Border Collie X Diagnosed with AIHA – Page 3

Keymaster

Hi Amy,
I am grateful that your vet advised you to have a splenic ultrasound done. It sounds like they were very knowledgeable about what they were looking for and what they saw.

I have been through this with Chance in 2007 and have studied this a great deal since then. I can try to walk you through how to decide what to do.

First, while splenic nodules can automatically make a vet think of a very serious canine cancer called hemangiosarcoma, the reality is that many of these growths on the spleen, as many as 60%, are considered benign. The trick then is, how do you know which thing it is? Benign or malignant? The skill of the person doing the ultrasound is very important as they are interpreting what they see. It is all black, gray and white images created as the sound wave bounces off internal tissues.

When Chance had an ultrasound of his splenic growth, I was allowed to sit in on it. The vet explained to me that what he was looking for to differentiate this growth was if there were “lace-like” areas in the growth. In technical terms this means that there would be areas of light and many areas of dark making it look like lace.

Why is this important? Hemangiosarcomas are sloppy rapid growths. They desire blood supplies to keep growing and they will seek out blood filled organs in this quest. So the spleen and other organs like the heart and liver are also targets. These growths build sloppy “pools” of blood as their supplies. This makes the growth very unstable because the attachments are not good and it can move around a lot in the abdomen.

An ultrasound will show these blood supplies as dark areas. The healthy splenic tissue will show light colored areas. Thus, the lace-like appearance.

As I watched, I saw that, while Chance’s growth was huge, it was also mostly returning a solid light color. There were NOT dark areas on his ultrasound. I said to the vet, this appears to be solid tissue. He cautiously agreed with me. He advised me to have this removed ASAP and to keep Chance VERY QUIET until I did that.

So from your perspective, they were telling you that the growth is encapsulated, or it is a relatively sound piece of tissue, and that is also telling you that it is most likely not this sloppy mess of a tumor. These hemangiosarcomas on the spleen, when removed, look like hundreds of little growths all over the spleen, it clearly looks diseased.

My local vet advised me the day she found it on the xray, “we never do a fine needle biopsy of these growths because we know that will “seed” these cells into the blood stream if it is a hemangiosarcoma. They will move much more quickly to other organs.” I would advise you the same thing. Do not allow them to do this. Especially since it appears encapsulated.

I would advise you first, keep JD very quiet. These growths can bleed a little, then heal, bleed a little and heal. If there is a sudden rapid movement, say JD runs around or jumps, it can rupture. This will lead to severe internal bleeding that is extremely painful and life threatening. So these little bleeds can be accounting for the continuing anemia.

Second, if you can afford it, I would advise you to have this growth and the spleen removed immediately. My local vet did the surgery, they are quite capable, and removed a 7 pound growth and the spleen. Yup, huge. I was allowed to sit in on the surgery and it drew all the staff into the surgery to watch. Big growth, the biggest they had removed.

So any vet can do this surgery. You don’t necessarily have to have a specialist remove it. If you are short on funds and your regular vet is capable and agreeable, then you may want to decide to do it locally. Since JD has already had transfused blood you are going to need to make sure you have a supply of blood that has been absolutely matched and typed to use if there is an emergency during surgery. This will require an overnight stay, unless you feel that you are capable of caring for JD at home. I brought Chance home with me.

Finally, the hard part to read. Sometimes, after even the best guess, the vet opens the abdomen and finds it is an hemangiosarcoma that they feel they can’t remove, they may ask you if you want to close JD up and let him come home or if you want to euthanise him while he is on the table. This is your choice and I can’t tell you one way or the other how to decide this. A hemangiosarcoma grows rapidly and spreads to many organs quickly. Death may be sudden and painful or slow and debilitating as it bothers other organs like the heart.

There are very very few viable treatment options for this condition. Even if you have the spleen and hemangiosarcoma removed, and do some form of chemo, the chances are that there wouldn’t be more than a few months before it will spread to another body organ such as the heart. There isn’t a good survival rate. I’ve already researched this in desperation. The only option I found was Chinese meds prescribed by a veterinarian. I thought about it but realized that in most cases it just doesn’t help much if the growths are numerous, which they can be.

Luckily Chance’s growth was benign and the vet said this was curative. The reality is that he went on to to develop severe bone marrow failure almost immediately after that surgery. We began to notice changes in him a month or so later. His treatment, and his survival, is a very very long story. You can read it under Our Stories. Suffice to say, that this website is here because of what happened to Chance and how he recovered to live another good three years. He died at the good age of 11 from an unrelated heart condition.

If you have any questions at all, please write me back, don’t guess at anything with this. I know some of this is confusing to you, but I will try to explain it another way if you need me to.

So in short, JD has anemia that is likely related to some internal bleeding of this growth. This growth appears to be a solid, thus removable, nodule on the spleen. These are common and there is a good chance it is benign. Surgery is usually advisable with these and can be successful. Dogs can live quite well without a spleen, there is no danger in removing it. The surgery is relatively simple and most vets are capable of doing this. The recovery is not that easy, the incision is going to be quite long. JD may need a transfusion during this surgery and you need pretested blood for this. JD may need to rest in hospital overnight and will need probably a week to recover from the incision. If this is successful the internal bleeding will likely cease and JD will recover quite well.
my best
patrice

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