血管肉瘤
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Hemangiosarcoma 血管肉瘤 Hemangioma 血管瘤 Hematoma 血肿 Schistocytes -supportive of a change in
microvasculature 裂细胞－说明有微脉管系统改变
Assessment 估计
Post fluid therapy values (PCV, TP) -moderate anemia and hypoproteinemia. 输液治疗后－中度贫血，低蛋白血
Due to widespread metastasis identification of the primary tumor may be difficult. 由于广泛转移，故原发肿瘤的诊断较为困难。
Clinical Presentation 临床表现
Depends on the primary tumor site and the organs affected. 根据原发肿瘤位置和受影响器官 • Progressive or intermittent lethargy 进行性或间断性昏睡 • Anorexia 厌食 • Collapse 虚脱 • Weight Loss 体重减轻 • Exercise Intolerance 运动不耐受
14岁母性混种/西伯利亚哈士奇
History 病史
Found in the backyard weak and unable to stand. 在后腕发现虚弱不能站立
Saha-on the ground, weak and ataxic upon rising. 躺在地上，虚弱，共济失调
Sasha presented nonambulatory with pale mucus membranes. 表现出粘膜苍白不能行走
a malignant tumor of endothelial cells 一种恶性内皮细胞肿瘤
Epidemiology 流行病学
• Increased incidence- German Shepherds 增加发病率－德国牧羊犬
• Other breeds affected- Pointer, Boxer, Labrador Retriever, Golden Retriever, English Setter, Great Dane, Poodle, Siberian Husky. 其他易发品种－波达，拳师犬，拉布拉多，金毛，英国塞 特，大丹，贵宾，西伯利亚哈士奇
No evidence of thoracic metastasis or abdominal metastasis were noted at the last treatment. 无明显证据显示在最后一次治疗有任何胸腔转 移和腹腔转移。
Sasha
In Nov. she returned for a recheck with pale mucus membranes 在11月份，再次出现粘膜苍白
皮肤血管肉瘤在雌性中更常见。 毛少，皮肤色素少的犬易发，威 伯赛犬，萨卢基犬，巡回猎犬和 英国波达。或许是光照导致。
Location and behaviour 位置和表现
• Primary- Spleen, Cardiac (right atrial appendage or right atrium), liver, lungs, kidney, skin (SQ), bone,
Leukogram -stressed animal. 白细胞像－应激动物
Chemistry panel and U/A -hemorrhage and possible dehydration 生化和尿检－出血也可能脱水
Plan 计划
Due to no other abnormalities observed in the abdomen and with no mets seen on thoracic rads splenectomy is indicated. 腹腔内无观察到其他异常，胸部X光无异物， 考虑脾切除术。
pulses, no pulse deficits. 脉搏虚弱，无脉搏不条 • RR呼吸速率: RR呼吸速率=30. Quiet breath sounds dorsally.
Breath sounds auscultable ventrally. 背侧呼吸不清，腹侧呼吸尚 可听诊 • NE神经末稍: Miotic pupils, no PLR direct or consensual. 瞳孔缩小或没有直接的瞳孔光反射或交感性瞳孔光反射 • GI/GU胃肠/泌尿生殖道: Splenic mass palpated. 触及脾有团块
Case Presentation- Sasha 案例陈述
Presenting ComplaintΒιβλιοθήκη Baidu(April 1)
现病史（4月1日）
Pale mucus membranes 粘膜苍白 Acute Weakness 急性虚弱
Signalment 症状
Sasha is a 14 year old Fs mix/siberian husky dog
Problem List 问题列表
Shock 休克 Pale mucus membranes 粘膜苍白 Splenic mass. 脾脏肿块
Emergency Treatment 紧急治疗
LRS -bolused. 乳酸林格氏溶液－快速注 入
Clinically improved ,BAR. Able to rise and walk comfortably. 症状改善，四肢可站起，可轻松行走
Bloodwork 血液
CBC : HCT=33.6%, rare schistocytes. 少量的裂红细胞
WBC=23,600, neut=20,532, bands=236.
Post Fluids液体治疗后 : PCV=23%, TP=4.8. Chem: Na=145, K=4.3, Cl=104. Ca=9.2. Crea=0.9,
Reason for the shock -hypovolemia secondary to internal hemorrhage.
休克原因－继发于内出血的血容量过低。
Diagnostic Plan 诊断计划
CBC 血常规 Chemistry panel 生化 Abdominal ultrasound 腹部超声 Abdominocentesis 腹腔穿刺术 Thoracic radiographs 胸部X光
Abdominal Ultrasound imaged metastasis in the liver and at the pedicle of the spleen. 腹部超声显示肝脏和脾脏根部有转移。
She was euthanized in November. 11月份实施安乐死。
Hemangiosarcoma 血管肉瘤
• Cutaneous hemangiosarcomamore common in females. Dogs with lightly haired, poorly pigmented skin are predisposed: whippets, salukis, bloodhounds, and English pointers. May be sunlight induced.
oral cavity, muscle, urinary bladder, peritoneum.
初级－脾，心脏（右心耳或右心房）， 肝，肺，肾，皮肤，骨，口腔，肌肉， 膀胱，腹膜
Location and behaviour 区域和表现
• Metastasis: most often- liver and lungs. In addition- kidney, skeletal muscle, peritoneum, omentum, lymph nodes, mesentery, brain, spinal cord, urinary bladder,adrenal gland, diaphragm. 转移：最常见－肝，肺。其他－肾，骨骼肌，腹膜，网膜，淋巴 结，肠系膜，大脑，脊髓，膀胱，肾上腺，隔膜
Thoracic radiographs 胸腔X光
Thoracic radiographs were unremarkable. 胸腔X光无异常
Assessment 估计
Internal hemorrhage. 内出血 Large splenic mass. 脾脏有大肿块
Assessment- Differentials 鉴别诊断
Abdominal Radiographs 腹部X光
Abdominocentesis 腹腔穿刺
peritoneal fluid: hemorrhagic exudate 腹水：血性渗出物
PCV -29% , TP of 5.7. (Peripheral外周血 PCV=23% (post-
fluids液体治疗后), Peripheral TP=4.8 (post)).
Physical Exam ( Abnormalities) 体格检查（异
常）
• GEN全身: Quiet, unresponsive. 全身，无反应 • EEN眼、耳、鼻、咽喉: Ears cold to the touch 耳朵冰冷 • MS: Nonambulatory 无法行走 • CV心血管: HR心率=120, MM粘膜=pale, CRT血凝时间=3s. Weak
Sasha was taken to surgery and a splenectomy was performed. 进行脾切除术
Splenic Hemangiosarcoma 脾血管肉瘤
Post Op手术后
Complications seen include VPCs, pain control, and bleeding. 并发症包括心室期外收缩，疼痛控制和出血
• Age- mean- 8-10 years. 平均年龄8－10岁 • No sex predilection (conflicting reports) 无性别差异（与报道冲
突） • No etiologic agent has been identified 病因尚未确定
Epidemiology (cont) 流行病学
Sasha was discharged 3 days after surgery with instructions to return to the VMTH for suture removal and chemotherapy. Sasha在手术后3天按指示拆线和化疗，出院
Sasha
Sasha was treated with chemotherapy- 6 treatments with adriamycin ( 30 mg/m2 each) 用阿霉素进行6个疗程的化疗
Clinical Presentation 临床表现
Depends on the primary tumor site and the organs affected. 根据原发肿瘤位置和受影响器官 • Dyspnea 呼吸困难 • Pallor 颜色苍白 • Acute hypovolemic Shock can be seen due to rupture of the tumor 由于肿瘤破裂，可见急性的低血容量性休克
BUN=38. Alb=2.6, Glob=2.9.
DIC panel: PT凝血酶原时间, PTT部分凝血致活酶时间
WNL（正常）, Fibrinogen=265. 纤维蛋白原
Abdominal Ultrasound 腹部超声
revealed mild to moderate hemo abdomen and a large splenic mass. 显 示出轻度到中度的血腹水，脾有大肿块
microvasculature 裂细胞－说明有微脉管系统改变
Assessment 估计
Post fluid therapy values (PCV, TP) -moderate anemia and hypoproteinemia. 输液治疗后－中度贫血，低蛋白血
Due to widespread metastasis identification of the primary tumor may be difficult. 由于广泛转移，故原发肿瘤的诊断较为困难。
Clinical Presentation 临床表现
Depends on the primary tumor site and the organs affected. 根据原发肿瘤位置和受影响器官 • Progressive or intermittent lethargy 进行性或间断性昏睡 • Anorexia 厌食 • Collapse 虚脱 • Weight Loss 体重减轻 • Exercise Intolerance 运动不耐受
14岁母性混种/西伯利亚哈士奇
History 病史
Found in the backyard weak and unable to stand. 在后腕发现虚弱不能站立
Saha-on the ground, weak and ataxic upon rising. 躺在地上，虚弱，共济失调
Sasha presented nonambulatory with pale mucus membranes. 表现出粘膜苍白不能行走
a malignant tumor of endothelial cells 一种恶性内皮细胞肿瘤
Epidemiology 流行病学
• Increased incidence- German Shepherds 增加发病率－德国牧羊犬
• Other breeds affected- Pointer, Boxer, Labrador Retriever, Golden Retriever, English Setter, Great Dane, Poodle, Siberian Husky. 其他易发品种－波达，拳师犬，拉布拉多，金毛，英国塞 特，大丹，贵宾，西伯利亚哈士奇
No evidence of thoracic metastasis or abdominal metastasis were noted at the last treatment. 无明显证据显示在最后一次治疗有任何胸腔转 移和腹腔转移。
Sasha
In Nov. she returned for a recheck with pale mucus membranes 在11月份，再次出现粘膜苍白
皮肤血管肉瘤在雌性中更常见。 毛少，皮肤色素少的犬易发，威 伯赛犬，萨卢基犬，巡回猎犬和 英国波达。或许是光照导致。
Location and behaviour 位置和表现
• Primary- Spleen, Cardiac (right atrial appendage or right atrium), liver, lungs, kidney, skin (SQ), bone,
Leukogram -stressed animal. 白细胞像－应激动物
Chemistry panel and U/A -hemorrhage and possible dehydration 生化和尿检－出血也可能脱水
Plan 计划
Due to no other abnormalities observed in the abdomen and with no mets seen on thoracic rads splenectomy is indicated. 腹腔内无观察到其他异常，胸部X光无异物， 考虑脾切除术。
pulses, no pulse deficits. 脉搏虚弱，无脉搏不条 • RR呼吸速率: RR呼吸速率=30. Quiet breath sounds dorsally.
Breath sounds auscultable ventrally. 背侧呼吸不清，腹侧呼吸尚 可听诊 • NE神经末稍: Miotic pupils, no PLR direct or consensual. 瞳孔缩小或没有直接的瞳孔光反射或交感性瞳孔光反射 • GI/GU胃肠/泌尿生殖道: Splenic mass palpated. 触及脾有团块
Case Presentation- Sasha 案例陈述
Presenting ComplaintΒιβλιοθήκη Baidu(April 1)
现病史（4月1日）
Pale mucus membranes 粘膜苍白 Acute Weakness 急性虚弱
Signalment 症状
Sasha is a 14 year old Fs mix/siberian husky dog
Problem List 问题列表
Shock 休克 Pale mucus membranes 粘膜苍白 Splenic mass. 脾脏肿块
Emergency Treatment 紧急治疗
LRS -bolused. 乳酸林格氏溶液－快速注 入
Clinically improved ,BAR. Able to rise and walk comfortably. 症状改善，四肢可站起，可轻松行走
Bloodwork 血液
CBC : HCT=33.6%, rare schistocytes. 少量的裂红细胞
WBC=23,600, neut=20,532, bands=236.
Post Fluids液体治疗后 : PCV=23%, TP=4.8. Chem: Na=145, K=4.3, Cl=104. Ca=9.2. Crea=0.9,
Reason for the shock -hypovolemia secondary to internal hemorrhage.
休克原因－继发于内出血的血容量过低。
Diagnostic Plan 诊断计划
CBC 血常规 Chemistry panel 生化 Abdominal ultrasound 腹部超声 Abdominocentesis 腹腔穿刺术 Thoracic radiographs 胸部X光
Abdominal Ultrasound imaged metastasis in the liver and at the pedicle of the spleen. 腹部超声显示肝脏和脾脏根部有转移。
She was euthanized in November. 11月份实施安乐死。
Hemangiosarcoma 血管肉瘤
• Cutaneous hemangiosarcomamore common in females. Dogs with lightly haired, poorly pigmented skin are predisposed: whippets, salukis, bloodhounds, and English pointers. May be sunlight induced.
oral cavity, muscle, urinary bladder, peritoneum.
初级－脾，心脏（右心耳或右心房）， 肝，肺，肾，皮肤，骨，口腔，肌肉， 膀胱，腹膜
Location and behaviour 区域和表现
• Metastasis: most often- liver and lungs. In addition- kidney, skeletal muscle, peritoneum, omentum, lymph nodes, mesentery, brain, spinal cord, urinary bladder,adrenal gland, diaphragm. 转移：最常见－肝，肺。其他－肾，骨骼肌，腹膜，网膜，淋巴 结，肠系膜，大脑，脊髓，膀胱，肾上腺，隔膜
Thoracic radiographs 胸腔X光
Thoracic radiographs were unremarkable. 胸腔X光无异常
Assessment 估计
Internal hemorrhage. 内出血 Large splenic mass. 脾脏有大肿块
Assessment- Differentials 鉴别诊断
Abdominal Radiographs 腹部X光
Abdominocentesis 腹腔穿刺
peritoneal fluid: hemorrhagic exudate 腹水：血性渗出物
PCV -29% , TP of 5.7. (Peripheral外周血 PCV=23% (post-
fluids液体治疗后), Peripheral TP=4.8 (post)).
Physical Exam ( Abnormalities) 体格检查（异
常）
• GEN全身: Quiet, unresponsive. 全身，无反应 • EEN眼、耳、鼻、咽喉: Ears cold to the touch 耳朵冰冷 • MS: Nonambulatory 无法行走 • CV心血管: HR心率=120, MM粘膜=pale, CRT血凝时间=3s. Weak
Sasha was taken to surgery and a splenectomy was performed. 进行脾切除术
Splenic Hemangiosarcoma 脾血管肉瘤
Post Op手术后
Complications seen include VPCs, pain control, and bleeding. 并发症包括心室期外收缩，疼痛控制和出血
• Age- mean- 8-10 years. 平均年龄8－10岁 • No sex predilection (conflicting reports) 无性别差异（与报道冲
突） • No etiologic agent has been identified 病因尚未确定
Epidemiology (cont) 流行病学
Sasha was discharged 3 days after surgery with instructions to return to the VMTH for suture removal and chemotherapy. Sasha在手术后3天按指示拆线和化疗，出院
Sasha
Sasha was treated with chemotherapy- 6 treatments with adriamycin ( 30 mg/m2 each) 用阿霉素进行6个疗程的化疗
Clinical Presentation 临床表现
Depends on the primary tumor site and the organs affected. 根据原发肿瘤位置和受影响器官 • Dyspnea 呼吸困难 • Pallor 颜色苍白 • Acute hypovolemic Shock can be seen due to rupture of the tumor 由于肿瘤破裂，可见急性的低血容量性休克
BUN=38. Alb=2.6, Glob=2.9.
DIC panel: PT凝血酶原时间, PTT部分凝血致活酶时间
WNL（正常）, Fibrinogen=265. 纤维蛋白原
Abdominal Ultrasound 腹部超声
revealed mild to moderate hemo abdomen and a large splenic mass. 显 示出轻度到中度的血腹水，脾有大肿块