Leah diagnosed Sep 2016 with IMHA, now considering spleen removal

Heather,
I want you to know that I have looked over your blood work and I am doing some background research for you. I haven’t finished yet.

Absolutely contact Jean Dodds with this question. While I know first hand about dogs and surgical removal of the spleen, she has researcher level information about splenomegaly and removal. In general, the spleen is a really important organ to keep but if it is diseased or has a benign growth on it, removal is indicated.

What does the job of the spleen if it is removed? Well, the body is a little different without a spleen, but dogs do fairly well. Some of the jobs are picked up by other organs like the liver.

It has several important functions. The most basic is the storage and management of red blood cells in the body. It determines when RBC are too old to continue, destroys them and recycles the material. The do this primarily during rest periods.

In dogs the spleen provides an “instant transfusion” as my vet likes to tell me. It stores a lot of blood and if the dog suddenly needs it, powerful muscles squeeze most of the blood back into circulation.

On the immune side, the spleen makes certain WBC that are protective against invaders and works closely with the rest of the immune system to protect us. So the one major ability we have, to fight babesiosis (tick disease) is taken away when we remove the spleen. That leaves humans and dogs vulnerable.

The bigger question now-a-days is WHY has it become enlarged? Is it working on fighting something? Your blood tests show some kind of battle going on against some kind of invader like an infection or perhaps some kind of tumor. There are values that are out of their normal range that indicates “anemia of chronic disease.” But exactly what is it? This kind of anemia will smolder along, keeping the PCV around the mid 20’s for a very long time until the condition is resolved in some way.

One value that is indicative of a problem is the slightly low blood calcium. This really has nothing to do with dietary deficiency but is an important element in our ability to perform things like muscle contractions. It is also important to help blood clot and to make sure our blood stays at a certain thickness so it stays in the blood vessel. When calcium is low, there are a number of things that can be causing the problem, such as kidney disease (the bun/creatinine ratio is high), pancreatitits, hypoparathyroidism, or muscle breakdown such that occurs when taking prednisone.

The CPK,Creatine Phosphokinase, is high and this is indicative of muscle tissue damage. Where is this happening? I’ll take a guess and say that you need to think about two things, one is to make sure that they have done a urinalysis to check the kidney function and the other is to do this test: cPLI. This is Pancreatic Lipase Immunoreactivity, a specific lipase found only in canine pancreatic tissue. Let’s find out if one of these two is the chronic condition that is causing this anemia of chronic disease. These tests are relatively easy to do and may somewhat expensive, they are nowhere as invasive as removing the spleen would be.

The only caution is that if there is a growth on the spleen, it could rupture leading to severe pain and probably death. If she has already had an ultrasound and they ruled this out completely, then don’t worry about this.

So get these two tests done, ask about the lowish calcium leveland the high cPK test result. Then contact Dr. Dodds via her consultation and ask her point blank if you should let the vet remove the spleen.
my best
patrice