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Hemangiosarcoma

Many thanks in advance to Sylvia Evans for her kind permission in letting us reprint her article which first appeared in the Southern Afghan Club's 2004 magazine.
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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.

 

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