Pericardial Disease in Dogs

The pericardium has a two layer membrane that encompasses the heart; the layer closest to the heart is the visceral layer (epicardium), and the outer is the parietal layer. The space between the two layers is called the pericardial space, which contains a small amount of fluid. The pericardium is inflexible and does not expand easily. When there is an accumulation of pericardial fluid it affects blood circulation and results in distended veins and accrual of fluid in the abdomen. In addition, pericardial disease only allows a small amount of oxygen to get to the body’s tissues.  

Dogs with pericardial disease typically are middle age, male and medium to large in size. The disease is most common in Great Danes, Weimaraners, Boxers, Golden Retrievers and in the Great Pyrenees breeds. Pericardial disease is life threatening to your pet, if left untreated.

Pericardial disease is a rare heart disease that causes an excessive amount of pericardial fluid to build-up within the pericardial space. The pericardial fluid compresses the heart and limits the capacity to pump blood; the heart is unable to beat normally.

Symptoms may include one or more of the following:

• Difficulty in breathing
• Weakness
• Collapse 
• Pale gums
• Lack of appetite
• Weight loss
• Tires easily
• Abdominal distention
• Weak pulse

• Cancer is the most common cause (cancer of the blood cells or hemangiosarcoma)
• Idiopathic (no cause is established)
• Trauma to the heart or chest
• Bacterial infection
• Fungal infection

The veterinarian will take a thorough medical history of your dog.  Let your veterinarian know if your pet is on any current medication.  A log of when the symptoms occurred may be helpful to prepare before going to the veterinarian.  The veterinary caregiver will do a physical examination  of your pet which may include:

• Palpation of the stomach 
• Listen to his lungs and heart with a stethoscope
• Dog’s general body condition (weight, skin, coat)
• Take a look inside his ears and mouth
• Take his temperature
• Blood pressure checked

The physical examination of the patient may have determined if there were any muffled heart sounds, abdominal distension, distended jugular veins, tachycardia, breathing difficulties or high blood pressure.

After the physical exam the veterinarian may recommend a complete blood count (CBC), chemical profile, and a urinalysis to determine the overall health of your pet. Some patients with pericardial disease have anemia, so a complete blood count will help determine if your dog is anemic. Chest x-rays will help establish if there are any abnormalities in the size and shape of the heart. An ECG (electrocardiograph) can record the electrical action in your dog’s heart.

Another diagnostic test that your veterinarian may suggest is an echocardiogram (ultrasound of the heart) this procedure can help determine if cancer is the cause of pericardial disease.

If your pet is diagnosed with pericardial disease your veterinarian will discuss the best treatment plan for your dog. Your veterinarian may decide to remove the fluid from the pericardial sac.  Your pet will need to have general anesthesia for this procedure.  A catheter is inserted into the layers of pericardial and the fluid is removed. The pericardial fluid may need to be removed several times. Samples of fluid extracted will be sent to be analyzed, this is helpful to identify infectious pericarditis. If fluids have accumulated in your pet’s stomach, the veterinarian may prescribe diuretics.

If there is an infection your pet will be given antibiotic to take. Dogs with idiopathic pericarditis may also be given corticosteroid medication to help reduce inflammation. In severe cases of pericardial disease, the surgical removal of the dog’s pericardium may be necessary to prevent further occurrences. If it is determined that the cause of the pericardial disease is cancer your pet may have to undergo surgery and chemotherapy.

The recovery of pericardial disease depends on what the cause was.  Canines with idiopathic pericardial disease typically have good prognosis. Dogs that have pericardial fluid due to infection or trauma also have good prognosis.  It is very important to follow your veterinarian’s treatment plan for your pet. Follow-up visits will be needed to check on your pet’s progress.  Your veterinarian may want to retake x-rays and an echocardiogram (ultrasound of the heart). Unfortunately, canines that are diagnosed with a heart tumor have a poor prognosis.  Patients with hemangiosarcoma may only have a few months to live.