Hemangiosarcoma - Rugby

"Rugby" is a 10 year old Golden Retriever recently treated at Seattle Veterinary Specialists for right atrial hemangiosarcoma.  Hemangiosarcoma is a very aggressive, high-grade soft tissue sarcoma with the most common areas affected being the spleen and heart.  As a highly malignant cancer which originates from the blood vessels, it can spread rapidly, causing tumors almost anywhere in the body.  Hemangiosarcoma is insidious, as it attempts to build it’s own blood vessel network, making blood blister like formations which disrupts normal organ function.  It is commonly in the advanced stage before detection, making it a difficult tumor to cure.  There are three basics forms of Hemangiosarcoma:  dermal (skin), hypodermal (under the skin), and visceral (splenic or cardiac).  The visceral form is the most common.  Hemangiosarcoma is highly metastatic, and most forms of the disease are associated with a poor prognosis.  The spleen and the right atrium of the heart are the most common sites of occurrence of visceral Hemangiosarcoma. Dogs may have nonspecific signs such as lethargy, loss of appetite, weight loss or more specific signs such as difficulty breathing, pallor, or abdominal fluid. Regardless of the site of origin, visceral

Hemangiosarcoma is locally invasive and highly metastatic. Up to 25% of dogs with splenic Hemangiosarcoma have cardiac Hemangiosarcoma and up to 63% of dogs with atrial Hemangiosarcoma have metastatic disease. Metastases commonly affect the lower mesentery, lungs, and brain.

Rugby presented to SVS Emergency Service when the tumor in his right atrium/auricular appendage ruptured and he was bleeding into his pericardial sac (sac covering/enveloping the heart). This blood loss was causing him to be in critical condition and he was in need of immediate attention. To help stabilize Rugby, Dr. Jenna Arnaiz (ER) removed the blood from the pericardium via a process known as a pericardiocentesis. Shortly thereafter he was assessed by our cardiologist, Dr. Bryan Bottorff, DACVIM, who identified the bleeding mass on his heart using ultrasound (echocardiography).  After stabilizing Rugby, identifying the mass, and proper tumor staging, Rugby was fortunate enough to be considered a candidate for surgery to remove the mass (right auriculectomy) and eliminate the source of the bleeding.

Dr. Michael Mison, DACVS and Dr. Jessica Leeman (surgery resident) performed a right auriculectomy without complication. This procedure is considered an open chest surgery and can be very risky and challenging as a portion of the heart is removed while it is still beating! Rugby recovered very well from surgery and was comfortable and eating like a champ the very next morning. Amazingly, he was discharged from the hospital one day post-op!

Although this procedure was not curative in Rugby’s case, it did eliminate the ongoing blood loss and the bulk of the cancerous tissue present. This continues to give him more quality time at home to spend with his family. Overall, Ruby's owners were happy with the outcome.  Rugby’s owners also decided to visit multiple oncologists (including SVS’ Dr. David Vail, DACVIM) and participate in an ongoing chemotherapy study at Oregon State University College of Veterinary Medicine to hopefully extend the quality time they get to spend together. He has been doing great since leaving SVS and we are happy Rugby is another one of our success stories!