Page 2527 - Cote clinical veterinary advisor dogs and cats 4th

1266 Pericardial Diseases

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VetBooks.ir Differential Diagnosis Item Key Feature(s)
Distemper: flexor spasms of the limbs and neck strongly suggestive. Immunohistochemical staining of
Viral meningomyelitis (canine distemper virus, feline infectious
peritonitis, rabies)
skin biopsy, viral inclusion bodies seen on postmortem CNS histopathology for definitive diagnosis. FIP:
spinal cord deficits possible; Dx supported by CSF analysis/PCR; periventricular/meningeal contrast
enhancement on MRI. Definitive diagnosis obtained histologically +/− immunohistochemical staining.
Fungal meningomyelitis (Cryptococcus, Coccidioides, Blastomyces, Cryptococcus = dog/cat, regional, uncommon cause of paresis.
Histoplasma) Coccidioides/Blastomyces/Histoplasma = dog, regional, rare causes of paresis.
Protozoal meningomyelitis (Neospora caninum, Toxoplasma gondii) Young (<1 year) or immunocompromised dogs. Multifocal neurologic signs; predominantly pelvic limb
LMN deficits and muscle wasting due to myositis-polyradiculoneuritis; serial increases in IgG titers
> 1 : 64 support active infection; Dx with a combination of serum/CSF serologic titer and CSF PCR.
Meningomyelitis (steroid-responsive meningitis-arteritis [SRMA], SRMA: dogs typically 6-18 months old; acute signs (severe cervical pain/stiffness, fever, depression,
granulomatous meningoencephalomyelitis [GME]) stiff gait) or chronic signs (ataxia, paresis). CSF pleocytosis, elevated protein (acute) or mononuclear/
mixed cell population (chronic). GME: acute, progressive, focal/multifocal disease; mean age in dogs
= 55 months. Disseminated form is rapidly progressive; focal form is slowly progressive. CSF mild to
severe mononuclear pleocytosis with elevated protein; multifocal lesions of parenchyma and meninges
on MRI with predilection for white matter (disseminated form) or single space-occupying mass lesion
(focal form).
Vertebral trauma (fracture, luxation) History of major trauma (hit by car ≈50%); thoracolumbar spine most often affected. Multiple spinal
fractures/luxations in up to 20% of cases, warranting survey spinal radiographs as initial test (CAUTION:
Radiographs may underestimate degree of spinal displacement at time of injury). Presence of
nociception is most important prognostic factor.
Peripheral nerve injury (sciatic, peroneal, tibial, femoral) Sciatic nerve injury: severe monoparesis but weight bearing preserved, knuckled paw; hock and digits
do not flex or extend, absent withdrawal reflex, loss of sensation to paw except medially. Femoral
nerve injury: cannot extend stifle so non–weight-bearing, absent sensation medial paw. Tibial nerve
injury: dropped hock. Peroneal nerve injury: hyperextended hock; knuckled paw.
Ischemic myelopathy (fibrocartilaginous embolism [FCE], aortic FCE: most common in young large-breed dogs. May be preceded by mild trauma or vigorous activity.
thromboembolism) Commonly peracute to acute onset, nonpainful, nonprogressive after 24 hours, and asymmetrical
paresis. MRI is imaging modality of choice to evaluate intramedullary hyperintensity (T2-weighted),
which can be prognostic and presumptively diagnostic. Definitive diagnosis made only by
histopathologic exam. Aortic thromboembolism: variable paresis; painful; absent or decreased femoral
pulse; firm and painful pelvic limb muscles; cool, cyanotic nail beds and foot pads.

C&S, Bacterial culture and susceptibility; CNS, central nervous system; CSF, cerebrospinal fluid; CT, computed tomography; FNA, fine-needle aspiration; FIP, feline infectious peritonitis; IgG, immunoglobulin
G; LMN, lower motor neuron; MRI, magnetic resonance imaging; PCR, polymerase chain reaction; UMN, upper motor neuron.
Reproduced from the third edition in unabridged form.
THIRD EDITION AUTHOR: Dan Polidoro, DVM, DACVS

Pericardial Diseases

Congenital Disorders Cardiac rupture (especially left atrial)
Pericardial Defects Idiopathic
Peritoneopericardial diaphragmatic hernia Pericardial Mass Lesions (± Effusion)
Pericardial cyst Neoplastic
Acquired Disorders Granulomatous (actinomycosis, coccidioidomycosis)
Pericardial Effusion Pericardial abscess
Hydropericardium (transudate)* Constrictive Pericardial Disease
Congestive heart failure Idiopathic
Hypoalbuminemia Infectious
Peritoneopericardial diaphragmatic hernia Pericardial foreign body
Pericarditis Neoplastic
Infectious (bacterial, fungal)
Sterile (idiopathic, metabolic, viral; exudate rare)
Hemopericardium (hemorrhage)
Neoplastic
Traumatic
*Conditions that rarely compromise cardiac function.
From Kittleson M, Kienle R: Small animal cardiovascular medicine, St. Louis, 1998, Mosby, p 417.

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