{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T17:59:02Z","timestamp":1787507942445,"version":"build-2736575974"},"reference-count":39,"publisher":"American Veterinary Medical Association (AVMA)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["javma"],"published-print":{"date-parts":[[2023,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To evaluate the validity of the double two-thirds rule for a diagnosis of splenic hemangiosarcoma in dogs with nontraumatic hemoperitoneum due to a ruptured splenic mass.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>SAMPLE<\/jats:title>\n                    <jats:p>Systematic literature review.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PROCEDURES<\/jats:title>\n                    <jats:p>3 databases (PubMed, CAB abstracts, and World of Science) were searched in November 2020. Articles were included if data on dogs with nontraumatic hemoperitoneum due to a splenic mass were included and subsequent pathologic diagnosis could be determined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>In total, 2,390 unique articles were identified, with 66 articles meeting the criteria for full-text review and 14 articles included for analysis. A total of 1,150 dogs were evaluated, with 73.0% (840\/1,150) of dogs being diagnosed with a malignant splenic lesion and 27.0% (310\/1,150) being diagnosed with a benign splenic lesion. Of the malignancies, 87.3% (733\/840) were hemangiosarcoma. Levels of evidence were low, and bias was high as most included studies were retrospective case series.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CLINICAL RELEVANCE<\/jats:title>\n                    <jats:p>The double two-thirds rule should be refined when evaluating dogs with nontraumatic hemoperitoneum from a ruptured splenic mass, with more dogs being diagnosed with a malignancy and hemangiosarcoma specifically than the double two-thirds rule indicates. These findings may be useful in an emergency setting to guide owners on potential diagnoses for dogs with nontraumatic hemoperitoneum due to a ruptured splenic mass. However, there remains a portion of these dogs with benign conditions and nonhemangiosarcoma malignancies that may have a good long-term prognosis compared to dogs with hemangiosarcoma. Studies with higher levels of evidence, lower risks of bias, and large case numbers are needed in the literature.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2460\/javma.22.08.0389","type":"journal-article","created":{"date-parts":[[2022,11,2]],"date-time":"2022-11-02T10:33:43Z","timestamp":1667385223000},"page":"69-73","source":"Crossref","is-referenced-by-count":14,"title":["Evaluation of the validity of the double two-thirds rule for diagnosing hemangiosarcoma in dogs with nontraumatic hemoperitoneum due to a ruptured splenic mass: a systematic review"],"prefix":"10.2460","volume":"261","author":[{"given":"Ashley R.","family":"Schick","sequence":"first","affiliation":[{"name":"Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet A.","family":"Grimes","sequence":"additional","affiliation":[{"name":"Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1272","reference":[{"issue":"6","key":"ref1","series-title":"J Am Vet Med Assoc","first-page":"829","article-title":"Prevalence, type, and importance of splenic diseases in dogs: 1,480 cases (1985\u20131989)","volume":"200","author":"Spangler WL","year":"1992","unstructured":"Spangler WL, Culbertson MR. 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