Splenic Hemorrhage in Cats

Even though the cat seems just fine to its owner, it should still be examined and checked out by the cat’s vet as soon as possible after experiencing a significant injury or impact. A splenic hemorrhage may not happen quickly. Instead, the flow of blood is more like a leak, so symptoms may not appear for several hours.

Splenic hemorrhage in cats typically results after a traumatic accident. When a cat his hit by something heavy, such as a vehicle moving at high speed, the injury to its spleen may not be evident right away. Cats, like people, respond with a high level of epinephrine in their bloodstreams, so they will be able to ignore this potentially dangerous injury until the amount of blood in its abdomen becomes excessive.

Symptoms may not develop for hours after an accident or a health condition involving the spleen, and they may not point directly to a hemorrhage:

• Abdominal distension
• Weakness
• Difficulty breathing
• Pale mucous membranes
• Abdominal pain
• Tachycardia
• Cardiac arrhythmias
• Low blood pressure
• Broken ribs

Long-term hemorrhage causes additional symptoms:

• Lethargy
• Anorexia
• Weight loss
• Occasional weakness
• Confusion
• Unsteady walk
• Seizures
• Lameness

The causes of splenic hemorrhage can be divided into two groups:

Biological insults:

• Splenic masses or tumors (rare in cats)
• Splenic torsion (twisting)
• Enlarged spleen (splenomegaly): Inflammatory, Infiltrative, Hyperplastic, or Congestive 

Traumatic insults (accidents)

• Blunt-force trauma
• Penetrating trauma
• Gunshot wound
• Wild animal attack

Quick diagnosis is imperative once it’s obvious that something is wrong with the cat. Because its symptoms may not point directly to bleeding from the spleen, the vet will have to perform several diagnostic tests to diagnose a splenic hemorrhage.

The cat undergoes a complete physical as the vet makes note of clinical symptoms. Knowing that cats try to hide signs of illness or injury, the vet still moves forward, suspecting that their patient is slowly bleeding into its abdomen. 

After an accident, the spleen contracts and enlarges. As this happens, it releases a high number of red blood cells. The cat’s nervous system releases epinephrine and norepinephrine into its spleen, which results in an additional release of red blood cells. The vet has to get a baseline PCV (packed cell volume) and TP (total protein).

The cat undergoes X-rays, which may show blood in the abdominal cavity. While these tool is useful, an ultrasound can actually tell the vet if the spleen is ruptured or not. In addition to these diagnostic tests, the vet does an abdominocentesis, which tells them if there is blood inside. If this test is inconclusive, the vet does a diagnostic peritoneal lavage. If this test fails to give results, the vet infuses saline into the abdomen. The fluid is then removed (aspirated) and analyzed for the presence of blood.

A complete blood count (CBC) should also be taken, along with a coagulation panel, biochemical profile, CT scan or MRI.

Surgery isn’t the immediate treatment for splenic hemorrhage. Because these leaks are usually slow, the vet may put a snug belly wrap around the cat’s torso to slow the hemorrhage even more. The cat’s vital signs should be frequently monitored. The cat’s physical activity should be limited as much as possible, allowing the leak to slow even more.

The vet may prescribe pain medication to give the cat relief from its pain. The cat may also receive blood transfusions and intravenous fluid therapy to keep it from becoming dehydrated. It may also receive oxygen.

If none of these treatments helps, the cat may undergo an emergency exploratory surgery to determine the exact extent of damage. The surgeon also determines whether the cat may benefit from undergoing a splenectomy (removal of the spleen). After surgery, veterinary staff should monitor the cat for cardiac arrhythmias and ventricular tachycardia.

At home, the cat should be kept comfortable and quiet.

Like humans, cats can live without their spleens. Splenectomy surgery is generally safe, but does come with risks. These include infection, bleeding, pancreatitis, blood clots, arrhythmias, and death from anesthetic.

Once the cat has had its spleen removed, it should recover well from surgery. Depending on the cause of the hemorrhage, the cat may be able to go home the same day. If the condition leading to the hemorrhage was serious, the cat may need to be hospitalized for several days after surgery.

A full recovery takes about two weeks. The cat will have to wear a long bandage to cover and protect the incision, in addition to an E-collar to further protect the incision site.

The pet owner should monitor the cat at home to make sure it is recovering well. If the cat experiences any complications, it should be taken back to the vet. Follow up appointments enable the vet to tell the cat owner when the cat has made a full recovery and can return to normal activity levels.