When cancer strikes: coping with hemangiosarcoma diagnosis in your dog

Sherman at about age 3 in one of his favorite patches of bulbs.

I woke on a Friday morning to the odd discovery that our 7-year-old border collie mix, Sherman, wasn’t lying beside the bed. This wasn’t unprecedented, but it was unusual.

I rose and went to the kitchen to get coffee started and found him on the hardwood floor near the back door. His body language was subdued and lacked his typical pep. I opened the door to let him out, but he didn’t budge.

I was worried, but alarm bells didn’t go off. I went about my morning routine. I opened blinds, ate a small breakfast, and got ready for work. All that time, Sherman didn’t move.

I opened the door again and retrieved his harness and leash, an action that always produced a celebratory burst of yipping and body wagging. I coaxed him into a sitting position and put the harness around his shoulders, then encouraged him to get moving. We made it about 50 feet to a patch of snow that had fallen overnight, and he pooped standing up—something I’d never seen him do. Then he lay on the snow and refused to move.

Freshly graduated from obedience school at about 7 months.

Now I was concerned. Sherman would run 10 miles first thing in the morning if we’d let him.

I scooped up his 50-odd pounds in my arms and carried him back in the house and called the vet. When I described his symptoms, they asked to see him immediately.

I tried to figure it out: Had he injured a leg or rib playing fetch at the dog park the night before? Had he eaten something poisonous overnight? Was it food poisoning, or some dog version of norovirus? He’d been a completely normal, vibrant, middle-aged dog when we went to bed.

I carried him to the car and drove 15 minutes to the vet, then carried him into the office and put him on the scale. He was 52 pounds, about 10 pounds lighter than he’d been a month before. After a very short exam, the vet observed Sherman’s gums were paper white and that his belly was distended. The vet used ultrasound and showed me that Sherman’s belly was full of fluid. He stuck in a needle and extracted a syringe full of blood.

What was happening? Sherman had seemed perfectly healthy just 15 hours before.

That’s when the word hemangiosarcoma first came into my life. The vet explained that Sherman probably had hemangiosarcoma and that it might be limited to Sherman’s spleen, that they might be able to do an emergency surgery to remove the spleen and extend his life by a few weeks, maybe a few months, and if they did chemo, he might live a few months more.

Sherman feeling crummy at the vet’s office.

I only heard little parts of what he was saying, but my first thought was: of course we’ll operate. But first I needed to call my wife, who was on a work trip in Mexico.

This time I listened to the vet more carefully as he explained the situation to my wife on speaker phone, and it all sank in just a little bit more. Sherman was experiencing a dire emergency, and his prospects were grim. Then I heard my wife say what I had thus far refused to think: if surgery and chemo might only extend his life by weeks or months, shouldn’t we be considering euthanasia?

That’s when I choked back my first tears. Her words rang true, but I was far from emotionally prepared. Just 12 hours before he’d been yipping happily in the back of the truck on our way to the park.

We asked the vet to take x-rays and perform some blood work to see if his hunch was right, and I went to work to wait for the results.

What is hemangiosarcoma?

Instead of diving into work, I logged on and started researching hemangiosarcoma. I read scientific papers, blog posts, and sad personal accounts from loving pet owners. My heart sank as I read.

Hemangiosarcoma, sometimes called blood cancer, is a deadly and aggressive cancer that can affect dogs of any breed, age, or gender. It comes from the cells that line blood vessels, and it can spread rapidly to organs and tissues, making it very challenging to treat.

Hemangiosarcoma is most commonly found in the spleen, but it can also occur in the heart, liver, skin, and other organs with high densities of blood vessels. A frequent cause of death is when a hemangiosarcoma tumor ruptures, and the dog bleeds to death.

Symptoms and diagnosis of hemangiosarcoma

Hemangiosarcoma symptoms can be subtle, especially in the early stages of the disease. Some of the most common include lethargy, weakness, loss of appetite, weight loss, pale gums, abdominal swelling, and difficulty breathing. In some cases, dogs may suddenly collapse and require emergency medical attention.

Diagnosing hemangiosarcoma can be challenging, because there’s no test to definitively diagnose the disease. Veterinarians typically run blood tests to check for anemia (low red blood cell count). Imaging tests such as ultrasound and x-rays can be used to look for tumors. In some cases, a biopsy or aspirate of the tumor may be used to confirm the diagnosis.

Prognosis and life expectancy for dogs with hemangiosarcoma

The prognosis for dogs with hemangiosarcoma depends on the location and size of the tumor, the extent of the disease, and the dog’s overall health. Dogs with hemangiosarcoma that’s confined to the spleen may have a better prognosis.

Even with aggressive treatment, though, average survival time is only a few months. I found a few rare stories about dogs surviving for much longer, but there weren’t enough to reassure me.

Causes and risk factors for hemangiosarcoma

The exact causes of hemangiosarcoma aren’t well understood, but there are risk factors. Some breeds are more prone to developing hemangiosarcom: golden retrievers, boxers, flat coated retrievers, and others. Sherman was half flat coated retriever. He was also a boy—another risk factor. Hemangiosarcoma is also more common in middle-aged and older dogs.

Treatment options for dogs with hemangiosarcoma

Treatment options depend on the location and size of the tumor, the extent of the disease, and the dog’s overall health.

As our vet indicated, surgery is often the preferred treatment because it can remove the tumor and surrounding tissue and help slow the spread. Chemotherapy may also be used to kill remaining cancer cells and to prevent the cancer from spreading to other organs.

While surgery and chemotherapy may help prolong a dog's life, they are not usually effective at curing hemangiosarcoma. Unfortunately, the prognosis for dogs with hemangiosarcoma is generally very poor, and the majority of dogs succumb to the disease within a few weeks or months of diagnosis.

The results of Sherman’s tests

I’d been at work about an hour scouring the internet for information—and feeling my heart sink while I did—when the phone rang.

The vet informed me Sherman’s case was worse than he’d suspected. His belly was full of cancer with a large tumor on his liver and fairly large tumor on his spleen. One of those had ruptured and was causing Sherman’s internal bleeding. He was extremely anemic.

Sherman had a relatively late-stage case, and operating to remove the tumors wasn’t possible. Our only choice was to make Sherman comfortable. I scheduled his euthanasia for the next day, hung up, and sobbed.

My wife, meanwhile, switched flights and headed for the nearest airport in Mexico. We exchanged texts while she rode a shuttle. She’d land at midnight, in time to spend a final night and morning with Sherman.

Sherman’s last day

Watching dog movies on Netflix, usually a favorite, very energetic passtime, after getting home from the vet.

When Sherman and the vet walked through a double door in the lobby, Sherman offered me his customary dynamic body wag and celebratory whine.

In a short conversation, the vet said he’d prescribed a Chinese herbal medicine called Yunnan Baiyao, which would help Sherman’s ruptured tumor to clot and ease the pain. They’d given him two capsuls already. I asked what the biggest hazard was for Sherman at that point. He said because Sherman was so anemic, he could go into cardiac arrest at any time.

Sherman was able to walk under his own power again, and we went to the truck where I lifted him into the back seat. For the rest of the afternoon, Sherman and I hung out together. We went for a drive, ate ice cream, shared a package of sliced turkey, and watched dog movies on Netflix.

And, finally, right before sunset, we went for a hike. This is one of the ways hemangiosarcoma presents challenges for pet owners struggling to make challenging decisions quickly. As the ruptured tumor clots and the bleeding slows or stops, the anemia gradually resolves even though the dire sickness remains.

Sherman didn’t run like he always did when he was off leash, but he walked a quarter mile and climbed a 300-foot knoll overlooking the city where we sat in the dirt and pondered the view. His belly might be a mess of cancer, blood, and clots, but he was managing, and he seemed to understand I was upset.

At midnight, Sherman and I went to the airport to pick up my wife, and a half hour later the three of us curled up on the couch. In the morning, I went to the living room and found Sherman and my wife still cuddled together under a blanket.

After feeding Sherman whatever he wanted, we called a half dozen people we knew Sherman loved, and every single one of them visited to say goodbye. Sherman celebrated with each person’s arrival, but his breathing gave away a struggling body. His breaths ranged from 58 to 65 per minute, well above the 15 to 30 breaths per minute that are normal for a dog at rest.

That afternoon, after cuddles, scratches, hugs, dog treats, beef jerky, bowls of whipped cream, chewing on a stick, and a few short walks, we took him to the vet and said goodbye.

It’s the most challenging and heartbreaking thing I’ve ever done.

Grief and trying to make sense of it all

Returning to a silent house stricken with grief was tough. Movie clips of Sherman’s life played over and again in my mind, but the clips that hurt most were from Sherman’s final two days. Leading a companion you love to their death is the most unnatural thing I’ve ever done. I had to find more reassurances that we’d done the right thing.

That led me to more scouring of the internet looking for even more information, and over the course of three or four days, I read dozens more articles.

Partially, the reading distracted me from the grief, but the more I read about hemangiosarcoma the more I understood just how sick Sherman was to have been laid flat by a hemorrhaging tumor. The more I read, the more I understood we were lucky to have had a final decent day with Sherman—and he with us.

It’s weeks later now, and I still get teary at unpredictable times. I also still see and hear the ghosts of Sherman, when my imagination conjures his routine grunts, yips, and wags, or his gentle scratch at the back door, or his dissatisfied groan when laying down with excess energy.

He was an uncommonly smart, energetic, and devoted dog, who wore his emotions on his sleeve. It’s hard to believe he left us so early.

Always and forever, buddy.