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

Small Volume vs Large Volume Bleeder, revised, October 4, 2014

Figure 1  Doing Global FAST® as “an extension of your physical examination” is important pre-operatively.  The combination of. AFAST, TFAST and Vet BLUE, called Global FAST rapidly stages the patient as localized or disseminated disease.  When localized, in the absence of a coagulopathy and with the finding of a splenic mass, on a Focused Spleen, the patient is a surgical candidate.

In addition, by using the AFAST®-appliedabdominal fluid scoring system, and its small volume bleeder versus large volume bleeder concept, 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 as well as betetr provide a cost estimate for surgery.

Common sites of metastasis for the most common cause of a canine splenic tumor, hemangisarcoma (HSA) include the liver, lungs, and right atrium.  Global FAST® takes only minutes without shaving and with minimal patient restraint; and includes screens for liver metastasis using AFAST®, screens for cardiac involvement using TFAST®, and screens for lung metastasis using Vet BLUE®.  In the absence of any obvious metastasis using the Global FAST® approach, the patient is a surgical candidate and a work-up should continue with the objective of surgical treatment.  By doing a Global FAST® the presentation to clients is greatly improved over flashing, which may have been the reason that only 86 hemoabdomen dogs were operated out of 432, with most euthaized or left untreated, in a study population of mostly non-traumatic, bleeding masses (91%) published by Lux et al. JAVMA 2013.

DH,_Revision_Figure_3 No C

Figure.  “Racetrack sign” of pericardial effusion is almost unmistakable seen at the AFAST®-TFAST® Diaphragmatico-Hepatic (DH) view

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