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Basics ⬇

Basics

Overview

  • May occur as a separate entity or in association with gastric dilatation-volvulus syndrome.
  • Acute or chronic.
  • Pathophysiology-unknown.
  • Systems affected-hemic/lymphatic/immune and cardiovascular.
  • Isolated splenic torsion uncommon.

Signalment

  • More common in large-breed, deep-chested dogs, such as German shepherd, standard poodle, and Great Dane.
  • No sex predilection.

Signs

Historical Findings

  • Acute-cardiovascular collapse and abdominal pain.
  • Chronic-intermittent anorexia, vomiting, weight loss, and possibly hemoglobinuria.

Physical Examination Findings

  • Pale mucous membranes, tachycardia, and other signs of hypoperfusion.
  • Palpable abdominal mass (spleen).

Causes & Risk Factors

  • Large-breed and deep-chested dogs.
  • Prior stretching of gastrosplenic, phrenicosplenic, and splenocolic ligaments (e.g., prior gastric dilatation and volvulus).
  • Historical gastric dilatation.
  • Excessive exercise, rolling, and retching may contribute.
  • Nervousness and anxiety have been associated with an increased risk of GDV but not of isolated splenic torsion.

Diagnosis ⬆ ⬇

Diagnosis

Differential Diagnosis

  • Other splenic disease (e.g., neoplasia and immune-mediated disease).
  • Acute gastrointestinal disease with abdominal pain.

CBC/Biochemistry/Urinalysis

  • Anemia
  • Thrombocytopenia
  • Leukocytosis
  • High liver enzyme values
  • Hemoglobulinuria

Other Laboratory Tests

Coagulation test-DIC, with prolongation of clotting times and thrombocytopenia.

Imaging

Abdominal Radiography

  • Cranial or midabdominal mass may be seen.
  • Spleen may be abnormally located.

Abdominal Ultrasonography

  • Splenic congestion/lack of blood flow to spleen.
  • Dilated splenic veins.
  • Splenic infarction.

Diagnostic Procedures

ECG-may show ventricular arrhythmias.

Pathologic Findings

Splenic congestion and infarction.

Treatment ⬆ ⬇

Treatment

Medications ⬆ ⬇

Medications

Drug(s)

  • No specific drugs required.
  • Postoperative pain relief advised.
  • Heparin (unfractionated or low molecular weight) or plasma transfusion (rarely due to size of patient) may be considered if DIC and coagulopathy are documented.

Contraindications/Possible Interactions

None

Follow-Up ⬆ ⬇

Follow-Up

Surgical correction considered curative.

Miscellaneous ⬆

Miscellaneous

Abbreviations

  • DIC = disseminated intravascular coagulation
  • ECG = electrocardiogram
  • GDV = gastric dilation and volvulus

Author Elizabeth A. Rozanski

Consulting Editor Alan H. Rebar

Suggested Reading

Neath PJ, Brookman DJ, Saunders HM. Retrospective analysis of 19 cases of isolated torsion of the splenic pedicle in dogs. J Small Anim Pract 1997, 38:337–392.

Stoneham A, Henderson A, O'Toole T. Resolution of severe thrombocytopenia in two standard poodles with surgical correction of splenic torsion. J Vet Emerg Crit Care 2006, 16:131–135.