Question:

My 10 year old Golden Retriever, Gracie, was recently diagnosed with a ruptured splenic mass. She had surgery performed to stop the bleeding and remove the mass. Unfortunately, the mass returned as a type of cancer called hemangiosarcoma. She is doing great currently, but we are not interested in pursuing traditional chemotherapy. Are there any other options available.

Answer:

I am sorry about Gracie’s recent cancer diagnosis, though am happy to hear that she is currently doing well. Hemangiosarcoma is a cancer of the endothelial cells (cells that line the inside of blood vessels). The spleen is one of the most common primary sites for this tumor to start. Unfortunately, since this is a tumor of the blood vessels, it often metastasizes throughout the body via the blood stream even if we do not see evidence of cancer spread during surgery or on x-rays or ultrasound.

Although traditional chemotherapy with doxorubicin (Adriamycin) is the standard treatment recommendation following surgery, other options are available.

A different option for chemotherapeutic treatment is metronomic, or low dose, chemotherapy. This form of chemotherapy does not eliminate tumor cells themselves, but instead targets the blood supply of the tumor cells to inhibit their growth. Two drugs would be given orally at home each day with this form of treatment: cyclophosphamide (Cytoxan) and a nonsteroidal anti-inflammatory drug (NSAID), such as Deramaxx or Meloxicam. In a recent study, little adverse reaction was seen associated with these drugs. Because the chemotherapy drug doses required are very low, side effects, such as stomach upset or a low white blood cell level, are uncommon.

There are also alternative options available. At the University of Pennsylvania, the mushroom extract I’m-Yunity® (containing polysaccharopeptide) has shown promise in preliminary studies of dogs with splenic hemangiosarcoma. Yunnan Baiyao, a Chinese Herbal supplement, can be used to help prevent bleeding from tumors such as hemangiosarcoma. These supplements can be used alone, or in conjunction with any of the above options.

Suzanne E. Rau, DVM

Diplomate ACVIM (Oncology)