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

Year 2016, Volume: 63 Issue: 3, 289 - 296, 01.09.2016

Meriç Kocatürk Hakan Salcı Volkan İpek Nureddin Çelimli Zeki Yılmaz

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

Keywords

Echocardiography electrocardiography pericardial effusion pericardiectomy dog

References

  • Adeyanju JB, Perry R, Yakubu AS, et al. (2012): Idiopathic pericardial effusion in 2-year-old labrador managed with ultrasound-guided pericardiocentesis: Case report. Sokoto J Vet Sci, 10, 36-39.
  • Atencia S, Doyle RS, Whitley NT (2013): Thoracoscopic pericardial window for management of pericardial effusion in 15 dogs. J Small Anim Pract, 54, 564-9.
  • Boddy KN, Sleeper MM, Sammarco CD, et al. (2011): Cardiac magnetic resonance in the differentiation of neoplastic and nonneoplastic pericardial effusion. J Vet Intern Med, 25, 1003-9.
  • Bonagura JD, Pipers FS (1981): Echocardiographic features of pericardial effusion in dogs. J Am Vet Med Assoc, 179, 49-56.
  • Boon JA (1998): Manual of Veterinary Echocardiography. 356-371. Williams and Wilkins, Baltimore.
  • Bruch C, Schmermund A, Dagres N, et al. (2001): Changes in QRS voltage in cardiac tamponade and pericardial effusion: reversibility after pericardiocentesis and after anti-inflammatory drug treatment. J Am Coll Cardiol, 38, 219-226.
  • Buchanan JW, Bucheler J (1995): Vertebral scale system to measure canine heart size in radiographs. J Am Vet Med Assoc, 206, 194-199.
  • Cagle LA, Epstein SE, Owens SD, et al. (2014): Diagnostic yield of cytologic analysis of pericardial effusion in dogs. J Vet Intern Med, 28, 66-71.
  • Case JB, Maxwell M, Aman A, et al. (2013): Outcome evaluation of a thoracoscopic pericardial window procedure or subtotal pericardectomy via thoracotomy for the treatment of pericardial effusion in dogs. J Am Vet Med Assoc, 242, 493-8.
  • Chun R, Kellihan HB, Henik RA, et al. (2010): Comparison of plasma cardiac troponin I concentrations among dogs with cardiac hemangiosarcoma, noncardiac hemangiosarcoma, other neoplasms, and pericardial effusion of nonhemangiosarcoma origin. J Am Vet Med Assoc, 237, 806-11.
  • Côté E, Schwarz LA, Sithole F (2013): Thoracic radiographic findings for dogs with cardiac tamponade attributable to pericardial effusion. J Am Vet Med Assoc, 243, 232-5.
  • Dunning D, Monnet E, Orton C, et al. (1998): Analysis of prognostic indications for dogs with pericardial effusion: 46 cases (1985-1996). J Am Vet Med Assoc, 212, 1279-1280.
  • Guglielmini C, Diana A, Santarelli G, et al. (2012): Accuracy of radiographic vertebral heart score and sphericity index in the detection of pericardial effusion in dogs. J Am Vet Med Assoc, 241, 1048-55.
  • MacGregor JM, Faria ML, Moore AS, et al. (2005): Cardiac lymphoma and pericardial effusion in dogs: 12 cases (1994-2004). J Am Vet Med Assoc, 227, 1449-1453.
  • Olivier NB (2002): ECG of the month. J Am Vet Med Assoc, 1154-1155.
  • Pepi M, Muratori M (2006): Echocardiography in the diagnosis and management of pericardial disease. J Cardiovasc Med, 7, 533-544.
  • Root C, Bahr R (1994): The heart and great vessels. 316- 317. In: D Thrall (Ed), Textbook of Veterinary Diagnostic Radiology. WB Sounders Co., Philadelphia.
  • Scollan K.F, Bottorff B, Stieger-Vanegas S, et al. (2015): Use of Multidetector Computed Tomography in the Assessment of Dogs with Pericardial Effusion. J Vet Intern Med, 29, 79-87.
  • Serres FJ, Chetboul V, Tissier R, et al. (2006): Doppler echocardiography-derived evidence of pulmonary arterial hypertension in dogs with degenerative mitral valve disease: 86 cases (2001-2005).J Am Vet Med Assoc, 229, 1772-1778.
  • Shoemaker W (2000): Pericardial tamponade. 1097- 1101. In: A. Grevnik (Ed), Textbook of Critical Care. WB Saunders Co., Philadelphia.
  • Sisson A, Thomas WP, Ruehl WW, et al. (1984): Diagnostic value of pericardial fluid analysis in the dog. J Am Vet Med Assoc, 184, 51-55.
  • Sisson D, Thomas W (1999): Pericardial disease. 668- 669. In: PR Fox, NS Moise (Eds), Textbook of Canine and Feline Cardiology Principles and Clinical Practice – II. W.B. Sounders Co., Philadelphia.
  • Stephen R, Withley N, Dubielzig R (2000): Idiopathic or mesothelioma-related findings and survival in 17 dog studied retrospectively. J Small Anim Pract, 41, 342-347. effusion: Clinical
  • Witt A, Mathews K (2000): Successful management of traumatic right atrial rupture. J Vet Emerg Crit Care, 10, 85-89. Geliş tarihi: 02.03.2015 / Kabul tarihi: 08.07.2015 Address for correspondence : Zeki YILMAZ, DVM, PhD, Prof. Uludağ University, Faculty of Veterinary Medicine, Department of Internal Medicine, Animal Hospital, Bursa, Turkey. e-mail: zyilmaz@uludag.edu.tr

Perikardiyal efüzyonlu köpeklerde etiyoloji, tanı ve tedaviye klinik yaklaşım – retrospektif bir çalışma

Year 2016, Volume: 63 Issue: 3, 289 - 296, 01.09.2016

Meriç Kocatürk Hakan Salcı Volkan İpek Nureddin Çelimli Zeki Yılmaz

Abstract

Bu çalışmada, retrospektif olarak perikardiyal efüzyonlu (PE) 17 köpeğin signalement, klinik bulgu, diagnostik araştırma ve terapötik sonuçları ele alınmıştır. PE intrakardiyak neoplazi (n=6) veya non-neoplastik nedenlerden [dilate kardiomiyopati (n=5), sağ kalp yetmezliği (RSHF, n=2) ve idiopatik (n=4)] ileri gelmişti. Yaygın bulgular egzersiz intoleransı (%70), boğuk kalp sesleri (%60) ve asitesti (%50). Elektrokardiyografik olarak düşük voltajlı QRS (%60) ve supraventriküler taşikardi (%40) belirlendi. Ekokardiyografi ile PE olduğu doğrulanan tüm köpeklerde, radyolojik bulgular kalbin büyük ve globoid olduğunu gösterdi. RSHF’li köpeklerde, Doppler-derive pulmonar hipertansiyon belirlendi. Perikardiyosentezle alınan sıvı analizleri kardiyak tümörlü köpeklerde hemorajik efüzyonu, diğerlerinde ise transudat varlığını gösterdi. Neoplastik PE’lu 4 köpekte perikardiyektomi ve tümör rezeksiyonu yapıldı. Histopatolojik muayeneler aortik body adenom (n=1), aortik body karsinom (n=1), papillar mesoteliom (n=1) ve malignant epiteloid mesoteliomu (n=1) gösterdi. İki köpekte neoplastic PE sınıflandırılamadı. Köpekler etiyolojilerine göre medical olarak tedavi edildi. Non-neoplastik PE’li köpeklerin prognozları ilk 12 ay için daha iyiydi. Sonuç olarak, ekokardiyografik muayene PE tanısında en iyi yöntemdir. Pratikte fiziksel muayene bulguları ile birlikte değerlendirildiğinde ekokardiyografi neoplazik ve neoplazik olmayan PE’lerin prognozunun belirlenmesinde önemli katkılar sağlamaktadır. Neoplastik PE olgularında perikardiyektomi yaşam süresinin uzatılmasına katkı verebilir

Keywords

Ekokardiyografi elektrokardiyografi perikardiyal efüzyon perikardiyektomi köpek

References

  • Adeyanju JB, Perry R, Yakubu AS, et al. (2012): Idiopathic pericardial effusion in 2-year-old labrador managed with ultrasound-guided pericardiocentesis: Case report. Sokoto J Vet Sci, 10, 36-39.
  • Atencia S, Doyle RS, Whitley NT (2013): Thoracoscopic pericardial window for management of pericardial effusion in 15 dogs. J Small Anim Pract, 54, 564-9.
  • Boddy KN, Sleeper MM, Sammarco CD, et al. (2011): Cardiac magnetic resonance in the differentiation of neoplastic and nonneoplastic pericardial effusion. J Vet Intern Med, 25, 1003-9.
  • Bonagura JD, Pipers FS (1981): Echocardiographic features of pericardial effusion in dogs. J Am Vet Med Assoc, 179, 49-56.
  • Boon JA (1998): Manual of Veterinary Echocardiography. 356-371. Williams and Wilkins, Baltimore.
  • Bruch C, Schmermund A, Dagres N, et al. (2001): Changes in QRS voltage in cardiac tamponade and pericardial effusion: reversibility after pericardiocentesis and after anti-inflammatory drug treatment. J Am Coll Cardiol, 38, 219-226.
  • Buchanan JW, Bucheler J (1995): Vertebral scale system to measure canine heart size in radiographs. J Am Vet Med Assoc, 206, 194-199.
  • Cagle LA, Epstein SE, Owens SD, et al. (2014): Diagnostic yield of cytologic analysis of pericardial effusion in dogs. J Vet Intern Med, 28, 66-71.
  • Case JB, Maxwell M, Aman A, et al. (2013): Outcome evaluation of a thoracoscopic pericardial window procedure or subtotal pericardectomy via thoracotomy for the treatment of pericardial effusion in dogs. J Am Vet Med Assoc, 242, 493-8.
  • Chun R, Kellihan HB, Henik RA, et al. (2010): Comparison of plasma cardiac troponin I concentrations among dogs with cardiac hemangiosarcoma, noncardiac hemangiosarcoma, other neoplasms, and pericardial effusion of nonhemangiosarcoma origin. J Am Vet Med Assoc, 237, 806-11.
  • Côté E, Schwarz LA, Sithole F (2013): Thoracic radiographic findings for dogs with cardiac tamponade attributable to pericardial effusion. J Am Vet Med Assoc, 243, 232-5.
  • Dunning D, Monnet E, Orton C, et al. (1998): Analysis of prognostic indications for dogs with pericardial effusion: 46 cases (1985-1996). J Am Vet Med Assoc, 212, 1279-1280.
  • Guglielmini C, Diana A, Santarelli G, et al. (2012): Accuracy of radiographic vertebral heart score and sphericity index in the detection of pericardial effusion in dogs. J Am Vet Med Assoc, 241, 1048-55.
  • MacGregor JM, Faria ML, Moore AS, et al. (2005): Cardiac lymphoma and pericardial effusion in dogs: 12 cases (1994-2004). J Am Vet Med Assoc, 227, 1449-1453.
  • Olivier NB (2002): ECG of the month. J Am Vet Med Assoc, 1154-1155.
  • Pepi M, Muratori M (2006): Echocardiography in the diagnosis and management of pericardial disease. J Cardiovasc Med, 7, 533-544.
  • Root C, Bahr R (1994): The heart and great vessels. 316- 317. In: D Thrall (Ed), Textbook of Veterinary Diagnostic Radiology. WB Sounders Co., Philadelphia.
  • Scollan K.F, Bottorff B, Stieger-Vanegas S, et al. (2015): Use of Multidetector Computed Tomography in the Assessment of Dogs with Pericardial Effusion. J Vet Intern Med, 29, 79-87.
  • Serres FJ, Chetboul V, Tissier R, et al. (2006): Doppler echocardiography-derived evidence of pulmonary arterial hypertension in dogs with degenerative mitral valve disease: 86 cases (2001-2005).J Am Vet Med Assoc, 229, 1772-1778.
  • Shoemaker W (2000): Pericardial tamponade. 1097- 1101. In: A. Grevnik (Ed), Textbook of Critical Care. WB Saunders Co., Philadelphia.
  • Sisson A, Thomas WP, Ruehl WW, et al. (1984): Diagnostic value of pericardial fluid analysis in the dog. J Am Vet Med Assoc, 184, 51-55.
  • Sisson D, Thomas W (1999): Pericardial disease. 668- 669. In: PR Fox, NS Moise (Eds), Textbook of Canine and Feline Cardiology Principles and Clinical Practice – II. W.B. Sounders Co., Philadelphia.
  • Stephen R, Withley N, Dubielzig R (2000): Idiopathic or mesothelioma-related findings and survival in 17 dog studied retrospectively. J Small Anim Pract, 41, 342-347. effusion: Clinical
  • Witt A, Mathews K (2000): Successful management of traumatic right atrial rupture. J Vet Emerg Crit Care, 10, 85-89. Geliş tarihi: 02.03.2015 / Kabul tarihi: 08.07.2015 Address for correspondence : Zeki YILMAZ, DVM, PhD, Prof. Uludağ University, Faculty of Veterinary Medicine, Department of Internal Medicine, Animal Hospital, Bursa, Turkey. e-mail: zyilmaz@uludag.edu.tr
There are 24 citations in total.

Details

Primary Language English
Subjects Veterinary Surgery
Other ID JA95BM82ZK
Journal Section Research Article
Authors

Meriç Kocatürk

Hakan Salcı

Volkan İpek

Nureddin Çelimli

Zeki Yılmaz

Publication Date September 1, 2016
Published in Issue Year 2016Volume: 63 Issue: 3

Cite

APA Kocatürk, M., Salcı, H., İpek, V., Çelimli, N., et al. (2016). Clinical approach to etiology, diagnosis, and treatment in dogs with pericardial effusion – a retrospective study. Ankara Üniversitesi Veteriner Fakültesi Dergisi, 63(3), 289-296.
AMA Kocatürk M, Salcı H, İpek V, Çelimli N, Yılmaz Z. Clinical approach to etiology, diagnosis, and treatment in dogs with pericardial effusion – a retrospective study. Ankara Univ Vet Fak Derg. September 2016;63(3):289-296.
Chicago Kocatürk, Meriç, Hakan Salcı, Volkan İpek, Nureddin Çelimli, and Zeki Yılmaz. “Clinical Approach to Etiology, Diagnosis, and Treatment in Dogs With Pericardial Effusion – a Retrospective Study”. Ankara Üniversitesi Veteriner Fakültesi Dergisi 63, no. 3 (September 2016): 289-96.
EndNote Kocatürk M, Salcı H, İpek V, Çelimli N, Yılmaz Z (September 1, 2016) Clinical approach to etiology, diagnosis, and treatment in dogs with pericardial effusion – a retrospective study. Ankara Üniversitesi Veteriner Fakültesi Dergisi 63 3 289–296.
IEEE M. Kocatürk, H. Salcı, V. İpek, N. Çelimli, and Z. Yılmaz, “Clinical approach to etiology, diagnosis, and treatment in dogs with pericardial effusion – a retrospective study”, Ankara Univ Vet Fak Derg, vol. 63, no. 3, pp. 289–296, 2016.
ISNAD Kocatürk, Meriç et al. “Clinical Approach to Etiology, Diagnosis, and Treatment in Dogs With Pericardial Effusion – a Retrospective Study”. Ankara Üniversitesi Veteriner Fakültesi Dergisi 63/3 (September 2016), 289-296.
JAMA Kocatürk M, Salcı H, İpek V, Çelimli N, Yılmaz Z. Clinical approach to etiology, diagnosis, and treatment in dogs with pericardial effusion – a retrospective study. Ankara Univ Vet Fak Derg. 2016;63:289–296.
MLA Kocatürk, Meriç et al. “Clinical Approach to Etiology, Diagnosis, and Treatment in Dogs With Pericardial Effusion – a Retrospective Study”. Ankara Üniversitesi Veteriner Fakültesi Dergisi, vol. 63, no. 3, 2016, pp. 289-96.
Vancouver Kocatürk M, Salcı H, İpek V, Çelimli N, Yılmaz Z. Clinical approach to etiology, diagnosis, and treatment in dogs with pericardial effusion – a retrospective study. Ankara Univ Vet Fak Derg. 2016;63(3):289-96.