American College of Veterinary Surgeons Dr. Chris Wood BSc, DVM (Dist), MS
DACVS (Small Animal)
For veterinary teams

Tufts T-STAT and HeLP

Enter one case to get two separate assessments: T-STAT estimates whether a spleen lump is cancer; HeLP estimates concern for hemangiosarcoma (HSA), a cancer of blood-vessel cells, in dogs with abdominal bleeding.

Use the case record and the veterinarian’s imaging interpretation. Unknown is not the same as normal or absent. Neither result gives a definite diagnosis.

1 Enter the findings

Have the available blood results and ultrasound report ready. The veterinarian confirms which models apply. Each result can be completed independently.

Tufts T-STAT · spleen lump assessment

For dogs with a splenic mass, with or without internal bleeding. T-STAT considers any cancer, not just HSA.

Use the veterinarian-selected laboratory results. The study used results at admission or within the preceding 30 days; if there were several, it used those closest to spleen surgery. Record the sample date below.

Use the laboratory serum result. This is separate from HeLP’s plasma / total-solids reading.

Nucleated red blood cells, from the blood-count / differential report. Use the count per 100 WBCs, not the total red-cell count.

Use the largest measurable diameter of the largest splenic lesion from the ultrasound report.

Use the veterinarian’s reviewed ultrasound findings.

Inhomogeneity means variation within the lump’s ultrasound appearance. Ask the veterinarian to confirm the category.

Effusion means fluid in the abdomen. Use the ultrasound assessment, not a guess from the pet’s appearance.

Count liver nodules reported on ultrasound.

Specifically mesenteric, omental or peritoneal nodules. These are tissues within the abdomen; this question is not about lymph nodes.

0 of 8 T-STAT findings entered

HeLP · concern for HSA with abdominal bleeding

The veterinarian confirms blood in the abdomen (hemoabdomen) without an injury, with a primary clotting disorder (primary coagulopathy) excluded. If not confirmed, HeLP is not calculated.

Use admission findings: the initial assessment and samples when the dog arrived. These may differ from the results chosen for T-STAT.

Use the recorded weight in kilograms.

Use the admission refractometer reading, not T-STAT’s laboratory serum protein. A value between the published bands remains unscored; do not round it.

Use ×10⁹/L (same number as K/µL). For /µL, divide by 1,000: 120,000/µL = 120 here. Values between published bands remain unscored.

Use the veterinarian’s interpretation. Metastatic means findings thought to represent cancer spread. “No thoracic radiographs available” uses the published 17-point option; it does not mean the chest is normal.

0 of 4 HeLP findings entered

Calculated on this device. Entries are not saved or sent.

Evidence, methods and limitations

Tufts T-STAT

This local calculator reconstructs the equation in Burgess and colleagues’ 2021 study and Supplementary Appendix S1. It estimates any splenic malignancy, not specifically HSA. It has not been compared with the original calculator’s code or independently clinically validated.

The study involved dogs selected for spleen surgery and complete abdominal ultrasound. Its results do not automatically apply to every spleen lump. A later external study reported T-STAT AUC 0.68; that describes separation between groups, not certainty for this patient.

How the published equation is applied here

Serum protein is converted to g/dL and rounded to the nearest whole number, as Appendix S1 directs; exact half-way values round up in this local version. Diameter uses continuous piecewise slopes with a change at 7 cm. Liver nodules use separate categories: one, or two or more.

Unit labels and the worked-example sum are inconsistent within the published supplement. This version uses g/dL, supported by the main paper’s Table 1 and example, and the listed coefficients rather than the erroneous printed sum. The example then reproduces approximately 98.1%.

Burgess et al., 2021 · paper and supplement ↗ · Hillier et al., 2024 · external validation ↗

HeLP

HeLP predicts HSA diagnosis, not survival, all malignancy, or the complexity of surgery. The paper labels scores 0–40 low, 41–55 medium, and above 55 high. “Low” does not mean cancer is excluded.

A non-HSA result can still represent another tumour. Tissue diagnosis remains necessary; a high score alone is not a reason to recommend euthanasia.

The original study included 406 dogs: 219 for model construction and 187 for validation. A 2024 external study found acceptable, imperfect discrimination. Use the score alongside the examination and other findings.

The original study reported HSA in 36% of its low group, 76% of its medium group and 96% of its high group. These are study-group frequencies, not precise probabilities for an individual dog and not the probability of any cancer.

Original study graph

The solid curve is the original study’s model. The dashed lines show its 95% confidence interval. A higher score raises suspicion, but the score itself is not a percentage.

Complete the findings above to mark this dog’s score.

Schick study graph: hemangiosarcoma likelihood rises with HeLP score; wide dashed confidence limits show uncertainty

Original Figure 3, Schick and colleagues, 2019, extracted directly from the paper. The blue marker shows the calculated score on the horizontal axis; it does not create a new probability estimate. The model was constructed from 219 dogs with spontaneous hemoabdomen.

How to explain this to an owner

“This score helps assess concern about hemangiosarcoma, a cancer that can cause bleeding. It cannot show for certain what your dog has. The broken lines show how uncertain the estimate can be. The whole picture still matters, and the tissue still needs testing.”

Why do the points look counterintuitive?

The four variables were modelled together. Normal radiographs receive 17 points; an abnormal, nonmetastatic lung pattern receives zero. Protein and platelet categories are also not monotonic. These are the published model weights, not independent clinical rules.

The original validation dataset lacked thoracic radiograph findings and assigned the normal category. Selecting “unavailable” here explicitly reproduces the paper’s 17-point option without describing the chest as normal.

Study applicability and validation

The original cohort excluded primary coagulopathy and required histology obtained at surgery or necropsy. Do not apply its group frequencies to incidental, nonbleeding splenic masses. The score remains uncertain for an individual dog.

Schick et al., 2019: Original HeLP study. Point assignments verified against Figure 2; category frequencies from the reported study results.

Hillier et al., 2024: External validation. Among 141 dogs with HeLP data, cumulative-score AUC was 0.79 and categorical-score AUC 0.73. These values describe how well the model separates groups, not the probability for one patient.