The abdominal cavity contains many of the major organs of the body, such as the spleen, liver, kidneys, and intestines. When there’s bleeding in the abdomen of dogs, it should be considered a major medical emergency that warrants immediate veterinary attention and intervention. Blood in the abdomen is often referred to as internal bleeding and can lead to severe anemia and death if treatment is not given immediately. Keep reading to learn how to respond to this type of pet emergency.
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A higher incidence of hemoabdomen has been observed in senior dogs. More cases have also been diagnosed in Golden and Labrador Retrievers, and German Shepherds.
The causes of abdominal bleeding (hemoabdomen) in dogs are divided into two major categories - traumatic and spontaneous causes.
- Traumatic Hemoabdomen: The most common cause of this type of hemoabdomen is a traumatic injury, such as when a dog is hit by a car, a gunshot, or a fall. Surgery is sometimes required for this type of hemoabdomen, but often the blood is reabsorbed by the body.
- Spontaneous (Non-Traumatic) Hemoabdomen: This is the more common type of hemoabdomen in dogs. The cause is often the rupture of a tumor that is growing in any of the abdominal organs. Profuse bleeding can lead to substantial blood loss and pooling of blood in the abdominal cavity.
Common Tumors That Cause Abdominal Bleeding in Dogs
Benign Tumors
- Splenic hematomas
- Hemangiomas
- Tumors of the liver or adrenal glands
Malignant Tumors
- Splenic hemangiosarcoma - This is the most common malignant tumor that causes abdominal bleeding in dogs
- Hemangiosarcoma originating in the liver or other parts of the abdomen
- Hepatocellular carcinoma (liver cancer)
- Adrenocortical carcinoma (arises from the adrenal glands)
- Pheochromocytoma
Tumors in the Spleen
The rupture of a mass in the spleen is the most common cause of hemoabdomen in dogs. Splenic tumors can be benign (hemangiomas) or malignant (hemangiosarcomas, mast cell tumors, and lymphosarcoma).
Hemangiomas and hemangiosarcomas are the most common splenic masses in dogs. The spleen is composed of red pulp and white pulp. Both of these tumor types develop from the blood vessels of the red pulp. The tumor is made up of abnormal blood vessels that are wildly proliferating. Eventually, the growth ruptures, leading to bleeding of the spleen. Take note that the spleen is a highly vascular organ. When there is bleeding in the spleen, there is a very high risk for life-threatening blood loss.
Signs of Bleeding in the Spleen
- Weakness
- Hypothermia - abnormally low body temperature
- Pale or bluish gums
Sometimes, the bleeding in the spleen will stop on its own. But it will surely bleed again if surgical intervention is not performed. There is a need to remove the spleen to prevent the dog from bleeding to death. Removing the spleen is a viable option as long as the dog has not lost too much blood to survive the procedure.
Ideally, any growth in the spleen should be detected before it has started to bleed. Surgical removal of the spleen is generally done when the tumor is not actively bleeding. However, if it’s actively bleeding, emergency surgery should be performed immediately.
Diagnosing a Splenic Mass
A splenic mass can be an incidental finding during a routine physical exam. Your vet may feel the large, firm mass when palpating your dog’s abdomen. To know more about the problem and determine its extent and severity, the following procedures are often performed:
- Abdominal x-rays are performed to determine where the mass is located.
- Chest x-rays are also taken to check for evidence of metastasis (spread of cancer to the lungs).
- An ultrasound can confirm if there is fluid within the abdominal cavity and where it’s coming from.
- Blood biochemistry is also an important diagnostic tool. The results of these tests and procedures can help your vet decide whether the removal of the spleen can be performed or not.
Treating Splenic Tumors
Considering that a moderate percentage of tumors in the spleen are benign, surgery should be a treatment option because splenectomy is curative in this case. If during surgery, there is no evidence of metastasis (tumor spread), the spleen can be removed, and chemotherapy can be started to maximize the dog’s longevity and quality of life if malignancy is confirmed.
Chemotherapy, however, is not a reasonable treatment option if the primary tumor in the spleen cannot be removed. Eventually, bleeding may recur from which the dog cannot recover.
Bleeding Abnormalities in Dogs
The most common cause of coagulopathies that lead to hemoabdomen in dogs is the ingestion of toxins that interfere with the proper clotting of blood. Toxins that cause coagulopathies include rat poison and coumadin (a heart medication for humans).
Bleeding in affected dogs may be superficial and/or within body cavities (hemoabdomen). Treatment will include the administration of vitamin K to promote blood clotting. Blood transfusions may be needed if there is extensive loss of blood.
Other Causes of Internal Bleeding in Dogs
Bleeding in the abdomen of dogs may also be a result of torsion, a condition in which an organ twists on its long axis, like what is seen in spleen torsion and gastric dilatation-volvulus (commonly called ‘bloat’).
Can dogs with internal bleeding survive?
Following surgery, your dog will need intensive care to address any symptoms that may develop. This may include continued blood loss and post-operative pain. If hemoabdomen is caused by trauma in the abdomen, additional surgery may be necessary.
In dogs with non-traumatic hemoabdomen, the short-term prognosis is generally good as long as there are no complications after surgery. However, the long-term prognosis will depend on the underlying cause of the bleeding in the abdomen. Prognosis is generally good for dogs with benign causes.
Hemangiosarcoma is an aggressive type of cancer. While removing the tumor can prevent the dog from dying of hemorrhage, the patient eventually succumbs to cancer. The survival times of dogs with hemangiosarcoma can be variable depending on the dog and if additional treatment options, such as chemotherapy, have been pursued. Fortunately, dogs with malignant causes can still have a relatively normal quality of life after surgery, until metastatic tumors start to develop. When this happens, euthanasia is generally recommended.
Read more:
Intestinal Cancer in Dogs and Cats
Common Causes of Coughing in Dogs
Melanoma in Dogs
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The abdominal cavity is a space containing many different organs, such as the spleen, liver, intestines, and bladder.
A hemoabdomen is diagnosed when there is blood in this cavity. This is abnormal since blood does not normally exist in the abdominal cavity freely. This is often called “internal bleeding” and can lead to severe anemia (a low blood count) and eventual death if not treated.
The free blood in the abdomen usually comes from one of the organs in the abdominal cavity. The spleen is the most commonly affected organ followed by the liver, adrenal glands and kidneys. Occasionally the blood comes from one of the vessels in the abdomen or the abdominal muscles themselves.
Hemoabdomen is divided into two categories: traumatic and spontaneous. Traumatic hemoabdomen usually occurs after a pet sustains a traumatic injury, such as a fall or being hit by a car. Traumatic hemoabdomens rarely require surgery, and the body usually reabsorbs the blood. By contrast, spontaneous hemoabdomen is more common and is most often due to rupture of a tumor present in an abdominal organ(s). This leads to loss of blood from the bleeding tumor because it accumulates in the abdomen instead of staying in the blood vessels/organs where it belongs.
What Kinds of Tumors Can Be Present in My Dog?
Benign or malignant tumors can lead to hemoabdomen. Benign tumors are the kind of tumors that will not spread anywhere else in the body and complete removal can be curative. Malignant tumors are cancers that may spread to other areas in the body and/or recur if not completely removed.
Splenic hematomas and hemangiomas are the most common benign tumors to cause hemoabdomen. Occasionally, benign tumors of the liver or adrenal glands can rupture and cause hemoabdomen.
Splenic hemangiosarcoma is the most common malignant tumor to cause hemoabdomen. This is a highly aggressive tumor that will eventually spread, even after the spleen has been removed. Hemangiosarcoma can also arise from liver and other locations in the abdomen. Other tumors with potential to rupture include hepatocellular carcinoma (a liver tumor) and adrenal gland malignancies such as adrenocortical carcinoma and pheochromocytoma.
All of the latter are less aggressive than splenic hemangiosarcoma.
Many patients come to the hospital on an emergency basis. Patients are fully examined to determine the severity of their illness and are treated appropriately to ensure they are stable. This typically involves administering intravenous fluid in order to make the patient feel better and stronger and ready for potential surgery. From a diagnostic standpoint, blood work and thoracic radiographs (chest X-rays) are performed to evaluate the status of the patient’s metabolic systems, as well as to search for any possible metastatic tumors in the chest. When possible, an abdominal ultrasound may be ordered to better evaluate the abdominal organs, determine the tumor location and check for evidence of tumor spread. Once all of this has been done and the patient is deemed ready for definitive treatment, emergency surgery is most often pursued.
Blood transfusions are not always administered and are considered on a case-by-case basis. Blood transfusions have minimal risks in dogs that have never had a blood transfusion before. However, much like people, allergic reactions are possible and are monitored closely for. MedVet carries all of the different blood products that could potentially be needed for your pet.
What Complications Come with Surgery for Hemoabdomen?
Complications can be related to abdominal surgery in general or related to the specific organ(s) involved. General complications include incisional infections and poor incision healing (reopening of incision). These complications can be minimized with adherence to post-operative care instructions including exercise restriction and prevention of licking the incision area for 2 weeks. General anesthesia itself is a potential risk for all surgical procedures. Complications related to the acute blood loss include severe anemia, heart rhythm disturbances, blood clot formation and sometimes death.
The prognosis is divided into short-term and long-term prognosis. In the short- term, the great majority of dogs having surgery for hemoabdomen recover and are discharged from the hospital within a few of days of surgery. The long-term prognosis is more difficult to determine, and is dictated by the underlying cause, i.e., was the cause a malignant or benign tumor? Surgery for benign tumors can be curative; however, surgery for malignant tumors is not curative, and the long-term prognosis depends on the specific tumor type as determined by biopsy results (results take 3-5 working days).
Hemangiosarcoma, the most common malignancy associated with hemoabdomen, can benefit from postoperative chemotherapy treatment. There have been many studies on the long-term survival for patients with hemangiosarcoma of an abdominal organ, and there is much variation. In general, a pet with hemangiosarcoma having surgery alone has a median survival time of 3-6 months. This median survival time means 50% of pets survive longer then 3-6 months and 50% survive for less time. Medical oncologist directed chemotherapy has the potential to approximately double survival time while maintaining good quality of life (median survival time of 6-9 months). We strongly advise owners of pets with hemangiosarcoma to meet with a medical oncologist and their regular veterinarian to discuss chemotherapy in more detail.
By | Posted InPet Owners | TaggedEmergency Care, Internal Medicine, Surgery