Hemoabdomen: Management of Pets with Internal Bleeding
Why Should I bring my Pet to Willows for Treatment of a Hemoabdomen?
Willows is one of Europe’s leading small animal referral centres. Our state-of-the-art hospital is led by internationally renowned Specialists, committed to providing the highest standards of veterinary care. The Specialist-led Emergency and Critical Care (ECC) service provides advanced diagnostics and treatment for the most critical patients.
Based within our advanced Intensive Care Unit the ECC service is fully supported by Willows’ experienced multi-disciplinary team including the Specialist Diagnostic Imaging, expert Anaesthesia Specialists, Soft Tissue Surgery, Specialist Orthopaedic Surgeons, Specialist Oncologists and a 24-hour veterinary and nursing team, all of whom help to optimise the potential for our patients to make a full and uneventful recovery.
What is a Hemoabdomen?
A hemoabdomen is an abnormal build-up of blood in the abdomen. This condition is commonly seen within the ECC unit at Willows and so our team have extensive experience in the management of pets that present with internal bleeding.
What Treatments are Available for a Hemoabdomen?
If a splenic mass is the cause of abdominal bleeding, surgery is the only option. Before surgery can be considered, the patient’ shock must be addressed through circulatory support and oxygen therapy. As a result of the active bleeding a patient can become quickly anaemic, requiring a blood transfusion prior, during or after the surgery.
Surgery is considered an emergency procedure for a bleeding pet and the removal of the spleen (splenectomy) is often the preferred option. A full abdominal inspection will be undertaken to determine any related issues or signs of secondary growths, to ensure the most appropriate management of the patient if they are stable enough for surgery. Following surgery the removed spleen will be sent for examination to a pathology lab.
Chemotherapy can also be considered where the analysis of the removed mass reveals malignancy, however this therapy is usually only started post-surgery.
What are the Signs of Hemoabdomen Due to a Splenic Mass?
Splenic hemangiosarcomas is a common type of cancer that can affect any animal of any gender and age. This is a cancer of the blood vessels: as the spleen is an extremely vascularised organ, this is where the tumor grows first. Abdominal bleeding is are most commonly found in older, nine to ten-year-old male dogs particularly German shepherds, Golden retrievers and Labradors. In cats, an abdominal bleeding is a rare finding.
The symptoms relating to an abdominal bleeding can be vague as the bleeding is internal and not readily visible. They can range from polyuria (abnormally large production of urine) and polydipsia (excessive thirst), anorexia, vomiting, weakness, abdominal enlargement and rapid breathing, to acute collapse and sudden death.
How is a Hemoabdomen Diagnosed?
An initial assessment of a collapsed patient that has suddenly developed clinical signs of hypovolemia should include a full haematology and biochemical analysis, a blood smear, an abdominal ultra sound and possibly a coagulation profile depending on the initial findings and history. Ultrasonography is an imaging tool frequently used to determine splenic architecture, and is a very sensitive test to determine the presence of splenic masses, free abdominal fluid and intraabdominal metastasis. The diagnosis of a hemoabdomen can then be achieved by retrieving intra-abdominal fluid for analysis through a “blind” or ultrasound guided abdominocentesis (aspiration of a sample of the fluid). Usually, the fluid obtained is of a sanguineous non-clotting nature.
Diagnostic imaging may include thoracic and abdominal X-ray, CT or MRI studies, which can enhance the overall assessment of the abnormality, detect intra-thoracic and abdominal metastasis (tumor extension) as well as being able to, differentiate between different types of masses. Unfortunately, despite such diagnostic techniques and approaches, only a full examination of a removed splenic mass can be truly diagnostic of its nature.
HeadingWhat are the Most Common Causes of a Hemoabdomen?
If a splenic mass is the cause of abdominal bleeding, surgery is the only option. Before surgery can be considered, the patient’ shock must be addressed through circulatory support and oxygen therapy. As a result of the active bleeding a patient can become quickly anaemic, requiring a blood transfusion prior, during or after the surgery. Surgery is considered an emergency procedure for a bleeding pet and the removal of the spleen (splenectomy) is often the preferred option. A full abdominal inspection will be undertaken to determine any related issues or signs of secondary growths, to ensure the most appropriate management of the patient if they are stable enough for surgery. Following surgery the removed spleen will be sent for examination to a pathology lab. Chemotherapy can also be considered where the analysis of the removed mass reveals malignancy, however this therapy is usually only started post-surgery.
What Can I Expect if my Pet is Treated for a Surgical Hemoabdomen?
Patients can unfortunately experience a number of pre and post-operative complications. As such, they may require close and expert monitoring throughout treatment. If no complications occur, patients can recover in 48 hours and return home soon after with the aid of pain medications and rest.
Long Term Management
The long term outlook depends on the nature of the splenic abnormality, its behaviour (whether it has metastasized or not), the severity of the presenting signs and the presence or absence of any other related issues.
Splenic malignant tumours such as hemangiosarcoma have historically been associated with a guarded to poor prognosis with limited survival times of 86 days due to previous microscopic metastasis prior to the time of presentation. Common metastatic sites include the liver, lungs and right atrium. However, new adjunctive therapies such as chemotherapy may prolong the median survival time up to 179 days depending on the clinical staging and protocol used.
Surgery may however offer the potential to cure animals presenting with benign non-metastatic tumours or in non-cancer patients. Early investigations with appropriate diagnostic imaging and prompt medical and surgical therapies are key factors to improve the general health and outcome of animals with a hemoabdomen caused by splenic masses.
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Emergency and Critical Care
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To assist owners in understanding more about Emergency and Critical Care, we have put together a range of information sheets to talk you through some of the more common critical disorders cared for by our Specialists.
