What is a Diplomate?
The term "ACVS Diplomate" refers to a veterinarian who has been board certified in veterinary surgery. Only veterinarians who have successfully completed the certification requirements of the ACVS are Diplomates of the American College of Veterinary Surgeons and have earned the right to be called specialists in veterinary surgery.Splenectomy is a procedure to remove the spleen, either partially or in its entirety. Most commonly, a complete splenectomy is performed. A full open abdominal exploratory surgery (Figure 1) is typically performed, allowing for access to the full blood supply and for evaluation of other abdominal organs. However, in non-emergency situations, minimally invasive techniques (laparoscopy) have been reported in both dogs and cats to remove the spleen. Removal of the spleen can serve as a diagnostic and therapeutic endeavor. During surgical exploratory, biopsy of other organs (such as liver or lymph node) may be performed. Prior to surgery, bloodwork, blood pressure monitoring, EKG monitoring, x-rays or an abdominal ultrasound may be recommended.
A majority of patients undergoing splenectomy on an emergency basis have hemorrhage from the spleen. Prior to surgery, these patients are often stabilized with fluid support and blood products or intensive care monitoring, as necessary. Due to the critical nature of many of these patients, splenectomy is often performed by an ACVS Board-certified Surgeon. Upon removal, the spleen is often sent to a pathology lab for biopsy (histopathology) to obtain a definitive diagnosis.
- Splenic Trauma
- Splenic Torsion (Figure 2)
- Splenic Neoplasia (Cancer) (Figure 3)
- Benign splenic masses
Removal of the entire spleen is a technically less challenging procedure compared to complete splenectomy. Additionally, many patients that undergo splenectomy have evidence of hemorrhage or suspicion of a cancerous process. Thus, the majority of dogs and cats with conditions affecting the spleen will have a complete splenectomy.
Potential Complications:
- Hemorrhage (Bleeding):
Bleeding prior to or during surgery is common with diseases involving the spleen. Thus, close monitoring of the patient is necessary. Blood products may be indicated and recommended prior to, during or after the procedure.
- Cardiac arrhythmias:
Cardiac arrhythmias are a potential complication in patients with splenic disease. Monitoring of the heart prior to, during and following surgery with an EKG is often recommended. Occasionally, medications to or oxygen therapy may be used to help treat the arrhythmia until resolution. Most resolve within 24-48 hours of surgery.
- Systemic Inflammatory Changes:
Changes to bloodwork, including anemia or disruption of the normal coagulation (clotting) and inflammatory pathways can be impacted in patients with splenic disease. Your ACVS Board-certified surgeon may discuss these potential complications or changes. If this occurs in your pet, additional therapies may be recommended prior to, during and following surgery.
- Gastric Dilatation Volvulus (GDV):
GDV, or torsion of the stomach, has been described in patients undergoing splenectomy. Many of these patients are already at risk for GDV, regardless of splenic disease. Your ACVS Board-certified surgeon can make recommendations as to whether a gastropexy (tacking of the stomach) should be performed during the splenectomy procedure. Read more about Gastric Dilatation Volvulus (GDV).
- Infection:
Infection poses a small risk for all surgeries, and applies to splenectomy as well. Blood borne infections are rare in patients with splenectomy, however some breeds in certain endemic areas may be more prone to development of disease after splenectomy. Speaking with your ACVS Board-certified surgeon about this risk can be considered.
