CPD. Did surgery and it must have been a benign mass because she lived another 4 years.

Mariette

RE: Splenectomies

Martin Atkinson — Tue, 16 May 2017 14:35:00 GMT

[quote user="Anthony Dennison"]Does anyone ever bother with chemotherapy after a splenectomy has come back on histo as a haemangiosarcoma? I know there are various prognostic factors to consider etc.[/quote]Yes. I would give a COP plus Doxrubicin (CHOP in fact) but only after honestly discussing the cost/prognosis with the owner. It is likely to give 3 months extra life rather than 3 weeks.

RE: Splenectomies

Thomas Johnson — Tue, 16 May 2017 12:00:31 GMT

[quote user="J G Wray"]Multiple splenules - who knew?[/quote]

I learnt the word 'splenule' yesterday, I found 2 dark red spheres free in a cat's abdomen (the same cat as the post about the unusual liver tumour), one was 3mm diameter and the other was 6mm in diameter, I sent the larger one for histo and this was the report:

This nodular mass may be a necrotic and haemorrhagic splenule, sometimes known as an accessory spleen. These are additional miniature spleens that are found occasionally in dogs and other species. Splenules may sometimes be congenital. In other cases, they may reflect splenosis: seeding of splenic explants on omentum or peritoneum following splenic rupture, which may arise as a result of abdominal trauma or a consequence of splenomegaly. This is a harmless, incidental finding.

RE: Splenectomies

Iain Richards — Tue, 16 May 2017 10:16:12 GMT

I did a similar audit to JW, it had the same conclusion, but fewer data as he's had longer to collect it!!

My wife (oncologist) is fairly certain that most of our spelnic masses are secondaries anyway, so any surgery is potentially just buying time for the owner.

RE: Splenectomies

Nicola Cole — Mon, 15 May 2017 21:17:28 GMT

Nope I've never done chemo with haemangiosarcomas.

(P.S. Just in case it didn't read properly on the post you tangented I didnt mean chemo for haemangiosarcs)

RE: Splenectomies

J G Wray — Mon, 15 May 2017 18:31:36 GMT

I'd forgotten about our little "clinical study"

1997-2011 With no'but basic ultrasound, mechanical probes etc

57 Splenectomies

3/57 Younger animals 3-5 years "spontaneous" splenic haemorrhage, no history trauma, all alive 2 years later

1/57 2yo 35 day pregnant Lab with acute onset abdominal distension and lethargy, multiple mass lesions haemabdomen splenectomy, 7 foetal units day 35, 5 pups delivered survived >2 years. Multiple splenules - who knew?

53/57 6 plus years 5/53 "malignant" histiocytoma, the rest HSA, no lymphoma, all euthanased/ died within 3 months irrespective of adjunct therapy

Not inclined to be positive when there has been a haemorrhage. There's probably going to be another and it's not the bleed which kills the patient that is the problem, it's the one which doesn't quite

RE: Splenectomies

Anthony Dennison — Mon, 15 May 2017 18:12:09 GMT

Sorry yes, it came back as a haemangiosarcoma. That's why I was asking about chemo.

RE: Splenectomies

Thomas Johnson — Mon, 15 May 2017 17:36:05 GMT

[quote user="Anthony Dennison"]For example, late last year I had an older labrador that presented because he had a couple of days of 'not being right'; off his food, vomited once. I scanned him, and there was a splenic mass. No bleeding, I performed a splenectomy, no visual signs of metastases. PCV returned to low normal, everything else normal. Prognostic factors all point positively here - would you go for chemo?[/quote]

Did you send it for histopathology? I have never given chemotherapy after removing a splenic tumour, but if I were contemplating it I would definitely want to know what sort of tumour it was first. I saw a JRT with a splenic mass about 3 years ago that presented with a 1-2 month history of lethargy and inappetance. A splenic mass was found and removed. The mass was benign with a necrotic centre. The dog was back to normal within a couple of days of surgery. I suspect the necrosis was the reason it was unwell.