Splenic hematoma is an enlargement of the spleen that is caused by poor circulation through the spleen, or bleeding within the spleen due to weak and/or ruptured splenic blood vessels. Splenic hematomas can lead to mild enlargement of the spleen, but many cases present with very large, grossly abnormal spleens. Splenic hematomas not associated with trauma are common in middle to senior aged canines, but quite rare in cats, with hematomas occurring in felines almost exclusively as the result of blunt trauma to the abdomen. However, even this presentation is rarely encountered in cats.
There are often few clinical signs associated with splenic hematomas in dogs, with many found incidentally as the result of routine imaging of the abdomen. In other cases, dogs with splenic hematomas may present with the chief owner complaint of lethargy, distended abdomen, or poor appetite, due to the space filling of larger hematomas. With hematomas that bleed into the abdomen, severe fatigue, pale gums, general palor, and trouble breathing are often reported, as the result of anemia that can be caused by blood loss. In the case of hematomas that rupture acutely, severe, rapid internal bleeding can even lead to sudden collapse and death.
Diagnosis of splenic hematoma often begins with the palpation of an abdominal mass on physical examination by the attending veterinarian. Diagnosis is confirmed through imaging of the abdomen by x-ray and ultrasound.
Treatment of splenic hematoma is surgical removal of the spleen, a procedure known as splenectomy. Due to patient’s with splenic hemtatomas carrying a high risk of chronic or acute hemorrhage, surgery is often recommended as an emergency priority, or at least in as timely a fashion as possible. If a hematoma has caused significant hemorrhage, patients may need to be stabilized with packed red cells, or whole blood transfusions prior to surgery.
Other rule outs for enlargement or growths of the spleen in dogs include other masses of the spleen, such as hemangiosarcoma, hemangioma, and splenic hyperplasia.
Roger L. Welton, DVM
Founder and Chief Editor, Web-DVM.net
President, Maybeck Animal Hospital
Article updated 6/3/2014