 Dobie,
is a 5 year old Labrador mix breed, who presented to us with a
history of weakness, lack of appetite, vomiting and depression for 2
days. On presentation, Dobie was very dull and minimally
responsive. His gums were very pale and tacky. He had an
accelerated heart rate and weak pulses. His belly was tense and
painful to palpation.
Our initial rule-outs included gastric dilatation (bloat), ruptured
abdominal mass from the liver or spleen, some metabolic disease or toxin
ingestion. We developed a diagnostic plan which included blood
chemistry profile and complete blood count, chest and abdomen
radiographs.
The blood tests did not show any organ system damage. The white
blood cell count was elevated at 31000, indicating a possible infection
or severe stress.
Radiographs of the chest were normal, however the abdomen films
suggested a central abdominal mass:
Because of our suspicions, we advised an ultrasound exam to elucidate
the origin of the mass. Ultrasound showed this to be a huge spleen
which had a uniform consistency, that is to say, there were no obvious
masses in the spleen and the spleen was not ruptured.
Based on how "shocky" Dobie was feeling, we diagnosed a splenic
torsion. Splenic torsion is an unusual syndrome where the spleen
twist around its blood supply. When this happens, blood can still
get into the spleen because the arterial blood is under pressure,
however, the veins coming out of the spleen get occluded and the blood
can't get out. So the spleen gets continuously bigger and bigger until
it eventually ruptures. As the blood gets sequestered in the
spleen, the pet gets weaker and weaker.
This is a surgical emergency, and so we took Dobie directly to
surgery. When we opened him up, we found the huge spleen twisted
around its blood supply:
After checking the abdomen for other problems, we
proceeded to remove the spleen. The spleen is an organ which is
involved in the creation of red blood cells, and it acts as a central
processing station for the immune system. Fortunately, dogs can
live without the spleen and continue to have a normal life.
This is what the spleen looked like once we removed it:
 
This spleen was about 3 times the normal size for this
dog's weight.
We closed up the belly and treated Dobie with supportive
care for 3 days post operatively in the hospital. He felt much better
once we finished surgery and went home feeling normal again. The
spleen was sent to the lab for analysis and no tumors were found.
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