A splenectomy is the surgical procedure performed to remove the spleen from the body. The most common reason for splenectomy is to treat a ruptured spleen.
The spleen is an oblong organ that sits just below the stomach, in the middle of the abdomen. Comparatively, on a size-by-size basis, it is much bigger in dogs and cats than it is in people.
Although pets can live normally without a spleen, the spleen performs some helpful functions in life:
- Storage supply for blood. The spleen has a tremendous amount of red blood cells moving throughout its countless winding blood vessels at any given time. Following trauma or hemorrhage from tumor rupture, the splenic muscles will contract, releasing a fresh supply of blood.
- “Culling” (The spleens ability to filter old, damaged or abnormal blood cells). Old red blood cells are more fragile than their younger counterparts. As they move through the numerous winding vessels through the spleen, many older red cells rupture as they make the tight turns, releasing their iron. The spleen captures and recycles the iron. Thus the spleen helps remove old red blood cells from the circulation, and recycles vital nutrients.
- “Pitting” (The spleens ability to remove damaged infected blood cells). The spleen has the ability to remove a piece of red blood cells without destroying the cell itself. The immune system ‘marks’ the site of the red blood cell to be ‘bitten off’/removed/”pitted”. In this way the spleen can remove infections of red blood cells from the circulating red blood cells, This helps keep cells functioning that otherwise might become irreparably damaged if their infection is allowed to persist. Entire red cells may be removed from the circulation in this way, thus preventing the spread of the red cell parasite inside. This seems as though this should be a good thing but it can lead to anemia in some cases. In severe cases the spleen may need to be removed.
- Helps fight infection. The spleen contains a lymphatic system allowing it to also act like a lymph node. Lymph nodes are centers of activity for the immune system, especially antibody-producing lymphocytes that fight infection. As circulation arrives to the spleen, the lymphocytes may become stimulated into reacting. Lymphocytes move through the spleen to fight infection.
Splenectomy at Metropolitan Veterinary Center is used to treat a wide variety of diseases and conditions. The doctors at Metropolitan Veterinary Center may recommend a splenectomy for your pet if he/she has one of the following:
- Ruptured spleen.When the spleen ruptures due to a severe abdominal injury, cancerous mass, cyst or benign tumor it can lead to life-threatening, internal bleeding. This will cause weakness and often pale gums in your pet.
- Tumors, Cysts and Cancer of the Spleen: Often the spleen is removed when a tumor, cyst or mass is found to diagnose the pathology and prevent continued growth with possible rupture. In some cases, non-bleeding tumors or cysts will be monitored with Ultrasound. Only biopsy can tell the type of tumor, cyst or cancer that is affecting the spleen.
- Splenic tumors are generally either benign tumors (hemangiomas) or malignant tumors such as hemangiosarcoma, mast cell tumors and lymphosarcoma. In dogs, most splenic masses are either hemangiomas or hemangiosarcomas, while in cats they are usually either mast cell tumors or lymphosarcoma. In cats, Mast Cell cancer may be limited to the spleen and removing the spleen can provide a long remission or even a cure. If the splenic tumor is benign, removing the spleen is considered curative.
- Splenic Torsion. Splenic torsion, or twisting of the spleen, may occur by itself, or with gastric dilatation-volvulus (GDV). It may occur suddenly, or slowly twist over a period of time. Although rare, when it does occur, there seems to be a genetic relation as it is most commonly seen in large-breed, deep-chested dogs, like German shepherds, standard poodles, and great Danes. Excessive exercise, rolling and retching may increase the spleen’s ability to move by stretching of the ligaments that normally stabilize the spleen resulting in twisting of the spleen. Nervousness and anxiety may also contribute.
- Gastric Dilatation and Volvulus (Bloat): In this condition, the stomach becomes filled with air and twists on its axis cutting off its circulation. This is a life-threatening condition requiring emergency surgery. The spleen sits just below the stomach. When the stomach twists, the spleen will often twists with it. Conversely, a recent study in the Journal of the Veterinary Medical Association, showed that there is an increased risk of GDV in cases receiving splenectomy. Depending on breed and safety, the doctors at Metropolitan Veterinary Center will discuss prophylactic gastropexy with you at the time of splenectomy.
- Infection of the spleen.
- Stop severe pitting as discussed above.
How do we Detect Splenic Masses? There are few ways to determine if a dog has a splenic mass:
- Physical examination. The doctors at Metropolitan Veterinary Center may be able to feel a mass in the area of the spleen during a routine physical examination.
- Radiographs – Metropolitan Veterinary Center has state of the art digital x-ray capability.
- Blood work. Metropolitan Veterinary Center has a comprehensive in-house lab. As stated above, blood work often misses splenic tumors, but there may be clues such as an unexplained anemia. However, your pet will need to be experiencing chronic mild internal bleeding from the tumor for this to be seen on blood work. Obviously, not an ideal situation.
- Ultrasound – The doctors at Metropolitan Veterinary Center are trained to perform an ultrasound to detect splenic masses.
- Cancer screening blood test. This tests for markers of inflammation associated with cancer in general (and seen in some other disease states).
Is it Benign or Malignant?
It is usually impossible to tell before surgery if a tumor is benign or malignant. In some cases, a less invasive procedure called a fine needle aspirate of the spleen may be done that can better determine prior to surgery what the pathology is. In cases that the spleen is surgically removed, it will be submitted to the lab for biopsy.
We will take chest x-rays prior to surgery to screen for evidence of lung cancer (a sign of metastasis from the splenic tumor). If we find that the lungs have cancer, it is generally too late for splenectomy to be a meaningful treatment. If there is no evidence of tumor spread, the mass may be benign, or it may simply be too early to detect tumor spread.
If the spleen can be removed and minimal or no metastasis has occurred, chemotherapy may be a reasonable treatment option. Chemotherapy options all depend on what type of cancer the tumor turns out to be.
What if a mass is found and you choose not to remove the spleen?
It will generally be recommended to monitor the tumor growth closely by ultrasound. Unfortunately, eventually if the tumor grows, it will at some time cause internal bleeding, from which your pet will not be able to recover.
Splenectomy is generally a safe procedure and one that we perform regularly at Metropolitan Veterinary Center. Although the overall prognosis for uncomplicated splenectomy is good, as with any surgery, splenectomy carries the potential risk of complications, including:
- Blood clots
- Cardiac Arrhythmias
- Anesthetic death
At Metropolitan Veterinary Center, we ensure the procedure is as safe as possible. We have invested time, energy and finances to have an in-house blood donor program. This allows us to give your pet a blood transfusion if your pet may need one before, during or after surgery. We also have trained Certified Veterinary Technicians performing and monitoring anesthesia. The doctors at Metropolitan Veterinary Center will create an anesthetic plan specific to your pet’s size, breed and health status.
Your pet may be able to go home the same day or may require several days of hospitalization. When discharged, full recovery should occur in two weeks. The diseased spleen and its large blood clots may weigh up to 10 lbs in a large dog and therefore, pets will appear substantially thinner after surgery. There will be a long incision to accommodate this large organ and perhaps a bandage to control any leaking of blood from the incision. Dogs will need to be restricted to short leash walks for two weeks after surgery. Your pet will need to wear an E-collar, t-shirt or some form of protection to prevent self-trauma to the surgical site.