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Emergency Splenectomy


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Guest babyphoenix

Phoenix (11) was lethargic and not moving yesterday morning at in-laws (they were doggy sitting while we were out of town). Mil took him to small town vet and called us. That vet thought phoenix was having some sort of a heart event but wasn't able to diagnose/treat further than that because of limited resources. Heart rates were extraordinarily high, over 220.

We had him taken to nearest e-vet and met them there. When We arrived they had done initial X-rays and first diagnosis was heart disease. They were attempting to stabilize him and we were going to proceed to ecg for more definitive answers. Vet called later to say he took another set of films (after I'd questioned heart disease dx) and upon those he said he suspected possible bloat/torsion. Stomach looked to be turned about 90 degrees and was larger in 2nd films. We went ahead with bloat surgery.

While in surgery vet found splenic torsion and a basically "dead" spleen. Spleen was removed. Stomach repositioned and tacked into place.

1st day of recovery and he's not perking up quite as quickly as they'd like but are giving him time, given his age. Heart rate is still high (120-140) which is the bigger concern right now.

So. What am I missing? What questions do I need to be asking? Any experience you might have to relate? I'll take anything. Any advice. We've been blessed with not having any major health events before now so I'm feeling out of my depth in dealing with this and being a good advocate for Phoenix.

Help! Please :(

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How awful! Sending good thoughts for your guy. The situation is frightening enough with a middle aged dog and is even more scary when it is your senior.

 

Years ago I had a non-Grey who had GDV surgery which included splenectomy. My guy was younger, about 7 yo. He has acted slightly odd that day, in very minor ways but still out of character. He had not acted painful (though in retrospect I realized those couple odd behaviors indicated he likely was), nor did he appear bloated until he suddenly needed to go outside where he proceeded to start dry heaving. We rushed him to the vet immediately but his spleen and part of his stomach already had necrosis. (Vet was 45 min away.) He did have some heart issues overnight while still at e-vet & during the next day at his regular vet. Not sure about heart rate. If I remember correctly, he had arrhythmias. Though it was a really rough experience, quite nerve racking, my boy did recovery rather fast, all thing considered.

 

Something of note: The vet found a mass on his spleen so it was sent to the lab. It proved benign, thank heavens, and my guy lived another 3 years.

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Yes, high heart rate and arrhythmias are what they're still seeing. For now they're saying it's not totally out of the range of expectation given his situation but it's something we're watching (and I'm concerned about).

It sounds like it's possible they'd still send him home even with elevated heart rate/ sporadic arrhythmias. We're reevaluating in the a.m. but I'm trying to find out how concerned I need to be about bringing a dog home in that condition. Granted, we can't really afford to keep him recuperating at e-vet but I want to do what's best to support his recovery as well.

Just feeling really confused and unsure of any decision right now :( and like I'm not asking the right questions.

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Dancer was 6ish when she had her spleen removed due to a torsion. It was diagnoised immedately at the e-vet and was removed promptly with no complications or recovery issues. She lived to be 12 to 13.

 

Sending healing energy. :grouphug

Wendy and The Whole Wherd. American by birth, Southern by choice.
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Dancer was 6ish when she had her spleen removed due to a torsion. It was diagnoised immedately at the e-vet and was removed promptly with no complications or recovery issues. She lived to be 12 to 13.

 

Sending healing energy. :grouphug

Thank you so much for your thoughts! I need it right now! 😢

 

Also i did search the forum but if anyone knows of a thread here that might have some relevant info, I'd love a link.

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What sort of arrythmias? Ventricular premature contractions (VPC)?

Deanna with galgo Willow, greyhound Finn, and DH Brian
Remembering Marcus (11/16/93 - 11/16/05), Tyler (2/3/01 - 11/6/06), Frazzle (7/2/94 - 7/23/07), Carrie (5/8/96 - 2/24/09), Blitz (3/28/97 - 6/10/11), Symbra (12/30/02 - 7/16/13), Scarlett (10/10/02 - 08/31/13), Wren (5/25/01 - 5/19/14),  Rooster (3/7/07 - 8/28/18), Q (2008 - 8/31/19), and Momma Mia (2002 - 12/9/19).

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Bruiser, my AB recovered very nicely after having his spleen removed at 12 due to a mass, which unfortunately turned out to be cancerous. His recovery from the splenectomy itself though was without problem. Sending healing thoughts and white light for a full and trouble free recovery for your boy. :hope:candle

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Yes, high heart rate and arrhythmias are what they're still seeing. For now they're saying it's not totally out of the range of expectation given his situation but it's something we're watching (and I'm concerned about).

It sounds like it's possible they'd still send him home even with elevated heart rate/ sporadic arrhythmias. We're reevaluating in the a.m. but I'm trying to find out how concerned I need to be about bringing a dog home in that condition. Granted, we can't really afford to keep him recuperating at e-vet but I want to do what's best to support his recovery as well.

Just feeling really confused and unsure of any decision right now :( and like I'm not asking the right questions.

 

Daniel was home less than 24 hours after surgery. Deal was he was transferred from overnight e-vet to regular with instructions to then bring him back to e-vet for overnight observation. When I went to pick him up the regular vet felt the heart issues were stabilized. Can't remember if arrhythmia was fully resolved yet or not. Instead of having us return to e-vet, my regular vet said Dan would be more comfortable at home overnight & to just bring him back to them, regular vet, the next morning for continued fluids and observation. He came home looking awful, with catheter in his leg and ... well, I distinctly remember laying in bed, watching his discomfort & thinking, "This was a really bad idea." In retrospect, for Daniel at least, it probably was the right decision. For me, maybe not so much. :lol Dan spent two day at "day care" with his regular vet.

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Guest babyphoenix

What sort of arrythmias? Ventricular premature contractions (VPC)?

Would V-tach make sense?

That is what he initially had when he arrived at evet.

Sorry. Like I said I'm a bit overwhelmed with info. ..

I'll double check that when I talk to vet in morning.

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What sort of arrythmias? Ventricular premature contractions (VPC)?

 

Edit: Since I need to head off to bed and it will be tomorrow night until I'm back on, I'll tell you my thoughts. If they are VPC's, you'll want to find out how often they are occurring, and if they are considering, or have already started, anti-arrythmia therapy such as IV lidocaine. VPC's are not unexpected after a splenectomy or similar major surgery (my Symbra developed them after her leg amputation), and my understanding is that if the heart rate is not extremely elevated, the VPC's will likely resolve themselves over time. However, Symbra's surgeon consulted with the cardiologist after the surgery, who got her on IV lidocaine in order to convert her heart rhythm, and then she was sent home with oral sotalol to take for two weeks (her amputation was on a Friday and she went home on Monday evening - she was kept there until her number of VPC's was significantly reduced). I don't recall her heart rate precisely, but mentally reviewing the scene of me watching her ECG on that Saturday, I believe it was in the 130 range while she was throwing the VPC's.

 

Another possible cause of elevated heart rate (and possibly the VPC's) is pain - it may be worth asking if they feel his pain is being adequately controlled. I know I discussed that with Symbra's doctor at one point, and I recall that at some point over the weekend, they did indeed change her pain medications.

Deanna with galgo Willow, greyhound Finn, and DH Brian
Remembering Marcus (11/16/93 - 11/16/05), Tyler (2/3/01 - 11/6/06), Frazzle (7/2/94 - 7/23/07), Carrie (5/8/96 - 2/24/09), Blitz (3/28/97 - 6/10/11), Symbra (12/30/02 - 7/16/13), Scarlett (10/10/02 - 08/31/13), Wren (5/25/01 - 5/19/14),  Rooster (3/7/07 - 8/28/18), Q (2008 - 8/31/19), and Momma Mia (2002 - 12/9/19).

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Guest babyphoenix

 

Edit: Since I need to head off to bed and it will be tomorrow night until I'm back on, I'll tell you my thoughts. If they are VPC's, you'll want to find out how often they are occurring, and if they are considering, or have already started, anti-arrythmia therapy such as IV lidocaine. VPC's are not unexpected after a splenectomy or similar major surgery (my Symbra developed them after her leg amputation), and my understanding is that if the heart rate is not extremely elevated, the VPC's will likely resolve themselves over time. However, Symbra's surgeon consulted with the cardiologist after the surgery, who got her on IV lidocaine in order to convert her heart rhythm, and then she was sent home with oral sotalol to take for two weeks (her amputation was on a Friday and she went home on Monday evening - she was kept there until her number of VPC's was significantly reduced). I don't recall her heart rate precisely, but mentally reviewing the scene of me watching her ECG on that Saturday, I believe it was in the 130 range while she was throwing the VPC's.

 

Another possible cause of elevated heart rate (and possibly the VPC's) is pain - it may be worth asking if they feel his pain is being adequately controlled. I know I discussed that with Symbra's doctor at one point, and I recall that at some point over the weekend, they did indeed change her pain medications.

This helps! Thank you!

Yes he was on iv lidocaine when they first brought him in and that seemed to calm things down. I do know at our visit today the tech (doc was in surgery and unable to talk to us at the time) mentioned he was on fentanyl for pain. And I know he'd had a reaction (diarrhea) to "a pain med" (according to my husband who took the last call from doc) [note- my husband is THE WORST at processing, remembering and relaying this info]

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How horrible for you and Phoenix! I'm so glad you found that in time.

My ten year old Sid had an emergency splenectomy a few months ago. It wasn't associated with any kind of bloat or torsion event, it was just that I'd noticed he was a bit off and had been watching him carefully (and, incidentally had taken him to the vet several times for check-ups when they could find nothing out of the ordinary) and eventually noticed when he was lying down that he had a large mass in his abdomen. The vet had to lay him on the table to see and feel it, but when he did, Sid was immediately booked in for surgery.

We were lucky the huge mass didn't rupture before we found it - he'd have bled out and died.

 

During recovery he did have some arrhythmia and a rapid heart rate due to hypovolemic shock: his spleen was enormous and full of small chambers containing blood, so when it was removed, he lost a lot of circulating blood volume. When you get a very high heart rate, you often notice more sinus arrhythmia, which is basically harmless and normal in dogs anyway. Sid's heart rate returned to normal after a couple of days when he'd made enough new red blood cells to cope with the loss.

 

If Phoenix's spleen was twisted so that blood could enter but not leave, it may have been very swollen with blood. If so, his arrhythmia and rapid heart beat could be due to the same cause as Sid's, which is to say, the loss of a large amount of blood. Sid's spleen weighed five and a half pounds, if that helps with comparison.

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Guest Muscovy

Yep, my boy lost a lot of blood during a biopsy of his haemangiosarcoma tumour (they bleed). His heart rate was rapid that night when I brought him home, around 140bpm I think. This was due to anaemia/hypovolemic shock, and improved when we put him on IV fluids the next morning at the emergency vet. Could your boy have lost a lot of blood during surgery?

 

Also, he was on a fentanyl patch when we brought him home - the thing is, the patch takes 12-24 hours to take effect fully, so the pain relief probably wasn't entirely adequate. Just thought that might be worth mentioning,

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Good thoughts for you boy.

Kyle with Stewie ('Super C Ledoux, Super C Sampson x Sing It Blondie) and forever missing my three angels, Jack ('Roy Jack', Greys Flambeau x Miss Cobblepot) and Charlie ('CTR Midas Touch', Leo's Midas x Hallo Argentina) and Shelby ('Shari's Hooty', Flying Viper x Shari Carusi) running free across the bridge.

Gus an coinnich sinn a'rithist my boys and little girl.

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Guest babyphoenix

Thank you all for your kind thoughts and for relaying your experiences. It all is of immense help and comfort.

Keep stories coming.

I'll be visiting Phoenix and doc at some point today. Will update when I can. Hopefully with promising news :/

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Guest babyphoenix

Heard from over night doc.

Still not eating. Still not up and moving. Concerning bruising and beginning some possible weepiness at incision. Heart rate is still high and arrhythmias are a little better. Doc thinks his pain is being managed. He's on a "middle of the road" fentanyl dosage right now.

 

And we're over $1,000 above the "high end" estimates for the surgery and recovery. I love this dog more than I can adequately convey but are we chasing a recovery that is going to cost is far more than we have? (I dont really expect you guys to answer that but if you have any words of wisdom is happily take them)

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I'm sorry things are not looking good. :(

If he isn't on Amicar already he needs to be started on it immediately.

 

Can you tell me more about Amicar? the whats and whys of it? (sorry, i'm feeling very uneducated and just plain stupid about all of this)

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