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November is the month to fight pet cancer. Among the most deadly cancers in dogs is hemangiosarcoma or blood vessel cancer. Hemangiosarcoma can manifest as either a skin cancer that can be successfully treated if caught early enough, or a cancer of the internal organs, especially the spleen or heart. The prognosis for splenic or cardiac hemangiosarcoma is extremely poor, even with aggressive treatment, as often the first sign of a problem is when the tumor ruptures and causes massive internal bleeding. An additional complication arises from the fact that because it is a cancer of the blood vessels, the cancer cells have usually spread to other parts of the body by the time of diagnosis. As a result, the average survival time for internal tumors after diagnosis is measured in weeks or months, even with surgery and chemotherapy. Hemangiosarcoma can occur in any breed, but there is an established predisposition in German Shepherds, Labrador Retrievers and Golden Retrievers. Within my own circle of pet parent friends, we lost a Siberian Husky, an Australian Shepherd, a Golden Retriever, and my own miniature poodle, Tiny, from a hemangiosarcoma in the last year.
What are the signs and symptoms to watch out for? In the case of skin tumors, any abnormal growth on the skin should be evaluated by your veterinarian and biopsied if there is any suspicion of cancer. It’s a good idea to check your pet’s skin often, especially with age, for any unusual lumps or bumps. Many of them are benign, but only your veterinarian and pathologist can identify cancerous skin growths.
In the case of cancer of the internal organs, the symptoms can be much more subtle and sometimes non-existent. In the cardiac form of hemangiosarcoma, you may notice weakness, weight loss, loss of appetite, difficulty breathing, or difficulty recovering from any type of exertion. All of these can be signs of simple aging, other heart or lung problems, or tumor growth. Again, a visit to your veterinarian is for possible X-rays, ultrasound, CT or other diagnostic scans to determine the cause of the problem. If not diagnosed, the heart tumor will eventually rupture and cause massive internal bleeding.
In splenic hemangiosarcoma, unless the tumor is extremely large and can be seen on abdominal examination, the first warning sign may be total collapse when the tumor ruptures. In the case of Little Dog, he showed a greater than usual “old man’s weakness” one night at home and could not stand up. He was seventeen at the time and had a bulging abdomen in the beginning due to loss of muscle tone associated with aging. I quickly took him to the veterinary emergency clinic (he never had an emergency during the regular hours of the veterinary clinic), where the doctor quickly patted him on the abdomen and drew bloody fluid. She told me about her suspicions that she had a ruptured tumor of the spleen and recommended an ultrasound to confirm her diagnosis. The ultrasound showed a very large spleen, as well as some suspicious spots on the liver. We discussed two options: surgery to remove the spleen and suspicious parts of his liver, or euthanasia. Given his age and all the possible complications, we made the difficult decision to say goodbye.
But when Tini was brought to the last procedure room, he had miraculously recovered from his collapse, was very excited to see us, and began begging us to play with him. The veterinarian suspected that the internal bleeding had stopped and had recurred. After more discussion of the other alternatives, and based on the fact that he seemed to be telling us he wasn’t ready to go yet, we brought him home and scheduled a visit to a specialist early the next morning.
The boy underwent splenectomy and partial lobectomy of the liver and underwent surgery with brilliant results, especially given his age. We chose a shortened and low-dose course of chemotherapy, and for the rest of his life he took several medications such as doxycycline and Deramaxx to help maintain cancer. He also received acupuncture and Chinese herbal formulations in addition to Western medicine. Despite six months or less in which most patients with hemangiosarcoma survive, Thinkey lived another two and a half years until the cancer spread to his brain and mouth. When he began to have difficulty eating and began to have seizures, it was time to help him cross the Rainbow Bridge. The result and duration of his survival with a good quality of life were unusually positive, but he was a fighter with a strong will to live.
Survival in hemangiosarcoma largely depends on how early it is caught and whether it is a superficial / skin lesion instead of an internal tumor. Treatment options can be limited, especially if the tumor ruptures, and diagnosis, surgery, and chemotherapy can be expensive. You know your dog better than anyone and are in the best position to make informed decisions (with the help of your veterinarian) about the best course of action if this deadly cancer strikes your dog.