– 14 year old FS Golden Retriever
– 4 day history of diarrhea, lethargy but owner has thought pet has been “slowing” for some time now
– bloodwork unremarkable – fecal testing negative for parasites
– u/s showed moderate abdominal effusion (yellowish-clear on tap) and dilated hepatic veins/cvc, pleural and pericardial effusion
– no cardiac tumor identified on ultrasound (looked before pericardiocentesis)
– drained 380ml dark bloody, non-clotting fluid from pericardium
– 14 year old FS Golden Retriever
– 4 day history of diarrhea, lethargy but owner has thought pet has been “slowing” for some time now
– bloodwork unremarkable – fecal testing negative for parasites
– u/s showed moderate abdominal effusion (yellowish-clear on tap) and dilated hepatic veins/cvc, pleural and pericardial effusion
– no cardiac tumor identified on ultrasound (looked before pericardiocentesis)
– drained 380ml dark bloody, non-clotting fluid from pericardium
– after tap, pet is still lethargic (24 hours later) eating some but not back to her normal self
– cytology from fluid (spun down) not helpful only indicated that bleeding is chronic and not acute from seeing hemosiderin laden macrophages, no neoplastic cells, reactive mesothelia cells
– my experience has been in the past that once the cardiac tamponade is relieved, these pets usually feel much better, at least for a little while
– performed chest rads (below) to look for evidence of a mass/tumors – can see the pleural effusion possible mass cranial to heart?
– anyway my gut feeling is that this is a neoplasia case as the pet continues to go downhill – wouldn’t an idiopathic pericardial effusion case feel better post-tap?
– any thoughts here?
Comments
Check for tick borne. I cover
Check for tick borne. I cover for infectious doxy clindamycin just because I think I am doing something but 85%+ of these just need to wait for the tumor to grow. Just a good placed needle and drain and some jump right up others are punky for a while and others fill right back up. Europe fenestrates these US guided and I have done it as well… they do well btu out of the box here in north america. Pericardectomy an option too. Use every out of the box US approach to the RAUR that you can. The search has plenty of these in sonopath so you can see what viuews we use.
There is a PH on the pc effusion to macth the blood that is mor econsistent wiht tumor but can’t remember. Remo?
Check for tick borne. I cover
Check for tick borne. I cover for infectious doxy clindamycin just because I think I am doing something but 85%+ of these just need to wait for the tumor to grow. Just a good placed needle and drain and some jump right up others are punky for a while and others fill right back up. Europe fenestrates these US guided and I have done it as well… they do well btu out of the box here in north america. Pericardectomy an option too. Use every out of the box US approach to the RAUR that you can. The search has plenty of these in sonopath so you can see what viuews we use.
There is a PH on the pc effusion to macth the blood that is mor econsistent wiht tumor but can’t remember. Remo?
Usually with idiopathic
Usually with idiopathic effusion there is a marked improvement afer drainage. Have you repeated the echo to ensure that the effusion has not reformed? Would also tap and analyse the pleural effusion as it may be diagnostic for neoplasia/infection. Tick borne disease possible but would expect some CBC changes. Eric refers to pH changes in pericardial effusion, which, unfortnately is not that diagnostic.
Usually with idiopathic
Usually with idiopathic effusion there is a marked improvement afer drainage. Have you repeated the echo to ensure that the effusion has not reformed? Would also tap and analyse the pleural effusion as it may be diagnostic for neoplasia/infection. Tick borne disease possible but would expect some CBC changes. Eric refers to pH changes in pericardial effusion, which, unfortnately is not that diagnostic.
Thanks Eric and Remo
I think
Thanks Eric and Remo
I think tick-bourne disease would be unlikely as not a common problem seen where I live but definitely worth investigating to cover all basis cause you never know. Hate it when you can’t provide a definitive diagnosis for your clients! The thoracic fluid tap is a good idea for possible clues. Will also recheck the pericardial sac for fluid again (but heart did not look huge on chest rads). This is what the fluid looked like:
Thanks Eric and Remo
I think
Thanks Eric and Remo
I think tick-bourne disease would be unlikely as not a common problem seen where I live but definitely worth investigating to cover all basis cause you never know. Hate it when you can’t provide a definitive diagnosis for your clients! The thoracic fluid tap is a good idea for possible clues. Will also recheck the pericardial sac for fluid again (but heart did not look huge on chest rads). This is what the fluid looked like:
Macroscopic appearance
Macroscopic appearance typical for idiopathic hemorrhagic effusion – thus would expect patient to improve after centesis.
Macroscopic appearance
Macroscopic appearance typical for idiopathic hemorrhagic effusion – thus would expect patient to improve after centesis.
Report today is that the pet
Report today is that the pet is doing really well! Somewhat of a delayed response? Will keep monitoring the chest/heart.
Report today is that the pet
Report today is that the pet is doing really well! Somewhat of a delayed response? Will keep monitoring the chest/heart.