Dobie, is a 5 year old Labrador mix breed, who presented to us with a history of weakness, lack of appetite, vomiting and depression for 2 days. On presentation, Dobie was very dull and minimally responsive. His gums were very pale and tacky. He had an accelerated heart rate and weak pulses. His belly was tense and painful to palpation.
Our initial rule-outs included gastric dilatation (bloat), ruptured abdominal mass from the liver or spleen, some metabolic disease or toxin ingestion. We developed a diagnostic plan which included blood chemistry profile and complete blood count, chest and abdomen radiographs.
The blood tests did not show any organ system damage. The white blood cell count was elevated at 31000, indicating a possible infection or severe stress.
Radiographs of the chest were normal, however the abdomen films suggested a central abdominal mass:
Because of our suspicions, we advised an ultrasound exam to elucidate the origin of the mass. Ultrasound showed this to be a huge spleen which had a uniform consistency, that is to say, there were no obvious masses in the spleen and the spleen was not ruptured.
Based on how “shocky” Dobie was feeling, we diagnosed a splenic torsion. Splenic torsion is an unusual syndrome where the spleen twist around its blood supply. When this happens, blood can still get into the spleen because the arterial blood is under pressure, however, the veins coming out of the spleen get occluded and the blood can’t get out. So the spleen gets continuously bigger and bigger until it eventually ruptures. As the blood gets sequestered in the spleen, the pet gets weaker and weaker.
This is a surgical emergency, and so we took Dobie directly to surgery. When we opened him up, we found the huge spleen twisted around its blood supply:
After checking the abdomen for other problems, we proceeded to remove the spleen. The spleen is an organ which is involved in the creation of red blood cells, and it acts as a central processing station for the immune system. Fortunately, dogs can live without the spleen and continue to have a normal life.
This is what the spleen looked like once we removed it:
This spleen was about 3 times the normal size for this dog’s weight.
We closed up the belly and treated Dobie with supportive care for 3 days post operatively in the hospital. He felt much better once we finished surgery and went home feeling normal again. The spleen was sent to the lab for analysis and no tumors were found.