Splenectomy Experience - Advice Please

[Fiona3]

Fiona has been monitored since mid-April for a lesion on her spleen. The most recent ultra-sound indicates that the lesion has grown slightly so she is scheduled for a splenectomy on June 19th. She has some additional medical issues such as higher levels of protein in her urine, Hypertension which has been controlled by two medications, and mild incontinence. A biopsy will be performed on her spleen and her kidneys during the procedure. All tests for kidney disease have been normal and shown nothing out of the ordinary. Any suggestions about what might be causing the protein levels in her urine? Her diet has been changed to a Kidney diet but this has not lowered the levels of protein.

 

In spite of all the above issues, Fiona looks happy and healthy and has responded well to all the medication given to her. She will be 12 years old on Aug. 29th so we are concerned about her undergoing this surgery at her age.

 

I would appreciate any advice or experience that anyone has had with their greys undergoing a splenectomy and what to prepare for her recovery. Thanks for your help.

[GreyTzu]

Dancer lost her spleen to torsion and lived a happily for about 8 years until LS took her.

[Fiona3]

Dancer lost her spleen to torsion and lived a happily for about 8 years until LS took her.

 

That is really good to know that Dancer's surgery was successful. It must have been frightening to have the torsion.

[Trekkysmom7]

I do not know if you want to hear this, but I thought I should let you know of a poor outcome. My angel Trixie had a splenectomy at University of Pennsylvania at age 9 1/2 for an mass in her spleen which turned out to be malignant. Prior to the surgery she was healthy with no issues. She did very poorly after the surgery and would not eat. She passed away 1 week after the surgery when her surgical wound opened and she developed a massive infection. By this time we had found out that the mass was malignant and had spread to her liver so her projected life expectancy was 2-3 months. I could not see putting her through another major surgery to debride and close the wound so I helped her cross the rainbow bridge. I would encourage you to stock up on different foods to entice Fiona to eat. I wish you and Fiona good luck and a speedy recovery.

[tbhounds]

Glomerulonephritis is a rather common condition seen with our hounds and fortunately it progresses slowly compared how it advances in other breeds such as Wheatens. Dr Couto does have a theory as to why-may be bacterial related (track diet). The key with proteinuria is to monitor the UPC levels. I assume your hound is already taking enalapril? If taking low dose aspirin for the proteinuria you should be advised to stop prior to the surgery. One thing I would definitely consider is giving Amicar to prevent the post operative greyhound bleeding syndrome (500mg three times daily for 5 days starting the day before or the night of the surgery).

Regarding the splenectomy-of course with any surgery there is a risk but, in qualified hands splenectomys can be rather routine--however, whenever a mass is present obviously that changes things. It doesn't sound like your dog has a very large mass (I have seen masses up to 9lbs-ugh). Dogs can develop an irregular heartbeat post surgery (pre mature ventricle contractions) so, follow up ekg's may be recommended for 72 hrs post surgery. Your veterinarian may will most likely take a healthy peek at her liver during the surgery and may consider biopsing any suspicious lesions.

One of my own girls had a very complicated splenectomy and did very well with no long term problems.

I'm assuming the veterinary clinic is well staffed overnight and she will be monitored though out the evening. Sending all my best -keep us posted!

[Fiona3]

Thanks for the suggestions and information.

 

Trekkysmom - I'll be sure to stock up on food that will appeal to her after the surgery. She isn't very fond of the kidney diet food but I will need her to eat. The lesion appears to be very small so the hope is that it will be benign. We'll see what the biopsy reveals.

 

tbhounds - Good idea to mention the Amicar & enalapril. Our vet put Fiona under the care of a specialist at the emergency and outpatient clinic when this all began. There is a surgeon who specializes in this type of procedure who will perform the surgery. She will have 24 hour care for the time she is in the clinic. Because of the hypertension, they will be monitoring her blood pressure as well.

 

Fiona has been on the low dose aspirin but that was discontinued two weeks ago in case of surgery. The proteinuria has been monitored every two weeks and has been puzzling for the cause. This is helpful to know that it seems to be a common condition and progresses slowly. Perhaps the kidney biopsy will reveal something that has been missed in the tests.

 

I appreciate all your ideas and thoughts. We will be worried until she safely comes through the procedure and she is home with us again.

[tbhounds]

Sounds like she'll be in good hands--please update after her surgery :-)

[MP_the4pack]

My Pearl had a splenectomy for fibrosarcoma. While she did recover from the surgery, the cancer spread to her liver quickly and she was gone 3 weeks later.

[carronstar]

Aquitaine had an emergency splenectomy in December 2011. She had a softball sized mass in her spleen removed, biopsied, found bening. She did have some elevated BP and arrythmia (sp?) after the surgery so they kept her for a couple of extra days. She came home and healed quite well. The only issue was that three staples were missed at the first removal. She seems to be a dog that does better with stitches as she did not like the staple removal AT ALL!

 

She was diagnosed late last summer with PLN by an internal specialist here in NYC. The Greyhound Wellness Program at OSU said they would not have made that diagnosis based on her blood/urine levels. I am treating her as if she does have PLN and monitoring her levels very closely.

 

Holding very good thoughts for Fiona.

[GeorgeofNE]

We had an English Setter who went IN for a spleenectomy, and was euthanized on the table. When they opened him up, they found cancer had spread everywhere, and we opted to have him put down. He was 8.

[MaryJane]

If you are given any "fish-oil products", you might want to also discontinue their use 10 days to 14 days before surgery. Fish-oil has aspirin like tendencies in that it keeps platelets from clotting. Note, there have not been any studies done to identify how much (if any) bleeding issues arise from fish oil in people or animals but, you might want to be on the safe side and just discontinue.

[Fiona3]

To those of you who have lost a beloved friend to a mass found during/after a splenectomy, I am so very sorry. It's heartbreaking to say goodbye so unexpectedly.

 

It is a possible outcome for Fiona that there could be a malignant area in the spleen (or that the kidney biopsy will show the same result). As the lesion was discovered during an incidental ultrasound, our hope is that it was found at a very early stage of development. Unfortunately, we won't know until the biopsies are performed with the removal of the spleen.

 

carronstar - thank you for the mention of PLN. It may be very important information in treating the problem with protein in her urine. Its good to know that Aquitaine recovered nicely from her surgery.

 

MaryJane - Fiona hasn't been on any fish-oil products but this is something that is very good to know. I had no idea that fish-oil would have the same aspirin like affects.

 

Thank you everyone who posted. Every bit of information is important. Fiona has so many different medical issues. We'll just have to tackle each one step-by-step.

[Wonder]

Lucky had an emergency splenectomy in Dec. He's 6. He was "lucky" and it wasn't cancer although Dr Kellogg warned me that the mass could return else where. He will have blood work done every 6 months (I'd do it monthly but he freaks too much at the vet and has non-milignant hypothermia). One of the complications of the splenectomy is something with the heart rhythm so he had to have a drip for 24 hours. Then he had some issues with his kidneys which I don't recall now.

 

Good luck to you both.

[Fiona3]

Lucky had an emergency splenectomy in Dec. He's 6. He was "lucky" and it wasn't cancer although Dr Kellogg warned me that the mass could return else where. He will have blood work done every 6 months (I'd do it monthly but he freaks too much at the vet and has non-milignant hypothermia). One of the complications of the splenectomy is something with the heart rhythm so he had to have a drip for 24 hours. Then he had some issues with his kidneys which I don't recall now.

 

Good luck to you both.

 

It must have been a big relief that Lucky didn't have cancer after his emergency splenectomy. I am sure there will be a number of tests to regularly monitor Fiona's urine and blood levels as well. The surgeon called this afternoon and mentioned that Fiona will be in their clinic for 48 hours after the surgery. They will be monitoring her blood pressure and I can ask about the heart rhythm as well.

 

Best of luck to you and Lucky that all his tests will continue to have good results.

[tbhounds]

The arrhythmia other posters are referring to is the pvc (pre mature ventricle contraction) I mentioned in an earlier post. Doesn't happen in people post splenectomy's but, often happens in dogs post surgery. Can be seen for the first 72 hours post surgery--treatment is a lidocaine IV drip. I'm sure the surgeon will be watching for this very closely. Try not to worry-its controllable if it should happen.

[4My2Greys]

I think your doing the wise thing in having the splenectomy done. He wasn't a greyhound, but my American bulldog, Bruiser had to have a splenectomy because of a ruptured mass. It turned out to be HSA. He did fine with the surgery, but I lost him 8 months later to the cancer. My vet feels the outcome could have been better if we had caught the mass before it ruptured.

[Fiona3]

The arrhythmia other posters are referring to is the pvc (pre mature ventricle contraction) I mentioned in an earlier post. Doesn't happen in people post splenectomy's but, often happens in dogs post surgery. Can be seen for the first 72 hours post surgery--treatment is a lidocaine IV drip. I'm sure the surgeon will be watching for this very closely. Try not to worry-its controllable if it should happen.

 

 

I think your doing the wise thing in having the splenectomy done. He wasn't a greyhound, but my American bulldog, Bruiser had to have a splenectomy because of a ruptured mass. It turned out to be HSA. He did fine with the surgery, but I lost him 8 months later to the cancer. My vet feels the outcome could have been better if we had caught the mass before it ruptured.

 

Thank you both for this reassuring information. Fiona has been monitored since mid-April when this small lesion was discovered. The last ultra-sound showed a small increase in size. Her specialist felt it was a sign that the spleen needed to be removed as a preventative measure. Hopefully we will hear it is Benign!

[Wonder]

The arrhythmia other posters are referring to is the pvc (pre mature ventricle contraction) I mentioned in an earlier post. Doesn't happen in people post splenectomy's but, often happens in dogs post surgery. Can be seen for the first 72 hours post surgery--treatment is a lidocaine IV drip. I'm sure the surgeon will be watching for this very closely. Try not to worry-its controllable if it should happen.

 

Yep that's it. It was all a blur when it was happening that I couldn't remember details but that all sounds familiar.