Your dog’s heart health is vital for their survival and well-being. If your veterinarian has treated your dog for pericardial effusion by way of a pericardiocentesis, commonly known as draining the fluid off the heart, and the procedure was ineffective, your dog may need a total pericardiectomy. In this case, the sac, or the pericardium, around the heart would be fully removed instead of drained. Your dog will have been diagnosed with idiopathic pericardial effusion or possibly a more severe cardiac tamponade. In most cases, a total pericardiectomy would be the last procedure suggested after other procedures have failed. 

A total removal of the pericardium requires general anesthesia and a veterinary surgical team. Before the surgery, your veterinarian will run a battery of tests to determine the dog’s overall health and chance of survival depending on the cause of the pericardial effusion. X-rays, ultrasounds, and bloodwork will precede the surgery. Because your dog will require general anesthesia, your surgeon will require the dog to fast for at least 12 hours prior to surgery.

Your veterinary surgeon will open the chest between the ribs to remove the pericardium sac. After removal, the surgeon will observe the heart for additional defects or tumors.

The rate of efficacy will depend on the reason for the swelling in the pericardial sac. If tumors are found during the total pericardiectomy, or if additional tumors are discovered in a dog who is treated for tumors, the dog’s survival rate may decrease. For idiopathic pericardial effusions, the removal of the pericardial sac could ultimately resolve the troubled heart. For dogs without malignant tumors, studies show the efficacy rate of 80%-90% with a low mortality rate and years of healthy and active dogs post surgery. 

A total pericardiectomy is a last resort surgery. Your veterinary surgeon or cardiologist will recommend this major surgery if draining the fluid of the heart has not proven effective with your dog previously. If your dog is healthy when diagnosed with an idiopathic pericardial effusion, the prognosis after a total pericardiectomy is good.

Because a total pericardiectomy is a major surgery, your surgical team will require the dog to be observed in the hospital for three to five days once the surgery is complete. While in the hospital, the veterinary staff will watch your dog carefully, ensuring their heart is pumping blood as it should. Your dog may need additional ultrasounds to view the heart. Blood work will also be done while still in the hospital. Your veterinarian will want to ensure your dog is not anemic and that blood is passing through the heart and to all limbs and organs as it normally would. 

Once your dog is home, you may need to change bandages at the surgical site. Your veterinarian will provide home instructions for recovery and care once your dog is released from the hospital. Your dog should be back to normal activity after about two weeks. Be sure to attend all follow-up exams your veterinarian requests.

Because a total pericardiectomy is a major surgery involving the heart, you may need not only a veterinary surgeon but also a veterinary cardiologist. Veterinary specialists have additional training and warrant the extra cost. Your total price with your cardiologist or veterinary surgeon should include their surgical fees and clinic fees. You may be working with your local veterinarian as well. A total pericardiectomy will upwards of $5,000 including pre-surgery testing and hospital stay. Plan to budget an additional $500 for medications including diuretics, steroids, anti-inflammatories, and antibiotics as well as post-op appointments for follow-up care. 

If your veterinarian has suggested a total pericardiectomy, it is because your dog’s heart is not pumping blood through their body efficiently or effectively and other treatments have failed. Your veterinarian will have already drained the excess fluids or prescribed medications to improve the heart’s functionality.

If your dog has been diagnosed with cancer and has metastatic tumors in the area, the heart sac could swell. The prognosis may not be good for dogs with cancer, and the total pericardiectomy will only aid in treating the symptoms of cancer by ridding the heart and sac of tumors. However, cancer may remain, and additional treatment will be necessary.

However, if your veterinarian has recommended a total pericardiectomy as a result of an idiopathic effusion, the chances of your dog’s survival after removing the recurring swelling of the pericardium are high. A total pericardiectomy would improve your dog’s overall health, and a healthy dog should be able to return to a normal life with regular activity once recovery is complete. 

Early detection is the best prevention against heart failure. Give your dog healthy food choices and proper diet options, so they have the best chance for a long healthy life. Unfortunately, many of these conditions, either cancer related, congenital, or idiopathic are not preventable or even noticeable until symptoms begin to show. Leading a healthy lifestyle with your dog will give them the best opportunities for the best life possible. Follow your veterinarian’s instructions for heartworm medications, vaccines, and diet. Have your dog checked regularly with your veterinarian to ensure they are healthy. If you notice lethargy or a difference in breathing or lack of desire for activities, have your dog seen by your veterinarian right away. These are signs your dog gives to let you know there is a problem.

There are not necessarily breeds susceptible to heart failure or heart disease, but know your breed and learn as much as you can about the best foods, supplements, and activities for your specific breeds.