Splenectomy

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Splenectomy means removal of the spleen. If the spleen is removed, the dog will be less able to fight off infection. Exercise & actvity will need to be restricted too. Removal of the spleen in AIHA treatment is only considered when all drug therapy has been unsuccessful in stopping the destruction of red blood cells by the spleen by pitting or “biting lumps” out of them. This is thankfully quite rare. This procedure requires very careful consideration & discussion.

Other reasons for removing the spleen include:

Splenic masses – Hemangioma (benign tumor of the red pulp of the spleen), Hemangiosarcoma (malignant tumor of the red pulp of the spleen),  or less commonly in the dog, mast cell tumor or lymphosarcoma (which grow in the white pulp of the spleen). These masses grow & eventually cause bleeding which can be profuse because the spleen is packed with many, many blood vessels.  The earlier these masses can be detected, the greater the chance of recovery.  Hemangiosarcoma is particularly problematic as it is a very aggressive form of cancer which spreads easily. If it has spread, removing the spleen (if that is even possible) will only prevent further bleeding and prognosis is poor as the tumor will continue to spread. If it has not spread significantly, removal of the spleen & chemotherapy are options to give a longer & better quality of life. Ultrasound can be used to asses the situation, although sometimes the full extent of the spread of the tumor is not evident until the abdomen is opened for surgery.

Injured spleen, hematoma or ruptured spleen – the spleen can sometimes be repaired, but sometimes will have to be removed to prevent the dog bleeding to death.

Gastric (stomach) bloat or dilation.  This is a build up of gas in the stomach which twists round & the blood supply can be restricted or cut off altogether – an emergency situation.  The spleen can be twisted along with the stomach because it sits underneath it.  Part of or the whole of the spleen may need to be removed n this instance.

Several transfusions may be needed before, during & after splenectomy.

After removal of the spleen, there is a risk of bleeding which is the most common complication post surgery.  The dog will usually be given antibiotics & painkillers.  Iron supplements may be given too. As mentioned earlier, there will always be a higher risk of infection in dogs without a spleen, so they will always need careful monitoring & they may be less energetic too. It is advisable not to allow a dog with no spleen to over-exert itself.

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