Clinical approach to etiology, diagnosis, and treatment in dogs with pericardial effusion - a retrospective study

Abstract

In this study, signalement, presenting clinical signs, results of diagnostic investigations and therapeutic outcomes of 17 dogs with pericardial effusion (PE) were evaluated retrospectively. Common findings were exercise intolerance (70%), muffled heart sound (60%) and ascites (50%). ECG showed low voltage QRS (60%) and supraventricular tachycardia (40%). Radiological findings revealed enlarged and globoid cardiac silhouette in all dogs. PE was confirmed by echocardiographic examinations, which was due to intracardiac neoplasia (n=6) or non-neoplastic causes [dilated cardiomyopathy (n=5), right-sided heart failure (RSHF, n=2), and idiopathic (n=4)]. In dogs with RSHF, Doppler-derived pulmonary hypertension was also observed. Analysis of pericardial fluids that was collected by pericardiocentesis showed a hemorrhagic effusion in dogs with intracardiac neoplasia, and transudate in the rest. In 4 dogs with neoplastic PE, pericardiectomy and tumor resection were performed. Histopathological examinations revealed an aortic body adenoma (n=1), aortic body carcinoma (n=1), papillary mesothelioma (n=1) and malignant epitheloid mesothelioma (n=1). In 2 dogs, neoplastic PE could not be classified. Dogs were treated medically for heart failure and neoplasia, as well. Prognosis was better for the first 12 months in dogs with non-neoplastic PE. In conclusion, echocardiographic examination is the best means to diagnose PE. In practice, when added to physically examination findings echocardiography also provides solid information in determining prognosis of PE due to neoplasia versus non-neoplastic causes. Survival time may be extended by pericardiectomy in the case of neoplastic PE, as well.