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936 Splenomegaly

Surgical treatment: as soon as the patient is
stable:
VetBooks.ir releases microthrombi or thrombi, vasoactive
• Do not reposition/untwist the spleen, which
amines, and cellular breakdown products (e.g.,
free radicals, tumor necrosis factors, toxins).
• Splenectomy: submit for histopathologic
analysis
• Gastropexy: performed unless the patient is
unstable
Postoperative supportive care:
• Intravenous fluid therapy: must replace
volume lost in spleen
• Electrolyte and acid-base correction
• Additional blood products based on
hematocrit
• ECG monitoring for arrhythmias

Possible Complications
• Undiagnosed or delay in treatment: splenic
necrosis, septic peritonitis, hemolytic anemia,
disseminated intravascular coagulation SPLENIC TORSION Lateral abdominal radiograph of a dog with splenic torsion shows the characteristic
possible reversed C shape of the torsed spleen (arrows). (Courtesy Dr. Richard Walshaw.)
• Pancreatitis (compromised vascular supply
of the left limb of the pancreas)
• Breeds associated with a high incidence of Client Education
PROGNOSIS & OUTCOME GDV are also at risk for splenic torsion. Large/giant-breed dogs are at risk for developing
• Gastropexy should be performed after a splenic torsion, and chronic splenic torsion
Prognosis is good to guarded. splenectomy to prevent GDV. can produce vague, nonspecific abdominal signs.
• Chronic torsion has a better prognosis than
acute torsion. Technician Tips SUGGESTED READING
• In acute form, early treatment improves • Be familiar with the signs of hypovolemia to DeGroot W, et al: Primary splenic torsion in dogs:
prognosis. help guide postoperative fluid management. 102 cases (1992-2014). J Am Vet Assoc 248:661-
• Be able to recognize accelerated idioven- 668, 2016.
PEARLS & CONSIDERATIONS tricular rhythm, R-on-T complexes, and AUTHOR: Otto I. Lanz, DVM, DACVS
ventricular tachycardia to know when to EDITOR: Elizabeth A. Swanson, DVM, MS, DACVS
Comments alert a clinician for treatment of ventricular
• Splenic torsions can be acute or chronic and arrhythmias (pp. 1033 and 1457).
can occur in association with a GDV or as
an isolated event.

Splenomegaly Client Education
Sheet

BASIC INFORMATION ASSOCIATED DISORDERS ○ Splenic torsion may result in hypovolemic
Thrombocytopenia, arrhythmia shock.
Definition ○ Ruptured splenic HSA may result in pallor
Focal or diffuse splenic enlargement Clinical Presentation and arrhythmia.
DISEASE FORMS/SUBTYPES
Epidemiology Diffuse or focal enlargement Etiology and Pathophysiology
SPECIES, AGE, SEX • There are myriad causes of diffuse or focal
Dogs or cats of any age and either sex HISTORY, CHIEF COMPLAINT splenomegaly (p. 1282).
Depends on cause, but nonspecific signs (e.g., • Extramedullary hematopoiesis is a common
GENETICS, BREED PREDISPOSITION lethargy, anorexia) are common. cause of splenomegaly, usually in response
• German shepherd dogs have a large spleen to bone marrow disorders.
normally. PHYSICAL EXAM FINDINGS • Neoplasia is another common cause of
• Certain breeds are predisposed to conditions • Palpable cranial to mid-abdominal mass; splenomegaly. The most common splenic
that commonly result in splenomegaly (e.g., usually left-sided but may extend to the cancers in dogs are lymphoma (diffuse) and
Staffordshire bull terriers and Babesia gibsoni; right side HSA (focal), and mast cell tumor is common
poodles and immune-mediated hemolytic • Other exam findings depend on the cause in cats.
anemia [IMHA]; golden retriever and of splenomegaly: • Many infectious diseases cause splenomegaly
hemangiosarcoma [HSA]). ○ Lymphoma may result in generalized (p. 1282).
lymphadenopathy. • Splenic congestion may be drug induced
CONTAGION AND ZOONOSIS ○ Immune-mediated thrombocytopenia or related to disease (e.g., portal hyper-
Several infectious diseases can cause spleno- (ITP) may result in petechiae. tension, right-sided heart failure, splenic
megaly (p. 1282). torsion).

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