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What is Pericardial Effusion?

The pericardium is a thin membrane that surrounds the heart similar to how a fetus is protected by the amniotic sac. It holds about 5 milliliters of fluid for lubrication and to protect the heart. Pericardial effusion is when the sac fills up with more fluid from various sources and compresses the heart and lungs. This can stop the heart ventricles from filling completely, which affects the heart’s ability to beat effectively. Although all breeds, sexes, and ages of dogs are susceptible, it is more common in Golden Retrievers and males about seven to nine years old.

Pericardial effusion is a life-threatening condition in dogs from a buildup of blood, pus, or another bodily fluid in the pericardial sac. This dangerous problem causes a huge pressure on the heart and slows its ability to pump blood through the body. It also puts pressure on the lungs, making breathing more difficult.  There are many causes of pericardial effusion such as cancer, infections, metabolic disorders, toxins, trauma, and cardiovascular disease.

Symptoms of Pericardial Effusion in Dogs

The signs of pericardial effusion can vary greatly depending on the underlying cause of the condition. Some of the most often reported include:

Congenital

  • Weakness
  • Coughing
  • Exercise intolerance

Inflammatory

  • Collapsing or fainting
  • Loss of weight
  • Fatigue
  • Pale gums

Cardiovascular

  • Respiratory distress
  • Rapid breathing
  • Increased heart rate

Toxic

  • Coughing
  • Wheezing
  • Extreme lethargy
  • Collapse
  • Death

Metabolic

  • Appetite loss
  • Abdominal distention
  • Weakness
  • Lack of interest in exercise
  • Weight loss

Infectious

  • Vomiting
  • Diarrhea (sometimes bloody)
  • Fever
  • Difficulty breathing

Neoplastic 

  • Weight loss
  • Vomiting
  • Exercise intolerance
  • No appetite
  • Weak heartbeat

Injury

  • Sudden coughing
  • Frothing at the mouth
  • Collapse
  • Death

Types

  • Congenital
  • Cancerous
  • Traumatic (injury)
  • Inflammatory
  • Infectious
  • Toxic
  • Metabolic
  • Cardiovascular
  • Idiopathic (unknown)
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Causes of Pericardial Effusion in Dogs

Sometimes, the cause of pericardial effusion is unknown, but there are also many causes that can include:

  • Idiopathic- No known cause

  • Congenital - Peritoneopericardial hernia, mitral valve dysplasia, congenital pericardial cysts, tricuspid dysplasia
  • Inflammatory – Endocarditis, pericarditis, myocarditis
  • Cardiovascular – Congestive heart failure, mitral valve disease
  • Toxic – Pesticides, radiation therapy, toxic plants
  • Metabolic – Kidney failure, liver failure, hypothyroidism
  • Infectious – Bacteria, parasites, fungi, tuberculosis
  • Neoplastic pericardial effusion – Malignant tumor, pericardial lipoma, hemangiosarcoma
  • Injury – Surgical complication, accident
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Diagnosis of Pericardial Effusion in Dogs

The first thing your veterinarian will want is your dog’s health history and immunization records if you have them. After that, a complete physical examination will be performed, which will likely include vital signs with special concentration on the heart. Auscultation, pulse, heart rate, breath sounds, and capillary refill time are all essential tests to evaluate the health of the heart. A simple blood test can detect a cardiac peptide in the blood that can detect heart failure and determine the severity as well. In addition, complete blood count (CBC), biochemical analysis, and blood cultures will be done to detect underlying conditions that may be the cause of the pericardial effusion. An echocardiogram (ECHO) shows the function and structure of the heart. Also, an electrocardiogram (ECG) is usually used to check the heart’s electrical function. Thoracic radiographs (x-rays) will show the size and shape of your dog’s heart.

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Treatment of Pericardial Effusion in Dogs

The treatment for pericardial effusion depends on the cause of the condition. However, the first thing the veterinarian will want to do is stabilize your dog. Once that is done, the veterinarian can treat the fluid build up.

Pericardiocentesis

To stabilize your dog, the veterinarian will need to remove the extra fluid from the pericardium. The fastest and least invasive way to do this is by performing a pericardiocentesis. The veterinarian will sedate your dog and use a catheter to slowly extract the fluid while watching the heart with echocardiography (ultrasound of the heart) to see what is going on. An electrocardiograph will also be used to watch for arrhythmia. The fluid will be sent to the laboratory for analysis. Your dog will be kept overnight for continuous cardiac monitoring due to the risk of arrhythmia and shock.

  • Congenital - If the problem is congenital, it may require surgery to repair a defect or medication to treat an ongoing issue
  • Cancerous - The veterinarian will most likely refer you to a veterinary oncologist for treatment due to the seriousness of the illness
  • Traumatic (injury) - A traumatic injury needs to be treated right away, usually with surgery
  • Inflammatory - Some of the inflammatory causes require medication such as diuretics and possibly antibiotics but it depends on the specific cause  
  • Infectious - Infections require medication such as antibiotics, antifungals, or antiparasitics
  • Toxic - Toxins require special treatment depending on the type of toxin and how long it has been since consumption. Usual treatments include prompting emesis, gastric lavage, fluid therapy, and medication
  • Metabolic - A metabolic disease or disorder is usually treated with medication
  • Cardiovascular - Cardiovascular conditions often require surgical repair and possible medication
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Recovery of Pericardial Effusion in Dogs

The prognosis depends on the cause of the pericardial effusion and how severe the problem is. In many cases, with immediate treatment, your dog could have a complete recovery. However, there are some causes of pericardial effusion that cannot be fixed and supportive treatment is all that can be given. If the condition is severe and unresponsive to treatment, euthanasia may be the only choice.

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Pericardial Effusion Questions and Advice from Veterinary Professionals

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Ask a Vet

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Codie Melendez

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Maltipoo

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10 Years

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Fair severity

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0 found helpful

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Fair severity

Has Symptoms

Vomiting With Diarrhea

Hello, I would like to share my very sad excruciating experience and loss of my 10-year-old Maltese bichon male dog named Codie, that I had since he was 8 weeks old, so on August 14th, 2018, I had to put him to sleep, the most horrible decision or mistake I've done, he started with diarrhea and vomiting which he has had before, and gave him Pepto Bismol vet's approval and bland chicken with rice diet, and went back to normal, so all this was in a matter of only 4 days the only symptoms was vomiting and diarrhea, the reason I took him to the vet was because his diarrhea didn't stop but his vomiting stopped in 2 days, the 3rd day I took him cause of his diarrhea, so they wanted so many tests for him which I couldn't afford which I know or thought I knew my dog because he has had these same symptoms in the past, so I told the vet to just give him medication, which the vet did, but on the 4th day August 14, I woke up to give him his medication, mind you when I took him to the vet the day before when I got him he was himself barking alert no symptoms of lethargic, coughing or difficulty breathing just very mild symptoms of an upset stomache which I thought he had, but on August 14 in the morning when I went to give him his medication he wasn't himself his breathing was heavy, not normal, but mind you he didn't have dire emergency symptoms, so on August 14 which a day I cannot forget, I took him to a different Vet and I did request all tests for him x-ray blood test everything, so the vet suggested an overnight observation with tests I agreed, so when I left the vet no more than half an hour I get a phone call saying for me to come pick up my dog I was confused cause I thought he was staying overnight observing him and running test, but didn't think twice just went to see what is going on, when I arrived the Vet sat me down to say they took a chest x-ray and found fluid around his chest area, so he suggested to take him to a heart specialist I was so confused and not in the right state of mind cause I was so scared for him, so long story short they reffered me to a specialist and they faxed his x-ray and got his diagnosis which it was Pericardial Effusion, but when I got to the other location I had hopes and the travel going there with Codie he didn't seem grave just not himself, so when I got to the other location no more than half hour or his Vet comes to me saying he cannot be safed and that I can have all the money in the world and there was nothing that he and I can do, my only option was to put him to sleep, cause he found a lump around his chest area that can be cancerous, I just can't understand to be diagnosed with cancer you do need blood work and many test but he never got any blood work, just an x-ray, I was so distraught I didn't want him to suffer cause the vet should know more than me, but now 6 months later I do my own research and he have been saved, did he think I couldn't afford the bill I was willing to pay whatever I didn't have the money on me, but I have family that was willing to loan me the money, I just can't get over on how fast I had to put him down, and last thing no more than half hour me being there and the vet telling me my only option is putting him to sleep, I came to terms and not in the right state of mind saying ok but could'nt stop crying, they told me they will put me in a private room to say my last goodbye's, so when that happened they gave him to me being shaved on the side and with the euthanation needle, so Im saying the vet kinda made up his mind way before he came to tell me his diagnosis,

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