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Splenic Torsion

Photo courtesy of Hill's Pet Nutrition

Photo courtesy of Hill’s Pet Nutrition

Anatomy
The spleen is a tongue shaped organ within the abdomen that filters the blood. It removes and processes aged red blood cells and bacteria from the blood. In addition, the spleen is a reservoir that stores blood, in the event that the body suddenly needs it. Humans and animals can live normal lives without a spleen.

What is a splenic torsion?
A splenic torsion is a condition in which the spleen twists about it arteries and veins. Because veins normally have low blood pressure, they become collapsed first. The arteries, having a much higher blood pressure, will continue to pump blood into the spleen, resulting in a very large, painful organ.

There are two forms of a splenic torsion: acute and chronic. The acute form of the condition causes marked acute abdominal pain and shock within a few hours after the spleen twists. Because the spleen essentially consumes the blood from the body, the affected patient will display signs of shock. The chronic form likely is due to a partial twist of the spleen; thus the blood flow is incompletely cut off. In these cases, clinical signs often are those associated with vague illness.

Signs and diagnosis
Splenic tumors tend to affect large deep-chested dogs such as German shepherds and great Danes. Clinical signs of an acute splenic torsion include acute weakness, collapse, pale gums, rapid heart rate, retching, drooling, abdominal pain, abdominal distention and enlargement of the spleen. Signs of the chronic form of the condition include pale gums due to anemia and port wine colored urine due to breakdown of red blood cells.

Abdominal X-rays usually show marked enlargement of the spleen and sometimes free fluid (blood) within the abdomen. Ultrasound of the abdomen will confirm the presence of a very enlarged spleen and loss of blood flow within the veins of the spleen. Blood work is also necessary prior to surgery to ensure that the internal organs are functioning well and to ensure that your companion is not so anemic that a transfusion is needed.

Treatment
Initially, your companion will be assessed and intravenous fluids, artificial plasma (hetastarch) and potentially blood transfusions may be required to reverse shock and anemia. The spleen is removed via an abdominal incision. Commonly, hemostatic staples are used to seal the blood vessels of the spleen; therefore, you should not be alarmed if an X-ray made after the surgery shows metal staples within the abdomen. After the surgery, blood pressure, EKG, and other vital signs will be monitored to ensure that your companion has an uneventful recovery. Intravenous fluids are continued after surgery to keep the patient well hydrated and to maintain blood pressure. Most pets will stay in our hospital for 24 to 72 hours after surgery.

Results
The prognosis for acute splenic torsion is not quite as good as the chronic form, as these dogs are more severely affected by toxins in the blood and shock. With early aggressive medical and surgical treatment, the prognosis can still be favorable. One study reported a 100% survival of cases that had surgical removal of the spleen.

For more information on this subject, speak to the veterinarian who is treating your pet.