HEMOABDOMEN - A TICKING TIME BOMB
In today’s blog I want to discuss the condition I most commonly see pets present to me with for emergency euthanasia, hemoabdomen (blood within the abdominal cavity). Most commonly in my patients, this is caused by a tumor or mass (spleen, liver, gastrointestinal tract, etc) rupturing. I tell owners these masses are like ticking time bombs, because they may be grow quite large or for a long time without your pet showing physical symptoms, and they can cause an acute, sudden decline. This is a reason why at a minimum, routine veterinary physical exams are recommended yearly for all pets, and in particular every 6 months for senior pets. Depending on its size and/or location, your veterinarian may be able to palpate (feel) a mass if one is present. Bloodwork and imaging (radiographs, ultrasound, etc) are also helpful tools for identifying certain masses. If a mass is found, your veterinarian may need to perform surgery (+/- biopsy), chemotherapy, or other treatments.
The majority of masses that rupture within the abdominal cavity are malignant tumors, with hemangiosarcoma being most common. However, without a biopsy and histopathology testing, there is no way to tell. The rupture of a mass leads to internal hemorrhaging. If hemorrhaging is severe, your pet will enter a state of shock, including low blood pressure, elevated heart rate, breathing changes, pale mucous membranes (gums, eyelids), collapse, and even death. Your pet may have less severe bleeding, which may even resolve temporarily, then occurs again. This can be responsible for the “waxing and waning” of symptoms which is very difficult for pet owners.
If you elect to treat your pet, when they are in a state of shock from hemoabdomen, they will need emergency care including fluid therapy, pain medications (hemoabdomen is extremely painful), and maybe even a blood transfusion. You and your veterinarian will have to decide, after the source of the bleeding is identified, if surgery is an option or recommendation for your pet. Anesthesia is high risk and difficult for patients in shock, but veterinarians use excellent staff, equipment, and protocols to monitor your pet and do everything they can to support them during a procedure.
Humane euthanasia is an option, sometimes the best one, for senior pets with hemoabdomen, especially if they are in a critical state or do not have the option for surgery. The tumor may have already metastasized to other organs (full body radiographs may be needed pre-operatively to try to rule this out, but there is no guarantee the mets would be visible). The possibility of an acute crisis is ever present from such a mass. You should learn to monitor your pet’s vital signs so you can understand what their “normals” are. Dr. Shea Cox has provided some great resources at https://www.pethospice.com/products/resources including handouts on “How to Take and Monitor Vital Signs”, a “Daily Vital Sign Monitoring Calendar”, and “The Potential for Internal Bleeding”. I highly recommend downloading and using these free resources. Please let me know if you have any questions about the information I’ve presented in today’s blog, and thank you for reading!