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This information is provided by
Provet for educational purposes only.
You should seek the advice of your
veterinarian if your pet is ill as only he or she can correctly advise on the
diagnosis and recommend the treatment that is most appropriate for your pet.
Pericardial effusions
are not common in dogs, and they are rare in cats, and differentiating the
underlying cause is important so that appropriate therapy can be given. Basically
a pericardial effusion is an abnormal accumulation of fluid within the
pericardial sac, and it can consist of :
- A transudate
- Right-sided heart failure
- Hypoproteinaemia
- Diaphragmatic-pericardial hernia with liver lobe trapped in
pericardial sac
- Inflammatory fluid (exudate)
- Bacterial infection - foreign bodies, bite wounds, haematogenous
spread
- Feline infectious peritonitis
- Toxoplasmosis (cats)
- Coccidiomycosis - in endemic parts of the world (not in UK)
- Blood/serosanguinous
- Neoplasia - the commonest cause of pericardial effusion in
dogs.- aortic body tumours (most often seen in old
brachycephalic dogs) , chemodectomas, haemangiosarcoma (especially in
German Shepherd Dogs and Golden Retrievers), mesothelioma,
intrathoracic thyroid carcinoma
- Idiopathic pericardial effusion - second most common cause of
pericardial effusion in dogs. Does not occur in cats.
- Coagulopathies - eg warfarin poisoning
- Trauma
The history and clinical signs associated with pericardial effusions and
the cardiac tamponade that results are the same whatever the fluid consists of
:
History :
- General weakness
- Poor exercise tolerance
- Collapse
- Ascites/pleural effusion may be present as well
- Weight loss
- Dyspnoea/tachypnoea - not common
Key clinical findings include :
- A weak, rapid pulse
- Heart sounds are difficult to hear (muffled)
- Distension of the major veins - jugular pulse
In addition there may be signs associated with an underlying cause, for
example :
- Elevated body temperature if there is infection present
- Other signs of trauma eg fractured ribs.
- Epistaxis
- Cough - if the animal is in heart failure
- Diarrhoea if the re is a protein-losing enetropathy
- Polydispsia/polyuria if there is a protein-losing nephropathy
The diagnosis is confirmed by radiography with/without ultrasound
examination
Management of pericardial effusions involves :
- Identification and treatment of any primary cause
- Pericardiocentesis - successful for about 50% of idiopathic pericardial
effusions
- Pericardiectomy - can cure idiopathic pericardial effusions which
otherwise require repeated pericardiocentesis.
- Rescetion of neoplasm - justifiable for chemodectomas which are slow
growing
- Anti-tumour therapy for neoplasia - eg cisplatin may cause remission in
mesotheliomas
- Haemangiosarcoma - prognosis poor - even after paricardiectomy (mean
survival time 4 months)
Updated October 2013
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