Hemangiosarcoma (Canine)

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Canine Hemangiosarcoma is a highly malignant form of cancer that comes from the vascular endothelium (lining of blood vessels). Hemangiosarcoma can arise from blood vessels located in any tissue. The most common affected sites include the spleen, heart, subcutaneous tissue and liver. These tumors invade locally and also metastasize (spread to other organs). Splenic tumors have often spread to the liver and lungs by the time of diagnosis.

Common name:Hemangiosarcoma
Scientific name:Hemangiosarcoma, angiosarcoma, malignant hemangiothelioma

Diagnosis

Signalment
This disease often affects adult to older dogs with an average age of 8-13 years old. German shepherds are among the most commonly affected breed. Other breeds with a high incidence are golden retrievers, Labrador retrievers, boxers, schnauzers, pointers and Doberman pinchers.

Incidence/prevalence
In dogs, hemangiosarcoma accounts for about 5-7% of all malignant cancers.

Geographic distribution
There is no specific geographic distribution for hemangiosarcoma.

Clinical signs (primary, most to least frequent, scientific term, synonyms)
Collapse, lethargy (decreased energy), anorexia (loss of appetite), weight loss.

Clinical signs (secondary, most to least frequent, scientific term, synonyms)
Pale mucous membranes (pale gums), abdominal effusion (fluid in the belly), difficulty breathing, distended abdomen, arrhythmias (abnormal heart rhythm).

Cause (scientific, common term)
Neoplasia (malignant cancer).

Organ systems affected (most to least affected)
Spleen, heart (right atrium), liver, subcutaneous tissue, skin.

Diagnostic tests
Routine blood analysis, urine analysis, coagulation profile (blood clotting tests), chest radiographs (X-rays), abdominal ultrasound, echocardiogram (ultrasound of the heart), surgery with biopsy.

Differential Diagnosis
Hematoma (benign tumor), hemangioma (benign tumor), splenic torsion (twisted spleen), lymphoma, idiopathic pericardial effusion (fluid around the heart).

Overview

Canine Hemangiosarcoma is a malignant form of cancer that originating from vascular endothelium (lining of blood vessels). The most commonly affected sites include the spleen, heart, subcutaneous tissue and liver. Because this type of cancer comes from blood vessels, which are found throughout the entire body, any part of the body can be affected. These tumors are aggressive and can spread rapidly to other organs. Clinical signs depend on the location of the tumor and range from intermittent weakness and decreased appetite to sudden collapse and death due to rupture of the tumor with internal bleeding. Other clinical signs seen are abdominal distention (swelling from tumor size or internal bleeding), weight loss, trouble breathing and pale gums.

Treatment

Home Care
If any weakness, pale gums or other clinical signs are noted, veterinary attention is required immediately. All new skin lumps should be evaluated by a veterinarian. Minimize sun exposure, especially in dogs that have thin hair coats and light skin.

Professional Care
Based on the dog's history and physical exam findings, routine blood work, urinalysis and blood clotting tests should be performed. Abdominal x-rays and ultrasound are used to help identify the site of the tumor. Abdominocentesis (removal of fluid from the belly), is also performed to look for fluid or non-clotting blood. X-rays of the chest are recommended to look for evidence of metastasis (spread). An echocardiogram (ultrasound) is used to look for tumors on the heart. Surgery to remove the tumor and/or to collect biopsies (small samples of the tumor) is usually required to make a final diagnosis.

Action
The pet will be stabilized if internal bleeding is occurring or if fluid is building up around the heart. These pets will be hospitalized and treated aggressively with intravenous (IV) fluids and supportive care. Some require blood transfusions and fluid removal from around the heart. Depending on the location of the tumor, surgery may be preformed. If the tumor is on the spleen, the entire spleen may be removed. If the tumor is in the skin, then a large area around the mass should be removed. If the tumor is on the heart it may also be surgically removed depending the exact situation. Potential complications with include bleeding, infection and irregular heart rhythm. Because these tumors spread rapidly, chemotherapy is often recommended in addition to surgical treatment. Dogs typically handle the side effects of chemotherapy fairly well and the survival time with a combination of surgery and chemotherapy is better as compared to surgery alone. Follow up examinations and tests, as recommended by the veterinarian, should be performed to help increase the chance of successfully treating the patient and to ensure that potential side effects are minimized.

Outcome
The outcome and prognosis vary according to the location of the tumor. Survival time with treatment varies from weeks to months. Survival time is increased with the addition of chemotherapy as compared to surgery alone.

Recommended Treatment
See your veterinarian immediately for proper diagnosis and care if hemangiosarcoma is suspected.

References/Additional Readings

Couto, C. Guillermo. Selected Neoplasms in Dogs and Cats. In: Nelson, R.W. & Couto C.G. Small Animal Internal Medicine 3rd Edition. St. Louis: Mosby, 2003; 1142-1144.

Chun, Ruthanne & Edwards, N. Joel. Hemangiosarcoma. In: Cote, Etienne. Clinical Veterinary Advisor; Dogs and Cats. St. Louis, Mosby, 2003; 471-475.

Author

Marisa C. Altieri, DVM

Editor

Steven Hansen, DVM, MS, MBA

DABVT, DABT

Please note that PetVet should only be used as a guide and in no way should be substituted for licensed veterinary care.