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When To Euthanize A Dog With Hemangiosarcoma? The Truth

When To Euthanize A Dog With Hemangiosarcoma

Learning that your dog has hemangiosarcoma can be shocking. And the steps you need to take next – confusing.

Euthanasia is a hard choice. But when could it be for the better?

This article will reveal:

  • What the symptoms of hemangiosarcoma are.
  • Whether you should euthanize a dog with hemangiosarcoma.
  • The things you should know about each stage of hemangiosarcoma.
  • When should a dog suffering from hemangiosarcoma be euthanized and why.
  • And more…

Should you euthanize a dog with hemangiosarcoma?

To euthanize a dog with hemangiosarcoma depends on whether they will have a quality life. Some dogs lead happy lives even while undergoing treatments. Other dogs have benign tumors that are not life-threatening. And there are dogs who experience intense pain and great suffering. 

When to euthanize a dog with hemangiosarcoma?

A dog with hemangiosarcoma is euthanized only when they have no chances of survival. Almost all dogs with hemangiosarcoma will eventually succumb to this cancer. Some sooner than others. Consider euthanasia if your dog’s suffering will lead to poor quality of life.

What is hemangiosarcoma?

Hemangiosarcoma is a malignant tumor affecting endothelial cells.

Endothelial cells are responsible for creating blood vessels.

This is one of the most challenging cancers in dogs because the cause is not known. In addition, it’s usually too late when the cancer is diagnosed. 

This is because the signs may go unnoticed for a long time. So one moment your dog is fine. The next, they collapse and in shock.

Primary tumor sites

The tumor can occur in any part of the body. However, there are three primary sites where the tumor grows.

  1. Spleen (28-50%).
  2. Right atrium and auricle (3-50%).
  3. Subcutaneous tissue (13%).

Other primary sites include:

  • Lung.
  • Liver.
  • Kidney.
  • Vertebral body.
  • Central nervous system.

The tumor infiltrates normal tissues and also metastasizes (spread to other sites).

Stages of hemangiosarcoma

Hemangiosarcoma is also categorized into 3 stages as follows:

Splenic hemangiosarcoma

Stage 1 – Tumor confined to the spleen.

Stage 2 – Ruptured tumor that may or may not involve the regional lymph node.

Stage 3 – Ruptured primary tumor and distant metastasis.

Here’s Winnie with stage I splenic hemangiosarcoma:

The doctor says that they have not found tumors in other parts of the body. And from the x-ray, there’s no evidence of a ruptured tumor.

Dermal hemangiosarcoma

Stage 1: Tumor confined to the dermis.

Stage 2: Tumor affects the hypodermis, may or may not involve the dermis.

Stage 3: Tumor with muscular involvement.

Which dogs are at risk?

Did you know that hemangiosarcoma is more common in dogs than other species?

In fact, hemangiosarcoma accounts for 5-7% of all canine cancer cases. 

Hemangiosarcoma can afflict dogs of any age. But this is more common in middle-aged to older dogs.

Some dog breeds are also more susceptible to hemangiosarcoma, including:

  • Boxers.
  • Great Danes.
  • Skye Terriers.
  • Golden Retrievers.
  • German Shepherds.
  • Labrador Retrievers.
  • Flat-Coated Retrievers.
  • Bernese Mountain Dogs.
  • Portuguese Water Dogs.

Among these, the large breeds are usually affected by splenic hemangiosarcoma. 

On the other hand, dermal hemangiosarcoma affects dogs with light coats and sparse hair. These include Beagles, Dalmatians, and Whippets. 

Dermal tumors manifest on the abdomen or in areas where the hair is thin.

Lastly, atrial hemangiosarcoma affects males and neutered females more.

Hemangiosarcoma signs and symptoms

Symptoms depend on where the tumor is.

If it’s a cutaneous (on the skin) tumor, you may notice a reddish or purplish bump. It could bruise or bleed. 

If it’s under the skin, there may be a swelling that appears like a fatty tumor.

On the other hand, internal tumors manifest the following symptoms:

  • Cough.
  • Shock.
  • Lethargy.
  • Collapse.
  • Confusion.
  • Pale gums.
  • Weakness.
  • Incontinence.
  • Sleeping more.
  • Distended belly.
  • Loss of appetite.
  • Decreased stamina.
  • Unexplained and sudden weight loss.

Diagnosis of hemangiosarcoma

Hemangiosarcoma is diagnosed through a biopsy. This is reviewed by a veterinary pathology specialist.

Other tools of diagnosis are abdominal ultrasound, surgery, x-rays, and CT scan.

Why hemangiosarcoma is dangerous

Dog Suffering From Hemangiosarcoma

What makes hemangiosarcoma dangerous is the rapid onset of metastasis. 

Usually, the tumor has already metastasized by the time the disease is diagnosed.

In addition, there’s the possibility of tumors rupturing at the same time. This leads to internal hemorrhage that could end in death.

Unfortunately, the survival times for a dog with splenic hemangiosarcoma is 4 to 6 months. 

It’s hard to diagnose hemangiosarcoma because the symptoms appear in advanced stages.

Most dogs are diagnosed only when a tumor ruptures. And by then there’s severe internal bleeding.

Unfortunately, there are no screening tests for the early diagnosis of hemangiosarcoma.

Is hemangiosarcoma curable?

Sadly, hemangiosarcoma is incurable.

To make matters worse, the diagnosis is usually at a time when the cancer has progressed. 

Dogs may not experience pain. But they could experience worsening of symptoms. These could be bleeding or weakness.

Can a dog survive hemangiosarcoma?

A dog’s chance at survival depends on several factors.

First, it depends on the type of hemangiosarcoma. There are dogs that survive dermal hemangiosarcoma after surgery. 

Dogs with dermal hemangiosarcoma have survival times between 5 to 10 months. For dogs with hypodermal hemangiosarcoma, 6 months.

The only downside is that affected dogs have to avoid sunlight exposure from then on.

Unfortunately, there is no preventative method for other types of hemangiosarcoma. 

Second, it depends on the stage of the cancer. Dogs at stage I have higher chances of surviving.

Dogs with stage I hemangiosarcoma have a median survival of 257-273 days. Those with stage II have a survival median of 156-210 days. 

Lastly, dogs with stage III have a median survival of 73-87 days.

If a dog has surgery and receives chemotherapy, their survival rate increases to 12-20%

That means about 4 to 8 months.

If with surgery only, survival time is between one to 3 months. 

But when a tumor ruptures, it diminishes a dog’s survival rate. Their survival time becomes short and unpredictable. 

This is also true for dogs that have metastasis.

Almost all dogs will die either from rupture of tumor or metastasis.

This study proved that the survival of dogs with internal hemangiosarcoma was poor. In fact, dogs that received surgery and chemotherapy died within a year.

Dogs with internal hemangiosarcoma without treatment might die sooner. Probably within one to 2 weeks of diagnosis. 

However, this is not the same for all dogs. 

Some dogs actually survive for months. While others die within a day.

But, if the tumor has metastasized rapid, survival time is about 2 months.

However, there are treatments available to lengthen a dog’s life. These could also give them a good quality of life.

3 treatment options for hemangiosarcoma

Hemangiosarcoma is usually at its advanced stage before it is detected. This makes it resistant to treatments. 

However, treatment options such as surgery, chemotherapy, and radiotherapy can make a difference. Particularly if cancer is diagnosed early.

#1: Surgery

Surgery is usually the ideal treatment for hemangiosarcoma.

In some instances, surgery alone works. Such as when treating dermal hemangiosarcoma.

Usually, superficial dermal hemangiosarcoma is cured after surgery. But there are cases when new tumors appear in some areas of the body.

For dermal hemangiosarcoma, the surgery sites cover a large area. That’s because it’s necessary to remove all affected tissues.

For hemangiosarcoma involving the heart, surgery is not recommended. 

That’s because cardiac surgery is quite difficult. Surgery for vascular (of vessels carrying blood) tumors are even more difficult.

On the other hand, surgery alone is the best treatment for splenic tumors. Experts recommend the removal of the spleen. 

This is even though one can’t know in advance whether the tumor is benign or malignant.

About 50% of splenic tumors are benign. But even then, these tumors are dangerous. 

That’s because the spleen is vascular. When splenic tumors rupture, it can lead to serious bleeding.

During surgery, the abdominal cavity will be checked to see if metastasis exists. As such, more samples of tumors will be taken for biopsy.


Surgery may be a dog’s best bet against hemangiosarcoma. It can give them the highest chance of survival time.

Unfortunately, the risks are high, too. There could be severe internal bleeding during the surgery.

In addition, dogs in advanced stages may be in a compromised situation. 

Before surgery, they have to be stabilized. This is either through fluid therapy or blood transfusions. There’s intensive care monitoring as well.

Also, there’s a chance of cardiac arrhythmias occurring after surgery.

Another disadvantage of surgery is that it makes dogs prone to gastric torsion. This is usually more common in deep-chested dogs. 

That’s because the removal of the spleen leads to more space in the abdominal cavity.

Gastric torsion refers to the stomach being overstretched due to excessive gas content. In other words, bloat.

As a result, gastropexy may be needed. Gastropexy is a surgical procedure to treat gastric torsion.

#2: Chemotherapy

Chemotherapy is done following surgery for these sites:

  • Liver.
  • Bone.
  • Spleen.
  • Beneath the skin or in the muscle.

Chemotherapy is also usually the best option for hemangiosarcoma of the heart. Because as I have mentioned, surgery is very difficult to do.

As hemangiosarcoma metastasizes, chemotherapy works as an adjunct treatment to surgery. Most especially where there is incomplete surgical removal of the tumor.

The following drugs are the most commonly used for chemotherapy:

  • Piroxicam.
  • Vincristine.
  • Doxorubicin.
  • Methotrexate.
  • Cyclophosphamide.

Note: Chemotherapy slows down cancer while giving the dog a good quality of life.

Metronomic chemotherapy

Metronomic chemotherapy (MC) is also known as low dose chemotherapy. 

It refers to the frequent oral administration of chemotherapy drugs in low doses. The MC could be given daily or every other day without extended drug-free breaks.

According to a veterinary oncologist, responses to MC can take weeks. Sometimes it’s 6 to 8 weeks.

She recommends that the dog undergo MC for at least 6 months.

The use of MC has 2 purposes:

  • Minimize drug reactions.
  • Target endothelial cells and tumor cells.
Traditional chemotherapy versus MC

MC is different from traditional chemotherapy in that MC targets the tumor cells. 

In addition, MC has fewer side effects because of the lower doses.

Note: Traditional chemotherapy doesn’t work well for dogs that have metastasis.

MC’s effectiveness

The first documented use of MC to treat dogs with splenic hemangiosarcoma was in 2007.

The study examined 9 dogs with stage II splenic hemangiosarcoma. They had surgery and were treated with MC.

The researchers compared the median survival of these 9 dogs with a second group of dogs. 

This second group consisted of 24 dogs. They also have stage II hemangiosarcoma, had surgery and treated with traditional chemotherapy.

The median survival of the 9 dogs was 178 days. On the other hand, the median survival of the 24 dogs was 126 days.

The difference wasn’t much. But the researchers concluded that MC was as effective as traditional chemotherapy.

Another study was in 2008. It studied MC’s use to prolong the disease-free interval in dogs.

The subjects were 85 dogs. All of them have incomplete surgical removal of soft tissue sarcomas.

Thirty of the dogs were treated with MC while the rest had no therapy. The results showed that dogs treated with MC had longer disease-free intervals.

#3: Radiotherapy

Radiotherapy (RT) uses radiation to kill cancer cells. It is recommended for use during the early stages of the cancer.

The good thing about RT is that it’s a local treatment. Meaning, it is aimed at the area where it needs treatment. 

Unfortunately, RT’s use for treating hemangiosarcoma can’t be maximized.

Here are the reasons why:

  • Tumors metastasize rapidly.
  • RT is not conducive for some sites where tumors grow. In addition, it does not reach all parts of the body.

RT can be used alone or with other treatments.

Signs of hemangiosarcoma in dying dogs

It’s devastating to see a dog with hemangiosarcoma suffering.

Pet owners who lost their dog to this cancer took note of various signs.  They have observed these shortly before their dog died.

For instance, a pet owner observed that his dog, Winni, occasionally bled internally. There were also times when her gums turned pale and she wouldn’t eat.

She also slept more than usual and had trouble walking. The owner also observed that her dog experienced incontinence at night.

Another dog, Rocky, also experienced incontinence. He was paralized in the lower half of his body.

The owner observed a dark red color around the navel. This suggested internal bleeding.

In some cases, dogs were disoriented and confused often. Other dogs went into shock, vomited, or collapsed.

A bloated abdomen was also common in dogs that had internal bleeding.

Euthanasia: The hardest decision

Euthanasia Of A Dog With Hemangiosarcoma

A lot of pet owners have painful memories of losing their dogs to hemangiosarcoma. 

One similar thing about their experiences: it happened without warning.

One moment their dog was their usual self. The next, they were either lethargic or confused. 

And before pet owners knew it, their dog was fighting for their life.

In some cases, the dogs had ruptured tumors that caused internal bleeding. And when it happened, there was no chance for their dog to survive.

Some dogs died immediately; others survived a few weeks or months. But they eventually succumbed to the cancer. 

There were only a few dogs that had happy lives while undergoing treatments

For pet owners who chose euthanasia, it was the hardest decision they ever made. But was it the right decision?

For Shana, it was. She shared on Whole Dog Journal that she lost two of her Flat-Coated Retrievers to hemangiosarcoma. 

Her first dog had surgery and chemotherapy. Unfortunately, the dog lasted only 6 weeks and had a poor quality life.

When her second dog showed the same symptoms, she knew the dog had hemangiosarcoma, too. And she didn’t let her dog suffer the same way.

Another pet owner, Karen, chose euthanasia as well. Her dog, Maggie, was fine one day. But the following morning, the dog was moribund.

A pet owner named Tiffani said she would choose euthanasia if it came to it. She said she wouldn’t let her dog, Echo, go through surgery.

And if Echo had to suffer, she would help her pass. 

Tiffani recognized that hemangiosarcoma is terminal. And that her dog could suffer from bleeding. She didn’t want that to happen.

Unsurprisingly, not all pet owners approve of euthanasia. And it is understandable.

But there are cases when euthanasia is the best choice. One, if the dog would suffer greatly. Two, if the dog would have a poor quality of life.

There’s no point in letting the dog suffer in pain until they die. 

But there were pet owners who went with their gut instinct

They have chosen surgery over euthanasia. 

One pet owner convinced his brother to choose surgery for the latter’s dog.

The dog had spots on lungs and liver. Her kidneys were also in bad shape.

Still, he was convinced to go over the surgery. His brother agreed.

Right after the surgery, the dog had breathing problems. This might be a sign of cancer in the lungs.

But the following day, everything was back to normal. The dog’s kidneys improved. But the most important discovery was that the tumor was benign.

The pet owner suggested choosing surgery if there’s money for it. He said he did not regret spending on the dog’s surgery.

To put one’s mind at ease, this is better discussed with a vet. Sometimes a dog can still enjoy a good life with the help of treatments.