Hemoperitoneum | Hemoabdomen | Splenectomy | fetch dvm360 conference in Atlantic City October 2024 скачать в хорошем качестве

Hemoperitoneum | Hemoabdomen | Splenectomy | fetch dvm360 conference in Atlantic City October 2024

Survival The survival time for canine splenectomy with benign and malignant disease is 338 to 650 days and 85 days, respectively. The 8 week, 36 week, 1 year, 3 year, and 6 year survival times with benign disease post-splenectomy is 85%, 75%, 64 to 85%, 45%, and 30%, respectively. The 1 year, 3 year, and 6 year survival times with malignant disease post-splenectomy is 20%, 10%, and 7%, respectively. These differences are significant. Post-operative hemangiosarcoma mean survival time is 19 days, with 31% of dogs alive at 2 months, 7% alive at one year with stage I being 151 days, stage II 107 days, and stage III 73 days (range 68 to 136 days). Hemangiosarcoma stage I to II was 50 to 75% with 86 day survival, significant 1 year survival 6%. Cases with a single mass, 16% are alive at 1 year. With hemangiosarcoma, the post-operative survival by 2 months is 30% versus an 85% survival with non-neoplastic hematoma. The hemangiosarcoma one year survival is 7% versus 65% with hematoma. Survival duration for hemangiosarcoma ranges from 19 to 65 days with surgery alone. The median survival post-operatively is 86 days and less than 10% survived for one year, while survival duration is 172 days with doxorubicin-based chemotherapy. If cancer is present 75% are HSA with a preoperative mortality of 40 to 60%. Canine hemoperitoneum in general results in death or euthanasia in 15% of cases. Predictive factors Some parameters evaluated in the literature and utilized as predictors to dictate the likelihood that any given canine with splenic disease may have hemangiosarcoma include red blood cell indices, platelet counts, total protein concentration, the presence of hemoperitoneum, and splenic mass size. The prevalence of hemangiosarcoma its higher in anemia dogs with splenic mass. In anemic dogs with a splenic mass + hemoperitoneum requiring transfusions shows dogs with splenic hemangiosarcoma have significantly lower total protein (less than 5.8 mg/dL) and platelets (less than 90,000) with a positive predictive value of 87.1% and -42.5% for total protein and 92% and -42.1% for platelets, when compared to non-hemangiosarcoma lesions. Abnormal red blood cell morphology is also seen in those with hemangiosarcoma. The prevalence of splenic hemangiosarcoma was 65 to 75% with hemoperitoneum and was strongly associated with the diagnosis of hemangiosarcoma. The hemangiosarcoma prevalence was 57.3%, independent of hemoperitoneum. Benign disease is seen with hemoperitoneum in 30% of cases. Metastatic disease to the liver was found 30.7% of such cases. Splenic weight as a percent of body weight in dogs with malignant and benign splenic masses showed 50% hemangiosarcoma with hemoabdomen in 80%, other malignancies 15% with hemoabdomen in 20%, benign disease in 40% with hemoabdomen in 50%. Benign disease mass to splenic volume ratio with splenic weight as a percent of body weight was 5 and with other malignancies 3, both greater than hemangiosarcoma at 1.8. Prognostic factors Some reported prognostic factors include age, anemia, gross lesion quantity, stage of disease, complete blood count findings, respiratory distress, bicavitary effusion, the presence of tachycardia, the need for a blood transfusion, the source of hemorrhage, lactate concentration, the presence of ventricular premature contractions, and the presence of splenic torsion. Age at the time of diagnosis shows that older age increases survival. With every decrease in red blood cell counts by 10%, the mortality increases by a factor of 3. When taking into account the number of gross lesions, more than one results in 0% of dogs alive by 1 year post-operatively and 1 lesion results in 16% of dogs alive at 1 year post-operatively. Stage I to II dogs that survive 7 days post-operatively are alive by 86 days with a range of 14 to 470 days and 6% are alive at 1 year. The prognosis for stage I dogs is better than those with stage II and stage III disease. Neutrophilia and thrombocytopenia is associated with a worse prognosis in canine visceral hemangiosarcoma, as disseminated intravascular coagulopathy occurs in 50% of cases. Acute respiratory distress syndrome or pulmonary thromboembolism results in death by a factor of 20. Bicavitary effusion results in death by a factor of 8. Tachycardia present may carry a worse prognosis, as this is associated with needing a blood transfusion, which results in death by a factor of 16. A positive prognostic indicator is that the spleen is the source of the bleeding. Factors associated with hemangiosarcoma mortality include high lactate concentration, the presence of ventricular premature contractions, and splenic torsion. Post-operative complications Canine hemoperitoneum cases in general have a hospitalization duration of two days with a 85% survival rate. Benign splenic growths result in 85% of these dogs being discharged from the hospital.