Surgery of the Spleen

Question 1

what are the functions of the spleen?

Answer 1

maturation of red blood cells
removal of RBCs from circulation
removal of microorganisms and antigenic particles from circulation
immunoglobulin synthesis
storage of RBCs and platelets
if needed can produce RBCs

Question 2

what are the types of generalized pathology of the spleen?

Answer 2

infiltration
infectious disease
immune-mediated hemolytic anemia
congestion

Question 3

what are the surgical diseases of the spleen?

Answer 3

canine splenic neoplasia
feline splenic neoplasia
splenic volvulus

Question 4

what are the types of benign splenic masses?

Answer 4

hematomas
lymphoid hyperplasia

Question 5

what are the potential clinical signs of canine splenic masses?

Answer 5

lethargy
inappetence
weight loss
weakness
abdominal distension
collapse

Question 6

what is ultrasound useful for canine splenic masses?

Answer 6

identify organ source
obtain fluid sample of abdominal effusion is present

Question 7

how common are clinically important long-term consequences of splenectomy?

Answer 7

rare

Question 8

when should you consider a prophylactic gastropexy during a splenectomy?

Answer 8

patient has risk factors for GDV: conformation, 1st degree relative
doing well enough under anesthesia to allow additional procedure
owner can afford additional cost

Question 9

what should you do if there are other bleeding sites during a splenectomy?

Answer 9

concern for malignancy with metastasis
inform owner, remove all bleeding masses if owner wishes to continue

Question 10

what is the most common cause of death prior to discharge after a splenectomy?

Answer 10

thrombotic and coagulopathic syndromes

Question 11

what is the long-term prognosis of hematoma in the spleen?

Answer 11

excellent
1 year survival 64%: 70% unrelated to splenic mass death
perioperative death possible with hemoabdomen

Question 12

what is the median survival time for surgery alone with hemangiosarcoma?

Answer 12

<3 months

Question 13

how can you distinguish between benign and malignant splenic masses in the dog?

Answer 13

histopathology is the only reliable way

Question 14

what is the rate of the diagnosis matching between histopathology and cytology?

Answer 14

60%

Question 15

how does the size of the mass indicate benign or malignant?

Answer 15

hemangiosarcoma more likely if 7cm or smaller
greater than 7cm more likely benign

Question 16

what fraction of all splenic masses are malignant?

Answer 16

2/3

Question 17

what is the chance of a splenic mass being hemangiosarcoma if there is a hemoabdomen with it?

Answer 17

at least 70%

Question 18

what percentage of hematomas are misdiagnosed on histopathology and are actually malignant?

Answer 18

11%

Question 19

how prevalent is non-traumatic hemoabdomen in cats?

Answer 19

uncommon

Question 20

who does splenic volvulus occur in?

Answer 20

large and giant breed dogs
deep-chested
males>females

Question 21

what can be seen on radiographs with splenic volvulus?

Answer 21

mid-abdominal mass
C-shaped
loss of serosal detail if effusion present

Question 22

what should you not do for a splenic volvulus in surgery?

Answer 22

derotate

Question 23

what drugs cause splenomegaly?

Answer 23

acepromazine
propofol

Question 24

what are the malignant splenic masses?

Answer 24

hemangiosarcoma
other sarcomas
mast cell tumor
lymphoma

Question 25

which dogs are more likely to have splenic masses?

Answer 25

middle aged to older
german shepherd
labrador retriever
golden retriever

Question 26

what can be seen on a CBC with a splenic mass?

Answer 26

anemia
schistocytes
acanthocytes
thrombocytopenia
neutrophilic leukocytosis
hypoproteinemia

Question 27

what does non-clotting blood in a hemoabdomen indicate?

Answer 27

nontraumatic hemoabdomen

Question 28

does splenectomy increase risk of GDV?

Answer 28

maybe

Question 29

what are the possible causes of VPCs after splenectomy?

Answer 29

anemia, hypoproteinemia: decreased myocardial perfusion
microthrombi to myocardium
catecholamine release

Question 30

what can lead to perioperative mortality after a splenectomy?

Answer 30

portal system thrombosis
pulmonary thromboembolism
disseminated intravascular coagulation

Question 31

what is the survival time for hemangiosarcoma with surgery and chemo?

Answer 31

4-6 months
1 year survival <16%

Question 32

is ultrasound able to distinguish between metastasis and nodular hypeerplasia in the liver?

Answer 32

no

Question 33

if there is an incidental splenic mass and no hemoabdomen, is it more likely benign or malignant?

Answer 33

benign, especially if large

Question 34

if a dog presents for right atrial hemangiosarcoma, should you check the spleen?

Answer 34

yes, but not necessarily other way around

Question 35

what is the most common reason for splenectomy in cats?

Answer 35

feline splenic neoplasia

Question 36

what do siderotic plaques look like?

Answer 36

yellow-brown
iron and calcium deposits
benign, no need to treat