What is Splenic Hemorrhage?
A splenic hemorrhage is an extremely dangerous situation that can become fatal quickly. The blood from the spleen leaks into the abdomen, causing anemia and shock from loss of blood. If the cause is from an injury, you will most likely know that your dog has internal injuries right away due to the swollen abdomen and sudden weakness or vomiting. However, if your dog has a spontaneous splenic hemorrhage, the most common cause is splenic tumors, which may be either cancerous (malignant) or noncancerous (benign). Both types can cause splenic hemorrhage, hematoma (accumulation of blood in the spleen), and death without treatment.
Splenic hemorrhage (hemoabdomen) is a life-threatening condition not uncommon in large breed dogs such as the German Shepherd, Labrador Retriever, Doberman Pinscher, and Great Dane. A splenic hemorrhage may be spontaneous or traumatic. The most common cause of a spontaneous hemorrhage is neoplasia (80% of the time), which is a tumor in the spleen and the most common cause of traumatic splenic hemorrhage is being hit by a car. That is one of the main reasons why it is so important to keep your dog on a leash when he is outside and not restricted by a fence. Splenic hemorrhage can be fatal in less than an hour if not treated, so if your dog collapses, weak, and has a bloated abdomen, you need to take him to a veterinary emergency hospital.
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Symptoms of Splenic Hemorrhage in Dogs
There are two types of splenic hemorrhage but if your dog has either type of splenic hemorrhage, you will likely notice signs such as:
- Bloated abdomen
- Difficulty breathing, may be labored or your dog may be gasping for air
- Pale gums or lips
- Not eating or drinking
- Sudden unexpected collapse for no obvious reason
- Weight loss (if the condition is chronic from slower blood loss)
- Low blood pressure (extreme lethargy, confusion, dizziness, fainting)
- Shock (nausea, anxiety, cold limbs, restlessness, collapse)
- Spontaneous splenic hemorrhage is caused by an underlying condition.
- Traumatic splenic hemorrhage is caused by an injury to the chest or abdominal area
Causes of Splenic Hemorrhage in Dogs
- Hit by car
- Blood clots
- Toxic chemical such as rodenticides
- Golden Retrievers
- German Shepherds
- Skye Terriers
- Portuguese Water Dogs
- Bernese Mountain Dogs
- Flat Coated Retrievers
- English setters
- Great Danes
- Doberman Pinschers
- Large mixed breeds
Diagnosis of Splenic Hemorrhage in Dogs
The veterinarian will do a fast examination while you explain the symptoms you have seen and if your dog has had any injuries or illnesses recently. In addition, the veterinarian will need to perform an abdominocentesis. This procedure is done by inserting a needle into the abdomen to extract a sample for microscopic evaluation. An echocardiogram (ECHO) and electrocardiogram (EKG) should also be done due to the possibility of shock and cardiac arrhythmias.
Additionally, abdominal x-rays, CT scans, an MRI, and an ultrasound are good for determining the amount of free fluid in the abdomen. Abnormal biochemistry results include a decrease in albumin and increased blood glucose, alkaline phosphatase, and alanine aminotransferase. Your dog will also be anemic (low iron) due to blood loss. Also, a coagulation profile will be done, but is normal in many cases. A packed cell volume (PCV) analysis will show a decreased PCV.
Treatment of Splenic Hemorrhage in Dogs
For a serious condition such as splenic hemorrhage, treatment may have already been started during diagnosis. The veterinarian may have started intravenous (IV) fluids, oxygen therapy, and blood transfusions. Other treatments include medication, abdominal wrapping, and possibly surgery.
Intravenous (IV) Fluids
Due to blood loss, intravenous (IV) fluids are essential to recovery. The standard treatment for splenic hemorrhage is isotonic crystalloids until vital signs improve followed by colloid boluses if needed.
The veterinarian will most likely transfuse your dog with fresh whole blood or packed red blood cells to increase the PCV. If coagulopathy is the cause, fresh frozen plasma may be used instead.
The veterinarian will wrap your dog’s abdomen tightly with a compression bandage, which slows the blood loss while getting further diagnosis if needed.
If your dog is having a difficult time breathing, oxygen will be provided with a nasal cannula or muzzle mask.
Pain relief is important to reduce stress on your dog, which helps any treatment succeed. Narcotics or NSAIDs may be given until your dog is stable. Steroids may be given to decrease inflammation and also help with pain.
Surgery to remove the spleen is only done if absolutely necessary. If the bleeding cannot be controlled with any of the above treatments, the veterinarian will perform a splenectomy (removal of the spleen). This surgery usually completely solves the problem. However, if the veterinarian finds a malignant tumor, radiation or chemotherapy will have to be done as well.
Recovery of Splenic Hemorrhage in Dogs
Your dog will most likely be kept in the hospital for several days so they can keep him under 24 hour observation while he recovers from surgery. Once you go home, your dog may be on cage rest for a few days and you will need to keep him under close observation as well.