Splenic Torsion in Dogs

This life-threatening condition can come on suddenly or develop more gradually.  But, in either case, the condition of the canine will deteriorate and will require emergent veterinary medical care and, potentially, a surgical procedure to save the life of the afflicted dog.  This condition seems to present in large and giant breeds of canine, whose deep chest conformation seems to predispose certain breeds (German Shepherds, Great Danes, English Bulldogs) to splenic torsion.

Splenic torsion in dogs can be defined as a twisted spleen, a  life-threatening condition in which blood flow is cut off, resulting in swelling and pain in the abdominal area.

The symptoms of splenic torsion in dogs will vary depending on whether it is acute or chronic.  Here are some symptoms you might see (with the acute symptoms listed first):

• Acute collapse with abdominal pain (seek emergency medical care immediately)
• Abdominal pain (more intermittent if the condition is chronic)
• Vomiting
• Lack of appetite
• Swelling of the abdomen
• Weight los
• Increased/excessive drinking and urination
• Urine color changes, may look like port wine
• Lethargy
• Depression 

Types  

There are several types of splenic torsion in dogs:

• Acute - A sudden attack in which the canine collapses in severe pain; this is an emergency situation requiring immediate veterinary medical attention
• Chronic - More gradual and subtle in its development, presenting with more non-specific symptoms than the acute type
• Primary -  More rare, it is the primary problem which does not emanate from gastric volvulus (an abnormal rotation of the stomach more than 180 degrees)
• Secondary -  Caused by or in conjunction with gastric dilatation volvulus, twisting the spleen to create a blockage or obstruction of the flow of blood

While no known cause has been firmly defined, it is felt that the causes might include trauma, previous surgery, rolling, retching, and exercise as contributing factors. Here is a brief synopsis of what occurs in splenic torsion:

• The spleen is a large efficient blood filter which removes aged, damaged or parasitic-ridden red blood cells from the bloodstream  
• The spleen is attached to the stomach by ligaments and is fed by its splenic artery and veins
• Splenic torsion is a condition in which the spleen has twisted around its own blood vessels  
• The ligaments which hold the spleen to the stomach become stretched with an episode of stomach twisting as it takes the spleen with it as it twists or rotates
• The now-stretched ligaments do not allow the spleen to return to its normal position,  closing off the thin-walled splenic veins, allowing them to collapse and occlude
• Meanwhile, the splenic artery, having a higher blood pressure, is continuing to pump blood into the organ as designed
• With the obstructed blood flow caused by the abnormal torsion or twist of the spleen, the blood keeps filling the spleen, causing it to enlarge and become painful

Of course, if the acute attack presents, you will absolutely know to get emergent medical attention for your canine family member to save his life, but, in the event, your dog suffers from the more non-distinct symptoms associated with chronic splenic torsion, you may not realize that medical attention will still be required.  It is important to understand that these less acute symptoms can lead to irreparable damage to the digestive system and the acute attack that could be waiting just around the corner.  

Your veterinary professional will require a complete history from you which will include any of the symptoms you have noticed, their severity and duration, along with daily feeding regimen, elimination habits and your assessment of your pet’s behavior.  He will do a physical examination, either on a scheduled basis or an emergent one, and will order testing based upon his findings, clinical signs and symptoms.  He might need blood work or other fluid samples (urine and feces perhaps), other tissue samples, abdominal radiography (x-rays), abdominal ultrasound and possibly CT imaging to assess the size, position and condition of the spleen.  There are other conditions and diseases which can cause the spleen to become enlarged and the above testing will help your vet eliminate them to get to the root of the problem more quickly.

In the event that your dog has collapsed from an acute splenic torsion event, your vet’s primary concern will be to stabilize his condition, utilizing aggressive intravenous fluids and intravenous antibiotic therapy.  If anemia is found (and it frequently is found), blood components will be administered via IV.  Once your canine family member’s condition has been stabilized, then recommendations and decisions can be made for possible surgical intervention to repair the problem. The surgical options can include but not limited to:

• Splenectomy - Removal of the spleen in part or completely
• Splenic repositioning
• Partial pancreatectomy (removal of a part of the pancreas) if the left pancreatic limb is affected by the torsion
• Prophylactic gastropexy - This procedure is done during surgery - it sews the stomach to the inside wall of the abdomen to hold it in a better/safer position to reduce repeat episodes in the future

Ongoing care of IV fluids, additional blood component administration and monitoring of heart rate changes should also be expected after an acute episode with surgery and for the chronic episodes in which surgery is recommended.

Once you get your canine family member back home, expect that you will have to monitor him very closely.  Your vet will schedule a follow up appointment but, in the meantime, you will need to check the incision site daily for signs of inflammation, infection or anything unusual. Your dog will have to placed on restricted activity levels and may even need an E collar to prevent his self-injury to the surgical site.  Your vet will need to educate you on the signs and symptoms of pancreatitis and gastric dilatation volvulus so you can also be watchful for those complications.

The prognosis of your doggy family member’s splenic torsion episode will be dependent upon how severe it was, how quickly diagnosed with appropriate medical care administered to him and if the surgical options were pursued.  The prognosis is generally good if medical care is appropriate and timely.  There are some less than favorable issues which can arise before, during and after treatment if that treatment is not administered in an appropriate and timely manner.  Don’t be reluctant to get your beloved family pet to your vet if you note any of the above listed symptoms. Waiting could be fatal.