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M15: Cardiorespiratory > Effusions in SA > Flashcards

Effusions in SA Flashcards

1
Q

What are the causes of pericardial effusions?

A
  • idiopathic
  • neoplastic haemangiosarcoma, chemodectoma, lymphosarcoma
  • LA rupture
  • hypoproteinaemia
  • haemorrhage
  • CHF
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2
Q

Describe the pathophysiology of pericardial effusion

A
  1. effusion
  2. compresses R heart
  3. decreased filling
  4. decreased CO and forward failure
  5. R CHF
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3
Q

Describe cardiac tamponade

A

P from effusion compresses RA and RV walls making them thin. Walls collapse leading to R HF. L side doesn’t fill as well so cardiac output decreases.

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4
Q

Describe the signalment and presenting signs seen in dogs with pericardial effusion

A

Signalment:

  • large breed dogs

Presenting signs:

  • exercise intolerance
  • lethargy
  • abdominal distension
  • weakness
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5
Q

What physical findings would be expected in cases with pericardial effusion?

A
  1. Poor CO - pallor, prolonged CRT, weak pulse, tachycardia, muffled heart sounds
  2. R CHF - jugular distension, ascites, hepatomegaly
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6
Q

What would be expected on diagnostic imaging in pericardial effusion?

A
  • radiography - cardiomegaly, rounded cardiac silhouette
  • ECG - small QRS complex
  • echo - see effusion
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7
Q

How are pericardial effusions treated?

A

Pericardiocentesis

  • effusion always haemorrhagic but shouldn’t clot
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8
Q

What is the prognosis with pericardial effusions?

A
  • recur in ~ 50% patients
  • pericardectomy recommened if effusion recurs (good prognosis)
  • if effusion recurs quickly, neoplasia likely. Guarded prognosis
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9
Q

Small pericardial effusions are seen with which conditions?

A
  • CHF
  • hypoproteinaemia
  • FIP
  • infection

*don’t usually require drainage

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10
Q

List the different types of abdominal effusions

A
  • transuadte
  • modified transudate
  • exudate
  • chylous
  • inflammatory (septic v non-septic)
  • haemorrhagic
  • bile
  • urine
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11
Q

What are the causes of abdominal effusion in dogs?

A
  • liver disease - chronic hepatopathies
  • cardiac disease - pericardial effusion, DCM, mitral valve disease, pulmonic stenosis, dirofilaria
  • neoplasia - haemangiosarcoma
  • hypoalbuminaemia - PLE, PLN
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12
Q

What are the causes of abdominal effusion in cats?

A
  • infectious disease - FIP
  • neoplasia - abdominal carcinoma
  • liver disease - chronic hepatopathies
  • cardiac disease - cardiomyopathies
  • hypoalbuminaemia - PLE, PLN
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13
Q

What are the physical signs of abdominal effusion?

A
  • abdominal distension - fluid thrill
  • tachypnoea, dyspnoea
  • abdominal pain - particularly when lifted
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14
Q

What changes would be expected to be seen on radiography in cases with abdominal effusion?

A
  • cardiomegaly
  • enlargement of caudal vena cava
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15
Q

What are the properties of transudates and what can cause them?

A

Properties:

  • clear
  • non-viscous
  • low protein <25g/L
  • low cells <1000/uL
  • slightly irritant

Causes:

  • hypoalbuminaeia
  • pre-sinusoidal obstruction - portal hypertension, hepatic fibrosis
  • early bladder rupture - fluid high in urea and creatinine
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16
Q

What are the properties of modified transudates and what can cause them?

A

Properties:

  • clear/straw coloured
  • non-viscous
  • high protein 25-75g/L
  • low/moderate cells 1000-7000/uL

Causes:

  • altered vascular permeability - chronic transudates, some tumours
  • altered hydrostatic P - CHF, sinusoidal and post-sinusoidal obstruction, Budd Chiari-like syndrome (obstruction in cd vena cava)
17
Q

What are the properties of exudates and what can cause them?

A

Properties:

  • straw coloured - purulent +/- haemorrhage
  • viscous
  • high protein > 30g/L
  • moderate-high cells >5000/uL

Causes:

  • non-septic - FIP, ruptured gall bladder/bladder, severe accumulations of neutrophils (pseudochylous)
  • septic - bacterial peritonitis, rupture of abdominal viscera, surgery, nocardiosis
18
Q

What are the properties of neoplastic effusions?

A
  • carcinoma - sero-haemorrhagic
  • lymphoma - chylous
  • necrotic - pseudochylous
  • haemangiosarcoma - haemorrhagic
19
Q

Which cardiac diseases can cause ascites?

A
  • acquired - pericardial disease, biventricularr CHF secondary to DCM/endocardiosis (dogs) and CM (cats), Dirofilaria immitus
  • congenital - pulmonic stenosis, tricuspid valve dysplasia, biventricular CHF secondary to end stage L-R shunts
20
Q

List the types of pleural effusions

A
  • transudate
  • modified transudate
  • exudate
  • chylous
  • haemorrhagic
21
Q

What are the causes of pleural effusions?

A
  • infectious - FIP, pyothorax
  • neoplasia - lymphoma, carcinoma, mesothelioma
  • cardiac disease
  • chylothorax - CHF, trauma
  • haemorrhage
  • hypoalbuminaemia - PLE, PLN
22
Q

What are the clinical signs associated with pleural effusions?

A
  • dyspnoea
  • tachypnoea
  • muffled heart sounds
  • dullness of ventral percussion
  • +/- cough
23
Q

How does heart worm present in dogs and cats?

A
  1. Dogs - cough, exercise intolerance, dyspnoea, syncope, hepatomegaly, ascites, death
  2. Cats - sudden death, vomiting, cough, dyspnoea, lethargy, anorexia, weight loss, chylothorax (secondary to CHF)
24
Q

What findings on haematology would be expected with heart worm?

A
  • eosinophilia
  • neutrophilia
  • basophilia
  • anaemia
  • lymphopenia
25
Q

On diagnostic imaging, which findings are indicative of heart worm infection?

A
  • radiography - R sided cardiomegaly, interstitial changes in lung fields
  • echo - worms may be visualised in R heart or pulmonary artery
26
Q

How can heart worm be diagnosed?

A
  • blood smear
  • Knotts/Filter concentration test
  • microfilaria Ab test
  • adult female worm Ag test
27
Q

How are heart worm infections treated in dogs and cats?

A
  • dogs - melarsomine dihydrochloride, surgical removal
  • cats:
  • no CS = spontaneous resolution
  • radiographic evidence of pulmonary infection = monitor, supportive therapy
  • severe disease = supportive therapy

M15: Cardiorespiratory (5 decks)

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