What are Ascites?
Ascites is common in cases of organ failures 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 fluids can cause discomfort, pain, and difficulties 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.
Symptoms of Ascites in Dogs
The general symptoms of ascites in dogs include:
- Distension of 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
Causes of Ascites in Dogs
The underlying causes of ascites in dogs include:
- Nephrotic syndrome
- Congestive heart failure
- Right heart failure
- Chronic liver failure
- Portal hypertension
- Kidney failure
- Malnutrition
- Abnormally low protein
- Hypoalbuminemia, or low albumin levels
- Lymphoma
- Peritonitis, or inflammation of the membranes lining the abdomen
- Hookworm infection
Diagnosis of Ascites in 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 fluid. A CT scan or ultrasound may be used to confirm the presence of fluid. Blood samples may be collected for testing. The peritoneal fluid, or abdominal fluid, may be collected by a syringe after administering medication to prevent shock. The fluid and blood 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 Ascites in Dogs
Treatment of the condition of ascites itself includes incorporating a restricted sodium diet. This may not be sufficient 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 every 7 to 10 days to 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 perform a liver transplant; or standard cancer treatments. Your veterinarian will discuss the disease and the risks involved and create a treatment plan specific to your dog.
Recovery of Ascites in Dogs
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 Questions and Advice from Veterinary Professionals
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My rottweiler 5 months. Has got fluid incstomach. We had his fluid removed. And he was fit. But after a few days my vet says the fluid is now once again in his stomach. His ascites is due to liver problem. Please help.
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The medications which Oscar is receiving would indicate that he has some infection causing destruction of red blood cells. There are many causes of ascites in dogs and determining whether the cause is primary or secondary would be important in directing treatment. Causes of ascites include infections, congenital anomalies (common in puppies), low blood protein, peritonitis, parasites, heart failure (unlikely in puppies), liver disease and kidney disease; it would be important to run a blood test to determine blood counts and blood biochemistry as well as possibly an ultrasound (to check for hepatic arteriovenous malformation) so that treatment can be directed appropriately. Regards Dr Callum Turner DVM
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My dog Oscar had fluid accumulation in his stomach.he had his fluid removed and now it has starting to buiLD up fluid again.we got his blood test and everything was alright but blood urea and creatinine was just above the level.my vet said he had ascites.please recommend his treatment. he also told he had liver prblm
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An increase in blood urea and creatinine levels would indicate some kidney disease; treatment for ascites is usually removal of fluid using lasix (furosemide) for removal through the kidneys, dietary management of low (but high quality) protein with low sodium will help relieve stress on the liver and the kidneys. Still the primary cause of the liver and kidney problems needs to be established by your Veterinarian so that more than just symptomatic treatment is given; ascites is a symptom not a disease. Regards Dr Callum Turner DVM
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My 10 year old Chihuahua was diagnosed with CHF and right side heart failure back in November of last year. An initial injection of Lasix removed the build up of Acites and he was then put on two half tablets a day. He was doing well until about a month ago and slowly over the past month his Abdomen again started swelling, we had the fluid drained about 18 days ago and now the fluid has returned at an even higher level. He is now eating substantially less and is obviously uncomfortable. He is still drinking, weeing and walking around okay. I am at a loss whether to have the fluid drained again and then the cardiologist said she could put him on a significantly higher dose of lasix and see how he goes and if the fluid will stay away for longer. We are not opting for heart surgery. I would like your opinion if I am being cruel in trying to pro long his life and if the abdocentisis is a painful procedure. Thanks Jo
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Managing cases of congestive heart failure can be a fine balancing act, not all dogs respond to treatment and treatment may stop being effective literally overnight. Increasing the dose of furosemide is an option, or changing to other diuretic with a different mechanism of action, if the Cardiologist feels it is suitable in Charlie’s case (difficult to comment as I haven’t examined Charlie or seen his numbers). Abdominocentesis (abdomen tap) causes pain and discomfort, but the benefit of the fluid being drained outweighs the negatives. Prolonging lifespan shouldn’t be confused with prolonging healthspan, you need to do the best for Charlie, but as his owner, you know him better than anyone and will know the right time. Regards Dr Callum Turner DVM
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Blood analysis shows decrease in protein and albumin but the cause is unknown. He has chronic diarrhea & GI issues altho controlled by Tylan powder and metronidazole. Liver and kidneys are good. Vet recommended ultrasound which confirmed fluid leaking into the gut and liver/kidneys looked normal. Other alternatives are biopsy but protein/albumin so low is not recommended due to risk of healing and/or infection. He had 350cc's drained but 12 days later, stomach seems bloated and tight again. Endoscopy was recommended but will give limited diagnosis. Chronic draining wasn't recommended as an alternative. I understand the cause must be found for treatment but right now, GI specialist recommends blood analysis again, with another ultrasound and ultimately a biopsy. He was put on 15mg prednisone. Please advise. Greatly appreciate it very much.
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Normally when you visit a Specialist, they will retake all the tests that the referring Veterinarian took to make sure that the results are showing similar levels and to see if there is any further progression in the condition since the tests were taken previously. Low blood albumin may be caused by liver and kidney disease, absorption disorders, protein losing enteropathy, pancreatitis, some infections or poor food quality. Further investigation is required, as otherwise you would be treating symptoms and not the underlying condition. Regards Dr Callum Turner DVM
I don't want my dog to suffer and to go thru a bull biopsy of his stomach if we are to find he's got some abnormalities with his organs, etc. My vet actually said if it was her dog, she'd be worried about the recovery because of the low albumin/protein. I want him to have a quality of life without suffering is my most biggest concern. I'm so worried about him. Thank you for any advice you can give me.
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My 16 year old dachshund went to the vet in December and she had liver damage and I want to say a grade 3 heart murmur. The vet gave her medicine to coat her liver and protect and she has been on a boiled chicken and rice diet ever since. I ran out of the medicine and have been barely surviving financially so I have not been able to get her medicine refilled. Now her belly has swollen so big that she can barely walk and when she does she is all off balance. She still has an appetite. I am taking her to the vet Monday. What is the most likely cause and can it be treated? She is my baby and I know she has lived a long life but I want to do anything I can to to help her live.
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Ascites (fluid in the abdomen) is a common symptom of liver disease and is generally due to low levels of protein in the blood. In some cases, ascites may be managed with diuretics which promotes the excretion of retained water by urination; however, in severe cases diuretics may not be enough and regular draining of the abdomen may be required. Your Veterinarian would most probably want to take another round of blood tests to see if there has been an increase in values since the last test. Regards Dr Callum Turner DVM
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Hi, my 2 year and 7 month old douge de bordeaux was diagnosed with ascites almost a month back. His heart is not able to pump enough blood to the body which results in water accumulation around stomach area. Since then there have been regular vet visits. Once in a week I go to vet and almost 3.5-5 litre of water is drained. His stomach area bloats and he's not able to sleep or lie down. As per doc this cannot be cured and we have to keep draining water every week along with medication. He has lost around 15 kg weight. He was 66kg at peak and now he's 51 kg
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Bruno is already on diuretics to expel fluid from his body; usually treatment consists of diuretics and treatment or management of the underlying condition. If the symptoms are progressing, you may need to have a conversation about his quality of life and overall welfare. Regards Dr Callum Turner DVM
my 8 month labra is suffering from Acities what to do for recovery
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Hey Doc. I have a 4 year old English Bully, he's showing these same symptoms. I took him to the hospital, and thru his blood work and xrays they are saying that he has fluid in the abdomen and it's his pancreas, they prescribed him tramadol and clavamox and fluid under his skin its been 48 hrs and im not seeing any signs of him improving,is this normal? How long will it take for him to recover? Will this be a lifelong disease for him? Do you think that this waa a proper diagnosis?
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My 7 year old Bloodhound, Winston, has been suffering from Ascites now for almost (2) months. I have taken him to (5) vets now, (3) of which are supposed specialist, we still do not have a diagnosis. He has had numerous blood tests, fluid tests, an ultrasound & (2) echoes - the pet cardiologists confirmed yesterday it is not heart disease or congestive heart failure. I also have him on a prescription, low fat diet, a diuretic & giving him a b-12 shot once a week. Although cancer has not been ruled out, it has not been detected with any of the testing either. We have had the fluid drained (4) times now - each time being around 5-6 liters & it is accumulating on a weekly basis now. Although the fluid makes him uncomfortable, he is eating, drinking well & having no issues with digestion/diarrhea. We have now spent close to $4K & I literally have no answers & I am at my wits end. He is an extremely happy, laidback boy & this is so extremely frustrating & heartbreaking. I cannot justify putting him down, but we are at a loss......Any, any advice would be greatly appreciated.
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There are many different causes for ascites in pets and is a symptom rather than a condition in it’s own right. Causes of ascites include heart failure, infection, peritonitis, kidney disease, liver disease, portal hypertension, low blood protein, cancer and hormonal conditions (like Cushing’s Disease). I do not think I will be able to add anything more than two Veterinarians and three Specialists; it may be a case of diuretic therapy and draining until an underlying cause is found. Regards Dr Callum Turner DVM
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Hello doc
My rott Oscar had fluid build up in his abdomen from the last 6 months.we took him to the Indian vet research institute where they tested his blood .the report indicated that blood urea and creatinine are slightly increased .his blood also tested negative for any blood parasite also.his ascitic fluid report indicated that the fluid was haemmoragic .so he had there his fluid tapped. But after two weeks fluid build up started.so our local vet incorrectly tapped him and now fluid has accumulated between the abdomen and skin.please advice us.
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I cannot see how fluid from the abdomen would go under the skin from an abdominocentesis; if there is an open umbilicus, fluid may pass through to under the skin or this may be subcutaneous edema. A more comprehensive examination is needed; an ultrasound would be my next step to look at the liver, kidneys and pancreas to look for structural problems as well as monitoring blood protein levels and cardiac function. Regards Dr Callum Turner DVM
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Hi, ascites on ultrasound and two undefined masses. Low albumin on bloods, less energy. Bowel motions occasionally hard. Planned bile acid stimulation test considered lacking in value following ultrasound findings. Advised further investigation possible but fairly certain advanced cancer. I am not keen to subject her to multiple stressful vet visits ( she does hate going) and so think palliative care is preferred route. I know dogs can tolerate chemo better than humans and cost is not a deterrent but if diagnosis is definite I would not choose further investigation. Do you feel ultrasound and symptoms can be definite or should I have accepted lab analysis of the fluid. Nine years old shepherd.
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My dog was diagnosed with liver problems a couple months ago she had really high alp levels. She's been taking ursodiol, denamarin, vitamin E, and some other meds that I can't remember the name to. But she is currently very bloated her stomach is really big now and they gave her some pills to help her drink a lot of water so she can urine often but it's not working she's still really bloated she is a small dog and her stomach is really big she hasn't been eating well I can't get her to eat more than one can a day. She's on a diet where all she's eating is canned ID and WD. What advice do you guys have on what I should do?? Her vet isn't giving me many options besides a liver biopsy but she is telling me that my dog will most likely not get better. But what can I do to keep her comfortable ?
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She had an ultrasound done, she's had two tests to recheck her alp levels but they did not decrease. The next step would be liver biopsy but her vet told me she cannot guarantee that she will be okay. She is due to be put down on Monday but I really want to look for more options do you think there are other medications that will help??? We believe that the cause for this was she ate all the medication my other dog was on which were some pain meds because ever since then she started losing weight and stopped eating. If you think there is something else that can be done please let me know I want to give her any chance she can have
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By your recommendation we got him a blood test.his RBC count,Haemoglobin and other things are fine,but blood urea and creatinine is just above the level.can you reccomend some medications