What is Hemoabdomen?

July 21, 2022

Introduction

Hemoabdomen (also known as hemoperitoneum) is a term used to describe free blood within the abdominal cavity.  Blood should always be within an organ or a vessel; so, blood “freely” within a body cavity is abnormal.

Clinical Signs

Some symptoms to look out for are:

• Sudden weakness or inability to rise
• Abdominal distension
• Elevated respiratory rate
• Pale mucous membranes (gums)
• Collapse
• Abdominal pain

Causes

Hemoabdomen can be caused by:

• A clotting disorder
• Trauma

• Rupture of a blood-filled mass in the abdomen

Hemoabdomen caused by a  rupture of a mass is most common in older dogs, especially German Shepherd Dogs, Labradors, and Golden Retrievers. These masses are usually on the spleen or liver but can be anywhere within the abdomen.

Diagnosis

Hemoabdomen is diagnosed by sampling the free fluid within the abdomen using a needle.  Abdominal imaging, such as x-rays, ultrasound, or CT can concurrently diagnose a mass.  Bloodwork can help evaluate for clotting disorders.

Unfortunately, patients with hemoabdomen and concurrent abdominal tumor will need surgery to remove the mass to achieve a definitive diagnosis of either malignant or benign.

Treatment

The treatment and prognosis for hemoabdomen is dependent on the cause:

Clotting Disorder: Most commonly treated with plasma. When caught early, the prognosis is favorable.

Trauma: Usually just monitored closely, but surgery can be necessary to stop the bleeding. The prognosis is largely based off of other trauma sustained.

Ruptured Mass: Requires emergency abdominal exploratory surgery.  If the mass is cancerous, patients can be treated with appropriate chemotherapy. If the mass is benign, surgery should be curative. Unfortunately, about 50-75% of these masses are malignant (“cancerous”). The most common cancer that causes hemoabdomen is hemangiosarcoma which is a tumor of blood vessel lining. 25-50% of these masses are benign and secondary to a hematoma (a “non cancerous” mass).
After surgery, malignant masses can be treated with chemotherapy, with studies showing that patients with hemoabdomen due to hemangiosarcoma that are treated with surgery followed by chemotherapy have a median survival time of approximately 6 months.

Ethos Discovery, a non-profit organization that conducts scientific research to advance veterinary and human medical science, is facilitating a study (Ethos-PUSH) to help investigate novel treatments for this disease process in hopes of increasing survival time for these patients.

Prevention

• Please keep toxins (like rat poisons) out of reach to prevent them from developing a life-threatening clotting disorder.
• Please keep your pets leashed and supervised while they are outside to prevent major trauma, such as being hit by a car.

Unfortunately, there is nothing you as owners or we as veterinarians can do to prevent hemoabdomen secondary to a bleeding mass.

Hemoabdomen secondary to cancer is devastating for owners and veterinarians. Through research (like that being conducted through Ethos Discovery), we hope to find better alternatives for pre-operative diagnosis and improved treatment protocols to increase survival rates.

If you think your pet may have a hemoabdomen, please don’t hesitate to contact your veterinarian.