Malignant tumor of the spleen in cats. Disease of the spleen in dogs. How to diagnose splenomegaly or splenic mass

Spleen damage often observed with tumors of the hematopoietic system. But the spleen as an organ itself can become the site of localization of primary tumors and metastasis of other malignant tumors.

An enlarged spleen in dogs (splenomegaly) is found quite often. In 43-75% of cases, the cause is tumors.

What types of tumors and mass formations of the spleen occur in dogs?

1) Primary:

• - hemangioma
• - hemangiosarcoma
• - sarcoma (various types)

2) Secondary or multicentric:

• - lymphoproliferative or myeloproliferative diseases (for example, lymphoma)
• - malignant histicytosis, histiocytic sarcoma
• - hemangiosarcoma
• - mastocytoma
• - others malignant tumors With distant metastases(eg melanoma).

3) Non-tumor causes of splenomegaly:

• - nodular hyperplasia
• - hematoma
• - thrombosis or heart attack
• - stagnant changes
• - extramedullary hematopoiesis
• - torsion of the pedicle of the spleen.

The most common tumor of the spleen in dogs is hemangiosarcoma. This is a tumor high degree malignancy with hematogenous metastasis to early stages course of the disease. Rupture of the primary tumor can lead to acute and fatal hemorrhage. It develops in dogs aged 9-10 years.

What are the reasons for the development of spleen tumors?

The etiology of malignant tumors of the spleen is unknown. Their high prevalence among dogs of certain breeds ( German Shepherds, retrievers, Labradors) indicates the presence of genetic factors. Mutations of the PTEN gene may be involved in the mechanism of initiation and development of hemangiosarcoma.

What are the manifestations of splenic tumors?

Benign tumors of the spleen do not cause any clinical manifestations, even if they reach a significant size. The reason to consult a doctor is an increase in the volume of the abdomen, which occurs due to the growth of the tumor. Or such a tumor is discovered during a routine examination.

Animals with spleen sarcomas may develop nonspecific symptoms(for example, feeling unwell). They are detected during examination, x-ray or ultrasound examination, and during diagnostic laparotomy.

Hemangiosarcoma may have the following manifestations:

• - apathy
• - weakness
• - pallor
• - anorexia
• - fainting
• - hemorrhagic diathesis (spontaneous recurrent bleeding and hemorrhages of varying duration and intensity)
• - heart rhythm disturbances.

And other more severe manifestations:

• — acute collapse after rupture of primary space-occupying lesion
• - abdominal bleeding (in abdominal cavity)
• - acute vascular insufficiency.

However, hemangiosarcoma may not give any clinical manifestations and may be an accidental finding by a veterinarian.

How to diagnose splenomegaly or splenic mass?

1. General clinical blood test. Hemangiosarcoma gives a number of hematological abnormalities: anemia (decreased hemoglobin), acanthocytes (damaged red blood cells) and schistocytes (red blood cell fragments), thrombocytopenia (increased bleeding due to a decrease in the number of platelets).
2. X-ray examination. Allows you to identify a tumor or fluid (in case of bleeding) in the abdominal cavity.
3. Ultrasound. Allows you to obtain information about the structure of the neoplasm and its location in relation to normal spleen tissue.
4. Needle biopsy (there is a risk of bleeding) - tissue is taken using a syringe with a thin needle and examined under a microscope.
5. Excisional biopsy (diagnostic surgery involving removal of the entire tumor being examined). It is used if there is a clearly visible tumor in the spleen.
6. X-rays are used to detect metastases chest and ultrasound of other abdominal organs.

How to treat spleen tumors?

Treatment involves:

1. Surgical removal of the tumor. Unfortunately, in the case of a malignant tumor, surgery does not provide a cure.
2. Postoperative chemotherapy to prevent or delay the progression of micrometastases. Monotherapy or combination chemotherapy is carried out. However, survival is relatively short. For combination chemotherapy protocols, it is on the order of 141-179 days, and only less than 10% of dogs survive more than 1 year.

What's the forecast?

The prognosis for dogs with splenic hemangiosarcoma is poor. Metastasis in the early stages of the disease is typical for this type of tumor. In most cases, micrometastases are already present at the time the primary tumor is diagnosed. They progress rapidly and cause low survival - 15-86 days after tumor removal.

For other types of spleen sarcomas, the prognosis is also unfavorable. Survival is about 4 months. The cause of death of the animal is metastases.

Histiocytic sarcoma has an extremely unfavorable prognosis. Most animals are presented for euthanasia or die at the time of diagnosis from extensive metastases.

Spleen tumors in cats

Spleen tumors are less common in cats than in dogs. As in dogs, damage to the spleen is possible as a result of leukemia and lymphoma.

Classification of tumors and space-occupying formations of the spleen of cats

1) Primary tumors:

• - mastocytoma
• - hemangiosarcoma
• - sarcomas (various).

2) Secondary or multicentric tumors:

• - lymphoproliferative and myeloproliferative diseases (for example, lymphoma)
• - hemangiosarcoma
• - other malignant tumors with extensive metastasis (for example, adenocarcinoma).

3) Non-tumor causes of splenomegaly (or splenic masses):

• - nodular hyperplasia
• - hematoma
• - stagnant changes
• - extramedullary hematopoiesis.

About 15% of tumor pathologies of the spleen in cats are lymphoreticular and visceral mastocytomas.

Symptoms of visceral mastocytoma

1. Malaise.
2. Anorexia.
3. Chronic vomiting.

Presumably, these symptoms are associated with the formation of ulcers in the stomach and duodenum due to the influence of histamine on H2 receptors in the stomach. As the disease progresses, ulcers perforate, peritonitis and death of the animal occurs. Cases of splenic rupture have been recorded.

1. Anemia due to blood loss from stomach ulcers or duodenum(or as a result of infiltration bone marrow).

Treatment and prognosis of mastocytoma

Treatment consists of surgical removal of the tumor. The prognosis is unfavorable.

Splenomegaly is the growth of the spleen when it is involved in third-party pathological processes.

Definition.
The weight of the spleen, even under normal conditions, can vary to a greater extent than another organ, increasing 2 times. Therefore, establishing the threshold from which an enlarged spleen should be considered splenomegaly is always somewhat arbitrary. Normally, the weight of the spleen in an adult is 100-150 g. Splenomegaly is a symptom detected mainly by palpation and percussion. Normal spleen percussion does not exceed 7 cm diagonally. Enlargement of the spleen occurs in cases where:
"Its dimensions exceed this value,
"Splenic dullness is abnormally intense,
"The spleen is accessible to palpation.

By percussion, the boundaries of the diameter of the spleen are determined from the IX to XI rib; an increase in these dimensions may also indicate splenomegaly. Early signs splenomegaly can be detected by percussion with the patient positioned on the right side. In healthy people, there is no dullness in the left hypochondrium in the projection of the spleen; with splenomegaly it is detected (Ragosa's symptom).

A non-enlarged spleen can be palpated only under special circumstances (very soft abdominal tissue). The spleen is best palpated on the left side with the patient positioned on the right side with the legs raised high. If the spleen is palpable, it is necessary, especially if it is not painful on palpation, to determine its nature. The degree of splenomegaly, the consistency of the organ, and the homogeneity of the structure depend on the underlying disease that caused the enlargement of the organs. A dense spleen indicates a longer process; a very soft spleen is observed, first of all, with septic swelling of the spleen. A particularly dense spleen is observed in leukemic processes, lymphogranulomatosis, leishmaniasis, as well as in prolonged septic endocarditis. The spleen is less dense in hepatolienal lesions (with the exception of cholangitis) and in hemolytic jaundice.

Splenomegaly, or enlargement of the spleen, is a characteristic response of the organ to many pathological conditions. However, an enlargement of the spleen may also be a consequence of its fulfillment of its normal function, i.e. working hypertrophy is observed. The spleen performs a triple function in the body: firstly, it is the thinnest blood filter; secondly, it is the largest conglomerate of reticuloendothelial tissue, and thirdly, it is the largest lymph node in our body. Thus, the most common cause of splenomegaly in clinical practice is working hypertrophy, when the spleen intensively performs its normal filtering, phagocytic, and immune functions during acute infections, hemolytic anemia, diseases immune complexes. “Congestive” splenomegaly is just as common, since unique system microcirculation of the spleen, providing its filtering function, contributes to the enlargement of the spleen in response to increased pressure in the portal system. The fourth function of the spleen includes embryonic hematopoiesis, which can be restored after the birth of a child, forming a focus of extramedullary hematopoiesis in some myeloproliferative diseases. Other causes of splenomegaly include tumors, infiltration, trauma, and developmental defects.
Detection of minor splenomegaly may be difficult, especially in full faces. Ultrasound is used to study the condition of the spleen. computed tomography. These methods make it possible to identify changes in the structure of the spleen - tumors, cysts, infarctions, as well as additional structures, for example, an additional spleen (congenital feature), enlarged lymph nodes. Enlarged spleen, detectable only instrumental methods, It has diagnostic value when interpreting many syndromes, both hematological and caused by various other pathologies. Sometimes it is precisely this small splenomegaly that serves as an impetus for an in-depth examination and allows for the early diagnosis of serious diseases.

The main mechanisms of the development of splenomegaly.
1. Activation of the immune and reticuloendothelial systems during
autoimmune and infectious diseases.
2. Hyperplasia of the reticuloendothelial system occurs in diseases associated with the destruction of abnormal blood cells.
3. Changes in blood flow through the spleen in cirrhosis of the liver, thrombosis of the hepatic, splenic and portal veins. Overfilling of the spleen with blood due to increased pressure in the portal system causes hyperplasia connective tissue in the spleen.
4. Malignant neoplasms. Primary damage to the spleen
with lymphomas, hematological malignancies or angiosarcomas, metastases are possible
tumors in the spleen.
5. Extramedullary hematopoiesis in myelo- and lymphoproliferative diseases.
6. Infiltration of the spleen by macrophages filled with unmetabolized lipids or other metabolic products. This may be the cause of splenomegaly in storage diseases - Gaucher and Niemann-Pick diseases, which are based on a deficiency of enzymes that ensure the utilization of lipids. The mechanism of splenomegaly is the same in
amyloidosis, various forms hemochromatosis.
7. Volumetric lesions - cysts, hemangiomas.

The main causes of the development of splenomegaly.
"Working hypertrophy" of the spleen
Immune reaction
Hypertrophy in response to blood cell destruction
Congestive splenomegaly
Myeloproliferative splenomegaly
Splenomegaly in tumors
Splenomegaly in storage diseases

The causes of splenomegaly are grouped according to the pathogenetic mechanisms indicated above. As can be seen from the table, splenomegaly usually occurs in response to a systemic disease, only sometimes in response to primary disease spleen.

Clinical picture.
It can be asymptomatic, sometimes manifested by a feeling of heaviness in the left hypochondrium; on palpation - pain and enlargement of the spleen.

Diagnostically significant clinical symptoms.
The following clinical symptoms are of particular importance in determining the causes of splenomegaly.
1. Plethoric appearance, possibly with acrocyanosis, indicates the presence of polycythemia vera.
2. Generalized lymphadenopathy indicates infectious diseases, chronic lymphocytic leukemia or about collagenosis such as systemic lupus erythematosus. Local enlargement of lymph nodes may be a sign infectious mononucleosis or lymphoma.
3. Symptoms of ongoing or recent infections or inflammatory processes(fever, pharyngitis) indicate the development of splenomegaly due to “working hypertrophy”.
4. An increase in the size of the heart, murmurs over the heart area, additional heart sounds may indicate congestive cirrhosis of the liver with splenomegaly or “working hypertrophy” of the spleen or bacterial endocarditis.
5. Signs of liver cirrhosis or portal hypertension in the form of an enlarged or reduced dense liver, varicose veins esophageal veins, ascites, " spider veins", hyperemic palms, testicular atrophy indicates the possibility of congestive splenomegaly caused by cirrhosis of the liver (Banti syndrome).
6. Pallor, tachycardia, shortness of breath, especially during exercise, are a sign of anemia caused by autoimmune hemolysis or other causes, such as leukemia.
7. Rheumatoid arthritis can be a companion to splenomegaly. If they are detected, you should think about the possibility of Felty's syndrome in the patient.
8. Petechiae and purpura are signs of thrombocytopenia, which can be caused by hypersplenism itself. It is most pronounced and is combined with blood clotting disorders, for example, with liver cirrhosis or leukemia.

Dyspeptic symptoms, pain, a feeling of heaviness in the right hypochondrium are frequent companions of liver diseases: chronic hepatitis and cirrhosis. Serious complication liver cirrhosis - bleeding from varicose veins of the esophagus.
When collecting anamnesis from a patient with splenomegaly, it is necessary to pay attention to possible past viral hepatitis or malaria. Note that in a number of patients, viral hepatitis may be asymptomatic, and chronic hepatitis is immediately diagnosed in the stage of liver cirrhosis (especially in the case of hepatitis C).

Frequent companions of an enlarged spleen are anemia, leukopenia and thrombocytopenia in various combinations. In many cases, these are manifestations of hypersplenism that accompanies an enlarged spleen, regardless of the reason that caused this enlargement.

Hypersplenism.
The spleen has a hormonal, inhibitory effect on the bone marrow, mainly blocking the release of cells, as well as accelerating the death of old blood cells through their phagocytosis. An increase in these functions in splenomegaly creates a picture of hypersplenism, recognized on the basis the following symptoms: in the foreground - cytopenia, depending on the predominant suppression of one or another system, either leukopenia with neutropenia, or thrombocytopenia, or (less often) non-hemolytic anemia predominates. If all three systems are inhibited in the same way, pancytopenia occurs. The phenomena of hypersplenism can occur as a consequence of all forms of splenomegaly.

Diagnosis of hypersplenism
o On physical examination - enlarged spleen
o Peripheral blood test
o Anemia, often normocytic or macrocytic (after repeated bleeding - hypochromic microcytic with moderate reticulocytosis)
o Leukopenia with neutropenia and lymphomonocytopenia
o Thrombocytopenia - when platelets decrease to 30-50x109/l, clinical manifestations of hemorrhagic syndrome occur
o Compensatory bone marrow hyperplasia with a predominance of immature erythrocyte and platelet precursors (maturation delay).
The phenomena of hypersplenism are observed in 60-70% of patients chronic diseases liver (Bondar Z. A., 1970). Therefore, it makes sense to characterize in more detail blood changes in liver diseases. Pronounced shifts in the hemogram are observed when chronic hepatitis and cirrhosis of the liver, their interpretation may cause difficulties for the doctor and the need differential diagnosis with diseases of the blood system.

An increase in ESR with splenomegaly is not a specific diagnostic test. High ESR usually reflects dysproteinemia. Dysproteinemia accompanies any inflammatory processes, infectious diseases, liver diseases, systemic diseases connective tissue, autoimmune hemolytic anemia, lymphoma, Waldenström's disease (one of the paraproteinemic hemoblastoses), malignant neoplasms.

Currently, due to the intensive growth of the population of dogs and cats in urban environments, and the development of decorative service dog breeding, attention is increasingly being paid to non-infectious diseases of these animals. Surgical diseases of the spleen are a pressing problem in abdominal surgery of small domestic animals. Just a few years ago, the main attention of veterinary specialists was focused mainly on the pathology of the musculoskeletal system. But diseases of the abdominal organs are the most dangerous, as they can often lead to death. Currently at the Department of Veterinary Surgery of the Federal State Educational Institution of Higher Professional Education MGAVMiB named after. K. I. Scriabin are held Scientific research in the field of diagnosis, treatment and prevention of diseases of the abdominal organs (stomach, intestines, spleen) in animals.

In animals, the spleen performs several functions. As part of the reticuloenlothelial system, it phagocytizes (destroys) dead blood cells and platelets, and converts hemoglobin into bilirubin and hemosiderin. Because hemoglobin contains iron, the spleen is one of the richest iron reservoirs in the body. As a lymphoid organ, the spleen is the main source of circulating lymphocytes. In addition, it acts as a filter for bacteria, protozoa and foreign particles, and also produces antibodies. Finally, as an organ involved in blood circulation, it serves as a reservoir of red blood cells, which in a critical situation are released back into the bloodstream.

Diseases of the spleen undoubtedly belong to surgical pathology, since in almost 75% of cases it is necessary surgical treatment, and the role of non-infectious etiology in diseases of this organ is quite high. Mortality rate various diseases spleen can reach 70%, so quick and accurate verification of the diagnosis for spleen pathologies makes it possible to choose an adequate treatment method and, often, save the patient’s life.

In terms of breed, according to our data, dogs of medium short-haired breeds are most predisposed to diseases of the spleen: boxers, Staffordshire terriers, pit bull terriers, Labradors, etc. In terms of age, these are animals older than 7 years. The gender of the animal does not matter in the development of surgical diseases of the spleen.

Physiology of the spleen
The spleen plays an important role in humoral regulation body, performing several functions.
The most important of them:

• immune function,
• filtration function,
• hematopoietic function,
• participation in the metabolism of proteins and iron.

Most important function The spleen is an immune function. It consists of capturing and processing harmful substances, purifying the blood from various foreign agents (bacteria, viruses). The spleen captures and destroys endotoxins, insoluble components of cellular debris from burns, injuries and other tissue damage. The spleen is actively involved in the immune response - its cells recognize antigens foreign to the body and synthesize specific antibodies.

The filtration function is carried out, in particular, in the form of control over circulating blood cells. First of all, this applies to red blood cells, both aging and defective. Physiological death of red blood cells occurs after they reach approximately 120 days of age. It is not precisely established how phagocytes distinguish between senescent and viable cells. Apparently, the nature of the biochemical and biophysical changes occurring in these cells matters. For example, there is an assumption that the spleen clears the circulating blood of aging cells, identifying red blood cells with altered membranes. Thus, in some diseases, infected red blood cells cannot pass through the spleen, remain in the pulp for too long and die. It has been proven that the spleen has a better ability than the liver to recognize less defective cells and functions as a filter. In the spleen, granular inclusions (Jolly bodies, Heinz bodies, iron granules) are removed from red blood cells without destroying the cells themselves. Splenectomy and spleen atrophy lead to an increase in the content of these cells in the blood. The increase in the number of siderocytes (cells containing iron granules) after splenectomy is especially clearly visible, and these changes are persistent, which indicates the specificity of this function of the spleen.

Splenic macrophages recycle iron from destroyed red blood cells, converting it into transferrin, that is, the spleen takes part in iron metabolism.

The role of the spleen in the destruction of leukocytes is not well understood. It is believed that these cells are physiological conditions die in the lungs, liver and spleen; platelets in a healthy person are also destroyed mainly in the liver and spleen. It is likely that the spleen also takes another part in the exchange of platelets, since after removal of the spleen due to damage to this organ, thrombocytosis occurs.

The spleen not only destroys, but also accumulates the formed elements of blood - red blood cells, leukocytes, platelets. In particular, it contains from 30 to 50% or more of circulating platelets, which, if necessary, can be released into the peripheral circulation. At pathological conditions their accumulation is sometimes so large that it can lead to thrombocytopenia.

When the outflow of blood is disrupted, the spleen enlarges and, according to some researchers, can accommodate a large amount of blood, serving as its depot. By contracting, the spleen is able to release the blood accumulated in it into the vascular bed. At the same time, the volume of the spleen decreases, and the number of red blood cells in the blood increases. However, normally the spleen contains no more than 20-40 ml of blood.

The spleen is involved in protein metabolism and synthesizes albumin, globin (the protein component of hemoglobin), and factor Vlli of the blood coagulation system. The participation of the spleen in the formation of immunoglobulins, which is provided by numerous cells producing immunoglobulins, probably of all classes, is important.

The spleen takes an active part in hematopoiesis, especially in the fetus, producing lymphocytes and monocytes. The spleen is the main organ of extramedullary hematopoiesis when normal hematopoietic processes in the bone marrow are disrupted, for example, when chronic blood loss, sepsis, etc. There is indirect evidence confirming the possibility of the participation of the spleen in the regulation of bone marrow hematopoiesis. They are trying to confirm the influence of the spleen on the production of red blood cells based on the fact that reticulocytosis appears after removal of a normal spleen, for example, when it is damaged. However, this may be due to the fact that the spleen delays the early release of reticulocytes. The mechanism for the increase in the number of granulocytes after removal of the spleen remains unclear - either more of them are formed and they quickly leave the bone marrow, or they are less actively destroyed. The mechanism of occurrence of thrombocytosis developing in this case is also unclear. Most likely, it occurs due to the removal of the depot of these cells from the spleen. The listed changes are temporary and are usually observed only during the first month after removal of the spleen.

The spleen probably regulates the maturation and release of erythrocytes and granulocytes from the bone marrow, the production of platelets, the process of denuleation of maturing erythrocytes, and the production of lymphocytes. It is likely that lymphokines synthesized by spleen lymphocytes can have an inhibitory effect on hematopoiesis.

Change data individual species metabolism after removal of the spleen are contradictory. Most characteristic change in the liver is an increase in glycogen in it. Strengthening the glycogen-fixing function of the liver is persistently maintained even with effects on the liver leading to a weakening of this function. Experiments with the removal of the spleen in animals allow us to conclude that the spleen produces humoral factors, the absence of which causes increased glycogen fixation and, thus, has a secondary effect on the processes of fat accumulation in this organ.

The spleen plays an important role in the processes of hemolysis. Under pathological conditions, it can retain and destroy large numbers of altered red blood cells, especially in some congenital and acquired hemolytic anemias. A large number of red blood cells are retained in the spleen during congestive plethora and other diseases. It has also been established that the mechanical and osmotic resistance of leukocytes as they pass through the spleen decreases.

The spleen is not one of the vital organs, but in connection with the listed functional features plays an essential role in the body.

Currently, more than forty infectious and non-communicable diseases spleen, which can be divided into several groups:

As a result of studies of 46 clinically sick dogs conducted at the Department of Veterinary Surgery from 2000 to 2005, the incidence of surgical diseases of the spleen was established.

Diagnosis of surgical diseases of the spleen
The medical history and clinical picture of almost all diseases of the spleen have much in common with other surgical diseases of the abdominal organs in dogs.

The clinical picture in animals with spleen pathology depends on the nature of the disease. In the presence of purulent or acute inflammation There may be a fever and lack of appetite. Shortness of breath and anemia are characteristic of diseases accompanied by blood loss or impaired hematopoietic functions in the body. The presence of sporadic vomiting is characteristic of volvulus of the spleen, splenomegaly, or neoplasms of the spleen. In some cases, splenomegaly causes the development of ascites, liver edema, stomach bleeding. Splenic neoplasms that occur without metastases are characterized by the presence of cachexia with a simultaneous increase in the abdominal cavity in volume. In general, we can conclude that in the absence of changes in the patient’s history characteristic of surgical pathology of the spleen, some criteria may indirectly indicate problems with this organ.

A clinical examination of an animal with suspected spleen pathology must begin with palpation at the site of projection of the organ onto abdominal wall. In carnivores, approximately 1/3 of the organ is hidden behind the costal arch; in hounds and pointing breeds, the costal arch almost completely covers the spleen. Palpation is carried out at vertical position body of the animal with smooth movements of moderate force from the bottom up, so as not to damage the organ. This research method can determine the size and shape of the organ, its correct location in the abdominal cavity, and pain. In some cases, it is necessary to resort to percussion of the abdominal cavity in order to differentiate the location of the spleen during severe flatulence gastrointestinal tract.

Ultrasound diagnosis of spleen diseases is the main diagnostic method various pathologies of this body. For small animals, an ultrasound examination of the spleen is carried out in a dorsal position; in long-haired breeds, a triangle is shaved from the xiphoid cartilage and navel to the middle third of the last left rib (the place of projection of the spleen onto the abdominal wall).

To verify the diagnosis of surgical pathology of the spleen, it is necessary to evaluate the following criteria:

• The size and location of the organ must be determined to make a diagnosis of splenomegaly or volvulus of the spleen, and significant neoplasms of the spleen are also determined. In the middle and large breeds splenomegaly is detected in the supine position by scanning the midline of the body in the region of the xiphoid cartilage and pre-umbilical region. When the organ is enlarged, the spleen is found in this area; normally, in a dorsal position, the spleen remains in the left hypochondrium;
• the thickness of the capsule is determined for splenomegaly, cystic lesions and hematomas of the organ to predict the possibility of capsule rupture;
• Determining the homogeneity of the structure of the parenchyma of an organ makes it possible to identify foci ischemic lesions organ, small neoplasms of the splenic parenchyma, areas of splenic rupture or subcapsular hematomas, abscesses;
• changes in the vascular bed of an organ (expansion of the venous or arterial system) are informative for predicting the course of the disease and identifying treatment tactics.

The Doppler effect is used to detect hemodynamic disturbances in the vessels of the abdominal cavity and, in particular, to determine the presence of thrombosis of the splenic veins in splenomegaly. Ultrasound examination of blood flow is based on the Doppler effect. Its essence lies in the fact that the frequency of the sound emitted by a moving object changes when this sound is perceived by a stationary object. When an ultrasonic signal is reflected from moving red blood cells, its frequency changes. As a result of this phenomenon, a change in the frequency of the sent ultrasonic signal occurs. The greater the speed of red blood cells, the greater the frequency shift of the ultrasonic signal. If the movement of red blood cells is directed towards the sensor, then the frequency of the signal reflected from them increases; if from the sensor, then, on the contrary, it decreases. Knowing the frequency of the sent ultrasonic signal and the frequency of the reflected signal, it is possible to determine the speed of movement of the reflecting object (red blood cell) by the frequency shift. Sensors with lower frequency allow you to measure more high speeds blood flow Between the angle of the directional ultrasonic beam and the frequency shift there is inverse relationship. If the angle is zero, that is, the direction of the ultrasound beam and the course of the blood flow are parallel, then the maximum frequency shift can be measured. In practice, the angle between the direction of the ultrasound beam and the direction of blood flow should not exceed 20 degrees. Then the error in measuring blood flow velocity will be insignificant. This limitation dictates the need to direct the ultrasound beam during Doppler examination as parallel to the direction of the blood flow being studied as possible. When scanning with a Doppler effect device different colors movement is indicated: by tones of red - with a positive speed of movement, and by tones of blue - with a negative one. Taking this into account, it is possible to determine thrombosis of the veins and arteries of the spleen, as well as the presence of ischemic areas in the parenchyma of the organ.

Thus, when ultrasound examination An organ can detect almost all its organic damage.

X-ray examinations of spleen diseases are carried out when ultrasound examination is unavailable, as well as to exclude certain other diseases (for example, intestinal obstruction related to foreign body or intussusception). It is advisable to carry out an X-ray examination in the lateromedial projection in a position on the left side. In this projection, normally the cranial edge of the spleen is partially covered by the liver, and the body and caudal edge of the organ are located in the region of the xiphoid cartilage. With pathology of the spleen associated with enlargement of the organ (splenomegaly, neoplasms of the spleen), significant darkening will be visible in the area of ​​the xiphoid cartilage, the pre-umbilical region. With splenic volvulus, on the contrary, in these areas the spleen is not visualized; increased density in the area of ​​the ileum. Due to the stomach filled with gases and displaced by the spleen, a gas-filled spot of considerable size at the location of the stomach will be visible on the x-ray in the lateral projection, which will indirectly indicate volvulus of the spleen. X-ray examination in the dorsocaudal projection can be carried out if the X-ray data in the lateral projection are questionable.

Angiocontrast radiography is used to detect splenic vein obstruction. For such a study, radiopaque substances are administered intravenously: urografin, omnipaque in appropriate dosages. 15, 45 and 90 minutes after the administration of radiopaque substances, X-rays are taken in which the spleen is clearly visible, which makes it possible to most reliably identify its size and location.

Hematological studies of spleen diseases are an integral part of the study of a sick animal. First of all, if a disease of the spleen is suspected, clinical researches blood. The main criterion for assessing the condition of the spleen is the erythrocyte sedimentation rate as an indicator of not only impaired hemostasis, but also an indicator of a large focus of inflammation in the body. With splenitis, splenomegaly of various etiologies ESR reaches 20-35 mm/h. The amount of hemoglobin and red blood cells is higher than normal, the presence of poikidocytes and megalocytes indicates disturbances in the functioning of the red pulp of the spleen, disturbances in utilization in it shaped elements blood. Leukocytosis is characteristic of all inflammatory processes in the spleen.

Biochemical blood tests are carried out to determine the degree of inflammation and destructive changes in the spleen. To do this, the ALT and AST indicators are examined and the Ritis coefficient is determined. With an increased ALT and Ritis coefficient, a conclusion is made about the presence of destructive processes(strong inflammatory, ischemic, oncological). It must be kept in mind that when pathological processes in other parenchymal organs the picture of these indicators will be similar. To confirm oncological cause diseases carry out tests for serum alkaline phosphatase. If this indicator increases, the diagnosis is confirmed. Other criteria for assessing spleen pathology using hematological studies are not very informative, since they are also typical for most other pathologies.

In conclusion, we must conclude that spleen diseases in dogs have all sorts of clinical manifestations. This is due to a wide range of pathologies of the spleen and its relationship with other abdominal organs. Diagnosis of spleen diseases must be comprehensive and include clinical, hematological and sonographic studies without fail, angiocontrast radiography and the Doppler effect.

S. V. Timofeev, S. V. Pozyabin,
Department of Veterinary Surgery MGAVMiB named after. Scriabin, Moscow

Such a problem as an enlarged spleen in animals is very important for both their owners and veterinarians. The condition of the spleen, when its anatomical dimensions are increased to one degree or another, doctors call splenomegaly.

Spleen – important organ hematopoiesis, accumulation and destruction of blood cells in vertebrates. With various kinds of pathologies and the course of inflammatory phenomena, it increases in volume. A failure in its operation leads to dysfunction of other parts of the body, which leads to a deterioration in the condition of the animal as a whole.

Spleen diseases in dogs

In the practice of veterinary doctors, over 40 types of various spleen pathologies are diagnosed in dogs. Classifying diseases, they can be divided into main groups:

The spleen is a poorly protected, fragile organ of the lymphatic system, which is located in the upper part of the abdominal space, occupying the left hypochondrium. Its shape in a dog is similar to a “lady’s boot”, the color is cherry-red with a blue tint, and the consistency is dense. The relative weight depends on the breed and varies from 0.08 to 0.4%.

The functions of the spleen in a dog are very diverse:

• immune Spleen cells block pathogens and cleanse the blood of various agents. The organ takes part in the immune response - its cells recognize and destroy foreign substances;
• hematopoietic The spleen is an organ that produces cells responsible for immunity - lymphocytes and monocytes. Their task is to protect the dog’s body from foreign invasions and proteins, altered own cells, destruction of destroyed tissues and inflammatory foci;
• filtration The dog's organ recognizes, rejects and destroys abnormal, old and worn-out blood cells;
• exchange . The dog's spleen is involved in the metabolism of iron and proteins. Her responsibilities include storing a “reserve fund” of iron.

Enlarged spleen: causes

In most situations, a pathologically large spleen in dogs indicates problems in other organs.

The group of diseases leading to the development of splenomegaly in dogs is quite extensive and includes the following pathologies:

• infectious diseases;
• invasive pathologies;
• hepatolienal syndrome;
• stagnant processes (stagnation of blood in the heart, torsion of the spleen, acute dilatation/volvulus of the stomach);
• benign and malignant neoplasms;
• hematoma.

Enlarged spleen as an independent disease is rare, and it is usually accompanied by other pathology. The question of the nature of the pathology is decided by the veterinarian through a multi-stage diagnostic search, including various methods, and, if necessary, puncture of the spleen.

Treatment of an enlarged spleen

Treatment tactics directly depend on the root cause of the pathology.

For splenomegaly in dogs due to thromboembolism, medications are prescribed to inhibit thrombus formation, resolve blood clots, and improve blood rheology. In addition, medications are used to reduce inflammation and swelling.

If drug therapy is unsuccessful, then surgery to excise the spleen () is indicated.

Enlarged spleen in cats

If a cat’s spleen is enlarged in size, then this is a sign of trouble in the functioning of the organ itself, or the development of another disease. Splenomegaly affects not only adults, but also kittens. Characteristic features pathologies are enlarged lymph nodes, stool disorders, weight loss, bloating.

Reasons for the development of the disease

In cats, factors for the development of splenomegaly are non-tumor and malignant tumor formations.

Non-neoplastic lesions include:

• congestion;
• hypereosinophilic syndrome;
• hematoma;
• extramedullary hematopoiesis.

Cancerous tumors leading to the formation volumetric spleen in cats are:

• mastocytoma;
• lymphosarcoma;
• myeloproliferative diseases;
• hemangiosarcoma.

As can be seen, the classified causes of diseases of the large spleen in animals are different and range from cancerous tumors, infections, overload and infiltration of the organ to inflammatory diseases and blood pathologies.

How to treat an organ

Treatment of splenomegaly in felines should be aimed at getting rid of the main pathology. Splenectomy is indicated for tumors, traumatic lesions, Werlhoff and Minkowski-Choffard diseases. In the case of drug treatment, the same drugs are used in cats as in dogs, taking into account the weight of the animal.

The spleen was removed during sterilization of the cat 06/14/11 16:58

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Moscow
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Good afternoon. Today we took a cat, 10 months for sterilization, the operation ended around 13-00. The doctor after the operation said that he saw that the spleen had bad view that she is covered in scars, as if it were severe inflammation, and since the cat is on the table, he decided to remove it at the same time. Along the way, he asked if the cat was sick. They are pets, the cat lives with her husband’s parents, they are elderly, they haven’t noticed any particular complaints or problems. The only thing is that the cat eats very little and is quite thin. When asked what to do next - how to feed and care for it, the answer was that we don’t need to come up with anything special, what we fed is what we feed (dry food Purin One, wet friscus, periodically meat and fish, but I didn’t eat raw food, only boiled).
Now the cat has almost recovered from the anesthesia, but she walks slightly tucking her back left paw. Until she drank, I just lubricated her nose with some water, she was breathing very heavily and crying hoarsely, she would always get up, walk around, lie down, try to get under the blanket and walk around again and scream. They didn’t put a blanket on us at the clinic, and we couldn’t do it ourselves at home, so our belly is naked (I’m worried, but I decided that it was better to let her be in peace than to mess up with the strings)
Can you say something about what are the reasons for such a bad spleen, how best to care for it. Thank you.

The cat has an enlarged spleen and pancreas. They did an ultrasound, but it showed little, they made an incision in the abdominal cavity and determined that the spleen was greatly enlarged. The cat is constantly vomiting. She was given glucose and medications, but the relief was temporary. She started having an allergy (she scratched behind her ear and there was no hair there), we feed her special food, but she doesn’t eat it well. We contacted different clinics, but nothing new, they either shrug their shoulders or say poisoning. She's getting worse every day. Tell me what it could be and what else can be done?
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Vladislav Olegovich

Veterinarian
Veterinarian

Registered: 11/01/2006
Messages: 1426
Pets: Dog and cat
MessageAdded: 02/08/2007 4:03 Message title: Reply with quote
Biochemistry and general tests Did you do blood + general urine?

Differential diagnosis and treatment of splenomegaly and splenic tumors in animals.
Pozyabin S.V.
Department of Veterinary Surgery, Federal State Educational Institution of Higher Professional Education, Moscow State Academy of Veterinary Medicine named after. K.I. Scriabin.

In animals, the spleen performs several functions. As part of the reticuloendothelial system, it recycles dead red blood cells and platelets and converts hemoglobin into bilirubin and hemosiderin. As a lymphoid organ, the spleen is the main source of circulating lymphocytes. In addition, it acts as a filter for bacteria, protozoa and foreign particles, produces antibodies, and serves as a reservoir of red blood cells, which in a critical situation are released back into the bloodstream. Surgical diseases of the spleen are a pressing problem in abdominal surgery of small domestic animals. Currently at the Department of Veterinary Surgery of the Federal State Educational Institution of Higher Professional Education MGAVMiB named after. K.I. Skryabin conducts scientific research on the diagnosis, treatment and prevention of spleen diseases in animals. Diseases of the spleen mostly relate to surgical pathology, since in almost 75% of cases surgical treatment is necessary, and the role of non-infectious etiology in diseases of this organ is quite high. The mortality rate for various diseases of the spleen can reach 70%, so quick and accurate verification of the diagnosis for pathologies of the spleen makes it possible to choose an adequate treatment method and, often, save the animal’s life. According to studies of 54 clinically sick dogs conducted at the Department of Veterinary Surgery of the Federal State Educational Institution of Higher Professional Education MGAVMiB named after. K.I. Skryabin from 2000 to 2005, according to the degree of occurrence of surgical diseases of the spleen, we decided to present in table No. 1.

Table 1. Statistical data on surgical diseases of the spleen in dogs. According to the Department of Veterinary Surgery of the Federal State Educational Institution of Higher Professional Education MGAVMiB named after. K.I. Scriabin.

Type of disease Number of animals % of total
1. Neoplasms of the spleen in total:
vasogenic neoplasms
lymphoid neoplasms 22
10
12 40
18
22
2. Volvulus of the spleen total 13 24
3. Splenomegaly total:
in case of organ infarction
due to piroplasmosis
due to gastric volvulus 11
1
4
6 21
2
8
11
4. Traumatic injuries. 8 15
TOTAL: 46,100
In terms of breed, according to our data, dogs of medium short-haired breeds are most predisposed: boxers, Staffordshire terriers, pit bull terriers, Labradors, etc. in terms of age - the age of animals is more than 7 years. The sex of the animal does not matter in the etiology of surgical diseases of the spleen.

Currently, more than forty infectious and non-infectious diseases of the spleen have been identified in dogs, which can be conditionally divided into several groups, taking into account the etiological factor:

Mechanical reasons mean traumatic injuries spleen: ruptures of the capsule and pulp, subcapsular hematomas, splenic cysts, tear of the gastrosplenic ligament, volvulus of the spleen;

Immune toxic causes include splenomegaly caused by autoimmune causes, as well as exposure to toxic products chronic inflammation(for example, long-term subclinical endometritis, hepato-lienal syndrome, etc.)

Oncological causes are associated with neoplasms of vasogenic (hemangiomas and hemangosarcomas) or lymphoid (lymphosarcoma) origin, and spleen tumors can be both primary and secondary; almost all spleen neoplasms have metastatic activity;

As can be seen from table No. 1, 85% of diseases of the spleen are accompanied by an increase in its size: neoplasia with oncological pathology and edema with splenomegaly associated with impaired hemodynamics in the splenic vessels and myeloid proliferation of the organ. Accurate verification of the diagnosis allows not only to prescribe adequate therapy or resort to surgical intervention, but also often save the patient’s life. Palpation during a clinical examination can reveal volvulus of the spleen, splenomegaly, splenic neoplasm, however, the percentage of errors in diagnosis verification based on palpation alone is very high, so it is advisable to resort to special methods diagnostics The most reliable today are sonographic studies of the abdominal cavity, which are currently widely covered in the available literature. If it is impossible to use ultrasound, you can resort to X-ray studies with the use of radiopaque agents. Angiocontrast radiography is used to detect splenic vein obstruction, cysts, neoplasms, etc. For such a study, X-ray contrast agents are administered intravenously: urografin, Omnipaque in appropriate dosages. 15, 45 and 90 minutes after the administration of X-ray contrast agents, X-rays are taken in which the spleen is clearly visible, which makes it possible to most reliably identify its size and location. With radiography in the dorsoventral projection, it is possible to determine not only the size of the organ, but also its location, and make a conclusion about volvulus of the spleen. Direct angiographic signs of a neoplasm or cyst of an organ include the presence of a vascular-free area (“clearance zone”) in the projection of the enlarged spleen and changes in relationships in the architectonics of the intrasplenic arteries. An indirect angiographic sign is the displacement of nearby organs by a space-occupying formation. If it is impossible to use special substances, pneumoabdominography can be performed: X-ray air-filled abdominal cavity. Air is sterilized by ultraviolet light and introduced into the abdominal cavity using abdominocentesis until the cavity is completely filled. Clinical and biochemical tests blood tests do not make it possible to accurately diagnose the nature of organ damage, although they can reveal the presence of oncological or inflammatory processes. From the above, we can conclude that in diagnosing diseases of the spleen, it is necessary to resort not only to a clinical examination, but also to special research methods: x-ray and sonographic.

splenomegaly
Treatment of splenomegaly caused by thromboembolism should begin with the use of drugs that improve the rheological properties of blood (aspirin) to resolve existing blood clots and prevent the formation of new ones - clexane, heparin, decongestants and anti-inflammatory drugs. In the absence of positive dynamics on conservative treatment, in case of volvulus of the spleen, they resort to surgical intervention. If a thrombosed area is detected during the operation, the thrombus is dissolved by direct injection of heparin into the lumen of the vessel with the application of vascular clamps along the edges of the thrombus. In cases of splenic volvulus, splenopexy can be used. If the problem of restoring normal blood circulation in the organ cannot be solved, a splenectomy is performed.

Neoplasms of the spleen can be primary, arising directly in the spleen, or secondary - metastases from other organs and tissues. There are three types of spleen tumors, originating from the tissues most widely represented in the organ. These are hemangiosal, lymphoid and fibrous neoplasms. It should be noted that all splenic tumors are spherical in shape. Neoplasms of the red pulp are represented mainly by hemangiomas - mature, benign tumors blood vessels. Some of these tumors are developmental defects vascular system tumor-like in nature, some of them are true blastomas. Depending on which vessels the neoplasm copies, the following types of hemangiomas are distinguished: capillary, venous, cavernous, arterial. Hemangiomas and hemangosarcomas are different rapid growth, blood-filled, contain cavities filled with blood (cavernous hemangosarcoma), the metastatic activity of such neoplasms is low. When cutting such neoplasms, blood flows out profusely, the color is red, and the tissue density is low. Fig.2. Cavernous hemangioma of the spleen, boxer, male, 7 years old.

splenomegaly
White pulp tumors (lymphomas and lymphosarcoma) are characterized by average growth rates; when cut, they are white-yellow in color with areas of red pulp, and the tissue density is average. Such neoplasms are often secondary, that is, metastases of neoplasms localized in other organs and tissues; they themselves quite often give metastases both within the spleen and to the liver, lungs, and other organs. Therefore, if neoplasms of lymphoid origin are suspected, it is necessary to carry out full examination animal to detect metastases. Despite the above brief description spleen tumors, it is necessary to take into account that the tumor can be definitively recognized only after histological studies.

Fig3. Lymphosarcoma of the spleen mixed breed, 7 years old, female.

splenomegaly
Myeloid metaplasia is a panproliferative process accompanied by proliferation of connective tissue of the bone marrow, spleen and lymph nodes with simultaneous proliferation of hematopoietic elements in the liver, spleen and tubular bones. The reason is unknown. There is a significant enlargement of the spleen, and hepatomegaly is often noted. The appearance of portal hypertension can be caused either by liver fibrosis or an increase in hepatotropic blood flow. The clinical picture is usually characterized by anemia and increasing splenomegaly. Symptoms include abdominal pain due to splenic infarction, heaviness after eating, spontaneous bleeding, secondary infection, bone pain, pruritus, and hyperuricemia. Diagnostic criterion- peripheral blood smear. The presence of fragmented erythrocytes with poikilocytosis, prolapsed tear cells and elongation of their shape are noted. Surgical treatment of splenic tumors. For any complexity and stages tumor process in the organ, we recommend performing a splenectomy rather than limiting partial resection organ.