Splenic hemangiosarcoma is an unfortunately relatively common tumor of the spleen in dogs. It frequently requires emergency surgery and its prognosis is often poor, making it a real challenge for veterinarians.
What is the spleen?
The spleen is an organ that plays an important role in immunity and in the renewal of blood cells. It is involved in hematopoiesis, i.e. in the production of blood cells. It is also involved in the storage of platelets and red blood cells.
The spleen is located in the front of the abdomen, a little behind the diaphragm. It is dark red in color and is attached to the stomach.
The spleen constitutes a blood reserve and has the capacity to contract to release blood into the body in case of increased need (intense effort, hemorrhage...).
In spite of all its properties, the spleen is not an essential organ for life. Its removal, called splenectomy, is therefore possible when it is necessary (rupture following a trauma, torsion of the spleen, mass...).
Tumors of the spleen
Spleen tumors represent 7% of the tumors found in dogs. They are much rarer in cats.
The most common spleen tumor is hemangiosarcoma (called splenic hemangiosarcoma). Some breeds are predisposed to it: the German shepherd, the golden retriever, the labrador, the boxer, the poodle...
It is important to note that not all masses on the spleen are malignant tumors. We can also have for example simple hematomas, hemangiomas (benign tumors)...
When they are malignant tumors, which represents about one case out of two, their prognosis is often poor. Indeed, the strong vascularization of the spleen means that these tumors tend to metastasize rapidly.
How to deal with a splenic mass
A mass on the spleen can sometimes be felt by the veterinarian during abdominal palpation. It may also be visualized on x-ray, ultrasound or CT scan.
In all these cases, when a splenic mass is found, it is imperative that it be carefully considered and explored (imaging exam, blood work...). In all cases, follow the recommendations of your veterinarian, who can refer you if he/she considers it necessary. Most of the time, a surgery consisting in the removal of the spleen will be indicated.
It is not uncommon for masses on the spleen to be detected only at a late stage, when the organ has ruptured. Abdominal hemorrhage is then present. The animal is usually very depressed, in a state of shock, has pale mucous membranes, may have breathing difficulties and a distended abdomen. In this case, surgery will be performed urgently, with the first objective: to stop the bleeding. If necessary, additional examinations and an assessment of extension (blood work, abdominal and/or cardiac ultrasound, thoracic X-rays, etc.) may be performed at a later stage.
Treatment and prognosis of splenic hemangiosarcoma
In the presence of a splenic mass, surgery is required. Only after histological analysis can the nature of the mass be determined and thus the possible diagnosis of splenic hemangiosarcoma established. If this has not been done prior to surgery, the extension workup mentioned above can determine whether or not there are already metastases and thus refine the prognosis (which is of course clouded by the proven presence of metastases).
The decision of a chemotherapy protocol can then be taken. If necessary, and if not himself, the treating veterinarian can then refer to a specialist in cancerology.
The literature shows a poor prognosis for spleen hemangiosarcoma. After surgery alone (splenectomy), studies show a median survival of less than 3 months (19 to 86 days). If this surgery is followed by chemotherapy and depending on the protocols used, the median survival is painfully close to 6 months. A study conducted in 2012 showed the benefits of a fungus extract, Coriolus versicolor PSP, with a delay in the appearance of metastases a median survival of 199 days. PSP from Coriolus versicolor is now available in France in the form of a food supplement for dogs and cats: Versikor500®.
If your dog was affected by splenic hemangiosarcoma, you should carefully follow the recommendations of your veterinarian and discuss with him the therapeutic possibilities, in order to guarantee your dog a prolonged survival, but also and above all an optimized quality of life.