# Lila's first spleen screen



## lhowemt (Jun 28, 2013)

OK October is breast cancer month right? So now I consider it cancer month in general. Lila had her first spleen screen today, which is a quick ultrasound to look for signs of tumors. If the spleen has any, time to yank it out. Typically this specialty vet likes to start at 8 but we did Lila early. $50 and 15 mins. Hopefully a vet near you offers a similar service. Lila's spleen is clean!

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## hotel4dogs (Sep 29, 2008)

I ask this not to be obtuse, but because I have wrestled with it in my own mind.
What does the information give you?
Sadly, studies have shown that hemangiosarcoma and lymphoma survival times are no longer with earlier diagnosis. Quality of life is no better. By the time either one shows up on an ultrasound, they have spread.
Further, suppose you do find a small mass in the spleen. Many of them are benign. Do you remove the spleen "just in case"? The only way you can tell if it's malignant is to remove the spleen and biopsy it. 
Finally, just because it's clear today, doesn't mean it will be in a month. 
I'm all for being very proactive with my dogs' health. With Tito, because of his field exposure, I send out full tick panels at least every 6 months. We do chest xrays on him every 6 months because of his field exposure. We do blood and urine every 6 months from the time my dogs are 6 months old. So it's not that I don't want to do tests and so on.
I'm just not convinced of the value of the ultrasound, and would like to hear opinions from others.


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## lhowemt (Jun 28, 2013)

Thanks, I'd like to hear more too. My vet recommends this and both she and this specialty vet agree if there are signs of tumors to get the spleen out. I highly regard both of them, but medicine is "practice" after all. I haven't talked at length with them about "what if" and anticipate at least then we'd be able to fully assess her situation including possible treatment. After losing Hazel in a week and a half, I do also think I'd like to know. If only to refocus my time. 

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## lhowemt (Jun 28, 2013)

On the other hand, if it is benign and you do not treat or remove, how long might you be thinking your dog may be dying when it is not?

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## Dallas Gold (Dec 22, 2007)

Been there, done that with Toby- a terrifying experience for my husband and me! We were following an enlarged abdominal lymph node via U/S and a spleen nodule popped up. I had several conversations with 3 vets in the practice about what to do. One vet had a client in my shoes who elected to go with splenectomy and it was hemangio. The owner just had a hunch it wasn't a spot on the spleen but hemangio. They did full courses of chemo and oral chemo and the dog was alive at least 3 years post op. I got a referral to an internist for a consult and U/S on better equipment and he recommended we follow up with U/S every 6 weeks to monitor growth. After about 3 of them it resolved completely. He told me this sometimes happens and sometimes senior dogs develop these little nodules that do resolve. He then told me more and more internists are recommending preventive U/S for senior dogs and he screens his senior dogs already,not just for spleen nodules but other issues as well. Toby's 2 personal vets also do the same thing. As it stands now we do annual echo/abdominal U/S for other issues Toby has and we always look carefully at the spleen. It costs us a lot more though! You have a good deal and for $50 I'd do it.


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## Dallas Gold (Dec 22, 2007)

lhowemt said:


> On the other hand, if it is benign and you do not treat or remove, how long might you be thinking your dog may be dying when it is not?
> 
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It was a very stressful few months when we were experiencing this with Toby.


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## Megora (Jun 7, 2010)

It only costs you $50? That's not bad... ! Ultrasounds can be expensive - and that's generally why people do xrays first - even when ultrasounds are BETTER for spotting tumors. 

The problem with annual ultrasounds is... and we lost two goldens to cancer of the spleen... hemangiosarcoma doesn't take months or years to develop. And generally there is a very short period of time between the point the tumor begins developing and the point where it starts pushing on things inside the dog and making them sick. 

I reached that conclusion somewhat because my Danny had ultrasounds and xrays done a year before he died because of a pancreatitis re-occurrence. And then months before he died we had him fully checked out because he had a nagging cough and seemed sick. He had an ultrasound done at our vet - which looked him all over (keep in mind this was not too long after we lost his brother to cancer of the spleen) and then he was fully checked out and cleared at the cardiologist. They were not checking his spleen out there, but they were raving about the shape he was in. 

The period of time that he was sick was days. Same thing with Sam. 

Unfortunately, our experience with Danny - we have discussed ever going that route again (having surgery to remove the spleen) and that is something that my mom and I have come to tears about, because when you are at that moment and have a otherwise happy and healthy looking dog who just can't keep his food down or lay down comfortably - surgery makes sense. But in general, we feel we should not have put him through that surgery considering his age.


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## lhowemt (Jun 28, 2013)

I think he keeps it cheap to make it easy for people to do it for early detectio . A diagnostic ultrasound is $200-$300, I didn't recall exactly what we paid for Hazel's. 

Megora I can relate, our first golden got osteosarcoma and we did an aggressive treatment. We got another year with her but won't put another dog through that. She spent a month at WSU getting radiation and this was after surgery to remove the tumor on her cheekbone. It was brutal. We went over every fri-sun and took her out for the weekend but I won't do that again. At least that is what I say now. In the heat of the moment of Hazel's hemangioma inside her heart I wanted ANYTHING to keep her. My greedy love...

I accept there is only so much I can do. Annual I think is reasonable, even though something can slip by. 

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## Dallas Gold (Dec 22, 2007)

I thought about this more last night and have a few more questions and comments. Does your vet just look at the spleen or other organs too, or would he/she consider that a diagnostic at the higher cost? Also, is it your regular vet doing the U/S or someone who does the sonograms full time? The reason why I ask this is because more and more clinics are getting u/s machines and teaching the vets in the practice to use them. The vets we use have u/s machines but are both reluctant to do them and would still send them out to a specialist (radiologist, internist or cardiologist) to review and advise. Because of that they prefer to have someone come in to do them that does them every day, even though they are present and looking at the scan as its done. Getting a specialist review would drive costs up substantially. If my regular vet, without substantial experience in doing the u/s and reading them, were performing the scan, without being reviewed by a specialist, I'd be very reluctant to go on surgery on that scan alone. I'd want the specialist to do the U/S, get it reviewed and then decide what is best. 

Finally, do they shave the belly to do it? I've always heard you get better scans with a shaved belly. 

Toby is due in Dec or Jan for his annual sonogram and echo...always makes me nervous.


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## lhowemt (Jun 28, 2013)

We have a "specialty" vet in town who is referral only and does only the difficult cases around here. I don't believe he is a true specialist but he is as good as it gets in western Montana. He does the u/s, not our regular vet. She and many other vets send dogs and cats there for advanced diagnosis and difficult surgeties.. No shaving of the belly and he does look around a little bit but it is not a full abdominal u/s. 

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## lhowemt (Jun 28, 2013)

We do have access to WSU vet teaching hospital which may be a good choice if we do ever find anything. But I like them less and less as we and others experience what ends up feeling like a lot of treatment for dogs that mostly benefit their teaching. But each situation is new and I appreciate your comments.

I'm sure the soecialty vet would do a more comprehensive u/s if that is what we wanted. Would it be worth it to do that? Especially in light of how quickly hemango develops and kills.

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## Dallas Gold (Dec 22, 2007)

Like Hotel mentioned early diagnosis doesn't improve longevity in most cases. The only exception for a true cancer is the one case our vet clinic had and that dog did very well at least 3 years post op. In our case an early splenectomy would tell us if it is hemangio and hopefully give us time to steel ourselves for the inevitable. 

One other point is many nodules and growths on the spleen are benign and a splenectomy prevents a possible fatal bleed out, so it could be life saving in that case. Had our Toby had a large growth at his age of 7, we would definitely gone with a splenectomy just to prevent a bleed out in case it was benign.

One more thought....pet insurance! our policy on Yogi does not cover preventive scans but you can always craft a policy that does for a price!


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## lhowemt (Jun 28, 2013)

I've considered pet insurance but my husband just laughs. On the plus side our vet care isn't as expensive as many others, likely due to our location and our vet is a friend, but since we had Halley at WSU we haven't had any major bills. We have savings so that isn't a problem. The one nice thing about insurance is you'd never have to decide on cost.


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