Hemoabdomen in Dogs (Internal Abdominal Bleeding)

What Is Hemoabdomen in Dogs?

Hemoabdomen is internal bleeding in the abdomen. Internal bleeding is just what it sounds like—blood loss that happens inside the body.

Bleeding is always scary, but internal bleeding can be terrifying. So many questions need answers fast: How much blood is involved? Where is it coming from, and why? How can it be stopped? Will my dog survive?

The abdomen is the most common place for blood to collect inside the body—around the liver, spleen, stomach, intestines, and other abdominal organs. Blood can also collect in other areas, such as the chest cavity (thorax), in a condition called hemothorax.

Hemoabdomen is something that a vet will discover through a physical examination and diagnostic tests. Although you won’t see it directly, you may be able to notice visible signs of it.

Here’s what you need to know about the signs of hemoabdomen, what causes it, and how it’s treated.

Symptoms of Hemoabdomen in Dogs

Many of the symptoms associated with internal bleeding are similar to those seen with external bleeding. This is because no matter whether your dog’s blood stays inside their body or makes its way outside, it’s still not in the cardiovascular system where it needs to be. If your dog has a hemoabdomen, you might notice:

• Rapid breathing

• A faster heart rate than normal

• Weakness

• Mental dullness

• Mucous membranes (around the eyes, nose, and mouth) that are pale, blue, muddy, or a brighter pink or red than normal

• Skin that is cool to the touch, which is often first noticeable around the ears, feet, and tail

• A distended (enlarged) abdomen, although this isn’t always noticeable

Talk to a veterinarian immediately if your dog has any of these symptoms. Call an after-hours emergency clinic if needed. The veterinarian will probably want you to bring your dog in right away, since these signs are often associated with life-threatening health conditions.

This is true whether or not your dog has previously had any internal bleeding. A dog’s condition can very rapidly deteriorate if they are losing a lot of blood.

Causes of Hemoabdomen in Dogs

Many health conditions can cause a hemoabdomen. They can be put into four categories:

Trauma

Traumatic injuries to the abdomen can lead to internal bleeding. Penetrating wounds (from something entering the body) such as impalements, gunshots, or bite wounds may be obvious when they happen, but some injuries don’t leave much external evidence. Blunt-force trauma like falls, blows, or being hit by a car can cause potentially life-threatening internal bleeding without other obvious injuries.

Abdominal Tumors

Tumors (both benign and malignant) affecting the spleen, liver, or other abdominal organs may disrupt blood vessels and cause internal bleeding. The most common non-traumatic cause of a hemoabdomen in dogs is an aggressive type of cancer, hemangiosarcoma, that often involves the spleen. Unfortunately, it’s impossible to know for sure whether a dog has hemangiosarcoma or a different, more treatable type of tumor without surgery and sending a tissue sample to a pathologist to identify.

Post-Operative Bleeding

If your dog has recently had abdominal surgery, it’s possible that blood vessels that were closed off have opened back up and are bleeding. Your dog is losing dangerous amounts of blood if they are developing symptoms associated with a hemoabdomen.

Coagulation (Clotting) Disorders

Dogs may start bleeding if their blood coagulation (clotting) system isn’t working normally. Anti-coagulant rodenticide poisonings are a common cause of this. Immune disorders, severe allergic reactions (anaphylaxis), liver disease, and a condition called disseminated intravascular coagulation (DIC)—which can develop secondary to infection, inflammation, or cancer­—may also be to blame. Coagulation disorders can lead to bleeding in multiple sites throughout the body and need to be treated immediately.

How Veterinarians Diagnose Hemoabdomen in Dogs

When a dog arrives at the veterinary clinic with signs of internal bleeding, the doctor will quickly assess the situation. Dogs that are in critical condition may require intravenous (IV) fluids, transfusions, oxygen therapy, and other treatments before the search for an underlying cause can begin.

During this time, the veterinarian will also ask you questions about your dog’s health history, the signs you’ve been seeing at home, how quickly they developed, if they’ve changed, and whether your dog could have been injured or poisoned.

Diagnostic testing can begin when a dog’s condition is stable. This may include:

• A complete blood cell count to check the dog’s red blood cell and platelet levels (platelets help with blood clotting) and to look for signs of infection or inflammation

• A blood chemistry panel to measure electrolyte and protein levels in the blood and to monitor organ function

• A urinalysis to further check kidney function and to look for infections or blood loss

• Blood clotting times to check for coagulation disorders

• X-rays of the abdomen and chest to look for signs of bleeding and cancer

• Ultrasound of the abdomen to confirm the presence of blood (or other fluids) and to look for tumors

• Examining a sample of abdominal fluid

Treatment of Hemoabdomen in Dogs

Treatment for hemoabdomen will depend on the condition’s underlying cause.

• Trauma: Some injuries that lead to abdominal bleeding will heal with medical management. This can include fluid therapy, transfusions, medications to enhance blood clotting, belly wraps, and other symptomatic and supportive care. However, more serious injuries often require surgery to stop the bleeding and repair or remove damaged tissues.

• Abdominal tumors: Benign abdominal tumors can often be successfully removed with surgery, but hemangiosarcoma is a different story. Only about half of the dogs who are diagnosed with hemangiosarcoma live longer than six months, even with surgery and chemotherapy. While a veterinarian can’t tell you with certainty before surgery what type of tumor your dog might have, they can talk to you about your dog’s likely prognosis based on what they have found during their physical examination and diagnostic workup.

• Post-operative bleeding: Mild cases of post-operative bleeding can sometimes be handled with belly wraps, fluid therapy, transfusions, medications to enhance blood clotting, and other types of symptomatic and supportive care. Surgery to close bleeding vessels is usually necessary when blood loss is more significant.

• Coagulation disorders: Dogs that have eaten anti-coagulant rodenticides (warfarin, diphacinone, chlorophacinone, brodifacoum, difenacoum, and bromadiolone, for example) will usually recover if they are treated with prescription vitamin-K medications. Immune-mediated diseases can often be managed with immunosuppressive drugs, but it’s also important to deal with any potential underlying health problems, like infections. Supportive care, including transfusions, may also be necessary.

Recovery and Management of Hemoabdomen in Dogs

Dogs that are recovering from a hemoabdomen need to be watched closely. Follow your veterinarian’s instructions regarding home management and the need for future check-ups. Call your vet immediately if you notice the signs of internal bleeding returning or getting worse rather than better.