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Cause of ascites

-14 year old dog with ascites, fluid is red-tinged, non-viscous fluid.  

-severe tricuspid regurgitation and moderate MR on echo along with right heart enlargement

-no hepatic congestion

-possible gall bladder mucocele with surruounding inflammation

-small, presumably incidental, bladder mass

-no other significant findings in abdomen other than large volume ascites

 

-14 year old dog with ascites, fluid is red-tinged, non-viscous fluid.  

-severe tricuspid regurgitation and moderate MR on echo along with right heart enlargement

-no hepatic congestion

-possible gall bladder mucocele with surruounding inflammation

-small, presumably incidental, bladder mass

-no other significant findings in abdomen other than large volume ascites

 

Do you agree there’s no hepatic congestion?  Even though there is significant right heart disease, I am assuming without hepatic venous congestion, the ascites can’t be due to the heart disease, correct?  What do you think of the gall bladder?

Thanks!

smbrowndvm

6 responses to “Cause of ascites”

  1. Videos and imnages are pretty

    Videos and imnages are pretty dark but the right heart and pa look big to me. Really need TR velocities here and CVC/AO ratio at the diaphragm. Rt chf can occur with subtle or minor right enlargement its the TR velocity thats important. HV look a little big in the one view but can;t be sure. Position 12 SDEP right intercostal toward the spine gives a good cvc ao ratio which is very good for evaluating hepatic congestion. Cytospin the fluid and slide prep right away of the sediment to check for exfoliating neoplasia as well.

    • Thanks for the reply.
      The

      Thanks for the reply.

      The images are not nearly as dark when I view them on my machine, they just transferred much more darkly.  I wish you could see the gall bladder, it looks bad too.

  2. Yes i see the GB isnt normal

    Yes i see the GB isnt normal but depends on that being the issue or not. See if the fluid is inflammatory or says bile peritonitis. The cell type in the fluid is key to the direction here along wihtt he TR velocities and cvc/ao ratio.

  3. Ascites algorithm which may

    Ascites algorithm which may help.

    Not a great image. Available in most texts.

     

     

  4. Not sure why Ascites from R

    Not sure why Ascites from R sided heart disease would be blood tinged unless from the tap

  5. Thanks, I will pass the info

    Thanks, I will pass the info along.  I don’t work at the practice, they just call me in for imaging. I hope they did/will do fluid analysis on the fluid but I wouldn’t bet on it.  It’s an interesting case with both significant cardiac and abdominal disease.

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