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The Sad Realities of Hemangiosarcoma in Dogs

As a pet hospice and emergency veterinarian, I have seen my share of devastating loss but there is one cancer that often takes the cake.  An insidious monster that appears from nowhere and leaves a wake of suffering for owners that is profound.  A lightning bolt and rolling thunder that comes from nowhere on a day that was filled with blue skies only moments ago. Canine Hemangiosarcoma has always been a dreaded word for me with its great ability to disguise and appear with little warning. This boogeyman is ruthless and tragic.

The history is not uncommon. A wonderful, sweet dog was bounding through the yard the day before or maybe there had been a few days of being a bit off with less energy or less vigorous appetite and then without any warning, collapse, pale gums and panting. There is no time to mourn or process this tragedy for loving owners. In a moment everything has changed and suddenly a family is at the vet emergency clinic in the middle of the night and we are talking about canine Hemangiosarcoma.

What you need to know about Canine Hemangiosarcoma; the basics to prepare yourself since recognition and knowledge is power when it comes to cancer.

What signs do I look for in my pet? :

Hemangiosarcoma (HSA) arises from blood vessels. This nasty cancer affects the skin, heart, liver or spleen. It is aggressive and spreads fast to other parts of the body especially the lungs. Big clues that your pet may have this cancer include signs of vague lethargy or waxing and waning weakness. A belly may appear distended or mass may even palpated by a veterinarian. Bruising along the skin, pale gums, heavy panting or collapse is not uncommon. Your pet may have only a few of these signs or none at all if detected on a routine annual wellness exam or abdomen ultrasound. This type of cancer often invades the spleen or liver.  Both of these organs are highly vascular meaning there is a lot of blood making its way through each organ. A mass in one of these organs may rupture at any time without warning. As an owner, you may have no clues other than vague weakness, collapse or pale gums. The bleeding is internal into the abdomen cavity meaning there is no blood in the stool, none in the urine or anywhere visible.

If the body is able to control the bleeding your dog may even appear to recover and rebound.  The body may reabsorb the blood in the abdomen back into circulation and blood pressure stabilizes without intervention but more often these dogs present to a veterinarian in critical condition.

Canine Hemangiosarcoma may also invade the heart causing a bleed into the pericardium (sac surrounding the heart). These dogs often have similar signs of weakness, collapse, heavy panting, and pale gums.  In these cases, dogs may be having arrhythmias (irregular heart beat) or low blood pressure because the heart can’t beat normally.

What dogs are affected?

Usually large breed, middle aged to older dogs are affected but younger dogs may also be diagnosed with HSA. Any breed may be affected but more common breeds include German Shepherds, Golden retrievers and Labrador Retrievers.

How do veterinarians diagnose this type of Cancer?

A veterinarian uses clues including symptom history and physical exam findings.   Heart, liver, and spleen tumors on dogs are found by ordering radiographs and using an ultrasound. Your veterinarian will recommend chest radiographs (X-rays) to determine if there has been spread to the lungs. The appearance of a bleeding mass on an ultrasound is suspicious of Hemangiosarcoma but it is not a definitive diagnosis. Surgery is needed to remove the tumor and submit a biopsy to confirm Hemangiosarcoma from other types of cancer or a benign mass called Hemangioma.

How is this type of Cancer treated?

The first step is stabilization and surgery. If your pet has a history of collapse, intravenous fluids or even a blood transfusion may be be needed.  Your veterinarian will likely run a blood panel and monitor blood pressure or may recommend transferring to a 24 hour emergency clinic for further stabilization and treatment. The next step after stabilization is surgery to remove the bleeding mass.  Unfortunately, the survival rate for dogs with this type of cancer after emergency surgery to stop the bleeding is on average about three months. Chemotherapy after surgery is often recommended because this type of cancer spreads so aggressively to other areas of the body.  Chemotherapy and surgery increases survival times to an average of 5 to 9 months.

In about three quarters of these cases, a ruptured spleen or liver mass is diagnosed as Hemangiosarcoma. Unfortunately, a more rare diagnosis of Hemangioma is made by biopsy in less than 1/3 of these cases. This benign, slow growing tumor on dogs is cured by surgery.

My hope is that this glimpse into Hemangiosarcoma has armored you with knowledge to recognize signs of this nasty Cancer. Unfortunately, another trick up the sleeve for this deadly disease is time. Owners are faced with big decisions that need to be made in minutes when they are left with more questions than answers. Owners are faced with whether to take a pet to surgery or proceed with heroic stabilization without any guarantee for survival and a greater likelihood that this insidious disease is the culprit.  My hope is that this blog may give you enough to start the battle or make a better decision if you and your pet must face this canine cancer.

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