Experiencing Hemangiosarcoma in the Australian Shepherd
Hemangiosarcoma is a deadly form of canine cancer and one that is becoming more and more prevalent in the Australian Shepherd breed. For those of us who have lost a dog to this disease the shock and disbelief of its apparent sudden onset can be a very painful experience and one that leaves many of us grieving for the loss of our beloved ‘heart-dogs’. Hemangiosarcoma may only be fully verified by necropsy but the indications of this disease are unmistakably recorded by a veterinary doctor’s words: “a characteristic typically seen with hemangiosarcoma”. There is no cure and no hope for recovery with such a diagnosis and as yet, there are no known causative factors however in the view of some veterinarians heredity may play a strong part in it. While there are scientific and informative articles written in regard to hemangiosarcoma, several of which are referenced at the end of this article, it is the sudden shock and grief that many of us go through in loosing a beloved dog to this disease that has yet to be publicly recorded. In this article, it is hoped that by sharing the personal experiences of several Australian Shepherd owners whose own dogs have died from hemangiosarcoma that it may help inform and acknowledge the pain of loosing their beloved dogs to this devastating disease.
The Australian Shepherd Health & Genetics Institute (ASHGI) established in 2002 in California is dedicated to “the increase and diffusion of knowledge of genetics in the Australian Shepherd breed and the inherited diseases from which they sometimes suffer”. ASHGI works independently and in cooperation with researchers, breed clubs, canine health organizations and foundations that provide grant funds for canine genetics research. In 2009, $18,200.00 was raised for cancer research by a contributing community of Aussie owners and breeders. “Without research, specific to Aussies, modes of inheritance will not be determined for this breed nor will DNA screening tests be developed”. As responsible Aussie owners, we can all contribute to ASHGI’s efforts towards the healthy continuance of this wonderful breed. The future health and genetics of our breed depends upon owners and breeders alike to become more fully informed and knowledgeable about the lineages they buy into and breed into. Breeders must be willing to be open and honest with each other about whatever hereditary and genetic flaws they may find in their lines. To perpetuate such health issues is not in the breed’s best interest and then there is the moral issue which, in some cases, results in pain and heartache affecting not only breeders but pet owners alike.
For the dog owner, it is their responsibility to research a breeder’s lines and ask questions when purchasing a dog from that breeder regarding any health issues. It is important also to inform that breeder later on if health issues develop so that breeders may then make responsible decisions towards the future of their lines. For breeders who have worked for years to attain a certain quality of Aussie only to find that cancer or epilepsy creeps into their lines can be heartbreaking. Therefore, it is important that honesty above all else, occurs between people. As one Aussie breeder so eloquently and honestly said: “I haven’t had a litter in over five years because of the possibility of the hemangiosarcoma being genetic. Although it hasn’t been proven yet to be, I believe it most certainly is. I traced it back at least five generations on my foundation stud dog. I have lost five to it already. I just won’t take the chance that my bloodline would produce more heartache & expense for other people, not to mention the emotional turmoil that goes with having a much loved dog sick or in pain. I know all too well what that feels like. I still have several that I watch daily hoping not to see the signs of it rearing its ugly head again”.
My own personal experience with hemangiosarcoma began on the morning of April 21, 2010 when my ten and a half year old Australian Shepherd, Ceilidh, whom I had raised from a pup of eight weeks, became suddenly ill one morning. The day began as all others. She ate a full breakfast, accompanied us on our walk up our country laneway and down the next with the other dogs who live in our home but by ten o’clock that morning she had vomited a massive amount of mucous, bile and undigested food all over our mudroom floor. Wondering if she had eaten something that could have caused her tummy upset, I watched with mounting concern of her evident weakness and inability to stand and balance herself. I called our vet’s office and by mid-afternoon we were at the clinic and an x-ray was taken of her abdomen. It showed a large mass and pericardial effusion. Arrangements were quickly made to take her to our teaching hospital at the University of Guelph, an hour’s drive from home. When we arrived, Ceilidh was rushed into the emergency department and cardiology. An echocardiogram showed that she had valvular degeneration as well as an extensive mass on the wall of the right atrium of her heart which extended to the region of the atrioventricular junction. The mass was of a mixed or heterogenous echogenicity, a characteristic typically seen with hemangiosarcoma. Pericardialcentesis, a procedure where fluid is aspirated from the pericardium (the sac enveloping the heart) was twice performed on her with my permission for both times it could have caused immediate death. I made the decision there and then to do what I could for her because my only other alternative was to put her down immediately. I wasn’t ready to let her go. If there was some way in which I could prolong her life awhile longer without suffering, I was willing to take that chance. She managed to survive both procedures and was placed on intravenous although, the vets later said, they hadn’t expected she would live through the night. But the next morning she stood up in her crate, wiggled her bottom and smiled at the interns and two days later I brought her home. She continued to eat well and while her energy was slightly less than it had previously been, she managed well and participated in our lives as she had before. However, I began to notice an unusual and pungent odour about her; one that permeated her bedding, the rooms that she was in and one that permeated my olfactory system to the point where, even today, I can still sense and smell her presence. Late in the day of May 23rd I felt her abdomen and realized with dread that the fluid was building up in her tummy again. Early the following morning, the 24th of May, a holiday in Canada, I watched her struggle weakly downstairs to the main level of the house and knew that this would be her last day with me. I held her in my arms most of the day, crying, for I knew that I would have no other choice but to terminate her life. That evening, our vet came to our home and Ceilidh was carried gently out to the picnic table in our garden and there beneath the canopy of trees under which she had played throughout so much of her life, cradled in my arms she was quietly put to sleep. I still cry to this day when I think of her sweetness, her affection, her wonderful sense of whimsy and humour..…an Aussie who was so full of life, who would smell tiny flowers in the garden when she passed them by, who would chase brightly coloured butterflies and who, in the end wrapped herself around my heart in such an unexpected way. We can love many dogs in our life yet there is always that one special dog who is our heart-dog.
In an article published in the Aussie Times, Mar/Apr. 2008 written by Dr. Jaime F. Modiano, gives us an excellent overview of the disease. He writes: “Canine hemangiosarcoma is among the most challenging and mysterious diseases encountered in veterinary practice. It is an incurable tumor of cells that line blood vessels, called vascular endothelial cells. Hemangiosarcoma is relatively common in dogs; it is estimated that this type of cancer accounts for 5-7% of all tumors seen in dogs. Considering the lifetime risk of cancer for dogs is between 1 in 1 and 1 in 3, we can calculate that 1.5 to 2.5 million of the ~72 million pet dogs in the United States today will get hemangiosarcoma and succumb from it.” He goes on to say that “In dogs, the common primary sites for hemangiosarcoma are the spleen, the right atrium of the heart and the subcutis, which is the tissue beneath the skin. The pattern of growth for these tumors involves infiltration into normal tissues surrounding the tumor as well as distant spread (metastasis). The disease is indolent; in other words, it does not cause pain and the rate of growth in the early stages is relatively slow. Dogs harboring even large hemangiosarcomas may show no clinical signs or evidence that they have a life threatening disease. Since hemangiosarcoma tends to metastasize aggressively to the lungs, liver, intestine and mesentery (the membranous connective tissue that supports the intestines), distant spread (either microscopic or macroscopic) has inevitably occurred once the disease if finally diagnosed. The eventual outcome for patients with this disease often follows the rupture of a large or rapidly growing tumor, which results in acute, severe hemorrhage, collapse, shock and death. We do not precisely know what causes canine hemangiosarcoma. The observations that the disease occurs more commonly in dogs than in other animals and that some breeds are at higher risk than others tells us that heritable factors must contribute to risk”.
While not technical in their observations, it may be helpful to hear of other Aussie owners experiences and how they observed hemangiosarcoma in their dogs. With their permission, some of their stories are recorded here:
“My 10 1/2 year old Aussie male had what seemed to be a seizure while sleeping next to me in bed. It was due to his spleen rupturing – I took him to my vet (also an e-vet) immediately and they were able to diagnose the spleen issue quickly with an ultrasound. I was told immediately that the most likely scenario was cancer and it was most likely hemangiosarcoma (google spleen rupture & hemangiosarcoma – I believe it is upwards of 75% correlation). I was allowed to be present during the surgery, I believe mostly so I could make a call if there were significant tumors. The tumor was limited to his spleen, so they completed the surgery and sent the spleen in for biopsy. It was, of course, hemangiosarcoma and he lived only a few months longer, even with aggressive chemo”. A.S.
“My first Aussie, my first agility dog and my heart dog developed hemangio at age 6. There were no signs or symptoms prior to the day she was put down; we took her to the U of FL, she had a lesion on her heart which was filling her pericardium with blood. Her prognosis was 1-2 days if we did nothing, 1-2 months if we did surgery and chemo, and maybe 1 month if we did only chemo. We made the decision not to have her go through all that (she was too good a dog) and elected for euthanasia. We had a necropsy done and the cancer was found in her liver, pancreas, kidneys, and lungs. Charlie had eaten a full breakfast that morning and it was only at dinnertime that she would not eat and after a quick check her gums were white. Then we went to our vet and then to the U of FL. I would repeat, that prior to this, she was asymptomatic. I cried for 3 months and beat myself up for not seeing that she was in trouble. The fact is, that there were no indications……that is hemangio”. K.V.G.
“I too lost one of my dogs this year (Jan 16th) to hemangiosarcoma, although it wasn’t officially diagnosed as such. Koty was my soul mate. He was 12 years old the month before I lost him. I currently have 3 Aussies and have had the privilege of living with Aussies for 25 years now. Koty out of all my dogs has been the most special…..I still long for him each and every day. I try to focus on the other dogs and it is beginning to get a tiny bit easier but some days are much too hard to take. Here is the story of what happened to Koty. For about a week he stopped eating unless I made it so attractive he couldn’t refuse it….then he would either get diarrhea or he’d throw up. Then the next mealtime, he’d completely refuse to eat again. He began getting weak. By the 3rd day, in the evening, I told my husband that we were going to have to take him to the vet the next morning. We called the vet as soon as they opened and they couldn’t see us until 2:30pm. Koty was very weak and was not standing on his own by mid morning. We took him to the vet at 2:30pm as scheduled and she ran a series of tests in the amount of $560 and then told us he had a mass on his spleen, unknown if it was cancer. (tests were, X-rays, ultra-sound and bloodwork). It was decided that the next day we would bring him back in the am and she would remove his spleen for the cost of $750, and $250 for ea additional blood transfusion, which might entail several. We agreed and after she gave him some IV fluids, we took him home. That night we left him in our hallway so the other dogs would not disturb him. My husband and I both awakened every hr or less throughout the night to check on him. All he would do was to shift his eyes at us…..it was a very long night. The next morning he could not stand and had very labored breathing. I drove him to the vet (45 mins from our farm) and once there the vet faced me with the decision of putting him down or proceeding with the surgery to remove the spleen. The day before she felt he would last for awhile without the spleen, possibly even years. But now, his condition looked more serious and she couldn’t promise me he would even make it through the surgery. She didn’t know if it was “cancer” but could only speculate. She knew how much this dog meant to me and she wanted to do anything she could to give me more time with him. I loved him too much too let him die on the operating table so I put him to sleep while holding him in my arms. (just as I have done with 4 others before him). I have days that I regret my decision even though I know I did the right thing. I just want my dog back, my precious Koty…the one who held me together when my life was falling apart! I know he’s in heaven with my late husband and all our other Aussies but the special love he gave to me every time I just looked him in the eye will be forever missed!!!” R.L.
I lost my Rambo at the age of 7 year to hemangiosarcoma. On a Wed morning in 2004, we noticed he seemed very tired. My husband had an appt in town so we went to the appt and got home around Noon. He seemed very weak so I took him to my local vet. The vet drew blood and noticed his gums were a bit pale. He put him on some iron and B-12. On Thursday, Rambo seemed a little better but still tired. His blood tests came back and he was anemic. The vet called the Vet Specialty Clinic and made Rambo an appt for Monday, the soonest a specialist could see him for an ultrasound. Sat. he was better still so we thought he was going to be ok. On Sunday he seemed like his old self and wanted to play ball. We had a birthday party for Destiny, our other Aussie and he opened his gifts (we always got them both gifts) and ate birthday cake. At around 10 PM Sunday evening, he went outside. I looked out the window and noticed he just stopped on the patio. I went outside and he was standing but not responsive. His eyes seemed glazed and he seemed confused. My husband and I carried all 75 lbs of him to the car and drove to the emergency vet. His blood count was low and he was dehydrated. We chose to just give him IV fluids and keep him going without heroics until morning when the ultrasound doc came in. We were getting ready to go back to the emergency vet at 8 Am when we got the call from them telling us he had hemangiosarcoma throughout his abdomen, chest cavity, on his liver, and spleen which was leaking. The vet said we could try to remove the spleen and possibly buy him a few weeks but Rambo had lost so much blood he did not think he could survive the surgery. They kept him alive until we could get there and then I held him while they put him to sleep forever. Rambo was my heart dog. He was my service dog who I had trained and was the most loving, willing to please dog in the world. As I thought back, there were a few warning signs that my vet dismissed. I don’t like to think too much about that. S.W.
“I am writing with two hemangio anecdotal instances. I am far from a medical professional so I do lack possibly important details. My own heart dog – a Golden Retriever was aging somewhat gracefully until he suddenly could not get up one day and was off his food. The vet came to the house and pulled some blood. And gave him and IV with something we referred to as magic. Buck was up and around in a short time. Unfortunately the ‘cure’ only lasted a few days. The vet returned and repeated the IV and ‘magic’. Test results came back and he was diagnosed with hemangio. He made another few days and when he went down again – weaker than ever we decided that the vet would take him to her office and I would join them there shortly. She left him to get him a pillow and Bucky passed away on his own. I had a roll of photos developed not long after that and to my surprise were pictures of Buck – what I saw in those photos was a dog much heavier than the one I remembered. When I asked the vet she said he had been retaining water. Buck was 12 when he died.
My second story is of a friend’s dog – a young Portuguese Water Dog. They were competing at high levels of AKC agility. Nina – MACH2 had not turned 8. She was competing on a Friday – knocking bars – totally not usual. A visit to the emergency vet Saturday and surgery. Nina did not make Monday. Nina’s owner is incredibly dog savvy. If there had been a behavior or visible change I don’t doubt she would have caught it.
Again – not too scientific but what I get from both experiences is that this thing sneaks up on a dog and leaves a family feeling empty.” L.L.
In their article, Treatment of Canine Hemangiosarcoma: 2000 and Beyond by Clifford, Mackin and Henry note that “Canine hemangiosarcoma (HSA) is an aggressive and malignant neoplasia with a grave prognosis. Surgery and chemotherapy have limited success in prolonging survival times and increasing quality of life in dogs with HSA. Advances in medical oncology are resulting in increased survival rates and a better quality of life for veterinary cancer patients. An understanding of the mechanisms of metastasis has led to the development of new treatments designed to delay or inhibit tumor spread. Promising new treatment options include novel delivery systems (inhalation or intracavitary chemotherapy); use of immunomodulators such as liposome-encapsulated muramyl tripeptide-phosphatidylethanolamine; antimetastatic agents such as inhibitors of angiogenesis (interferons, thalidomide), matrix metalloproteinase inhibitors and minocycline; dietary modifications and gene therapy. Inhibitors of angiogenesis seem to be safe and unlike conventional chemotherapy do not induce drug resistance. Although many of the newer approaches are still under development and review, the use of multimodality therapy incorporating innovative treatment modalities may offer the best therapeutic option for dogs affected with HSA”.
None of us expect our dogs to die of hemangiosarcoma, yet many do. If we become better informed of this disease then we may be more emotionally prepared to deal with the diagnosis and inevitable outcome which will require us to make decisions none of us want to make. Hemangiosarcoma is a silent disease in the beginning but the end often comes abruptly and very quickly. It is this very abruptness that leaves many dog owners in complete and utter shock and disbelief of a diagnosis that has no positive end. The grief that follows may be ameliorated through becoming more aware of and in having greater knowledge of this devastating disease and through learning of the experiences of others who have walked this path before you.
Written and illustrated by Sandra Small Proudfoot, © 2010, Canada.www.farmerswalkbb.com
Canine Hemangiosarcoma – The Road from Despair to Hope, Jaime F. Modiano, VMD, PhD, et al. Printed in the Aussie Times, Mar/Apr. 2008
Treatment of Canine Hemangiosarcoma: 2000 and Beyond, Craig A. Clifford, Andrew J. Mackin and Carolyn J. Henry.
A Retrospective Study of visceral and nonvisceral hemangiosarcoma and hemangiomas in domestic animals, Patricia C. Schultheiss
Australian Shepherd Health & Genetics Institute (ASHGI): www.ashgi.org. Mailing address: 730 E. Weldon Ave., Fresno, California, USA 93704-6135
February 2017: New drug treatment for hemangiosarcoma: