4,503
edits
Changes
Jump to navigation
Jump to search
no edit summary
- Weight loss
- Weight loss
- Abdominal enlargement
- Abdominal enlargement
===Diagnosis===
====Physical Exam====
====Physical Exam====
-Signs of right-sided heart failure:
-Signs of right-sided heart failure:
*ascites
*Ascites
*pleural effusion
*Pleural effusion
*distension of the caudal vena cava
*Distension of the caudal vena cava
*hepatomegaly
*Hepatomegaly
Echocardiography is also useful to establish the cause of the pericardial effusion. Mass lesions may be small and difficult to distinguish in some cases, but may be very easily identified in others. Haemangiosarcomas can be seen infiltrating the right atrium, whereas heart base tumours typically surround the aorta and pulmonary artery.
Echocardiography is also useful to establish the cause of the pericardial effusion. Mass lesions may be small and difficult to distinguish in some cases, but may be very easily identified in others. Haemangiosarcomas can be seen infiltrating the right atrium, whereas heart base tumours typically surround the aorta and pulmonary artery.
===Pericardial Fluid Analysis===
====Pericardial Fluid Analysis====
Fluid should always be sent for further analysis, including total and differential cell counts, packed cell volume, specific gravity, cytology, bacterial culture and sensitivity. Pericardial effusions can be classified as haemorrhagic, transudate, modified transudate and exudate and the classification informs the likely underlying cause. Differentiating reactive mesothelial cells from neoplastic mesothelial cells can be incredibly difficult, sometimes a diagnosis can only be made following histopathological and immunohistochemical examination of the excised pericardium.
Fluid should always be sent for further analysis, including total and differential cell counts, packed cell volume, specific gravity, cytology, bacterial culture and sensitivity. Pericardial effusions can be classified as haemorrhagic, transudate, modified transudate and exudate and the classification informs the likely underlying cause. Differentiating reactive mesothelial cells from neoplastic mesothelial cells can be incredibly difficult, sometimes a diagnosis can only be made following histopathological and immunohistochemical examination of the excised pericardium.
- Infection
- Infection
====
====Surgery====
The most common surgical treatment is '''subtotal pericardectomy'''.
===Prognosis===
===Prognosis===
====Idiopathic====
This may be highly variable and effort should be made to find the underlying cause. In up to a third of cases, complete resolution will follow pericardiocentesis. However, owners should be warned that reoccurrence is possible anything from weeks to years later. If effusion recurs, surgical pericardiectomy should be recommended.
====Neoplastic====
The prognosis differs depending on the tumour type.
* Haemangiosarcomas are very malignant and commonly metastasize. Pericardiocentesis is palliative in these cases and relief may be short lived (days). With surgical resection and chemotherapy, the maximum reported survival time is 7-8 months.
* Heart base tumours are usually slow growing. Surgical resection may be possible, but clean margins are difficult to achieve and recurrence is common. Survival times up to 3 years have been reported in dogs that received pericardiectomy, and this is thought to significantly prolong survival.
* Mesothelioma typically results in rapid recurrence of pericardial effusion, following pericardiocentesis. Pericardiectomy could cause dissemination of the tumour into the pleural space, leading to chronic pleural effusion. Survival time is approximately 10 months. It may be difficult to differentiate idiopathic haemorrhagic pericardial effusion from mesothelioma, even with histopathology and immunohistochemistry. In cases with recurrence of significant pericardial effusion within 120 days of pericardiectomy, evidence suggests that mesothelioma should be suspected.
* Lymphoma in cats should be treated with palliative pericardiectomy and chemotherapy.
===References===
===References===