Histopathologic findings and survival outcomes of dogs undergoing liver lobectomy as treatment for spontaneous hemoabdomen secondary to a ruptured liver mass: retrospective analysis of 200 cases (2012–2020)

Alexandra M. Reist BluePearl Seattle Veterinary Specialists, Kirkland, WA

Search for other papers by Alexandra M. Reist in
Current site
Google Scholar
PubMed
Close
 DVM
,
Jennifer K. Reagan BluePearl Seattle Veterinary Specialists, Seattle, WA

Search for other papers by Jennifer K. Reagan in
Current site
Google Scholar
PubMed
Close
 DVM, MS, DACVS-SA
,
Shawna K. Fujita BluePearl Seattle Veterinary Specialists, Kirkland, WA

Search for other papers by Shawna K. Fujita in
Current site
Google Scholar
PubMed
Close
 DVM
, and
Alexis M. Walny BluePearl Seattle Veterinary Specialists, Seattle, WA

Search for other papers by Alexis M. Walny in
Current site
Google Scholar
PubMed
Close
 BS

Abstract

OBJECTIVE

To describe the distribution of histopathologic diagnoses in a large population of dogs undergoing surgical treatment for spontaneous hemoperitoneum secondary to a ruptured liver mass. Additionally, to describe survival outcomes and assess for prognostic factors for overall survival time in this population.

ANIMALS

200 client-owned dogs with spontaneous hemoperitoneum resulting from a liver mass.

PROCEDURES

Medical records from 19 veterinary referral hospitals were reviewed. Data collected included signalment, clinical signs, blood work, radiographic and ultrasonographic findings, surgical methods, intraoperative and postoperative complications, outcomes, and histopathologic findings. Follow-up information was obtained by contacting the referring veterinarian or owner.

RESULTS

Well-differentiated hepatocellular carcinoma, benign masses, hemangiosarcoma, and other malignant tumors accounted for 36% (72/200), 27.5% (55/200), 25.5% (51/200), and 11% (22/200) of cases, respectively. Overall survival time for all dogs was 356 days and for the above categories was 897 days, 905 days, 45 days, and 109 days, respectively. Prognostic factors for survival included diagnosis, increased ALT, anemia, and whether a transfusion was received. Overall survival time in dogs with increased ALT was 644 versus 63 days with normal values.

CLINICAL RELEVANCE

The majority of dogs (63.5%) were diagnosed with well-differentiated hepatocellular carcinoma or a benign process, resulting in favorable long-term survival. The distribution of histopathology for ruptured liver masses resulting in hemoperitoneum has not been previously reported and may be useful for client discussions prior to surgery.

Abstract

OBJECTIVE

To describe the distribution of histopathologic diagnoses in a large population of dogs undergoing surgical treatment for spontaneous hemoperitoneum secondary to a ruptured liver mass. Additionally, to describe survival outcomes and assess for prognostic factors for overall survival time in this population.

ANIMALS

200 client-owned dogs with spontaneous hemoperitoneum resulting from a liver mass.

PROCEDURES

Medical records from 19 veterinary referral hospitals were reviewed. Data collected included signalment, clinical signs, blood work, radiographic and ultrasonographic findings, surgical methods, intraoperative and postoperative complications, outcomes, and histopathologic findings. Follow-up information was obtained by contacting the referring veterinarian or owner.

RESULTS

Well-differentiated hepatocellular carcinoma, benign masses, hemangiosarcoma, and other malignant tumors accounted for 36% (72/200), 27.5% (55/200), 25.5% (51/200), and 11% (22/200) of cases, respectively. Overall survival time for all dogs was 356 days and for the above categories was 897 days, 905 days, 45 days, and 109 days, respectively. Prognostic factors for survival included diagnosis, increased ALT, anemia, and whether a transfusion was received. Overall survival time in dogs with increased ALT was 644 versus 63 days with normal values.

CLINICAL RELEVANCE

The majority of dogs (63.5%) were diagnosed with well-differentiated hepatocellular carcinoma or a benign process, resulting in favorable long-term survival. The distribution of histopathology for ruptured liver masses resulting in hemoperitoneum has not been previously reported and may be useful for client discussions prior to surgery.

  • 1.

    Aronsohn MG, Dubiel B, Roberts B, Powers BE. Prognosis for acute nontraumatic hemoperitoneum in the dog: a retrospective analysis of 60 cases (2003–2006). J Am Anim Hosp Assoc. 2009;45(2):7277.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Pintar J, Breitschwerdt EB, Hardie EM, Spaulding KA. Acute nontraumatic hemoabdomen in the dog: a retrospective analysis of 39 cases (1987–2001). J Am Anim Hosp Assoc. 2003;39(6):518522.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Fleming J, Giuffrida MA, Runge JJ, et al. Anatomic site and etiology of hemorrhage in small versus large dogs with spontaneous hemoperitoneum. Vet Surg. 2018;47(8):10311038.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Lux CN, Culp WT, Mayhew PD, Tong K, Rebhun RB, Kass PH. Perioperative outcome in dogs with hemoperitoneum: 83 cases (2005–2010). J Am Vet Med Assoc. 2013;242(10):13851391.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Crawford AH, Tivers MS, Adamantos SE. Owner assessment of dogs’ quality of life following treatment of neoplastic haemoperitoneum. Vet Rec. 2012;170(22):566. doi:10.1136/vr.100595

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Brown NO, Patnaik AK, MacEwen EG. Canine hemangiosarcoma: retrospective analysis of 104 cases. J Am Vet Med Assoc. 1985;186(1):5658.

  • 7.

    Prymak C, McKee LJ, Goldschmidt MH, Glickman LT. Epidemiologic, clinical, pathologic, and prognostic characteristics of splenic hemangiosarcoma and splenic hematoma in dogs: 217 cases (1985). J Am Vet Med Assoc. 1988;193(6):706712.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Hammond TN, Pesillo-Crosby SA. Prevalence of hemangiosarcoma in anemic dogs with a splenic mass and hemoperitoneum requiring a transfusion: 71 cases (2003–2005). J Am Vet Med Assoc. 2008;232(4):553558.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Guillot M, Danjou MA, Alexander K, et al. Can sonographic findings predict the results of liver aspirates in dogs with suspected liver disease? Vet Radiol Ultrasound. 2009;50(5):513518.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Acierno MJ, Brown S, Coleman AE, et al. ACVIM consensus statement: guidelines for the identification, evaluation, and management of systemic hypertension in dogs and cats. J Vet Intern Med. 2018;32(6):18031822.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Covey JL, Degner DA, Jackson AH, Hofeling AD, Walshaw R. Hilar liver resection in dogs. Vet Surg. 2009;38(1):104111.

  • 12.

    Patnaik AK, Hurvitz AI, Lieberman PH. Canine hepatic neoplasms: a clinicopathologic study. Vet Pathol. 1980;17(5):553564.

  • 13.

    van Sprundel RG, van den Ingh TSGAM, Guscetti F, et al. Classification of primary hepatic tumours in the dog. Vet J. 2013;197(3):596606.

  • 14.

    Liptak JM, Dernell WS, Monnet E, et al. Massive hepatocellular carcinoma in dogs: 48 cases (1992–2002). J Am Vet Med Assoc. 2004;225(8):12251230.

  • 15.

    Kinsey JR, Gilson SD, Hauptman J, Mehler SJ, May LR. Factors associated with long-term survival in dogs undergoing liver lobectomy as treatment for liver tumors. Can Vet J. 2015;56(6):598604.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Matsuyama A, Takagi S, Hosoya K, et al. Impact of surgical margins on survival of 37 dogs with massive hepatocellular carcinoma. N Z Vet J. 2017;65(5):227231.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Moyer J, Lopez DJ, Balkman CE, Sumner JP. Factors associated with survival in dogs with a histopathological diagnosis of hepatocellular carcinoma: 94 cases (2007–2018). Open Vet J. 2021;11(1):144153.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Millar SL, Curley TL, Monnet EL, Zersen KM. Premature death in dogs with nontraumatic hemoabdomen and splenectomy with benign histopathologic findings. J Am Vet Med Assoc. 2021;260(S1):S9S14.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Spangler WL, Kass PH. Pathologic factors affecting postsplenectomy survival in dogs. J Vet Intern Med. 1997;11(3):166171.

  • 20.

    Johnson KA, Powers BE, Withrow SJ, Sheetz MJ, Curtis CR, Wrigley RH. Splenomegaly in dogs. Predictors of neoplasia and survival after splenectomy. J Vet Intern Med. 1989;3(3):160166.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    Thamm DH. Hemangiosarcoma. In: Withrow SJ, Vail DM, Page RL, eds. Withrow and MacEwen’s Small Animal Clinical Oncology. 5th ed. Elsevier-Saunders; 2013:679688.

    • Search Google Scholar
    • Export Citation
  • 22.

    Balkman C. Hepatobiliary neoplasia in dogs and cats. Vet Clin North Am Small Anim Pract. 2009;39(3):617625.

  • 23.

    Strombeck DR. Clinicopathologic features of primary and metastatic neoplastic disease of the liver in dogs. J Am Vet Med Assoc. 1978;173(3):267269.

  • 24.

    Bergman JR. Nodular hyperplasia in the liver of the dog: an association with changes in the Ito cell population. Vet Pathol. 1985;22(5):427438.

    • Search Google Scholar
    • Export Citation
  • 25.

    Clendaniel DC, Sivacolundhu RK, Sorenmo KU, et al. Association between macroscopic appearance of liver lesions and liver histology in dogs with splenic hemangiosarcoma: 79 cases (2004–2009). J Am Anim Hosp Assoc. 2014;50(4):e6e10. doi:10.5326/JAAHA-MS-6059

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26.

    Leyva FJ, Loughin CA, Dewey CW, Marino DJ, Akerman M, Lesser ML. Histopathologic characteristics of biopsies from dogs undergoing surgery with concurrent gross splenic and hepatic masses: 125 cases (2012–2016). BMC Res Notes. 2018;11(1):122. doi:10.1186/s13104-018-3220-1

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 27.

    Linden DS, Liptak JM, Vinayak A, et al. Outcomes and prognostic variables associated with central division hepatic lobectomies: 61 dogs. Vet Surg. 2019;48(3):309314.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28.

    Oungsakul P, Perez-Guaita D, Shah AK, et al. Addressing delicate and variable cancer morphology in spectral histopathology using canine visceral hemangiosarcoma. Anal Chem. 2021;93(36):1218712194.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29.

    Leela-Arporn R, Ohta H, Nagata N, et al. Epidemiology of massive hepatocellular carcinoma in dogs: a 4-year retrospective study. Vet J. 2019;248:7478.

  • 30.

    Lapsley JM, Wavreille V, Barry S, et al. Risk factors and outcome in dogs with recurrent massive hepatocellular carcinoma: a Veterinary Society of Surgical Oncology case-control study. Vet Comp Oncol. 2022;20(3):697709. doi:10.1111/vco.12824

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 31.

    Vatnikov Y, Vilkovysky I, Kulikov E, et al. Size of canine hepatocellular carcinoma as an adverse prognostic factor for surgery. J Adv Vet Anim Res. 2020;7(1):127132.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 32.

    Kim J-H, Graef AJ, Dickerson EB, Modiano JF. Pathobiology of hemangiosarcoma in dogs: research advances and future perspectives. Vet Sci. 2015;2(4):388405.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 33.

    Lisciandro S. Focused or COAST3—spleen. In: Lisciandro GR, ed. Focused Ultrasound Techniques for the Small Animal Practitioner. John Wiley & Sons Inc; 2014:6579.

    • Search Google Scholar
    • Export Citation
  • 34.

    Millar SL, Zersen KM. Diagnostic value of the ultrasonographic description of a splenic mass or nodule as cavitated in 106 dogs with nontraumatic hemoabdomen. Am J Vet Res. 2021;82(12):970974.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 35.

    Griebie ER, David FH, Ober CP, et al. Evaluation of canine hepatic masses by use of triphasic computed tomography and B-mode, color flow, power, and pulsed-wave Doppler ultrasonography and correlation with histopathologic classification. Am J Vet Res. 2017;78(11):12731283.

    • PubMed
    • Search Google Scholar
    • Export Citation

Advertisement