The canine splenic mass and non-traumatic hemoabdomen caused by a ruptured splenic mass are common clinical presentations to both emergency veterinarians and daytime practitioners.
Our recent Internal Medicine (IM) and Emergency and Critical Care (ECC) Blogs tie in nicely with today’s Blog topic because the confirmation of the splenic mass by ultrasound suspected by abdominal radiography or palpation
Figure 1 on during physical examination is important pre-operatively. Identification of a splenic mass with ultrasound helps clarify the next steps for diagnosis and therapy including assessment of the need for a surgical procedure. In addition, by using the abdominal fluid scoring system, the clinician can anticipate the degree of expected anemia and the need for a blood transfusion (see previous ECC Blog on the Abdominal Fluid Scoring System). This helps the clinician to better direct resources. FASTVet Veterinary Ultrasound Training teaches the use of AFAST and its fluid scoring system (AFS, small volume vs. large volume bleeder) followed by a Focused Spleen exam as a minimum ultrasound data base. Moreover, the addition of our Global FAST (GFAST) ultrasound exam which includes evaluation of the thoracic cavity (pericardial effusion, lung metastasis) provides even more critical pre-operative information regarding the staging of the disease (localized vs. metastatic). Common sites of metastasis for the most common canine splenic tumor, hemangisarcoma [HSA]) include the liver, lungs and right atrium. Global FAST (GFAST) takes only minutes without shaving and with minimal patient restraint; and includes abdominal FAST (AFAST), thoracic FAST (TFAST) and Vet BLUE (bedside lung ultrasound exam) that routinely encompasses these metastatic regions. The FASTVet-trained sonographer looks beyond fluid-positive and fluid-negative within the abdominal cavity.
Figure 2 Global FAST or GFAST takes only minutes and with the FASTVet cerebral approach much information is gained including the presence or suspicion for liver metastasis, pericardial effusion (indirect evidence for right atrial mass), and lung nodules (uncertain by thoracic radiography).
We recommend performing an AFAST with the application of the dog’s abdominal fluid score (AFS), followed by a Focused Spleen to confirm a splenic mass (and the surgical procedure required, splenectomy).
To stage the disease a more thorough Focused Liver may be performed; and TFAST to look for any evidence of pericardial effusion (indirectly right atrial mass), and Vet BLUE (lung ultrasound) for lung nodules.
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