Ascites in Dogs

Ascites is common in cases of organ failure or low protein levels, such as in the case of nephrotic syndrome. Fluid and blood can leak into the abdominal cavity from diseased organs, from parasitic migration, from leaks in the tricuspid valve in the heart, or from blocked blood vessels due to high blood pressure. This accumulation of fluid can cause discomfort, pain, and difficulty breathing, as the fluid puts pressure on the organs in the body. While ascites can be treated with a combination of therapies, it will most likely return if the underlying condition is not successfully treated.

Ascites refers to the accumulation of fluid in the abdominal cavity, causing a distension of the abdomen. This is a secondary condition of a more serious issue, such as heart failure, liver disease, or cancer, and needs to be investigated immediately to identify and treat the underlying condition.

The general symptoms of ascites in dogs include:

• Distension of the abdomen due to fluid accumulation
• Lack of appetite
• Difficulty breathing
• Abdominal discomfort
• Abdominal pain

Due to the range of serious conditions that can cause ascites, other symptoms may be present that can point to the underlying problem, and should be reported to your veterinarian. These can include:

• Confusion
• Lethargy
• Decreased stamina
• Coughing
• Shock
• Anorexia
• Depression
• Vomiting
• Decreased defecation
• Diarrhea
• Fainting
• Difficulty sleeping
• Excessive panting
• Pale or bluish gums
• Seizures 
• Increased urination
• Increased thirst

The underlying causes of ascites in dogs include:

• Nephrotic syndrome
• Congestive heart failure
• Right heart failure
• Chronic liver failure
• Portal hypertension
• Kidney failure
• Malnutrition
• Hypoalbuminemia, or low albumin levels
• Lymphoma
• Peritonitis, or inflammation of the membranes lining the abdomen
• Hookworm infection, especially in young dogs

Your veterinarian will start by confirming the presence of ascites in your dog, and will then search for the underlying cause. This begins with a physical exam, considering all the symptoms present, and any you have reported. A fluid thrill test by palpating the abdomen may reveal the presence of a fluid wave. A CT scan or ultrasound may be used to confirm the presence of fluid. Blood samples will be collected for testing. The peritoneal fluid, or abdominal fluid, may be collected by a syringe for analysis, this is an abdominocentesis. The fluid will be tested for abnormalities, and the presence of bacteria, fungus, or any other cause of peritonitis.

Other tests can include fecal samples, a urinalysis, X-rays, MRIs, EKGs, and echocardiographs for heart issues. If a specific condition is suspected, further diagnostic testing can include biopsies of tissues or organs.

Treatment of the condition of ascites itself includes incorporating a restricted sodium diet. This is unlikely to eliminate the abdominal fluid alone, and in that case, diuretics may be used to increase the elimination of sodium through the urine. Prescribed diuretics can include spironolactone and furosemide. Your dog should be reevaluated regularlyto adjust medications as needed.

If the ascites is causing considerable discomfort, a significant loss of appetite, or difficulties in breathing, an abdominocentesis may be performed to manually remove only enough fluid to improve your dog’s comfort level. This is accompanied by the administration of polyionic fluids and diuretic therapy. Once the ascitic fluid is mobilized, diuretic therapy with a concurrent low sodium diet may be continued.

The underlying condition that caused the ascites needs to be treated as well. This therapy will be dependent on the condition itself. Treatments can include medications, such as antimicrobials, beta blockers, hepatic protectorants, anti-inflammatories, or antibiotics; replacement of fluids, blood, plasma, or electrolytes; surgeries to remove tumors; or standard cancer treatments. Your veterinarian will discuss the disease and the risks involved and create a treatment plan specific to your dog.

With concurrent treatments, ascites in your dog can be reduced and managed. You may be sent home with medications and a specific dietary plan, and may have future visits scheduled.

However, recovery will ultimately depend on the success of treatments for the underlying condition. If the ascites is resolved, but the underlying problem is not, the ascites may return. 

Your veterinarian will discuss any home care specific to your dog’s situation, which may include further medications to administer, post-operative care, dietary changes, and future veterinary visits for treatments, or to adjust therapy as needed.

Ascites can be expensive to treat. To avoid high vet care expenses, secure pet health insurance today. The sooner you insure your pet, the more protection you’ll have from unexpected vet costs.