Many
thanks in advance to Sylvia for her kind permission in letting us reprint
her article which first appeared in the Southern Afghan Club's 2004 magazine.
You
will notice that although the article is based on Afghan Hounds, Hemangiosarcoma
is also very prevalent in the German Shepherd hence our reasons for listing
it here on Gsdsrus. I also have a personal interest as we lost our
"precious gift, Corra" to a ruptured spleen and like Amudarya Shura, she
also slipped into a coma like state before quietly passing away.
HEMANGIOSARCOMA
"The
Silent Killer"
Whilst
the Afghan Hound IS a relatively healthy breed in comparison to some breeds
certain health conditions do occur, some more common than others
& also at a variety of ages.
A
number of conditions that ARE well documented within veterinary literature
as having been treated in an Afghan Hound, both in general practice, in
specialist referral practices and veterinary schools, may not necessarily
gain much attention or be spoken about in general discussion amongst enthusiasts,
show ring awards maybe of far greater interest ………
Because
of my known interest in health issues, I sometimes have an advantage in
being aware of when certain conditions arise by virtue that owners of some
sick dogs contact me or I have attended Health Seminars & learned about
certain disorders.
I
am prepared always to SHARE what I have learned with others & this
I have always attempted both, via my own Breed column in the canine press
and the regional club magazines, where such exist. Hopefully this means
of sharing can create a greater AWARENESS of certain medical conditions
presenting within the breed, which may be of help to owners if such are
met with in their dogs.
Recently
Lesley asked me about HEMANGIOSARCOMA because there had been some discussion
on this type of cancer on one of the American Internet sites, specifically
in regard to its effect on the heart.
First
let me say that HEMANGIOSARCOMA is NOT a newly recognized condition, although
it may be more commonly known of as a tumour that affects the spleen which
is situated in the abdominal cavity. I lost a dog with this type of malignant
tumour in the 1980s.
This
article includes some detailed information on this condition in general.
Many
of you will already be aware of splenic tumours or know of dogs who
have had successful treatment for a tumour of the spleen by surgical
removal; such are generally of the non-malignant variety known as an Hemangiothelioma.
When
a splenic mass is detected, it may NOT be possible to tell, prior to surgery,
if the mass is malignant or not. Some basic investigations, blood chemistry
profile testing; abdominal X-Ray or Ultrasound may give an indication of
the long term outlook, but only if it has been possible to undertake such
investigations if the dog has not presented as a clinical emergency.
Cancers
are often named for the cell type that they originate from. Hemangio means
association with blood or blood vessels and Sarcoma refers to a malignant
cancer.
Sometimes
the term Malignant Hemangiothelioma will be used by a vet to differentiate
between the non-malignant type tumour.
Hemangiosarcoma
is a rapidly growing, highly invasive variety of tumour. It is a blood
fed tumour developing in such a way that blood blisters form from its growth
which can easily rupture causing internal bleeding from the cancerous growth
site(s). The tumour disrupts normal organ function. A frequent cause of
sudden death is the rupturing of the tumour resulting in a massive internal
haemorrhage.
It
is not an uncommon type of cancer in dogs and most often affects the older
animal, 7 years upward.
Males
are said to have a greater incidence than Females and 2 breeds said to
be over represented in surveys, are the German Shepherd & the Golden
Retriever.
This
cancer is frequently referred to as the SILENT KILLER because it may NOT
give any indication of its presence until an advanced stage.
If
a dog does show any early signs, these might include, a decreased appetite:
weight loss: lethargy & weakness: pale gums: intermittent vomiting
episodes and abdominal distension. A mass may be felt in the abdomen.
The
most common primary sites for this tumour are the SPLEEN and the HEART
(right atrium), both being major vascular organs, although varieties can
also appear on the skin and in subcutaneous tissue. The Skin type of Hemangiosarcoma
does not prove to have such a poor prognosis as these are the most easily
removed surgically and thus have a greater potential for a complete cure.
If
the spleen is affected, the spleen will become enlarged and minor bleeds
may have already happened. Sometimes, in the early stages of growth, the
enlarged spleen can be felt by a vet on abdominal examination and the condition
diagnosed before much bleeding has occurred. Generally by the time
of diagnosis, there may already be secondary spread to the
liver.
When
the HEART is effected, bleeding occurs in to the sac, that surrounds the
heart, this sac is called the pericardium and this type of bleed will result
in so much pressure upon the heart that it cannot function correctly. This
is a cardiac emergency known as a Pericardial Tamponade. If undiagnosed
& it not possible for the blood to be drained off
quickly enough, the heart will stop and the resulting SUDDEN DEATH!
will be the scenario.
Research
has indicated that 25 per cent of dogs with hemangiosarcoma of the spleen
also have the heart based hemangiosarcoma.
Survival
times for surgery for splenic hemangiosarcoma are variable.
In
the words of one veterinary professional, this is a very difficult cancer
to diagnose at a time when surgical removal might really help the
dog long term. In some fifty percentage, the cancer has already spread
by the time of positive diagnosis.
Unfortunately
the most common way these patients are presented to a vet is when they
collapse, either from an acute anaemia, sudden haemorrhage or heart failure…..however
some patients, fortunate enough to be diagnosed early in the disease progress
can be “Bought” some “Quality Time” if it is practical to remove the spleen
and follow up with chemotherapy.
It
is not clear how effective ANY treatment may be in any one given case,
only a few studies appear to have been undertaken, primarily the United
States. Inevitably Hemangiosarcoma on internal organs is a progressively
fatal disease.
According
to one veterinary paper I read, it states “The biological behaviour
of Hemangiosarcoma is highly malignant, with both local infiltration
& metastases (secondary spread) occurring early in the course
of the disease. The exception is the dermal (skin) type .
Metastasis
occur to lungs, liver, brain, bone and the adrenal glands. Around
80% of dogs can have metastasis by the time a diagnosis is proven. Up to
25% with primary in the spleen have a concurrent cardiac involvement and
up to 63% with heart HS have concurrent metastatic disease”
Unquote………………………..
I
have said that one of my dogs had this condition in the 1980s.
At that time we did not have the specialized diagnostic tools, such as
ultra- sound, so readily available in general veterinary practices . My
dog's diagnosis was recognized relatively early when he presented with
some respiratory & cardiac signs, my vet found his spleen somewhat
enlarged and palpable on examination. A splenic mass was diagnosed, follow
up abdominal X-Rays confirmed this together with blood tests which showed
his liver function already compromised & the tumour had probably spread.
My vet of that time was cautious & wise. When I asked, “Could
he not go in and do an exploratory look, as I was aware of another dog
that had a successful removal of its spleen!”…. his reply to me was “I
agree that in this dog's case this was successful because non-malignant
hemangiotheliomas are slow growing, they do not spread to other organs
and surgery can indeed be curative but further investigations here
unfortunately have proven that this is not the same, this is a malignant
mass & my advice to you is that we should leave well alone and see
how the dog does given such an unfortunate & unpredictable diagnosis.
This same dog went on to survive a further 9 months. The end, as I was
all too aware, it would be, was a sudden collapse at home late one
evening. It was all too apparent to me, has a nurse, that he had
obviously had a massive internal bleed. There seemed to be no distress,
he slipped into a coma type sleep and just slipped quietly away, no fuss.
This dog had given me almost 10 great years, he was my AMUDARYA SHURA.
Coincidentally he had a daughter who also developed the same type of tumour
and several generations later, another bitch, whilst provisionally
diagnosed with a pelvic mass, it was suggestive of this condition,
it was decided by her owners to have no surgical intervention and she also
died suddenly but peacefully slipping away.
Current
research into the genetic and environmental factors underlying a wide range
of medical diseases in companion animals is probably the way forward for
the future and although it is only just in its infancy stage, the collecting
of DNA samples from animals where clinical features of specific diseases
are clearly defined is now commencing under the “Umbrella” of the
DNA ARCHIVES PROJECT based at Liverpool Veterinary College but involving
all the 6 UK vet Schools.
SYLVIA
EVANS. Amshura ©
September
2004.
For
full details on how you can take part in the Project,
please
contact Liverpool Veterinary College via the following link.
DNA
ARCHIVES PROJECT
DISCLAIMER:
THIS
ARTICLE IN NO WAY ESTABLISHES A CLIENT VETERINARIAN RELATIONSHIP.
THE
INTENT OF THE ARTICLES ARE TO COMPLIMENT THE USER'S CURRENT VETERINARY
/ TRAINING EDUCATION.
NO
CLAIMS ARE MADE AS TO CONTENT.

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