When to Euthanize a Dog With Hemangiosarcoma

I’ve been providing hospice care and euthanasia guidance since 2007 and unfortunately I have seen time and time again how devastating hemangiosarcoma can be. This particular type of Cancer is the most aggressive cancers above all others. This guide will give you more guidance on hemangiosarcoma. 

Hemangiosarcoma is a big name for a deadly villain. This cancer is insistent and devastating because it goes undetected. There are often no signs or only a vague history of decreased appetite, weakness or lethargy for a day or two. Other times there is sudden collapse with increased panting, labored breathing and pale gums. Before I started Paws Into Grace I was an ER veterinarian. These cases were so gut wrenching as owners were completely blindsided. Often times, families were forced to make a decision in seconds about whether to put a beloved pet to sleep or start emergency blood transfusions and surgery. Moments ago everything was completely normal and then in an instant they were saying goodbye or a pet was being rushed to the back for emergency surgery. 

What is Hemangiosarcoma?

Hemangiosarcoma is a cancer affecting blood vessels and organs such as the heart, liver and spleen. This type of cancer occurs in the skin if there is prolonged sun exposure. Hemangiosarcoma affecting skin can be cured with surgery to remove these tumors. Hemangiosarcoma affecting the liver, spleen or heart is far more insidious. These tumors spread to the lungs causing difficulty breathing. 

Hemangiosarcoma leads to the accumulation of fluid around the heart, known as pericardial effusion, which exerts pressure on the heart, hindering its function. Inadequate heart contraction due to this fluid accumulation results in an inability to maintain blood pressure. Common symptoms include collapse, difficulty breathing, pale gums, and overall weakness. Patients often experience heart arrhythmias, leading to severe distress and discomfort characterized by collapsing and labored breathing. Veterinarians may perform Pericardiocentesis to drain the fluid, but this procedure carries risks, and recurrence of fluid is likely, posing recurrent life-threatening complications with unpredictable timing.

Hemangiosarcoma can also affect the liver and spleen, where tumors may rupture spontaneously, resulting in internal bleeding within the abdomen. This bleeding can occur without any noticeable external symptoms, except for those induced by slow bleeding such as lethargy or decreased appetite, or sudden, severe bleeding leading to massive internal hemorrhage, characterized by collapse, labored breathing, and pale gums. Patients may recover if bleeding ceases, allowing the body to absorb the blood from the abdomen, or they may succumb to severe acute blood loss.

When to Euthanize a Dog With Hemangiosarcoma

Hemangiosarcoma presents a unique challenge in veterinary medicine, as it’s one of the few conditions where euthanasia may be recommended even when a patient appears to be doing well. Early intervention is crucial, and considering euthanasia preemptively can help prevent a crisis situation, as the disease inevitably progresses without a cure or effective medication to slow its progression. While oncologists may offer chemotherapy, the reality is that this cancer often advances rapidly, leading to severe suffering at any moment.

Small white dog sitting on beach with leash

Detecting Hemangiosarcoma early is notoriously difficult, often manifesting in advanced stages by the time symptoms become apparent. As a result, my focus has shifted towards advocating for early cancer detection in all forms. Hemangiosarcoma serves as a stark example of the importance of cancer screening, even in the absence of symptoms. I strongly recommend annual abdomen ultrasounds, blood panels, and chest x-rays for all senior patients, as proactive measures to detect Hemangiosarcoma before it progresses to a critical stage.

Factors Details
Quality of life
  • Above all to remember is dogs will suffer with this disease so early crisis intervention is recommended
Prognosis
  • Hemangiosarcoma has a poor prognosis, even with treatment
  • Rapid metastasis and progression 
  • Average survival is only one to six months after diagnosis
Advanced disease
  • Severe internal bleeding
  • Large invasive tumors
  • Widespread metastasis especially to the lungs
Treatment options
  • Surgery and chemotherapy may prolong life briefly
  • Pericardiocentesis: removing fluid around the heart if there is heart Hemangiosarcoma 
  • Blood transfusion for emergency stabilization followed by splenectomy (removing the spleen) or liver lobectomy (removing part of liver to remove tumor)
Goals and priorities
  • Recommend euthanasia to help dog’s transition before an advanced crisis occurs

Factors to Consider in Euthanizing Dogs With Hemangiosarcoma

Deciding when to euthanize a pet dog with cancer or hemangiosarcoma is heart-wrenching. As a veterinarian, I guide pet owners through the process by evaluating the disease severity and the dog’s quality of life.

Hemangiosarcoma presents a unique scenario where euthanasia may be advised even when the patient’s quality of life remains relatively stable. Our assessment of quality of life encompasses various factors, including meeting physical needs such as hunger, absence of vomiting/diarrhea, social interactions, adequate pain management, and the likelihood of life-threatening crises. While Hemangiosarcoma may not yet have significantly impacted a patient’s quality of life, the imminent risk of a life-threatening crisis is almost inevitable. Therefore, euthanasia is recommended to prevent unnecessary suffering.

A woman writing on a clipboard with a dog sitting next to her

The progression of Hemangiosarcoma is typically aggressive, with a high probability of life-threatening internal bleeding. When I observe signs of recurrent bleeding events or a confirmed diagnosis of Hemangiosarcoma, euthanasia is advised to alleviate potential suffering and prevent the inevitable complications associated with the disease.

Ways to Decide When to Euthanize Dogs With Hemangiosarcoma

Deciding to euthanize a dog with hemangiosarcoma is complex and deeply personal. It involves evaluating pain, the cancer stage, quality of life, whether treatments will be effective and in this case the high likelihood of a life threatening emergency crisis.

What is a Cancer Vaccine?  There has been research to develop a cancer vaccine against certain types of cancer including Hemangiosarcoma. In the past the only treatment options were surgery and chemotherapy. Neither option significantly improved Quality of Life or life expectancy. The median survival time is 5-8 months with both surgery and chemotherapy if there is no sign of metastasis to lungs or other organs. There has been some research suggesting that adding Doxorubicin chemotherapy with surgery if possible, may extend survival to 6 months in patients with heart hemangiosarcoma (Weisse C, Soares N, Beal M. W. Survival times in dogs with right atrial hemangiosarcoma treated by means of surgical resection with or without chemotherapy: 23 cases (1986-2000). J AM Vet Me Assoc. 2005; 226:575-579.) 

Immunotherapy has been researched as another treatment for Hemangiosarcoma. Vaccines have been developed for oral melanoma and osteosarcoma (bone cancer) with success improving survival times. Research by University of Florida has shown the GD2/GD3 vaccine used with chemotherapy slows down the metastasis rate (cancer spread) to the lungs and overall survival time for osteosarcoma (bone cancer) and oral melanoma but Only 12% of dogs with autologous cancer vaccine  have approximately a one-year survival rate with Hemangiosarcoma. 

Euthanasia Process and Aftercare for Pet Dogs With Hemangiosarcoma

When I guide pet owners through the euthanasia process for a dog suffering from hemangiosarcoma, I ensure that they understand each step. I typically encourage owners to spend the final moments with their pets. I will also explain aftercare choices, including emotional support services.

Canine Hemangiosarcoma Overview

Hemangiosarcoma is recognized as one of the most aggressive forms of liver cancer in dogs, often leading to a critical emergency crisis. This type of cancer also targets the spleen and heart. In my experience as a veterinarian specializing in end-of-life care, the signs a dog is nearing the end of life from hemangiosarcoma can often be subtle yet progress quickly. 

A woman and a family sitting on a couch, looking at each other

Related Questions

How Long Can Dogs Live With Hemangiosarcoma? 

Dogs with hemangiosarcoma typically only live for one to six months after diagnosis, even with treatment. The cancer tends to progress and spread rapidly, leading to a relatively short survival time.

What Are the Signs That a Dog Is Suffering From Hemangiosarcoma?

Dogs suffering from hemangiosarcoma may exhibit signs such as lethargy, abdominal swelling, pale gums, heavy breathing and occasional collapse. Symptoms are generally related to the tumor’s location.

How Can I Make a Dog More Comfortable After a Hemangiosarcoma Diagnosis?

Upon diagnosis, focus on palliative care to enhance a dog’s comfort. This can involve pain medication, nutritional support, and close monitoring for signs of pain or distress. A veterinarian should also be consulted to discuss when euthanasia would be recommended. 

Conclusion 

Assessing the quality of life of your beloved dog and consulting with a compassionate veterinarian can greatly aid dog owners in navigating the difficult decision-making process associated with hemangiosarcoma. When faced with the heartbreaking reality of this disease, prioritizing your dog’s comfort and dignity becomes paramount.

In such circumstances, opting for in-home pet euthanasia can offer a serene and familiar setting for your dog’s final moments. By choosing this option, you can ensure that your cherished companion is surrounded by the warmth and familiarity of home, providing them with a sense of peace and comfort during their transition. This compassionate approach allows you to honor your dog’s well-being and offer them the utmost care and respect in their final journey.

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I can't recommend them enough. I had to say goodbye to my 21 year old cat companion. I read the reviews here on Yelp and chose Paws Into Grace and they made an unbearable situation not worse - from the people on the phone to the amazing doctor who... read more

Renee C.

My absolute love Dante had heart failure three months ago. After having him on many medications to help him, his enthusiasm and appetite declined last couple of days. He was in pain and we decided to help him go to heaven rather than torturing him... read more

Diane C.

I wanted to thank you for sending Dr. Brown to euthanize our beloved Myleigh on March 4, 2021. She was compassionate and accommodating, she explained every step of the procedure, and gave us some alone time with Myleigh after she sedated her, but... read more

Terry A.

Renee C.

I can't recommend them enough. I had to say goodbye to my 21 year old cat companion. I read the reviews here on Yelp and chose Paws Into Grace and they made an unbearable situation not worse - from the people on the phone to the amazing doctor who came out to the house. She was so understanding and supportive. They were all so helpful, understanding and nice. My girl got to stay at home and say goodbye in the backyard (a hummingbird flew over and it seemed like a good sign too). So glad I didn't have to take her to a cold vet office.

Diane C.

My absolute love Dante had heart failure three months ago. After having him on many medications to help him, his enthusiasm and appetite declined last couple of days. He was in pain and we decided to help him go to heaven rather than torturing him with more medications which would make him even more miserable. I called and spoke to a very kind lady who was patient as I cried through making an appointment. We made an appointment for 1:30pm. Dr. Toni arrived. She was very kind, explained everything to us and gave us the time to be with our boy after the first shot. He wasn't relaxing enough so she gave him a second shot. We stayed with him throughout the entire process and I carried him to her car in the end. It was a very difficult decision but knowing that our boy is not in pain, gives us some peace. We are thankful to Dr. Toni for her kindness and compassion. They will arrange the cremation for us. Since we are in a pandemic, we had our masks on and said goodbye to our boy in our garden.

Terry A.

I wanted to thank you for sending Dr. Brown to euthanize our beloved Myleigh on March 4, 2021. She was compassionate and accommodating, she explained every step of the procedure, and gave us some alone time with Myleigh after she sedated her, but before she attached the IV. We were relieved that we made the decision to let her go to doggy heaven at home. It was a tranquil and serene passing for her, and it very much aids us in the grieving and healing process knowing that she passed away so peacefully. Based on the grace and compassion Dr. Brown demonstrated on one of the most awful days of our lives we would not hesitate to recommend Paws Into Grace for others facing this very painful time.
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