Acute hepatic rupture causing hemoperitoneum in a dog with anaphylaxis

Area of Science:

• Veterinary Medicine
• Pathology
• Toxicology

Background:

• Anaphylaxis can present with diverse clinical signs, sometimes leading to severe complications.
• Hepatic rupture is a rare but life-threatening condition in veterinary medicine.

Observation:

• A 2-year-old Siberian Husky presented with acute collapse, lethargy, hematochezia, and vomiting.
• Point-of-care ultrasound revealed gallbladder wall thickening and peritoneal effusion consistent with hemorrhage.
• Despite aggressive medical management, the patient progressed to cardiopulmonary arrest.

Findings:

• Necropsy confirmed severe acute hemoperitoneum secondary to a ruptured left lateral liver lobe.
• A tear in the hepatic capsule and a large hematoma were identified.
• A single adult Dirofilaria immitis nematode was found in a pulmonary vessel; other findings supported anaphylaxis.

Implications:

• This case report suggests acute hepatic rupture should be considered in cases of anaphylaxis-related hemoperitoneum.
• Early recognition and diagnostic investigation are crucial for managing severe hemoperitoneum in dogs.
• The findings underscore the complex and potentially fatal sequelae of severe anaphylactic reactions.