Splenectomy: Not as Uncommon (or Scary!) as You Would Think

by | Feb 25, 2021 | Blog

I made a joke the other day about how I perform more splenectomies than spays here. Granted, that’s not exactly true but I do take out 2-3 spleens a month. Many of these dogs are not originally my patients. They come here for either a holistic consult on tumors of the spleen or they were given not great odds and a very high estimate of cost at the emergency room so they are seeking another opinion.

I do not envy the veterinarians who work emergency. It costs a lot of money to keep a hospital open and fully staffed 24 hrs a day. They see a lot of terrible diseases and give out a lot of bad news. I, on the other hand, see a lot of wellness appointments and I don’t have to pay to keep a hospital open 24/7 so overall, I tend to be pretty optimistic and error toward the side of giving the dog a chance to live in this situation and can charge less than an ER or specialty hospital. I am a general practitioner with many years of experience in soft tissue surgery but I am not a board-certified surgeon.

When I find a mass on the spleen on a physical exam or because there are a few abnormalities on their bloodwork and I perform an ultrasound to look for one, I’m always asked the question, “what would you do if he was your dog?”. To me, this is overall an easy decision. I take it out. Obviously, you have to make sure that the dog can handle anesthesia, doesn’t have any signs of metastasis or other severe concurrent diseases, but overall, I take it out. No matter the age of the dog. Age is just a number, not a disease. I have performed splenectomies on 14-year-old dogs who have gone to live for another two years and died of old age.

So how could this be that easy of a decision for me? If I find a tumor on the spleen, no matter if it is cancerous or benign, that tumor has a high chance of rupture and bleeding. And some I don’t find until they are actively bleeding and the dog is not doing well. So your options are limited. We can give an herb to help stop the bleeding which could give us a little more time with your dog. We could euthanize that day if he is not doing well and has active internal bleeding. If it is not bleeding, then we can wait until it ruptures and then euthanize. Or we take it out and you take your pup home that night while we wait on results.
Most of these dogs do fantastic with surgery and often are back to their normal happy selves 24-48 hrs later. Even the old ones. They feel so much better getting that spleen out that their owners can’t believe how well they are doing just a day or two after a major abdominal surgery. The attached picture is of Jake, taken just 30 minutes after he was extubated. He was up and wagging his tail, happy to get that tumor out of him. We won’t know if Jake’s tumor is benign or cancerous until we get the biopsy results back in a week. And when we get those results, we can get a plan together for Jake. And even if it comes back as cancer, at least we know the results, we know what to expect in the future, and we were given a chance to digest this information.
Out of the last six spleens I removed, 66% of them were benign. That means those dogs are cured of this disease!! Would you spend $1500 to possibly cure your dog of a disease that could easily kill him (if the mass ruptured)?? I would. I understand that everyone does not have to financial ability to spend that amount of money and that is really okay. It is a lot of money. But it is a good idea to call around if you get a much higher estimate of the cost. Half of those six patients of mine came to me from other clinics because either their regular veterinarians do not feel comfortable performing those surgeries or they were quoted 2-4 times that amount at an emergency/specialty hospital.

I really hope Jake’s tumor is benign. And there are a couple of prognostic factors that give me hope that it could be benign. Jake’s tumor was not actively bleeding when it was found. Jake was not anemic and had a normal platelet count. Jake did not have signs of metastasis to his lungs or liver. And if it’s not benign, then I will have that tough conversation with his mom and go over the herbs we will use to slow down the growth of the tumor and I can give her some expectations for the next 3-10 months of his life. But at least, for now, Jake is home with his mom, he is feeling much better since taking his spleen out, and his mom can take a little time to come to terms with his diagnosis if it is not what we expect.

So yes, I would take out my dog’s spleen if I could afford $1500 and my dog was otherwise in good shape. I’ll take those odds that her mass would be benign. And if the pathology report said otherwise, then at least I was able to hug on my dog for many more months before I had to say goodbye.

Dr. Carrie Uehlein