How would you live, if you are told you only have a few months left?
This question sits on the minds of Babe and Georgie’s families. These two boys went through splenectomy recently. Both are diagnosed with hemangiosarcoma.
Babe is 11. Georgie is 7. They are not expected to live for more than 4 months. [* Babe passed on in Dec 2015]
what is hemangiosarcoma?
Hemangiosarcoma is a cancer of cells that line blood vessels (endothelial cells). The tumours are highly malignant and commonly develop in organs like the spleen, liver and heart.
Splenic masses (benign or malignant) tend to rupture and bleed profusely and splenectomy is needed to stop life-threatening haemorrhage. Unfortunately, in the case of hemangiosarcoma, the average life expectancy for dogs after surgery is less than 6 months. Even with chemotherapy, few survive longer than a year.
FUNCTIONS OF The spleen
The spleen is located near the stomach and has a similar consistency as the liver.
- Contains a reservoir of red blood cells and platelets which is released like a “transfusion” when there is profuse bleeding.
- Contains white blood cells to fight infections as part of the immune system.
- Filters old or damaged red blood cells from the circulation.
Many dogs live a normal life without a spleen although they may be more vulnerable to infections. Ref: Atlas of Veterinary Clinical Anatomy
symptoms of hemangiosarcoma
Hemangiosarcoma generally develops slowly with no signs of the disease in early stages. Small ruptures in the tumours may cause some dogs to be lethargic and weak now and then. If the enlarged spleen puts pressure on the stomach, there may be vomiting and loss of appetite.
Owners often do not notice any abnormalities until a large mass ruptures and internal bleeding causes the dog to “crash”. Life-threatening signs of haemorrhage include:
- Sudden weakness
- Pale gums
- Rapid heart rate & weak pulse
- Distended abdomen
Red Flag: unexplained Weight loss -> If your dog loses more than 10% of body weight, schedule a health check immediately.
“Babe is greedy by nature so his appetite loss was a huge red flag.” ~ Rachel with Babe before surgery
“Georgie always loves food. When he walked away from dinner on Sunday night & vomited few hours later, we knew something was wrong.” Even dogs like Georgie with large tumours show no symptoms until the tumour ruptures.
HOW Is hemangiosarcoma DIAGNOSED?
An enlarged spleen can be detected by:
- Physical Examination
A large firm mass in the abdomen may be palpable (felt by hands). Pale gums & the presence of an abdominal mass may indicate a ruptured splenic mass. The abdomen may also feel distended & fluid-filled if there is internal bleeding.
Dr Sebastian Monier performs an abdominal ultrasound on Babe. When a splenic mass is detected, it is not possible to confirm if it is benign (hemangioma) or malignant (hemangiosarcoma). The vet will send the mass for a biopsy after splenectomy. It is advisable for dogs above 7 years old to have a health check every 6 months, including an ultrasound to detect any abnormalities of internal organs.
Georgie’s ultrasound revealed severe splenomegaly (enlarged spleen) & a mass measuring about 15cm diameter with multiple cavities. Just a small part of normal tissue is left in the head of the spleen. The capsule is ruptured.
Georgie’s Complete Blood Count revealed anemia (decreased red blood cells) & thrombocytopenia (decreased platelets for clotting).
treatment of hemangiosarcoma – splenectomy (surgical removal of spleen)
Splenectomy is usually performed only if there is splenic torsion, trauma or tumour. For hemangiosarcoma, splenectomy is the treatment of choice.
Removing the spleen does not cure the disease as the cancer would have already spread (metastasised) to other tissues before diagnosis, commonly the liver, heart, lungs. Surgery, however, may slow the progress and give the animal (and family) some good days ahead.
Because of the aggressive nature of this tumour, the average life expectancy after surgery is about 3 months.
Hemangiosarcomas can cause very large tumours. The mass in Georgie’s spleen measures 15cm long & weighs about 2kg. Some dogs may require blood transfusion after surgery.
Dogs with splenic hemangiosarcoma tend to develop cardiac arrhythmia (irregular heart beat). An electrocardiogram (ECG) monitors the electrical activity of the heart. Georgie’s ECG detected ventricular premature contractions which is controlled with heart medications.
“After the tumour was removed, Babe looked like he felt much better. We figured we have done all we could to give him a second chance at living.” ~ Rachel & Gordon
“To us, the toughest part of this journey will be deciding when to let Babe leave in dignity.” * Babe passed on in December 2015.
few days after discharge…..
After the splenic tumour is removed, it is sent to the laboratory for examination by a veterinary pathologist. Histopathology gives us a definitive diagnosis.
“When the lab report confirmed Babe has hemangiosarcoma, we had mixed feelings. We decided before surgery that we would not make him go through chemotherapy. Prolonging his life may not be his wish. Who is to say if ‘we are treating Babe or treating ourselves’?” Babe & Jeno, both adopted.
“I just want Babe to live his remaining days feeling loved & happy. It was devastating to know he may only have 4 months to live. Although it is heart wrenching to race against time, maybe it is a blessing to know how long you have with your loved ones. ” ~ Rachel
“It’s hard to accept especially when this jolly greedy face in front of you is drooling for more treats. We are prepared for good days like this & not so good days. Made a deal with Georgie – no sighing or whining (from us humans!), no ‘oh you so poor thing’, no sad photos!” * Georgie is still alive & well 18 months after surgery.
So how would you live, if you know you only have a few months left? For Babe and Georgie, I guess the answer is simple. Eat more. Love all. Live happy. One day at a time.
As their vet Dr Dennis Choi says, “Georgie doesn’t know what is wrong or how long he’s got. He just wants to go home and is happy to feel better again. Just keep that up.”