Title:
Intra-abdominal bleeding in a horse: not always of traumatic origin
Author(s):
L. DE LANGE, A. DUFOURNI, L. LEFÈRE, L. SONCK, G. VAN LOON
Abstract:
A nine-year-old warmblood mare was presented with clinical signs of mild colic and fever. Onpercutaneous ultrasound of the abdomen, a mass was identified on the left side of the abdomenbetween the spleen and the stomach. During examination the following day, intra-abdominalblood was observed. On rectal examination, a mass was palpated in the pelvis. The presumptivediagnosis of hematoma with intra-abdominal bleeding was made. On consecutive ultrasoundsand radiographs, the mass evolved in shape and other masses were identified in the liver and thelungs. No change was noticed in the pelvic mass. Cytology and histology of a tru-cut liver biopsyrevealed abnormal, most likely neoplastic cells, whereas cytology of the abdominal and thoracicfluid did not reveal any neoplastic cells. Due to the presence of several rapidly growing masses,a neoplastic process was most likely. Because of the malignant character of the disease and thepersistence of the clinical signs, euthanasia was suggested but refused by the owner. Supportivetreatment was instituted. Initially, the general condition remained stable, after which the horsesuddenly collapsed and died. Post-mortem examination revealed a primary neoplasm located inthe pelvic cavity, as well as multiple disseminated masses within several tissues. The mass foundin the liver had ruptured with loss of probably 50 liters hemorrhagic fluid within the abdominalcavity. Based on gross pathology, cytological and histological findings, a hemangiosarcoma wassuspected. This diagnosis was confirmed using immunohistochemistry for von Willebrand factor.In this case report, the importance of differentiating hematoma from hemangiosarcoma in thehorse is highlighted.