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DCM + small to moderate pericardial effusion in a small breed dog

Sonopath Forum

DCM + small to moderate pericardial effusion in a small breed dog

10 yr FS Schnoodle with hx of syncopal episodes, vomiting and lethargy.  Radiographs showed an enlarged heart, normal vasculature and lungs.  Echo showed a markedly dilated left ventricle and moderate left atrial enlargement (minimal right heart enlargement).  There was also a relatively small amount of pericardial effusion, but enough that I did appreciate some tamponade at the heart base.  Seems strange given the breed.  Prior to the echo, the dog was placed on pimobendan – owner did not think it had made much of a difference, but LVIDs and FS were both normal.

10 yr FS Schnoodle with hx of syncopal episodes, vomiting and lethargy.  Radiographs showed an enlarged heart, normal vasculature and lungs.  Echo showed a markedly dilated left ventricle and moderate left atrial enlargement (minimal right heart enlargement).  There was also a relatively small amount of pericardial effusion, but enough that I did appreciate some tamponade at the heart base.  Seems strange given the breed.  Prior to the echo, the dog was placed on pimobendan – owner did not think it had made much of a difference, but LVIDs and FS were both normal.  Wondering how often you see pericardial effusion with a case like this and the potential for it vs. the DCM to be causing the syncope.  I have recommended full blood work including coags + UA and then pericardiocentesis (dog is stable right now), but owner has declined.  I am concerned about the pimobendan if the effusion worsens.

I can upload some pics on Friday, but did not retrieve them today.  

Comments

kromero

I’ve added some clips –

I’ve added some clips – hoping someone could give some input.  Thank you

EL

No need for pimo here and may

No need for pimo here and may hurt the scenario. There is definitive pc effusion but no right auricular collapse yet at least not in these views so no overt tamponade. I dont see a mass in the RAUR but could be out of view. I would scan the abdomen looking for something HSA-ish first and try more oblique views of the right auricle (Position3 SDEP Echo download available here if you don;t have it  https://sonopath.com/products/downloadable)  then tap the pc and analyze the fluid but avoid pimo lasix enaliopril or any of those with pc effusion in dogs. DDX neoplasia, idiopathic, pericarditis. Curbside Guide has a chapter on latest on pc effusion/cardiac neoplasia as well   (https://sonopath.com/products/book).

kromero

Thank you very much, Eric.  

Thank you very much, Eric.  

randyhermandvm

I would also suggest an EKG

I would also suggest an EKG to make sure the syncope is not due to an arrhythmia.