Page 216 - Small Animal Internal Medicine, 6th Edition

188 PART I Cardiovascular System Disorders

of a cardiac mass using echocardiography, CT, or another Atencia S, Doyle RS, Whitley NT. Thoracoscopic pericardial
modality usually is necessary for tumor identification. window for management of pericardial effusion in 15 dogs. J
VetBooks.ir Ultrasound-guided transthoracic fine-needle aspiration of Boddy KN, et al. Cardiac magnetic resonance in the differentiation
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some cardiac mass lesions might be possible depending on
of neoplastic and nonneoplastic pericardial effusion. J Vet Intern
their location and can yield cytologic diagnosis. Anesthesia
or sedation alone may be adequate in some cases. Med. 2011;25:1003–1009.
Boston SE, Higginson G, Monteith G. Concurrent splenic and right
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Unfortunately, for most patients with a heart tumor, there Brisson BA, Holmberg DL. Use of pericardial patch graft recon-
are few good long-term options. This is especially so for struction of the right atrium for treatment of hemangiosarcoma
HSA, mesothelioma, and other masses that cause recurrent in a dog. J Am Vet Med Assoc. 2001;218:723–725.
tamponade or obstruct blood flow. Pericardiocentesis is indi- Burns CG, Bergh MS, McLoughlin MA. Surgical and nonsurgical
cated immediately for cardiac tamponade (see p. 183). Con- treatment of peritoneopericardial diaphragmatic hernia in dogs
servative management, with pericardiocentesis as needed, is and cats: 58 cases (1999-2008). J Am Vet Med Assoc.
used in some patients until episodes of cardiac tamponade 2013;242:643–650.
become unmanageable. Whether antiinflammatory doses of Cagle LA, et al. Diagnostic yield of cytologic analysis of pericardial
effusion in dogs. J Vet Intern Med. 2014;28:66–71.
a glucocorticoid are of benefit is unclear. Surgical pericardi- Case JB, et al. Outcome evaluation of a thoracoscopic pericardial
otomy or subtotal pericardiectomy can help prevent recur- window procedure or subtotal pericardectomy via thoracotomy
rent tamponade. Heart base tumors (e.g., chemodectoma) for the treatment of pericardial effusion in dogs. J Am Vet Med
tend to be slow-growing; some never cause clinical signs and Assoc. 2013;242:493–498.
are found incidentally on echocardiogram or necropsy. For Chun R, et al. Comparison of plasma cardiac troponin I concentra-
those that cause cardiac tamponade, partial pericardiectomy tions among dogs with cardiac hemangiosarcoma, noncardiac
or pericardiotomy potentially could prolong survival for hemangiosarcoma, other neoplasms, and pericardial effusion of
months or possibly even years. nonhemangiosarcoma origin. J Am Vet Med Assoc. 2010;237:
Complete surgical resection rarely is possible because 806–811.
heart base, as well as many other tumors, are so locally inva- Cobb MA, et al. Percutaneous balloon pericardiotomy for the man-
sive. Nevertheless, an occasional mass might be amenable to agement of malignant pericardial effusion in two dogs. J Small
Anim Pract. 1996;37:549–551.
surgical resection depending on its location and extent; an Cote E, Schwarz LA, Sithole F. Thoracic radiographic findings for
example would be a small tumor localized to the tip of the dogs with cardiac tamponade attributable to pericardial effusion.
right auricle. However, surgical biopsy of a nonresectable J Am Vet Med Assoc. 2013;243:232–235.
mass could be helpful if chemotherapy is contemplated. Crumbaker DM, Rooney MB, Case JB. Thoracoscopic subtotal
Many, if not most, cardiac tumors are fairly unresponsive pericardiectomy and right atrial mass resection in a dog. J Am
to chemotherapy, although some are treated with short-term Vet Med Assoc. 2010;237:551–554.
success. Doxorubicin or carboplatin have been used in dogs Davidson BJ, et al. Disease association and clinical assessment
with HSA for temporary palliation, with or without surgical of feline pericardial effusion. J Am Anim Hosp Assoc. 2008;44:
mass resection. Lymphoma and malignant histiocytosis are 5–9.
treated using standard protocols. In regions where available, Day MJ, Martin MW. Immunohistochemical characterization of the
radiation therapy might provide another palliative option lesions of canine idiopathic pericarditis. J Small Anim Pract.
2002;43:382–387.
for dogs with chemodectoma or other masses. Early experi- De Laforcade AM, et al. Biochemical analysis of pericardial fluid
ence in dogs presumed to have HSA suggests that radiation and whole blood in dogs with pericardial effusion. J Vet Intern
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drug protocols, radiation therapy, or other tumor treat- Fine DM, Tobias AH, Jacob KA. Use of pericardial fluid pH to
ment modalities should be consulted as needed. Overall, distinguish between idiopathic and neoplastic effusions. J Vet
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cal signs because of a cardiac tumor generally is guarded Ghaffari S, et al. A retrospective evaluation of doxorubicin-based
to poor. chemotherapy for dogs with right atrial masses and pericardial
effusion. J Small Anim Pract. 2014;55:254–257.
Guglielmini C, et al. Accuracy of radiographic vertebral heart score
Suggested Readings
and sphericity index in the detection of pericardial effusion in
Ajithdoss DK, et al. Coccidioidomycosis presenting as a heart base dogs. J Am Vet Med Assoc. 2012;241:1048–1055.
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Amati M, et al. Pericardial lymphoma in seven cats. J Feline Med ability of survey thoracic radiography for the detection of heart
Surg. 2014;16:507–512. base masses in dogs. J Am Vet Med Assoc. 2016;248:1391–1398.
Aronsohn MG, Carpenter JL. Surgical treatment of idiopathic peri- Hall DJ, et al. Pericardial effusion in cats: a retrospective study of
cardial effusion in the dog: 25 cases (1978-1993). J Am Anim clinical findings and outcome in 146 cats. J Vet Intern Med.
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