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Hemangiosarcoma – A (Usually) Silent and Deadly Canine Cancer
November is Pet Cancer Awareness Month. Among the deadliest canine cancers is hemangiosarcoma, or blood vessel cancer. Hemangiosarcoma can appear either as a skin cancer, which can be successfully treated if caught early enough, or as a cancer of the internal organs, especially the spleen or heart. The prognosis for splenic or cardiac hemangiosarcoma is extremely poor, even with aggressive treatment, as often the first sign of a problem is when the tumor ruptures and causes massive internal bleeding. An additional complication comes from the fact that since it is a cancer of the blood vessels, the cancer cells have usually spread to other areas of the body by the time of diagnosis. As a result, the average survival time for internal tumors after diagnosis is measured in weeks or months, even with surgery and chemotherapy. Hemangiosarcoma can occur in any breed, but there is an identified predisposition in German Shepherd dogs, Labrador retrievers and golden retrievers. Within my circle of pet parent friends, in the past year we’ve lost a Siberian husky, an Australian shepherd, a golden retriever, and my miniature puppy, Tiny, to hemangiosarcoma.
What are the signs and symptoms to look out for? For skin-based tumors, any unusual growths on the skin should be evaluated by your veterinarian and biopsied if cancer is suspected. It’s a good idea to check your pet’s skin often, especially as he gets older, for any abnormal bumps or lumps. Many are benign, but only your veterinarian and a pathologist can identify cancerous skin growths.
For cancer of the internal organs, the signs can be much more subtle and sometimes non-existent. In the cardiac form of hemangiosarcoma, you may notice weakness, weight loss, loss of appetite, difficulty breathing, or difficulty recovering from any type of exertion. All of these could be signs of simple aging, other heart or lung problems, or tumor growth. Again, a visit to your vet is so that possible x-rays, ultrasound, CT or other diagnostic scans can determine the cause of the problem. If left undiagnosed, the heart tumor will eventually rupture and cause massive internal bleeding.
In the splenic form of hemangiosarcoma, unless the tumor is extremely large and can be felt on abdominal examination, the first warning sign may be total collapse when the tumor bursts. In Tiny’s case, he exhibited more than usual “senile frailty” one evening at home and could not stand up. He was seventeen years old at the time and had a bloated belly to begin with due to the loss of muscle tone associated with aging. I rushed him to the emergency vet clinic (he never had his emergency situations during regular vet clinic hours), where the doctor quickly tapped his abdomen and drained the bloody fluid. She talked to me about her suspicions that a splenic tumor had erupted and recommended an ultrasound to confirm her diagnosis. The ultrasound showed a very large spleen as well as some suspicious spots in the liver. We discussed the two options: surgery to remove his spleen and suspicious parts of his liver or euthanasia. Given his age and all the possible complications, we made the difficult decision to say goodbye.
But when Tini was brought into the room for that final procedure, he had miraculously recovered from his collapse, was so excited to see us, and started asking us to play with him. The vet suspected that the internal bleeding had stopped and that he had re-transfused himself. After more discussion about other options, and based on the fact that he seemed to be telling us he wasn’t ready to go yet, we brought him home and scheduled a specialist visit for early morning.
Tiny had a splenectomy and partial liver lobectomy and underwent surgery with flying colours, especially given his age. We opted for a shortened, low-dose course of chemotherapy and for the remainder of his life he took some mild medications like doxycycline and Deramaxx to help keep the cancer at bay. He also received acupuncture and Chinese herbal formulations in addition to Western medicine. Despite the six months or less that most hemangiosarcoma patients survive, Tiny lived another two and a half years until the cancer spread to his brain and mouth. When he started having trouble eating and started having seizures, it was time to help him cross the “Rainbow Bridge.” His outcome and length of survival with good quality of life was extremely positive, but he was a fighter with a strong will to live.
Survival in hemangiosarcoma is largely a function of how early it is caught and whether it is a surface/skin lesion rather than an internal tumor. Treatment options can be limited, especially if a tumor spreads, and diagnosis, surgery and chemotherapy can be expensive. You know your dog better than anyone and are in the best position to make informed decisions (with the help of your vet) about the best course of action if this deadly cancer strikes your dog.
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