Dear Dr Forsythe: I am debating whether or not to get surgery for my dog, Lucifer. He has a pretty large tumor on his spleen but they aren’t sure if it is cancer or not. The vet told me they need to take his spleen out or it will probably break open and he will die sometime in the near future. I am not sure if he can make it through such an invasive operation. He is 10 years old and Dobermans can have blood problems. I looked up on line and it seemed like a terrible thing to go through. I know that sometimes veterinarians suggest the most expensive way to go even if there is some other option. If it isn’t cancer, can’t they use some medicine to get the swelling down?
Jim in San Jose
Dear Jim: I’m sorry to tell you what you don’t want to hear, but in my opinion, it sounds like your veterinarian is telling you exactly what you need to know. When an elderly dog presents with evidence of a large splenic mass, the potential for an impending rupture is great. A simple fall or running quickly across the yard can cause the outer “capsule” of the delicate spleen to tear, leading to a fatal bleed-out. Two common causes of enlarged spleens are hemangiosarcoma, a cancer that is both invasive and tends to metastasize, and hemangioma, its benign counterpart. Most veterinarians determine via x-ray and/or ultrasound that a pet’s spleen is likely to be tumor filled. If this is the case with your pet, a splenectomy is probably the only chance “Lucifer” will have for surviving very long.
Fortunately, dogs can live quite well without their spleen. The spleen acts as a filter of blood and also makes blood cells but when it is removed, the bone marrow can take over these functions quite well. If “Lucifer” has the blood condition called Von Willebrands disease (a type of hemophilia very common in Dobermans), surgery may be slightly more risky, but with proper surgical precautions a splenectomy seems like a the only route to take, in my opinion. That is, if you are interested in getting a cure or long term survival for your pet. Keep in mind that my advice is based on my opinion, limited by the brief information you’ve shared with me in your letter and my absolute conviction that you are dreadfully wrong in suggesting that veterinarians “sometimes suggest the most expensive treatments” to make a profit when all we really want is to help your pet survive what is likely a terrible life-threatening disease.
Believe me, if there were a magic pill, or “medicine” to cure splenic tumors without surgery, veterinarians would be dispensing it very happily. Too many of us have lost our own beloved pets to cancer to keep the simple cures to ourselves and save the expensive suggestions for our “unwitting clients”. To even make that accusation is quite honestly pretty rotten! I know I myself didn’t devote all my blood sweat and tears, years of education and sacrifice and take out student loans to practice in a profession for any reason other than the joy and satisfaction of helping pets and their owners every day.
While I empathize with you that the cost of surgery for your Doberman may be quite costly, try to keep in mind that your veterinarian is not the one who gave your pet this tumor — he or she is trying to save your pet’s life and keep you and Lucifer together. Seems like a pretty simple, honorable goal to me. And now I’ll step off the soapbox, before I slip off and have to go to see my own doctor.