Splenic Abscess in a Dog

Abstract

Background: Splenic abscesses are rare in dogs, representing less than 1% of splenic injuries. Therefore, it has been seldom reported. The cases reported in veterinary medicine suggest trauma as the main cause of abscess formation in this organ. Due to the lack of information about the subject, the aim of this paper is to report the case and treatment of a splenic abscess in a dog. Case: A 4-year-old intact female Bernese Mountain dog was referred to the veterinary hospital with apathy and abdominal pain. The owner related estrous followed by artificial insemination three weeks prior to the referral. On physical exam the patient was mildly dehydrated and presented pale mucosal. Besides the abdominal pain and prostration, others signs were not found. The ultrasound images suggested uterine fluid collection and peritonitis. The patient was referred to laparotomy. During the procedure the uterus was normal, however it was verified peritonitis and a splenic mass of 15x10x5 cm. A total splenectomy was performed to remove the mass and two drains were placed in order to treat the inflammation of the peritoneum. The spleen with the mass was sent to histological examination and subcapsular splenic abscess was diagnosed. After the surgery, the patient was treated with antibiotics and lavage of abdominal cavity until the complete recovery. At the end of the eighth day post-surgery the dog was discharged and after 12 months it presented good clinical condition. Discussion: Splenic abscesses are rare and seldom discussed in the literature of veterinary medicine. In a study with 1480 dogs where it was assessed the prevalence and type of lesion found in the spleen, in only four cases (less than 1%) splenic abscess were presented [10]. The causes of this condition are divided into infection, trauma, haematological disorders and immunodeficiency. In the case presented here, the etiology was not identified considering that the patient had no historical that could fit in one of these categories. However, the authors do not rule the possibility of a trauma not observed by the owner. Clinical signs of splenic abscess are nonspecific. Normally apathy, cranial abdominal pain, vomiting and anorexia can be seen [9]. In this report, the patient had similar presentation, except for the vomiting. Others signs such as chest pain, splenomegaly, fever and diarrhea may be also present. For the diagnosis of splenic abscess, diagnostic imaging is essential. The ultrasound is a good tool, but its sensitivity is 76% [5]. In this case, the ultrasound examination did not allow the diagnosis. The difficulty in identifying the presence and origin of the mass can be attributed to the echogenic content and its size. The splenic mass had 15x10x5 cm and it was located in the upper left quadrant, anatomically compatible with the left uterine horn. Besides that, the echogenic content is a condition routinely observed in hemometra or piometra. When ultrasound is not helpful, computed tomography is indicated because it has approximately 98% sensibility. The treatment was total splenectomy, abdominal cavity lavage and broad-spectrum antibiotics. Splenectomy is the recommended treatment for these cases. However, percutaneous drainage guided by ultrasound or computed tomography may also be performed [4]. Splenectomy and antibiotic therapy was effective in managing the disease leading to a rapid and safe clinical improvement of the patient.