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Idiopathic hemorrhagic pericardial effusion in a 12 year old MN Boxer

History

A 12-year-old MN Boxer dog was presented for coughing. Physical examination was unremarkable and patient was treated with antibiotics pending thoracic radiographs. Thoracic radiographs were taken but no radiograph results were noted in the chart. The patient was treated with oral Torbutrol.

A 12-year-old MN Boxer dog was presented for coughing. Physical examination was unremarkable and patient was treated with antibiotics pending thoracic radiographs. Thoracic radiographs were taken but no radiograph results were noted in the chart. The patient was treated with oral Torbutrol.

Comments

Vasculitis, infectious disease, and idiopathic causes can also be responsible for hemopericardium in dogs. This patient did resolve when treated for bacterial or ricketsial disease even if a definitive diagnosis was not achieved. 

Clinical Differential Diagnosis

Cardiac disease: cardiomyopathy, myocardial failure, pericardial effusion; Tracheobronchial disease: allergic, infectious (viral, bacterial, protozoal), compression (lymph node, cardiac enlargement), neoplasia.

DX

Hemorrhagic pericardial effusion

Sampling

US-guided fine needle aspirate of the pericardial effusion revealed hemorrhagic effusion (120 mL of hemorrhagic pericardial fluid drained). Bacterial culture of the fluid yielded no growth.

Sonographic Differential Diagnosis

No masses were noted at this point. However, primary consideration should be given to cardiac hemangiosarcoma. May 18: Pericardial effusion without overt evidence neoplasia. Differentials include vasculitis, infectious disease or occult neoplasia.

Image Interpretation

May 11: The cardiac presentation revealed mild to moderate pericardial effusion. It measured approximately 2.0 cm in width separation of the endocardium to the pericardium. Internal volume, contractility and chamber sizes were largely normal and not overtly compromised at this point. May 18: No visible neoplasia was noted. The internal volumes were subnormal due to pericardial effusion.

Outcome

A trial period of clindamycin and/or doxycycline to rule out infectious disease was suggested. A recheck echocardiogram was performed a few days later, and 150ccs of pericardial fluid was drained. The patient was treated with clindamycin. At last communication 10 days later, the patient’s cough was reported as improved.

Video

Patient Information

Patient Name : Beau D
Age : 12 Years
Gender : Male, Neutered
Species : Canine
Liz Wuz Here : Yes
Status : Complete
Code : 15_00024

Clinical Signs

  • Coughing

Images

PericardialEffiusion

sonoadmin-KV 2018
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