The pc effusion is not

The pc effusion is not cardiogenic because the LA is normal size. I would check the abdomen for primary neoplasia that may met to the pc like lsa, mct or similar. Vasculitis, pericarditis and fip possible as well. The myocardium and rt aur look echogenic so inflammatory or neoplastic likely. That rt aur is flapping in the pc effusion which is why it looks strange but is a bit nodular too but not an overt mass.

 Tapping the pc effusion would help but more for analysis,,, cyto and culture.

IV torb for sedation or valium but not propofol becaus the cat is volume contracted.

Sure of course Randy good

Sure of course Randy good question and I hope I can explain it out wiht the rule that I go by typically and Im sure ther eare exceptions:

With tamponade occurs from non cardiac causes venous return to the la is diminished… such as in ra mass and pc effusion and tamponade or in idiopath pc effusion or even feline FIP wet form affecting the pericardium or mct. In cats in left and right cardiac failure the effusion never reaches tamponade levels as is passively spells into the pericarium and the pleural spaces in cats. La pressure has to reach 23 mmhg for effusions to form either in pericardium or pleural space in cats, pulmonary edema in dogs. In order to reach that level the la has to stretch til it stretches to the level that la contraction won’t push the volume into the lv… increasing the pressure… so dilation comes first to overload to left failure. So if the la is not big then left failure is not present. I have never seen a left chf case in a cat with pc effusion from left failure have a normal LA size.. They are always excessive even after lasix if there is pc or pleural effusion the la is always 1.5 or greater as a rule because of the 23mmHg pressure necessity for failure to occur. There may be some rare exception that maybe peter has seen but I haven’t.

Bottom line in general the pc effusion from chf in cats is usually there but not overwhelming where as pc effusion from non cardiac causes can be there without tamponade or with tamponade…. either way. Like this one of septic pericarditis

http://sonopath.com/members/case-studies/cases/septic-suppurative-pericarditis-13-year-old-fs-dsh-cat-diabetes

But you dont get tamponade with chf. Make sense? Peter is much more technical than I am so let me see if he can explain it out better.

Here is the typical pc effusion with a cat in left failure…its usually minor effusion not causing tamponade:

http://sonopath.com/members/case-studies/cases/intermediate-cardiomyopathy-left-atrial-clot-8-year-old-mn-cat

The only exception I can think of is with left atrial rupture and secondary hemopericardium on valvular breed dogs if you are in the right spot at the right time to see them alive like this one I did:

http://sonopath.com/members/case-studies/cases/left-atrial-enlargement-suspected-rupture-and-pericardial-effusion-13-yea

http://sonopath.com/members/case-studies/cases/1500048-sonny-c-mitral-insufficiency-suspect-left-atrial-tear

These examples still have enlarged LA but Ive seen a couple of these that the LA was only mildly enlarged but still enlarged.

Also in his image set note

Also in his image set note the volume contracted Lv (LVIDd < 1 cm) and the pseudohypertrophy as a result.

Tosullivan, I was doing the

Tosullivan, I was doing the final edit on curbside and here are the diffs from the pericardial effusion chapter:

Etiology:Causes of pericardial effusion include:

• Neoplasia
  • Right atrial (RA) hemangiosarcoma
  • Heart base (aortic body) tumors
  • Mesothelioma
  • Rhabdomyosarcoma
  • Ectopic thyroid carcinoma
  • Metastatic neoplasia
• Idiopathic
• Congestive heart failure
• Peritoneal-pericardial diaphragmatic hernia
• Pericardial cyst
• Hypoalbuminemia
• Infectious pericarditis (bacterial, Coccidioides immitus)
• Feline infectious peritonitis
• Left atrial tear secondary to valvular disease
• Coagulopathy

Cytology is helpful in the diagnosis of lymphoma, septic pericarditis, and idiopathic effusion, but not in cases of neoplasia.

Hopefully one of yours fits here or the book won’t sell lol:)

Here’s a case form the atlas

Here’s a case form the atlas pathology Cd (http://sonopath.com/products/cd) with pc effusion from mast cell disease that shows the typical non cardiogenic plericardial effusion… as peter said LSA can do this and I would add FIP and pericarditis… tap, cytospin, slide prep immediately and look for badness while culturing out.