Case study: Splenic mass in 8-year-old labrador retriever

Patient history

Lovey, an 8-year-old female spayed chocolate Labrador Retriever, first came to see us as a new patient in January of 2023. Lovey’s owners had noticed that morning that she was lethargic, with inappetence, but consumed a lot of water. Lovey’s owner also commented to staff that they noticed a bulge to her abdomen when she was lying down. Initial blood work showed and increased ALP at 312 U/L, an increased glucose at 137mg/dL, normal cPL test, and unremarkable CBC. During this visit, Lovey was given a Cerenia injection, Rimadyl for pain to go home, and some Royal Canin Recovery to encourage eating. With this Lovey improved at home.

Lovey, an 8-year-old female spayed chocolate Labrador Retriever (Image courtesy of CityVet)

She returned in March 2023 with similar concerns of lethargy and inappetence. Blood work showed similar elevations in ALP and glucose levels, but the CBC showed elevated White Blood Cells (18.73 10̂ ̂ 9/l) and decrease in Red Blood Cells (5.33 10̂12/l) and Platelets (101 10̂9/l).

Advanced diagnostics

With these results, Lovey was scheduled for an abdominal ultrasound which revealed a partly cystic splenic mass in conjunction with subcapsular fluid and a diffuse splenic appearance concerning for infiltrative disease. Given Lovey’s breed and age primary consideration was given to malignancy such as Hemangiosarcoma with the subcapsular splenic fluid suggestive of recent hemorrhage.

Several diagnostic and treatment options were discussed with Lovey’s owners including splenectomy surgery and oncology referral. However, given the disappointing survival time for dogs with Hemangiosarcoma, Lovey’s owners chose to do as needed supportive care including Yunnan Baiyao for help managing bleeding from the splenic tumor, which remained mild. An Onco K9 test was also performed as a less invasive way to confirm the presumptive Hemangiosarcoma diagnosis. The Onco K9 cancer detection test results were no cancer signal detected.

Surgery

With the hope that Lovey’s tumor was truly benign, and a splenectomy could prevent further hemorrhage, Lovey underwent a splenectomy and prophylactic gastropexy and her entire spleen was submitted for histopathology. The mass measuring 12.9cm by 15.2 cm and was found to be a splenic hematoma with hemorrhage, necrosis, extramedullary hematopoiesis and lymphonodular hyperplasia. While, ALP remained elevated visual inspection of the liver during surgery showed no areas of concern. Lovey did well under anesthesia and her recovery was uneventful. Her CBC returned to normal levels, and she continues to do well 17 months after surgery.