What is Total Liver Lobectomy?
A lobectomy of the liver is a surgical procedure that is used to remove masses or tumors of the liver and their surrounding tissues. Tumors of the liver are often discovered by the presence of elevated liver enzymes on routine blood tests. They are then located using diagnostic imaging. The liver is made up of six lobes. Often if a tumor has developed, the removal of the entire lobe where it is located is the safest course of action to prevent the spread of cancer. Up to 70% of the liver may be removed safely, as the organ regenerates. The procedure is performed by a veterinary surgeon and is generally the only effective treatment for many types of liver tumors. Often, the type of tumor is only diagnosed after it has been excised. Chemotherapy or radiation therapy may also be paired with a total liver lobectomy.
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Total Liver Lobectomy Procedure in Dogs
To assess if a total liver lobectomy is an appropriate treatment for your dog, blood work will be needed to ensure that the animal will respond well to general anesthesia. Ultrasounds, CT scans or MRIs may be used to locate all affected areas of the liver prior to surgery. At this point, a fine needle aspiration biopsy may be used to diagnose a tumor caused by lymphoma. The vet will then determine if a lobectomy is the best treatment option in this individual instance.
To begin the surgical procedure, a midline incision is made to the dog’s abdomen. The blood supply to the liver will be temporarily sealed off using sutures or staples to prevent hemorrhaging. The surgeon will then remove as much of the liver lobe mass as possible, if not all of it. Sometimes a portion of the growth must be left behind due to a risk of excessive bleeding. The removed tissue will be sent to a lab for histopathological examination. The incision will be closed using staples or sutures.
Efficacy of Total Liver Lobectomy in Dogs
A liver lobectomy carries a very high success rate, with 93% of dogs recovering from the procedure and the healing period. If the tumor has been removed properly, dogs who have been diagnosed with hepatocellular carcinoma will often not die from tumor related issues. If the dog does not undergo surgery, the rate of survival is much lower. Chemotherapy or radiation therapy alone may be used to treat tumors of the liver, however this has proven to be less effective in most cases. If the gallbladder is found to be diseased during the operation, it also may be removed to prevent the need for further surgeries. Although it is rare, tumor regrowth is possible.
Total Liver Lobectomy Recovery in Dogs
After the operation has been performed, the dog will need to be hospitalized and closely monitored for up to 4 days. During this time it will receive pain medication via injections. The dog's red blood cell count, breathing, and heart rate should be closely watched during this time. Any vomiting or diarrhea may indicate an adverse reaction to the anesthetic used.
Once discharged, the dog will need to be kept from any strenuous activity for the two weeks following the procedure. A follow-up appointment to assess the healing of the incision will be needed at this time. Lab results generally take a week to come back, at which point further treatment will be discussed if cancer has been found. The liver will begin to regenerate within hours of the surgery, and will complete the process by ten weeks’ time. This surgery carries an overall good prognosis.
Cost of Total Liver Lobectomy in Dogs
The average cost for a total liver lobectomy is around $9,000. If an ultrasound paired with chemotherapy or radiation therapy is chosen as a treatment due to lower cost, the bill drops to around $3,000, but survival rates are lowered. If advanced imaging and an FNA biopsy are used prior to surgery, the cost may be as high as $15,000.
Dog Total Liver Lobectomy Considerations
There are some risks associated with a liver lobectomy. Hemorrhage during the procedure is the greatest risk, occurring in approximately 12% of cases. This is generally managed by blood transfusions or stapling of the area of blood loss. Tachycardia may also develop in some instances. Operation complications usually do not affect the survival of the animal. Anesthesia does also pose a small threat, although most dogs make a full recovery. If the surgery is not performed, the animal is likely to experience a shortened lifespan. Recurrence of tumors is possible.
Total Liver Lobectomy Prevention in Dogs
The most common causes of liver tumor growth are old age and genetics. Weight and gender do not seem to affect the overall survival rates of dogs with liver growths. In cases of liver cancer, the avoidance of known carcinogens can help prevent cell mutation. This would include keeping your dog out of areas with lots of car exhaust, off of lawns treated with pesticides, and out of smoke-filled homes. Deciding not to smoke in the home may also greatly improve the health of the family that own the dog.
Strengthening the dog's immune system may be another effective way to prevent cancer. This can be done by providing an appropriate, healthy diet to your dog and giving it regular, outdoor exercise (which is beneficial to you also). Follow your veterinarian’s recommendations to provide vaccinations only when necessary. Your vet may also recommend giving your dog antioxidants, coconut oil, and an artemisinin supplement to help strengthen its immune system.
Total Liver Lobectomy Questions and Advice from Veterinary Professionals
Our 13 year old Golden, Goddard, had elevated liver enzymes at a regular checkup in October. We put him on Denamarin, but the enzymes didn't change. Ultrasound showed a tumor in one lobe of the liver, as well as a tumor in an adrenal gland. He has had a CT of his chest and thorax and nothing else showed up. We believe that having the liver lobectomy is the way to go, but are very concerned because of his age. Right now he is happy, eating and doesn't seem sick. Is doing the surgery a good idea? If we do it, should we expect him to bounce back to his happy self?
Our 13 year old lab just had an emergency splenectomy and liver lobectomy on December 1st. She is doing great! We started her on Yunnan Baiyao a couple hours before the surgery and she is still on it. I am convinced that’s been a large contributor to why she did so well in surgery and is recovering so well. Read up on it - it’s amazing stuff and has saved two of our pets now. Our dog’s spleen had ruptured. Her prognosis wasn’t good but we decided to proceed with the surgery to give her a chance to survive. We are so glad we did! Aside from a couple groggy days, recovery has been very easy for her. She’s happy, bright, active and eating great. We haven’t gotten the final pathology results back yet, but the liver came back cancer free. If you do decide to proceed with the surgery, I’d recommend starting on Yunnan Baiyao two days before surgery. Your vet (or surgeon) may be familiar with it. They keep it in most emergency vet hospitals to stop bleeding.
Best wishes to you and your doggie :).
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Should we let the veterinarian do a surgical procedure on our dog that has a large mass on his liver to determine if it's cancer or not. The mass is so large that he probably isn't a candidate for liver Lobectomy and a biopsy was inconclusive. The vet has asked that the biopsy be retested.
The decision to go forward with the surgery is yours, in cases where there is a single mass (regardless of size - as long as there is a sufficient amount of liver left) surgical removal is treatment of choice and may be part of a lobectomy. If you have concerns, you could visit a Specialist which may be able to give you more insights or send an image of the biopsy to PetRays for a second opinion. Regards Dr Callum Turner DVM
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