Pericardial Disease in Cats

Symptoms of pericardial disease may be the same as or similar to symptoms of other heart conditions. Early detection of pericardial disease is key for preventing cardiac tamponade – the buildup of pressure on the heart – which is a life-threatening condition. Seek immediate veterinary attention as soon as you notice any of the following symptoms:

• Lethargy
• Difficulty breathing
• Collapse or loss of consciousness
• Weak pulse
• Low blood pressure
• Vomiting
• Loss of appetite
• Weight loss
• Diarrhea
• Coughing

A variety of serious conditions can cause pericardial disease in cats, including, but not limited to:

• Cancer
• Bacterial infection
• Congestive heart failure
• Rupture of the left atrium
• Pericardial effusion: The buildup of fluid in the pericardium
• Peritoneopericardial diaphragmatic hernia: A congenital or traumatic defect in which the diaphragm is malformed or disrupted, allowing abdominal organs to move into the chest cavity
• Constrictive pericarditis: A condition in which the pericardium is thicker than normal and prevents normal heart function
• Septic pericarditis: A secondary condition of bacterial or fungal infection

The vet will make a tentative diagnosis based on a thorough physical examination and presentation of symptoms. Be sure to inform your vet of the extent and duration of your cat’s symptoms, as well as any previous history of heart problems or defects.

The vet can make a definitive diagnosis through a number of tests, depending on the symptoms present and the suspected underlying cause. Electrocardiography (ECG) is a standard diagnostic method for heart problems. Other tests may include ultrasound, chest and abdominal x-rays, biopsy, and pericardial fluid analysis.

Treatment will vary based on the severity and the underlying cause of the condition and ranges from drug therapy to surgery. The primary objectives of treatment are to reduce the buildup of fluid in the pericardium and resolve the underlying condition. Your vet will be able to advise you on a treatment plan based on your cat’s specific needs.

If cardiac tamponade has been confirmed, the vet will perform a pericardiocentesis, which involves draining the excess fluid from the pericardium. Pericardiectomy, or partial removal of the pericardium, may also be utilized. Bacterial infections are typically treated with a broad-spectrum antibiotic regimen and pericardiocentesis. If cancer is the underlying cause, treatment methods may vary depending on the location and stage of the cancer, and range from radiation and chemotherapy to surgery.

Constrictive pericarditis causative of pericardial disease is typically treated with surgery. The surgical procedure depends on the thickness of the pericardium and the degree to which the epicardium, or the inside layer of the pericardium that is attached to the heart, is involved. Pericardiectomy is the procedure of choice for most cases. Epicardial stripping may be required for more severe cases; this is a more complex procedure with a higher risk of mortality.

If the cat has suffered from a peritoneopericardial diaphragmatic hernia, it will be corrected with surgery. This will involve moving any displaced abdominal organs back into the abdominal cavity and repairing the diaphragm. The cat will be hospitalized for a few days in order to recover, and intravenous fluid and nutritional therapy will be required. 

Recovery and prognosis are dependent upon the severity of the condition and the underlying cause. Always follow your vet’s post-treatment and/or post-operative instructions carefully.

If pericardial disease is a result of a bacterial infection, it is imperative that you administer any prescribed antibiotics for the entire recommended duration of treatment even if the condition starts to improve. Failure to do so could result in aggressive recurrence and may cause further heart problems.

If your cat has undergone surgery, ensure it has a warm, safe place to rest upon the return home. Do not allow it to irritate the surgery site; an Elizabethan collar may help with this. Prevent your cat from engaging in excess activity or play for the recommended recovery period.

Your vet may schedule follow-up appointments as needed to monitor the condition. If you have any questions, or if the condition seems to be recurring, contact your vet immediately.