Pet Vet: Routine exam turns into emergency surgery

March 6, 2015

Annie walked into the exam room just like she had been doing for the past nine years, rear end wagging back and forth with her tail keeping time. She had a big smile on her face and lowered her head as always to make it as easy as possible to pet her head. It was time for her annual physical examination.

Annie is a 9-year-old yellow Labrador retriever and the joy of her family’s life. She has been the picture of health throughout her life, and today was no exception. Her body weight was excellent as was her stature and everything checked out fine — until I palpated Annie’s abdomen.

Annie is a very cooperative patient, and as a result, she is very easy to palpate. Some dogs will tense up their abdominal muscles to the point where palpation of the abdomen and the organs within is not possible. With Annie that is not the case and thankfully so, as this time I detected a possible mass in the left side of her abdomen. I discussed this finding with Annie’s "parents" and we formulated a plan to try to figure out what was growing in Annie’s belly and what might be done about it.

Our plan included abdominal radiographs and an abdominal ultrasound along with a complete blood panel. This was all accomplished within 90 minutes of her arriving for her visit. I point this out because timing turned out to be very important for Annie.

Annie’s radiographs revealed an abdominal mass about 5-inches in diameter possibly associated with the spleen or liver. Ultrasound identified the origin of the tumor as coming from the spleen. This study also showed that the tumor was somewhat cavitary and had grown to the point of rupturing the outer lining (called, the capsule) of the spleen. No other masses were found. Because of this rupture, Annie had bled into her abdomen, and the blood could be seen pooling in certain areas of her abdominal cavity. Annie and her folks were now facing emergency abdominal exploratory surgery.

Annie’s blood work revealed a slightly low red blood cell count consistent with the bleeding that was occurring from the tumor in her abdomen, so we elected to have two units of blood ready for transfusion as Annie was placed on a pain relief intravenous drip line and anesthetized for surgery. Upon entering her abdomen, I was easily able to locate her spleen and the mass growing within it. It was indeed seeping blood from several locations where the tumor had broken through the splenic capsule. Her spleen was removed as quickly and safely as possible with all the blood vessels supplying the spleen securely tied off to disallow bleeding. There were no other masses visualized, and Annie’s abdomen was closed, leaving behind the blood already free in her abdomen. This blood will actually be reabsorbed by Annie’s body. We did not have to transfuse Annie, and she woke up very comfortably thanks to her pain relief medications.

Annie’s caretakers were able to visit with Annie an hour after her surgery was completed and about four hours or so after she initially was brought in for her "routine" physical examination. Annie was discharged from our hospital the next morning with her usual tail wagging though perhaps a bit less aggressively than the day before. The key now for Annie’s future will be to find out what was growing in her spleen.

To be continued ....



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