Cardiac Hemangiosarcoma & Tamponade

History

Cardiac Hemangiosarcoma & Tamponade. 6-month quality survival with adriamycin and pericardial drainage.

Lindquist (DABVP) & Nicolas (RDMS) of New Jersey Mobile, Ryan Epple DVM of Harmony AH, Philippsburgh, NJ, USA.

Sonogram (Cardiac): “Hawthorne”

Cardiac Hemangiosarcoma & Tamponade. 6-month quality survival with adriamycin and pericardial drainage.

Lindquist (DABVP) & Nicolas (RDMS) of New Jersey Mobile, Ryan Epple DVM of Harmony AH, Philippsburgh, NJ, USA.

Sonogram (Cardiac): “Hawthorne”

History (Vasquez RVT, Lindquist DABVP): An 11-year-old MN Golden Retriever was presented for evaluation of lethargy and decreased appetite. Abnormalities on physical examination were lethargy and pulse deficits. Rectal temperature was normal. 4DX test showed a weak positive result for Anaplasma. Survey radiographs revealed cardiomegaly and suspicion of pleural effusion. Mild anemia was noted on CBC.

Comments

Special thanks to: Dr. Ryan Epple and staff at Harmony Animal Hospital, Phillipsburgh, NJ, USA, as well as the Kane family for their unsurpassed compassion and management of Hawthorne’s pathology.

Clinical Differential Diagnosis

Clinical Differential Diagnosis (Lobetti DECVIM)
Cardiac disease:
Dilated cardiomyopathy
Pericardial effusion:
Idiopathic
Neoplasia

Pleural space disease:
Neoplasia
Diaphragmatic hernia
Pyothorax
Chylothorax
Haemothorax

Hypoproteinaemia

Mediastinal obstruction/mass

Lung disease:
Parapneumonic effusion
Lung lobe torsion

Sampling

US-guided thoracocentesis and pericardiocentesis were performed (Lindquist DABVP, Nicolas RDMS, Epple DVM).

Sonographic Differential Diagnosis

(Lindquist DABVP): Heart based mass consistent with hemangiosarcoma and severe pericardial tamponade.

Image Interpretation

(Lindquist DABVP)

Outcome

(Lindquist DABVP, Nicolas RDMS): Immediately after the pericardial effusion was drained, the patient was started on Doxorubicin therapy and walked away asymptomatic from the drainage procedure. He responded well to therapy and finished out five treatments of Doxorubicin. After more than four months the patient was reported to be doing well and clinically stable. Current therapy included omega-3 fatty acid supplement and NSAIDS. The patient survived with a good quality of life for 6 months at which time tumor regrowth to 3 times the original size, pericardial hemorrhage and tamponade caused excessive weakness compromising quality of life. Follow-up echocardiogram findings confirmed this suspicion. The owners were very content with the extra 6 months of quality time even though empirical chemotherapeutic intervention was the mainstay of treatment.