Hello! I have a 14.5 year old japaenese splitz who had disc surgery 2 years ago. This year he developed new weakness in his lower extremities and had a 2.5 kg weight loss so he had a full body ct with contrast and ct brain.
Findings included a chronic herniated disc explaining his weakness and an incidental finding of a splenic mass with some splenomegaly and no evidence of metastasis. Ultrasound findings were non significant. The nature of the mass remains unknown. His blood tests were good and he has no anemia. My veterinary doctor recommends a splenectomy. But i am worried of putting him through general anesthesia given that he has a heart murmur (on no medical Tx). I want to maximize his quality of life. I dont know if i should put him through major surgery given that he is asymptomatic but i am also worried abt internal bleeding and the suffering of metastatic disease if i dont operate. What should i do?
Comments
Good morning-
The first thing that I would do is sit down with the vet and have a heart to heart about your thoughts and concerns. Hopefully you have a good relationship with them, and you are able to have an open discussion regarding whether or not surgery is the best option. I would mention your concerns (anesthesia, etc.) about quality of life and surgery risks for sure. I would also recommend having a “family” meeting with the household of applicable, regarding the pros and cons, the vets advice, and the recovery process (if you go through with surgery) or any other day to day changes that will be necessary in the near future for your pet. But again, my first step would be with my vet to weigh the options for my pet. Best of luck.
Hello,
I had the same situation a few weeks ago. I am asking that patients mom to contribute to this question too.
My first piece of advice is to ask for an echocardiogram exam. You don’t mention the degree or severity of the heart murmur (usually graded on a scale of 1-6) and it is important to say that a low grade doesn’t always indicate it is safe or irrelevant.
From here you can better assess anesthetic risk.
In general I tell clients to take out the spleen before it becomes a problem. A bleeding spleen can kill a dog quickly. So quickly you may not even have time for successful surgical intervention.
You have done an amazing job with diagnostics and treatment options. Don’t stop here.
Please let us know what happens.
Best of luck
Wow, what you are going through sounds quite sillier to what I just experienced with my oldest dog, who is almost 12. He is a Lab mix weighing about 54 lbs. A few months back he had is senior checkup, including a full blood panel and all looked good except trace amounts of blood in his urine and he has had a heart murmur his whole life and had never been on heart medication. He ate carpet a few weeks ago and while doing X-rays and ultrasounds to be sure it wasn’t causing a bowel obstruction, we found he had an enlarged heart and two masses on his spleen, with no indication of metastasis. He was acting himself, except for the belly issues from eating the carpet. Once we knew the carpet issue was under control, I got a second opinion about the spleen and had long talks with my vet about the situation. Both veterinarians suggested a splenectomy, and also to consider a cardiology evaluation to be sure his heart was strong enough for surgery. I was so nervous about what to do, he is older, acting fine and his quality of life is great. The thought of putting him through what I felt was major surgery was so frightening, especially since he is older, but I was also getting nervous about internal bleeding and ending up in emergency surgery and that being life threatening. I made the decision to see a cardiologist and they cleared him for surgery, and started him on heart medication; he then had the splenectomy the next day. The recovery was quick and he actually wasn’t much bothered by the surgery, maybe a day or two of lethargy. By the end of the first week I was having to keep him from playing and running, he was back to himself. Now, a few weeks later, I am so thankful I made the decision I did, he is just so happy, playful and back to being his energetic (in the old man style) self and even starting play sessions with his siblings. It was a roller coater ride for the few weeks after getting the diagnosis, getting a second opinion and making the decision to go forward with the surgery, but it was all worth it to have him back and not sit here and worry if he might be bleeding internally. I learned your mind can play those games with you when you know there is a potential unseen problem with your dog. One thing that made the decision a little easier was my vet telling me the surgery wasn’t much more on him then say a spay for a girl, it really wasn’t as major as I thought it would be, and based on the experience I went through, I’d agree it really didn’t take much out of him at all. I wish you all the best in making your decision, and I’d be happy to help answer any other questions you may have.
Trish
this is the answer from my client, Trish, who’s dog had a very similar issue (heart murmur and incidental splenic mass found via ultrasound).
“Wow, what you are going through sounds quite sillier to what I just experienced with my oldest dog, who is almost 12. He is a Lab mix weighing about 54 lbs. A few months back he had is senior checkup, including a full blood panel and all looked good except trace amounts of blood in his urine and he has had a heart murmur his whole life and had never been on heart medication. He ate carpet a few weeks ago and while doing X-rays and ultrasounds to be sure it wasn’t causing a bowel obstruction, we found he had an enlarged heart and two masses on his spleen, with no indication of metastasis. He was acting himself, except for the belly issues from eating the carpet. Once we knew the carpet issue was under control, I got a second opinion about the spleen and had long talks with my vet about the situation. Both veterinarians suggested a splenectomy, and also to consider a cardiology evaluation to be sure his heart was strong enough for surgery. I was so nervous about what to do, he is older, acting fine and his quality of life is great. The thought of putting him through what I felt was major surgery was so frightening, especially since he is older, but I was also getting nervous about internal bleeding and ending up in emergency surgery and that being life threatening. I made the decision to see a cardiologist and they cleared him for surgery, and started him on heart medication; he then had the splenectomy the next day. The recovery was quick and he actually wasn’t much bothered by the surgery, maybe a day or two of lethargy. By the end of the first week I was having to keep him from playing and running, he was back to himself. Now, a few weeks later, I am so thankful I made the decision I did, he is just so happy, playful and back to being his energetic (in the old man style) self and even starting play sessions with his siblings. It was a roller coater ride for the few weeks after getting the diagnosis, getting a second opinion and making the decision to go forward with the surgery, but it was all worth it to have him back and not sit here and worry if he might be bleeding internally. I learned your mind can play those games with you when you know there is a potential unseen problem with your dog. One thing that made the decision a little easier was my vet telling me the surgery wasn’t much more on him then say a spay for a girl, it really wasn’t as major as I thought it would be, and based on the experience I went through, I’d agree it really didn’t take much out of him at all. I wish you all the best in making your decision, and I’d be happy to help answer any other questions you may have.
Trish”
hope this helps.. i am going to ask Trish to add Reggie’s story to our storylines section asap!