Outcomes and Blood Product Use in 89 Surgically Managed and 79 Medically Managed Cases of Acute Spontaneous Hemoperitoneum in the Dog

Abstract

Objective: To describe a population of dogs with acute spontaneous hemoperitoneum (ASH) that were treated with either surgical or medical management in the first 12 h after presentation, and to perform a preliminary investigation into whether there were differences in achieving cardiovascular stabilization or patterns of red blood cell (RBC) transfusion between patients treated with early (<12 h) surgery vs.medical management.Design: A retrospective multicenter preliminary study performed on 168 dogs presenting with ASH between January 2015 and May 2019. Patients were excluded if they were euthanized or discharged from hospital within the first 12 h, or if clinical records were incomplete. All patients received appropriate medical stabilization efforts. Statistical analysis was performed comparing patients that underwent early (<12 h) surgery and those that did not.Results: Eighty-nine patients were in the early surgical group and 79 patients in the medical group. A significantly higher proportion of medical cases were euthanized (p < 0.001). A significantly higher proportion of early surgical cases were discharged from hospital (p = 0.005). There was no statistically significant difference between groups in achieving cardiovascular stabilization (OR 1.07 p = 0.82). A higher proportion of patients with body-weight over 20 kg achieved stabilization within 12 h than those with body-weight of 20 kg or less (62.7 vs. 41.4%, p < 0.01). A higher proportion of patients with splenic conditions achieved stabilization than patients with non-splenic conditions (56.5 vs. 28.6%, p = 0.05). The odds of receiving an RBC transfusion were higher in the early surgical group than the medical group [OR 3.81 (p < 0.001)].Conclusions: This preliminary study did not identify a significant difference in the ability to achieve cardiovascular stabilization in the first 12 h in dogs with ASH that underwent early surgical intervention vs. those managed medically. Patients in the early surgical group were more likely to receive a RBC transfusion than those in the medical group. At this time the decision on whether to pursue medical or early surgical management should be made on a case by case basis.

Blood product usage and factors associated with transfusions in cats with hemoperitoneum: 33 cases (2018–2022)

“…The findings of this study were consistent with our hypothesis that cats with hemoperitoneum have a high mortality rate and high blood product usage (51.5%). Blood product administration was common in cats with hemoperitoneum, which is similar to previously reported rates of transfusions in dogs at 47% ( 7 , 10 ). The majority of cats in this study had hemoperitoneum diagnosed seconday to neoplasia (51.5%), which is similar to previous studies ( 2 ).…”

“…Often, point-of-care diagnostics including PCV, TS and lactate are used to aid the decision of transfusion administration ( 6 ). In a recent study of canine spontaneous hemoperitonum, 47% of cases received packed red blood cell transfusions, however, no studies have evaluated blood product administration in feline hemoperitoneum ( 7 ). The purpose of this study was to determine the blood product usage and survival to discharge in cats with hemoperitoneum.…”

Clinical Use of Canine Thawed Refrigerated Plasma: A Historical Case Series

“…Some outcomes in our study were similar to those reported in the literature for dogs treated with FFP (e.g., for anticoagulant-rodenticide-induced haemorrhage); however, survival to discharge was numerically lower in our study for those with spontaneous hemoperitoneum (45.4% vs. 83.3% [43]) and traumatic haemorrhage (50% vs. 87% [44]) compared to the existing literature. The factors contributing to survival outcomes cannot be determined in a retrospective case series, but may be related to the use of TP or other factors such as severity of illness or owners' choice to euthanise due to poor prognosis, age, or financial considerations [45].…”

Molecular Profile of Canine Hemangiosarcoma and Potential Novel Therapeutic Targets

“…Non-cutaneous HSAs are highly aggressive tumors with a high metastatic rate [ 6 , 7 , 8 , 9 ]. The splenic form shows nonspecific clinical signs during its initial progression, yet is the most common cause of acute hemoperitoneum [ 10 , 11 ] with a high rate of metastases to the liver, mesentery, abdominal lymph nodes and lungs [ 7 , 8 ]. Cardiac HSA has a poor prognosis due to its fast local growth and progression, with frequent concurrent involvement of the lungs, spleen and liver [ 6 ].…”