Prevalence of malignancy and factors affecting outcome of cats undergoing splenectomy

Rossanese, Matteo; Williams, Heather; De La Puerta, Benito; Scott, Peter; Chanoit, Guillaume; Guillén, Alexandra

Abstract

S plenopathies in cats are uncommonly diagnosed , with a prevalence estimated at 5%, and include primary and metastatic neoplasia, nodu-lar hyperplasia, hematomas, ischemic obstruction and splenitis, among others. 1-4 Splenic diseases are typically identified by abdominal palpation and diagnosed with abdominal imaging followed by ultrasound-guided cytology or biopsy. 5,6 Even though cytologic and histopathologic agreement for splenic lesions is reported to be between 59% to 100% in dogs and cats, those studies contained very small numbers of cats. This, together with the different prevalence of splenic diseases between these species, makes the true accuracy of cytol-ogy to diagnose feline splenopathies unknown. 6-8 The ultrasonographic appearance of the feline spleen is generally considered nonspecific 9,10 ; however , presence of a splenic mass > 1 cm in cats was suggestive of malignancy. 7 In addition to these challenges , changes in the splenic size and parenchyma can be incidental, associated with nonspecific clinical signs or due to systemic disease. 7,9,10 OBJECTIVE To determine the prevalence of splenic malignancy in cats undergoing splenectomy and to investigate possible factors associated with post-operative outcome. ANIMALS 62 client-owned cats that underwent splenectomy. METHODS Medical records of 4 UK-based referral hospitals were searched and data reviewed retrospectively over 17 years. Factors associated with outcomes post-splenectomy were analyzed. RESULTS 50 out of 62 cats (81%) were diagnosed with splenic neoplasia. Mast cell tumor ([MCT], 42%), hemangiosarcoma ([HSA], 40%), lymphoma and histiocytic sarcoma (6% each) were the most common tumor types. Fifteen cats (24%) presented with spontaneous hemoabdomen and were all diagnosed with splenic neoplasia. The diagnostic accuracy of cytology to detect splenic malignant lesions was 73% (100% for MCTs and 54% for mesenchymal tumors). Median survival time for cats with nonneoplastic splenic lesions was 715 days (IQR, 18 to 1,368) and 136 days for cats with splenic neoplasia (IQR, 35 to 348); median survival time was longer for cats with splenic MCT when compared to cats with HSA (348 vs 94 days; P < .001). Presence of metastatic disease and anemia (PCV < 24%) at diagnosis were associated with a poorer survival when considering all cats. Presence of anemia, a splenic mass on imaging or spontaneous hemoabdomen were associated with a diagnosis of HSA (P < .001). CLINICAL RELEVANCE Benign splenic lesions were uncommon in this cohort of cats. Spontaneous hemoabdomen should prompt the clini-cian to suspect neoplasia in cats with splenic disease. Anemia and evidence of metastasis at diagnosis were poor prognostic factors regardless of the final diagnosis.

Citation

Rossanese, M., Williams, H., De La Puerta, B., Scott, P., Chanoit, G., & Guillén, A. (2023). Prevalence of malignancy and factors affecting outcome of cats undergoing splenectomy. Journal of the American Veterinary Medical Association, 261(11), 1-7. https://doi.org/10.2460/javma.23.05.0258

• Journal Article Type: Article
• Acceptance Date: Jul 12, 2023
• Publication Date: Aug 15, 2023
• Deposit Date: Jun 26, 2024
• Journal: Journal of the American Veterinary Medical Association
• Print ISSN: 0003-1488
• Publisher: American Veterinary Medical Association (AVMA)
• Peer Reviewed: Peer Reviewed
• Volume: 261
• Issue: 11
• Pages: 1-7
• DOI: https://doi.org/10.2460/javma.23.05.0258
• Keywords: General Veterinary