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Created page with '==Effusions== *Increased amount of fluid in peritoneal, pleural or pericardial cavity *Not a disease in itself *Indicates pathologic…'
==Effusions==
*Increased amount of fluid in [[Peritoneal cavity - Anatomy & Physiology|peritoneal]], pleural or pericardial cavity
*Not a disease in itself
*Indicates pathological process affecting fluid production and/or removal
*Classification
**Based on cell counts and total protein
***Transudate
***Modified transudate
***Exudate
**Haemorrhage
**Chylous effusion
*Transudate and modified transudate are usually present in the clinical sign '''"ascites"'''
===[[Transudate]]===
===Modified transudate===
*'''High cells''' and '''low protein''' OR '''Low cells''' and '''high protein'''
*Yellow to serosanguinous, turbid
*Specific gravity 1.018 - 1.030
*Total protein 25 - 50g/L
*Nucleated cells 0.3 - 5.5 x10e9/L (up to 7 x 10e9/L)
*[[Mesothelial cells|Mesothelial cells]], [[Macrophages - WikiBlood|macrophages]], non-degenerate neutrophils, small [[Lymphocytes - WikiBlood|lymphocytes]]
*'''Due to:'''
**Cardiac disease
***Increased hydrostatic pressure within blood vessels
***May be compounded by hypertension
**Chylous effusions (see below)
**Lymphatic obstruction (neoplasia - e.g. papillary adenocarcinoma of the ovary in the bitch, also produces fluid)
===Exudate===
*'''High cells''' and '''high protein'''
*Turbid - red, yellow, white
*Specific gravity > 1.018
*Total protein > 30g/L
*Nucleated cells >3 x 10e9/L
*[[Neutrophils - WikiBlood|Neutrophils]] non-degenerate or degenerate, [[Macrophages - WikiBlood|macrophages]], [[Lymphocytes - WikiBlood|lymphocytes]], [[Eosinophils - WikiBlood|eosinophils]] (with parasites)
*'''Due to:'''
**Inflammation of the pleural/abdominal cavities or their lining
***Septic
****Degenerate neutrophils
****Intracellular bacteria
****''In horses''
*****Yellow, brown turbid
*****Look for plant material - rupture or [[Enterocentesis|perforation]] of gut wall
*****Horses with gut rupture will quickly develop cardiovascular collapse
***Non-septic
****Non-derenerate neutrophils
****No bacteria
****''In horses''
*****Amber, slightly turbid fluid
*****[[Neutrophils - WikiBlood|Neutrophils]] > [[Macrophages - WikiBlood|macrophages]]
****e.g.[[Feline Infectious Peritonitis|FIP]]
**Long standing modified transudate becomes exudate
**Neoplasia (cell numbers really high)
===Haemorrhage===
*Turbid - red
*Specific gravity 1.025 - 1.040
*Total protein > 30g/L
*Nucleated cells 1.5 - 10 x 10e9/L
*WBC from peripheral blood (including [[Neutrophils - WikiBlood|neutrophils]] and [[Macrophages - WikiBlood|macrophages]])
*Recent or iatrogenic
**Erythrocytes
**Platelet clumps
*Long standing haemorrage
**Macrophages with erythrophagia of haeme pigment
*''In horses'' in addition to the above
**Haemorrhagic diapedesis
***Leakage of blood and fluid from the gut secondary to compromised vascular supply and venous return
***Seen with interstitial necrosis/ischaemia
***Fluid appears serosanguinous
'''Due to'''
*Most commonly seen in cats and dogs due to traumatic injury to the [[Liver - Anatomy & Physiology|liver]] (e.g. [[Infectious Canine Hepatitis|infectious canine hepatitis]]), spleen (e.g. '''haemangiosarcoma''') and kidney
*Warfarin toxicity
*Moldy sweet clover hay fed to pregnant cows may bleed from umbilical vessels into [[Peritoneal cavity - Anatomy & Physiology|peritoneum]]
*Manual ablation of [[Corpus Luteum|corpus luteum]] in cattle
===Chylous effusion===
*Opaque, milky
*Specific gravity > 1.017
*Total protein > 30g/L (variable)
*Nucleated cells 1.5 - 20 x 10e9/L
*Small [[Lymphocytes - WikiBlood|lymphocytes]], mature [[Neutrophils - WikiBlood|neutrophils]], variable [[Macrophages - WikiBlood|macrophages]])
*Chyle
**Triglycerides in fluid > in serum
**Cholesterol in fluid < in serum
**Formation of "cream top" (chylomicrons) if refrigerated
**Does not deparate on centrifugation
**Sudan III staining lipid droplets
==Ectopic sources of fluid==
*'''Urine'''
**Uroabdomen
**Transudate or modified transudate
*'''Bile'''
**[[Peritoneal Cavity Inflammatory - Pathology#Causes of peritonitis|Bile peritonitis]]
**Green in colour
**Modified transudate or exudate
*[[Pancreas - Inflammatory Pathology|'''Pancreatitis''']]
**Modified transudate or exudate
[[Category:Peritoneal Cavity - Pathology]]
*Increased amount of fluid in [[Peritoneal cavity - Anatomy & Physiology|peritoneal]], pleural or pericardial cavity
*Not a disease in itself
*Indicates pathological process affecting fluid production and/or removal
*Classification
**Based on cell counts and total protein
***Transudate
***Modified transudate
***Exudate
**Haemorrhage
**Chylous effusion
*Transudate and modified transudate are usually present in the clinical sign '''"ascites"'''
===[[Transudate]]===
===Modified transudate===
*'''High cells''' and '''low protein''' OR '''Low cells''' and '''high protein'''
*Yellow to serosanguinous, turbid
*Specific gravity 1.018 - 1.030
*Total protein 25 - 50g/L
*Nucleated cells 0.3 - 5.5 x10e9/L (up to 7 x 10e9/L)
*[[Mesothelial cells|Mesothelial cells]], [[Macrophages - WikiBlood|macrophages]], non-degenerate neutrophils, small [[Lymphocytes - WikiBlood|lymphocytes]]
*'''Due to:'''
**Cardiac disease
***Increased hydrostatic pressure within blood vessels
***May be compounded by hypertension
**Chylous effusions (see below)
**Lymphatic obstruction (neoplasia - e.g. papillary adenocarcinoma of the ovary in the bitch, also produces fluid)
===Exudate===
*'''High cells''' and '''high protein'''
*Turbid - red, yellow, white
*Specific gravity > 1.018
*Total protein > 30g/L
*Nucleated cells >3 x 10e9/L
*[[Neutrophils - WikiBlood|Neutrophils]] non-degenerate or degenerate, [[Macrophages - WikiBlood|macrophages]], [[Lymphocytes - WikiBlood|lymphocytes]], [[Eosinophils - WikiBlood|eosinophils]] (with parasites)
*'''Due to:'''
**Inflammation of the pleural/abdominal cavities or their lining
***Septic
****Degenerate neutrophils
****Intracellular bacteria
****''In horses''
*****Yellow, brown turbid
*****Look for plant material - rupture or [[Enterocentesis|perforation]] of gut wall
*****Horses with gut rupture will quickly develop cardiovascular collapse
***Non-septic
****Non-derenerate neutrophils
****No bacteria
****''In horses''
*****Amber, slightly turbid fluid
*****[[Neutrophils - WikiBlood|Neutrophils]] > [[Macrophages - WikiBlood|macrophages]]
****e.g.[[Feline Infectious Peritonitis|FIP]]
**Long standing modified transudate becomes exudate
**Neoplasia (cell numbers really high)
===Haemorrhage===
*Turbid - red
*Specific gravity 1.025 - 1.040
*Total protein > 30g/L
*Nucleated cells 1.5 - 10 x 10e9/L
*WBC from peripheral blood (including [[Neutrophils - WikiBlood|neutrophils]] and [[Macrophages - WikiBlood|macrophages]])
*Recent or iatrogenic
**Erythrocytes
**Platelet clumps
*Long standing haemorrage
**Macrophages with erythrophagia of haeme pigment
*''In horses'' in addition to the above
**Haemorrhagic diapedesis
***Leakage of blood and fluid from the gut secondary to compromised vascular supply and venous return
***Seen with interstitial necrosis/ischaemia
***Fluid appears serosanguinous
'''Due to'''
*Most commonly seen in cats and dogs due to traumatic injury to the [[Liver - Anatomy & Physiology|liver]] (e.g. [[Infectious Canine Hepatitis|infectious canine hepatitis]]), spleen (e.g. '''haemangiosarcoma''') and kidney
*Warfarin toxicity
*Moldy sweet clover hay fed to pregnant cows may bleed from umbilical vessels into [[Peritoneal cavity - Anatomy & Physiology|peritoneum]]
*Manual ablation of [[Corpus Luteum|corpus luteum]] in cattle
===Chylous effusion===
*Opaque, milky
*Specific gravity > 1.017
*Total protein > 30g/L (variable)
*Nucleated cells 1.5 - 20 x 10e9/L
*Small [[Lymphocytes - WikiBlood|lymphocytes]], mature [[Neutrophils - WikiBlood|neutrophils]], variable [[Macrophages - WikiBlood|macrophages]])
*Chyle
**Triglycerides in fluid > in serum
**Cholesterol in fluid < in serum
**Formation of "cream top" (chylomicrons) if refrigerated
**Does not deparate on centrifugation
**Sudan III staining lipid droplets
==Ectopic sources of fluid==
*'''Urine'''
**Uroabdomen
**Transudate or modified transudate
*'''Bile'''
**[[Peritoneal Cavity Inflammatory - Pathology#Causes of peritonitis|Bile peritonitis]]
**Green in colour
**Modified transudate or exudate
*[[Pancreas - Inflammatory Pathology|'''Pancreatitis''']]
**Modified transudate or exudate
[[Category:Peritoneal Cavity - Pathology]]