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Our 11 year old golden retriever started getting lethargic

on Friday, and we noticed...
Our 11 year old golden retriever started getting lethargic on Friday, and we noticed bloating of his stomach. Took him to our vet yesterday, and did some blood work and results showed low red blood count. We live in rural area, so not much availability on weekends. we hesitate to drive 3+ hours for emergency services, knowing the drive will not be good for him. He's calm, but not really comfortable. suggestions?
JA: I'm sorry to hear that. Could be a lot of things that cause lethargy. The Expert will know how to help the Golden Retriever. What is the Golden Retriever's name?
Customer: Carl
JA: Is there anything else the Veterinarian should be aware of about Carl?
Customer: No, he's just old. Our vet thought that maybe there was an organ "growth" that ruptured.
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Answered in 17 minutes by:
8/20/2017
Dr. Kara
Dr. Kara, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 17,140
Experience: Over 20 years of experience as a veterinarian.
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Customer reply replied 3 months ago
Hi Dr. Kara,
In my previous note, I said red blood, but maybe it was white? Hopefully it make sense. Thanks,Kent

I am very sorry to hear that your fellow started to be lethargic on Friday and appeared to have a bloated abdomen. I understand that blood tests yesterday showed anemia and your veterinarian believes that he may have a mass on an "organ" that ruptured. I understand how upsetting that news was to hear and that you feel undecided about how to proceed.

I suspect that the organ mass is actually a splenic mass that ruptured and he became anemic and his abdomen looked bloated due to a bleeding episode into his abdomen. The rupture must have been a relatively small/slow one as the spleen is filled with blood vessels and with a big rupture he quickly would have bled to death.
First the spleen is not an essential organ. The functions that it performs can be done by other organs in the body. It is a filter organ, removing damaged red blood cells, and it produces lymphocytes (a type of white blood cell) and stores red blood cells. These functions can also be performed by lymph nodes, the liver and the bone marrow. Don't worry about it not being there creating stress on other organs.
I think that a comprehensive ultrasound of his abdomen is a terrific idea. The most common malignant (spreads to other tissue and is very invasive) mass in the spleen is a tumor called a hemangiosarcoma. This tumor is a tumor of the lining of blood vessels and is easily transferred to other organs via the blood vessels carrying tumor cells. That means by the time we find it, the tumor has most certainly already spread to other tissues, usually the liver, lymph nodes, small blood vessels in the abdomen and lungs.
If we can see evidence of tumor spread on ultrasound then no matter what is done his prognosis is very poor and I wouldn't recommend surgery as his lifespan will be very short, usually less than 2 to 3 months, rarely as long as 6 months. There is no use putting him through major surgery knowing that we cannot change his comfortable life span.
If there are no metastases seen on his ultrasound or his chest radiographs, that is good news.

Do be prepared though that if you do decide to go through surgery and this is a hemangiosarcoma then it will have spread on a microscopic level and odds are even with chemotherapy his cancer will return soon.
There are other tumors though, such as hemangiomas, mast cell tumors and lymphosarcoma. Those are less common, but are more treatable.
If a splenic tumor starts to bleed one of two things can happen. It can clot after a small amount of bleeding and while the dog may feel a little woozy from blood loss, depending upon how much blood is lost they may be OK. It sounds like that is what happened with your fellow. If the tumor starts to bleed gain however and cannot stop the dog will become hypotensive (low blood pressure) and faint or have such low oxygenation to the brain they will become unaware and pass away. This is not painful for the dog but it is very difficult for owners to have to experience as the dog may vocalize or thrash a bit as this happens. The pet is unaware of what is happening because of lack of oxygen to the brain but it is upsetting for an owner to observe. This is what we are trying to avoid and a reason for getting your fellow evaluated and if possible to surgery as quickly as possible if that is the way you choose to proceed.
Here is a link to an article that accurately discusses spleen function and splenic masses: http://www.marvistavet.com/html/body_splenic_masses.html
I would make sure that the person that does the surgery is very experienced, ideally a board certified surgeon so that you can give him the best chance of doing well after this procedure.
In short I know the thought of driving a long distance with him today isn't pleasant, but my worry is that if the tumor starts to bleed again he may not make it. If you want to try treating him having this addressed as soon as possible is best.
Please let me know if you have any further questions.

Dr. Kara
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Customer reply replied 3 months ago
Thank you for the explanation. It is consistent with our Vet, and very detailed of the possible outcomes.
Kent

You are very welcome. I know that this is a very difficult time for your family with tough decisions ahead, so please let me know if I can be of any further help.

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