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Dr. Scott
Dr. Scott, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 15168
Experience:  15 years of small animal, equine and pocket pet medicine and surgery.
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shih tzu: my 12 year..12 year old..bile..her liver was normal

Resolved Question:

had routine bloodwork done on my 12 year old shih tzu it came back with high alk phos. we then did a dex supress test and it came back neg for cushings but did have a high bile acid. I took her for an ultrasound her liver was normal, had a bladder stone and a small mass in her spleen. I was told to do a acht test and a spleen biopsy. I am confused what to do, i biopsy or have spleen removed
Submitted: 7 years ago.
Category: Dog Veterinary
Expert:  Dr. Scott replied 7 years ago.
Hello there,

What size was the splenic mass?

What type of bladder stone is suspected?

Does the dog have any clinical signs of Addison's disease?

Dr. Scott
Customer: replied 7 years ago.
the mass was about 1 inch in diameter they didnt say what type of stone it was she is showing no signs of addisons or bladder problems
Expert:  Dr. Scott replied 7 years ago.
A biopsy is going to cost a lot and they will likely say remove the spleen either way with a mass that big. If the bladder stone is calcium oxalate, I would remove the spleen and the stone at the same time and skip the biopsy. Addison's disease usually shows very high potassium and low sodium and chloride on lab work. This occurs in 90% of the cases. If the dog does not have clinical signs and lab work not pointing in that direction, I would wait on the test and deal with the other problems. It would be improbable to have 3 major disease processes going on in the same dog that just came in for routine bloodwork. If the stone is struvite, it can be dissolved with diet. If they are unsure, get it out when the spleen is removed. That's what I would do if it was my dog, I have of course not seen the dog, the ultrasound or the lab results.
Customer: replied 7 years ago.
is this surgery more tramatic then a spay and is the recovery about the same
Expert:  Dr. Scott replied 7 years ago.
The surgery takes longer than a spay and recovery time will be longer due to age. The splen is easy to reach and the bladder heals quickly, if not too inflamed. There may be blood in the urine for a few days. Surgery becomes riskier with age in all species.
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