Delayed surgery can be considered for cardiovascularly stable dogs with hemoperitoneum due to a ruptured splenic mass

Objective To determine whether the timing of surgery affects morbidity and/or mortality of dogs with hemoperitoneum secondary to a ruptured splenic mass. Methods In this retrospective cohort study, medical records of dogs diagnosed with hemoperitoneum due to a ruptured splenic mass between 2010 and 2023 were reviewed for clinical data. Dogs were classified in the early group (early) if surgery occurred < 6 hours and the delayed group (delayed) if surgery occurred ≥ 6 hours after presentation. Results A total of 177 client-owned dogs (99 early, 78 delayed) were included. The median duration of time from admission to surgery was 4.1 hours (range, 2.2 to 5.95 hours) for early and 14.0 hours (range, 6.02 to 68.4 hours) for delayed dogs. Early dogs were more likely to present in hypovolemic shock, have a higher shock index, and receive crystalloid boluses and RBC-containing transfusions preoperatively than delayed dogs. There was no difference in the occurrence of hypotension intraoperatively between groups. Early dogs were more likely to receive an RBC-containing transfusion during and/or after surgery and had longer hospitalization than delayed dogs. Overall survival to discharge was 94.9% (168 of 177); there was no difference between groups. Conclusions There was no difference in mortality based on timing of surgery. Early dogs were more likely to receive RBC-containing transfusions throughout hospitalization and have a longer hospital stay compared to delayed dogs. Clinical Relevance Stable dogs may be able to have delayed surgery without increasing morbidity or mortality. Early surgery should be considered for dogs that have ongoing concerns for stability despite medical intervention.