Anatomic site and etiology of hemorrhage in small versus large dogs with spontaneous hemoperitoneum

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Abstract

Objective: To compare anatomic sources and underlying etiology of hemorrhage in small vs large dogs with spontaneous hemoperitoneum (SH). Study design: Retrospective cross-sectional study. Animals: Client-owned dogs with SH at 2 academic institutions. Methods: Medical records were reviewed for age, breed, sex, weight, and results of imaging, surgery, necropsy, cytology, and histopathology. Dogs were divided according to body weight (≤ 20 kg = small, > 20 kg = large). Confidence intervals were calculated to estimate rates of splenic and hepatic hemorrhage in small and large dog SH populations. Multivariable regression was used to compare prevalence of anatomic sources of hemorrhage and etiology in small vs large dogs. Results: We identified 742 dogs with SH, including 637 in which the anatomic site of hemorrhage was investigated. Splenic hemorrhage was diagnosed in 43.2% (95% CI, 34.3-52.4) of small dogs and 61.3% (95% CI, 57.0-65.6) of large dogs. Small dogs had lower prevalence of splenic hemorrhage (prevalence ratio, 0.70; 95% CI, 0.58-0.87; P <.001) and higher prevalence of hemorrhage from liver (prevalence ratio, 1.72; 95% CI, 1.20-2.47; P =.003) or from another location such as retroperitoneal mass, kidney, or adrenal (prevalence ratio, 2.73; 95% CI, 1.66-4.47; P <.001) vs large dogs. Hemangiosarcoma was associated with splenic hemorrhage and occurred more frequently in large vs small dogs (P =.011). Conclusion: Small dogs had a lower rate of splenic hemorrhage and higher rates of hemorrhage from liver and other sites compared to large dogs. Etiologies other than splenic hemangiosarcoma were common, particularly among dogs weighing ≤ 20 kg. Clinical significance: Clinicians should perform diagnostics and consider body size before making presumptive diagnoses in dogs with SH.

Original languageEnglish (US)
Pages (from-to)1031-1038
Number of pages8
JournalVeterinary Surgery
Volume47
Issue number8
DOIs
StatePublished - Nov 1 2018

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Hemoperitoneum
hemorrhage
etiology
Dogs
Hemorrhage
dogs
hemangiosarcoma
Hemangiosarcoma
liver
Liver
educational institutions
Body Size

ASJC Scopus subject areas

  • veterinary(all)

Cite this

@article{70badab53c914be09cf7b3debd6aa53e,
title = "Anatomic site and etiology of hemorrhage in small versus large dogs with spontaneous hemoperitoneum",
abstract = "Objective: To compare anatomic sources and underlying etiology of hemorrhage in small vs large dogs with spontaneous hemoperitoneum (SH). Study design: Retrospective cross-sectional study. Animals: Client-owned dogs with SH at 2 academic institutions. Methods: Medical records were reviewed for age, breed, sex, weight, and results of imaging, surgery, necropsy, cytology, and histopathology. Dogs were divided according to body weight (≤ 20 kg = small, > 20 kg = large). Confidence intervals were calculated to estimate rates of splenic and hepatic hemorrhage in small and large dog SH populations. Multivariable regression was used to compare prevalence of anatomic sources of hemorrhage and etiology in small vs large dogs. Results: We identified 742 dogs with SH, including 637 in which the anatomic site of hemorrhage was investigated. Splenic hemorrhage was diagnosed in 43.2{\%} (95{\%} CI, 34.3-52.4) of small dogs and 61.3{\%} (95{\%} CI, 57.0-65.6) of large dogs. Small dogs had lower prevalence of splenic hemorrhage (prevalence ratio, 0.70; 95{\%} CI, 0.58-0.87; P <.001) and higher prevalence of hemorrhage from liver (prevalence ratio, 1.72; 95{\%} CI, 1.20-2.47; P =.003) or from another location such as retroperitoneal mass, kidney, or adrenal (prevalence ratio, 2.73; 95{\%} CI, 1.66-4.47; P <.001) vs large dogs. Hemangiosarcoma was associated with splenic hemorrhage and occurred more frequently in large vs small dogs (P =.011). Conclusion: Small dogs had a lower rate of splenic hemorrhage and higher rates of hemorrhage from liver and other sites compared to large dogs. Etiologies other than splenic hemangiosarcoma were common, particularly among dogs weighing ≤ 20 kg. Clinical significance: Clinicians should perform diagnostics and consider body size before making presumptive diagnoses in dogs with SH.",
author = "Jeremy Fleming and Michelle Giuffrida and Runge, {Jeffrey J.} and Ingrid Balsa and Culp, {William T} and Philipp Mayhew and Steffey, {Michele A} and Epstein, {Steven E}",
year = "2018",
month = "11",
day = "1",
doi = "10.1111/vsu.12963",
language = "English (US)",
volume = "47",
pages = "1031--1038",
journal = "Veterinary Surgery",
issn = "0161-3499",
publisher = "Wiley-Blackwell",
number = "8",

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TY - JOUR

T1 - Anatomic site and etiology of hemorrhage in small versus large dogs with spontaneous hemoperitoneum

AU - Fleming, Jeremy

AU - Giuffrida, Michelle

AU - Runge, Jeffrey J.

AU - Balsa, Ingrid

AU - Culp, William T

AU - Mayhew, Philipp

AU - Steffey, Michele A

AU - Epstein, Steven E

PY - 2018/11/1

Y1 - 2018/11/1

N2 - Objective: To compare anatomic sources and underlying etiology of hemorrhage in small vs large dogs with spontaneous hemoperitoneum (SH). Study design: Retrospective cross-sectional study. Animals: Client-owned dogs with SH at 2 academic institutions. Methods: Medical records were reviewed for age, breed, sex, weight, and results of imaging, surgery, necropsy, cytology, and histopathology. Dogs were divided according to body weight (≤ 20 kg = small, > 20 kg = large). Confidence intervals were calculated to estimate rates of splenic and hepatic hemorrhage in small and large dog SH populations. Multivariable regression was used to compare prevalence of anatomic sources of hemorrhage and etiology in small vs large dogs. Results: We identified 742 dogs with SH, including 637 in which the anatomic site of hemorrhage was investigated. Splenic hemorrhage was diagnosed in 43.2% (95% CI, 34.3-52.4) of small dogs and 61.3% (95% CI, 57.0-65.6) of large dogs. Small dogs had lower prevalence of splenic hemorrhage (prevalence ratio, 0.70; 95% CI, 0.58-0.87; P <.001) and higher prevalence of hemorrhage from liver (prevalence ratio, 1.72; 95% CI, 1.20-2.47; P =.003) or from another location such as retroperitoneal mass, kidney, or adrenal (prevalence ratio, 2.73; 95% CI, 1.66-4.47; P <.001) vs large dogs. Hemangiosarcoma was associated with splenic hemorrhage and occurred more frequently in large vs small dogs (P =.011). Conclusion: Small dogs had a lower rate of splenic hemorrhage and higher rates of hemorrhage from liver and other sites compared to large dogs. Etiologies other than splenic hemangiosarcoma were common, particularly among dogs weighing ≤ 20 kg. Clinical significance: Clinicians should perform diagnostics and consider body size before making presumptive diagnoses in dogs with SH.

AB - Objective: To compare anatomic sources and underlying etiology of hemorrhage in small vs large dogs with spontaneous hemoperitoneum (SH). Study design: Retrospective cross-sectional study. Animals: Client-owned dogs with SH at 2 academic institutions. Methods: Medical records were reviewed for age, breed, sex, weight, and results of imaging, surgery, necropsy, cytology, and histopathology. Dogs were divided according to body weight (≤ 20 kg = small, > 20 kg = large). Confidence intervals were calculated to estimate rates of splenic and hepatic hemorrhage in small and large dog SH populations. Multivariable regression was used to compare prevalence of anatomic sources of hemorrhage and etiology in small vs large dogs. Results: We identified 742 dogs with SH, including 637 in which the anatomic site of hemorrhage was investigated. Splenic hemorrhage was diagnosed in 43.2% (95% CI, 34.3-52.4) of small dogs and 61.3% (95% CI, 57.0-65.6) of large dogs. Small dogs had lower prevalence of splenic hemorrhage (prevalence ratio, 0.70; 95% CI, 0.58-0.87; P <.001) and higher prevalence of hemorrhage from liver (prevalence ratio, 1.72; 95% CI, 1.20-2.47; P =.003) or from another location such as retroperitoneal mass, kidney, or adrenal (prevalence ratio, 2.73; 95% CI, 1.66-4.47; P <.001) vs large dogs. Hemangiosarcoma was associated with splenic hemorrhage and occurred more frequently in large vs small dogs (P =.011). Conclusion: Small dogs had a lower rate of splenic hemorrhage and higher rates of hemorrhage from liver and other sites compared to large dogs. Etiologies other than splenic hemangiosarcoma were common, particularly among dogs weighing ≤ 20 kg. Clinical significance: Clinicians should perform diagnostics and consider body size before making presumptive diagnoses in dogs with SH.

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