Canine pericarditis- inflammation outer shell heart (pericardium, cardiac sac). It can be acute or chronic; by origin - primary and secondary; by prevalence pathological process- focal and diffuse; according to the nature of the inflammatory exudate - serous, fibrinous, hemorrhagic, purulent. There are also dry (fibrinous) and effusion (exudative) pericarditis.
Etiology. Primary pericarditis occurs less frequently in dogs than secondary pericarditis, and is mainly aseptic in nature.
Its causes may be colds, drafts, allergies, blood diseases and hemorrhagic diathesis, malignant tumors, trauma, radiation exposure, autoimmune consequences, metabolic disorders - uremia, long-term treatment glucocorticoids, hypovitaminosis C. Secondary pericarditis is a complication of a number of infectious (plague, parvovirus enteritis, hepatitis, leukemia, etc.), invasive and non-communicable diseases (pneumonia, pleurisy, bronchitis, myocarditis, etc.).
Very rarely, traumatic pericarditis is a consequence of mechanical damage. chest and pericardium for rib fractures, stab and gunshot wounds.
Symptoms pericarditis depend on the origin and stage of its development. Dry (fibrinous) pericarditis is accompanied by low-grade fever body and increased heart rate. General state dogs depressed. Appetite is reduced or absent. Dogs avoid sudden movements and often stand with their forelimbs spread to the sides, elbows sharply turned outward. The pulse becomes small as the disease progresses, weak filling. The heartbeat is increased.
Palpation of the cardiac region causes a pain reaction. Exudative (exudative) pericarditis is characterized by severe constant shortness of breath, a forced dog pose - a sitting position with a forward bend. Body temperature is elevated at the beginning of the disease. Severe tachycardia appears. The pulse is small, weakly filled, sometimes thread-like, often arrhythmic. Heart sounds are weakened, dull, as if heard from afar, and are often arrhythmic. The liver enlarges and becomes painful. Arterial pressure decreased, and venous - increased. The speed of blood flow is reduced.
The disease is accompanied by gastritis, dysfunction of the liver, lungs, kidneys and other organs.
The course of pericarditis in dogs depends on the causes that caused it. Dry (fibrinous) pericarditis can often result in the patient’s recovery relatively quickly.
Exudative (exudative) pericarditis takes longer and is more severe. In some cases, when the myocardium and endocardium are affected, inflammation occurs quickly, within several days, and ends in the death of the dog.
Diagnosis. Dry pericarditis is determined by pain and friction noises in the cardiac region, increased cardiac impulse, tachycardia and other signs. Effusion pericarditis is characterized by displacement, weakening and diffuseness of the cardiac impulse, enlargement and merging of areas of relative cardiac dullness and absolute stupidity heart, weakening and dullness of tones, tachycardia, splashing noises, overflow and tension of the veins of the neck, edema.
Differential diagnosis. Venous pericarditis should be distinguished from hydrocele of the cardiac sac and effusion pleurisy. Dry pericarditis and the initial stage of effusion pericarditis must be differentiated from dry pleurisy, as well as from acute myocarditis and endocarditis.
Treatment of dogs. First of all, the owner of the animal should contact a veterinarian (call veterinarian at home), rather than trying to treat yourself. Treatment should be comprehensive and aimed primarily at the underlying disease that caused pericarditis. First, complete rest and silence is prescribed to the sick dog. Limit the animal's exercise as much as possible. Food should be high in calories, fortified and contain wide range microelements. In the first days of therapy, it is recommended to slightly limit the supply of water.
IN drug therapy Various diuretics and cardiac medications are used to absorb exudate to maintain normal heart function. Good medicinal properties have glucose solutions that are administered parenterally several times a day. At the same time, the veterinarian prescribes antimicrobial and vitamin therapy. Allergic phenomena are eliminated by using antihistamines. The course and dose of the medication is determined by the veterinarian.
Pericarditis in cats is inflammation of the heart sac (pericardium). There are acute and chronic form, primary and secondary pericarditis.
Causes
Inflammation of pericarditis in cats occurs for a number of reasons. These include:
- consequences of colds, invasive and infectious diseases;
- as a result of poisoning;
- with penetrating wounds;
- rarely with an inflammatory process in the lungs, pleura, myocardium.
Symptoms of pericarditis in cats
During the inflammatory process in the heart sac, the following symptoms are noted:
- depressed state;
- the pet lies and moans all the time;
- stoops when moving;
- appetite is partially or completely absent;
- rapid breathing;
- the nasal openings are widened;
- when palpating the chest on the left side, pain is noted;
- promotion rectal temperature;
- the heartbeat is sharply increased, the pulse is increased;
- edema subcutaneous tissue in the abdomen, chest, perineum.
At acute form the disease manifests itself:
- swelling of the intermaxillary spaces, eyelids, paws, lips, ears;
- cyanosis of the mucous membranes.
If any of the listed symptoms are present, the owner should immediately consult a veterinarian. Without rendering urgent help and subsequent treatment, the pet may die.
Diagnostics
To determine the diagnosis, the following examinations are prescribed:
- taking anamnesis;
- examination of the cat;
- collection of clinical and laboratory data;
- palpation of the left side wall;
- exclusion of other diseases.
Treatment
Treatment of pericarditis in cats is aimed at eliminating the underlying disease that caused the pericarditis. The veterinarian prescribes complex treatment:
- cold compresses on the left side;
- oxygen inhalation;
- puncture and removal of exudate from the heart sac;
- correction of animal nutrition;
- introduction of antiseptic drugs into the pericardial cavity (later they are removed);
- use of diuretics and cardiac drugs;
- a course of antibiotics and sulfonamides.
Danger
The disease usually occurs in a severe form. As a result inflammatory process In pericarditis in cats, a number of consequences occur:
- inflammation affects the parietal and visceral surfaces of the heart;
- the cardiac sac loses its smoothness and elasticity;
- pericardial friction noise appears;
- adhesions form, complicating the work of the heart;
- exudate accumulates in the pericardium;
- the heart is compressed, the blood circulation process becomes difficult;
- toxins enter the blood;
- pressure in the veins increases;
- general blood flow slows down;
- congestive edema appears in tissues and organs.
In its advanced form, death is common.
Prevention
As preventive measures it is necessary to adhere to a number of recommendations:
- provide the cat with adequate nutrition;
- remove indigestible diets from the diet;
- promptly treat invasive or infectious diseases;
- warn stress effects and injuries.
Attention: the above is for educational purposes only and does not constitute professional medical advice or scientific material.
Etiopathogenesis.
This is an inflammation of the pericardium with the accumulation of fluid in the cavity of the cardiac sac, developing as a complication of other primary diseases of an inflammatory or non-inflammatory nature.
Pericarditis can occur against the background of hemorrhage into the pericardial cavity (hemopericarditis) with traumatic damage to the main vascular trunks or the left atrium, or with destruction of the base of the heart by a tumor (brachiocephalic chemodectoma, metastases of thyroid and parathyroid cancer).
Complication bacterial infection there may be exudative pericarditis with accumulation of pus.
There are known cases of idiopathic serous-hemorrhagic pericarditis of unknown etiology.
During inflammation, sometimes the pericardial layers become fused with the disappearance of the pericardial cavity (adhesive pericarditis). Often, lime is deposited in such a pericardium and the so-called armored heart is formed. Scar tissue tightens the pericardium, causing compression of the heart (constrictive pericarditis).
Symptoms
The occurrence of pericarditis complicates the course of the underlying disease. The existing symptoms are accompanied by signs of cardiovascular failure associated with cardiac tamponade due to accumulated exudate.
Later, when the disease moves into the next phase, signs of failure are caused by the formation of scar strictures. Clinically, weakening or absence of the apical impulse and heart sounds, a small rapid pulse are noted; in severe cases - swelling of the neck veins, enlarged liver, ascites and hydrothorax.
Additionally, exudative pericarditis is indicated different contents pulse on symmetrical limbs, displacement of the apical impulse when changing body position.
Radiographically, when there is a large accumulation of fluid in the pericardial cavity, the trachea is pushed towards the spine. The greatly enlarged silhouette of the heart can fill the entire pulmonary field and is shaped like a pumpkin. The longitudinal diameter of the heart is larger than the vertical one. The cranial and caudal vena cava are dilated; detect the horizontal level of liquid in the cavities during radiography of a standing animal.
With adhesive pericarditis, it is possible to auscultate a presystolic murmur, retraction of the intercostal spaces in the heart region during systole, and the absence of respiratory excursion of the organs of the upper abdomen due to a sharp limitation of the mobility of the diaphragm are noted.
Constrictive pericarditis and “shell heart” are recognized in an x-ray image by the deformation of the heart shape and the layering of uniform intense shadows of bone density on it.
Summary clinic:
1. Abdominal dystension;
2. Anorexia (lack of appetite, refusal to eat);
3. Ascites, fluid accumulation in abdominal cavity;
4. Auscultation of the heart: muffled, decreased heart sounds;
5. Auscultation: Reduced, dull pulmonary sounds, absence of sounds;
6. Fast fatiguability with physical load;
7. Generalized weakness;
8. Hepatosplenomegaly, splenomegaly, hepatomegaly;
9. Dyspnea (difficulty breathing, shortness of breath);
10. Distension of peripheral veins, jugular distension;
11. Exhaustion, cachexia, unkemptness;
12. Cough;
13. Fainting, syncope, convulsions, collapse;
14. Pericardial murmurs,
15. Loss of body weight;
16. Pulse jugular;
17. Swelling of the hind feet;
18. Swelling of the front feet;
19. Swelling, edema of the hind legs;
20. Swelling, edema of the forelimbs;
21. Heart murmurs; Weak, thready pulse;
22. Tachycardia, increased heart rate;
23. Tachypnea, Increased frequency breathing movements, polypnea, hyperpnea;
24. Depression (depression, lethargy);
25. ECG: Low-voltage QRS complexes;
The diagnosis is made based on:
- Clinical signs,
- x-ray,
- ECG,
- pleuropericardiocentesis
and exclusion of other causes.
It is placed after pleuropericardiocentesis. First, the nature of the aspirated fluid (transudate or exudate) is determined under a microscope, then it is sent for bacteriological and cytological studies. Obtaining fluid from the pericardial cavity also serves as evidence of pericarditis when differentiating it from myocardial hypertrophy.
Purulent pericarditis, if urgent treatment measures are not taken, is extremely life-threatening. Serous pericarditis may result full recovery. Adhesive pericarditis creates a persistent painful condition.
Treatment.
Eliminate the underlying disease by prescribing antibiotics, cardiac glycosides and diuretics. Repeated pericardiocentesis is also necessary to aspirate fluid. The so-called idiopathic pericarditis can sometimes be cured after several punctures of the heart sac.
In case of constrictive pericarditis, surgical intervention is necessary.
Technique of operation.
General anesthesia with artificial ventilation lungs. Right lateral position of the animal. A thoracotomy is performed in the left fourth intercostal space. A 7x1 cm rectangular flap is cut out from the outer layer of the heart so that the pericardial cavity remains open and the heart is no longer compressed. Stitched up chest wall. Aspirate air from pleural cavity. Apply a pressure bandage.
Pericarditis is the development of the inflammatory process of the pericardium, that is, the inflammation covers the lining tissue of the heart, which contains from one to fifteen ml of a special fluid saturated with phospholipids, the main function of which is to ensure sliding and lubrication of the outer walls of the heart and its great vessels.
This diagnosis is represented by a complex syndrome that has great amount varieties and therapeutic approaches to eliminate it.
On initial stages development of the disease, the animal can be saved It is important to understand that in the initial stages of the development of the disease, the animal can be saved, provided it receives timely qualified assistance, otherwise the pet may die.
Before a diagnosis is made and therapy is initiated, a series of diagnostic measures, ensuring reliability healing process and preventing the development of complications. The implemented analyzes may include: metal indications, fluoroscopic examinations and some additional measures, for example, puncture of the cardiac membrane.
Symptomatic manifestations
Among the complaints of owners regarding their animal at a doctor's appointment, which indicate a disease such as pericarditis, there are: general lethargy of the animal, weakness and avoidance of physical activity, poor or absent appetite, fainting fits, bloating of the abdominal cavity, as well as the appearance of shortness of breath . Along with this, current manifestations may include: paleness of the mucous membranes, blue tongue and oral cavity etc. The duration and intensity of these symptoms directly depends on the form and stage of the disease, as well as the volume of fluid located in the pericardial cavity, characterizing the pathology as acute or chronic.
If the listed manifestations are detected in an animal, then it should be as soon as possible seek help from a competent person, qualified veterinarian, which could implement everything necessary in a specific situation.
Predisposition
According to statistics, about three percent of all those who were examined by a cardiologist were sick with pericarditis. Medium-sized and medium-sized dogs are more likely to suffer from the current illness. large breeds, in most cases these are shepherds, retrievers and Labradors. The disease occurs more often in dogs older than five years, correlating this with a violation of the procedural level and regulatory systems.
Regarding cats, the picture does not change much, but the disease is in this case is often of an infectious nature. Among the most common causes of the disease are: chronic fatigue, hypothermia, severe stress, and the like. IN certain situations the problem may have anatomical reasons, caused by the breed characteristics of the cat and act as a consequence of heart failure.
Treatment should be based on the results of the pet's examination. Treatment and diagnostic process
Treatment should be based on the results of the examination of the pet and the indications of studies carried out during the appointment. A thorough differential diagnosis is necessary, during which the correct and accurate diagnosis. In some cases, a lengthy examination is not required, especially when it comes to saving a pet.
First of all, treatment is based on timely identification of the causes of the disease and their elimination. On early stages Doctors recommend applying a cold compress to the heart area, as well as limiting the amount of daily drinking and eating. It is also necessary to provide the animal with rest.
Under some circumstances, a puncture may be used to suction out fluid accumulated in the pericardium - this will reduce swelling and reduce the risk of death.
Regarding drug treatment, the following tools are distinguished:
- diuretics;
- laxatives of various types;
- iodine-based preparations;
- various cardiotonic components;
- acetylsalicylic acid and glucose;
- various antibiotics;
- sulfonamides;
- cephalosporins;
- aminoglucosides;
- isibuprofen and so on.
Perhaps many have never heard of this disease in animals, which is why I decided to touch on this topic. Very often this diagnosis remains unestablished, which means the animal does not receive proper treatment, and sometimes loses its life due to “something with the heart.” But knowing the features of this disease, the owner can provide a huge service to his pet.
Pericarditis in dogs and cats is inflammation of the outer lining of the heart. The pericardium covers the heart and great vessels, normally contains from 1-15 ml of liquid rich in phospholipids, which ensures sliding without additional friction.
Symptoms
The most common complaints from owners of dogs with pericarditis are lethargy, tolerance to physical activity, lack of appetite, collapse or fainting, bloating and shortness of breath, pale mucous membranes, bluish mucous membranes. Intensity clinical manifestations Pericarditis directly depends on whether the process is acute or chronic and on the volume of free fluid in the pericardial cavity.
If your pet has pericarditis or notices the symptoms described above, contact one of our veterinary centers by phone +7 499 110 66 86 (24 hours a day).
Predisposition to pericarditis
Pericarditis, according to various sources, occurs in middle-aged and elderly dogs and accounts for from 3.5 to 0.4% of all dogs examined by a cardiologist. These are mainly dogs of large and medium breeds, over 5 years old, often male, there is a breed predisposition (Labradors, golden retrievers, german shepherds, Great Danes).
There are no statistics on pericarditis in cats, but on average the figure does not exceed 1-5% and is mainly associated with infectious peritonitis, less often it is a consequence of congestive heart failure.
According to various sources, neoplasms cause pericarditis from 30% to 80%, which is nevertheless a low percentage of the total number of neoplasms (only about 0.19%). In cats the figure is even lower, only 0.03% and almost always lymphoma.
Diagnostics
Diagnosis is based on physical examination, x-ray, Echocardiography of the heart, blood tests, ECG.
An examination of an animal with suspected pericarditis should be carried out qualitatively, but with some caution. Often the patient comes to see a doctor in serious condition, with severe symptoms right-sided heart failure, as a result of cardiac tamponade, sometimes similar symptoms can develop within 24 hours. In this case, weakness, shortness of breath are expressed, the cardiac impulse is reduced, the pulse is weak or not palpable at all, jugular veins dilated, pale mucous membranes, SNC more than 3-5s. There may also be abdominal enlargement due to ascites and wheezing due to developing edema lungs and chest effusion. Such patients should not be subjected to thorough diagnostics; it is enough to verify the presence of free fluid using ECHO and perform a skin puncture of the pericardium.
If the patient's condition is more stable, a thorough examination is necessary. At X-ray examination reveal the rounded contours of the heart. The method also allows you to determine metastasis lung tissue.
On ECG Alteration of R waves, sometimes a decrease in voltage and depression of the ST segment are diagnosed.
The gold standard for diagnosing pericarditis is cardiac echocardiography; this method also allows one to assess hemodynamics, the presence of chest effusion, and sometimes identify neoplasms (the right atrium is most often affected). The presence of fluid in the pericardial cavity is determined in all projections as an echo-negative space limited by the pericardial layers, and abnormal (side to side) movement of the heart is also observed.
Blood tests necessary for differential diagnosis. Sometimes they may not have serious abnormalities, but leukocytosis, increased urea and creatinine, and anemia are common.
Analysis of pericardial fluid is used for differential diagnosis. The resulting material is examined to identify the causative agent of infection, and a purulent process is excluded. The resulting liquid is sent to cytological examination to exclude tumorigenesis of the disease
Treatment
It depends on the speed of development of the process and the cause of the disease, and comes down mainly to three components:
— puncture of the pericardium and removal of fluid.
- antibiotic therapy and control of heart failure.
- pericardiotomy.
Conservative treatment. If it is possible to identify the pathogen, it is selected individually, routine antibiotics are recommended for all patients to prevent complications. Diuretics and ACE inhibitors are also indicated but with caution so as not to provoke a decrease in pressure. It is important to monitor the functioning of the kidneys, as they are primarily affected by sharp changes pressure. For severe anemia, iron supplements and folic acid, in acute cases - blood transfusion. It is also possible to use drugs with antihypoxic and antioxidant properties.
In cats conservative treatment more effective, and almost always occurs with the administration of steroids. Surgical treatment is ineffective because in severe cases, unlike dogs, pulmonary edema often develops.
It is better to prepare a wide surgical field from the 2nd to 8th intercostal space; the puncture is performed in the thoracic position or in the lateral position. WITH right side to reduce the risk of injury to the left coronary artery. To do this, use guides from intravenous catheters, the catheters themselves, or spinal needles, depending on the size of the patient. Before the puncture, it is necessary to perform sedation (nalbuphine 0.4 mg/kg + propofol 6 mg/kg if necessary), most patients, due to the severity of the condition, behave calmly. It is also important to ensure venous access, the availability of a resuscitation kit and monitoring electrical activity heart and blood pressure.
The injection site can be infiltrated with a 1% lidocaine solution; usually the injection is performed in the 4-5 intercostal space, slightly above the junction of the ribs with breast bone, you can also use the ultrasound sensor to select a location. Due to the fact that the pericardium is overstretched, it is not always possible to feel resistance when puncturing it, so you can focus on the free movement of the needle tip, the depth of needle insertion, and the presence of fluid flowing freely under pressure. If the fluid is serous or purulent, it is important not to confuse it with the contents of the chest, and hemorrhagic exudate with blood from the chambers of the heart. To clarify the location of the needle, you can use an ultrasound sensor; also, in case of myocardial trauma, as a result of a puncture or contact with the needle, ventricular extrasystoles often appear on the ECG.
In response to fluid removal, the patient's condition rapidly improves, primarily due to an increase in cardiac output. After aspiration of the fluid, it is necessary to replacement therapy colloid and crystalloid solutions and leave patients for observation for min 6-12 hours.
Often a single puncture is not enough; you have to repeat them 3-4 times or resort to pericardiotomy. It is important to inform the owner about this so that he is prepared for possible deterioration and constantly keeps in touch with his doctor. According to some reports, timely surgery allows you to significantly increase the duration and quality of life. For patients with idiopathic pericarditis may also have healing effect and does not allow the development of concentric pericarditis, in case of tumor pericarditis, this will avoid tamponade, improve the quality of life and obtain material for histological examination, which means the opportunity for chemotherapy. As for excision of tumors, opinions differ. Surgical excision of angiosarcoma carries a poor prognosis, given that micrometastases are usually already present, with an average survival of about four months. With other types of neoplasms, the survival rate is slightly higher, up to 5-8 months. After performing pericardiotomy, survival rate increases (according to some data, up to 3 years).
Conclusion: Males are more prone to pericarditis average age 5-12 years old, Labrador Retrievers are a more susceptible breed. Echocardiography is the most sensitive means of diagnosing pericarditis, in particular, it allows differentiating various acquired heart diseases that cause cardiomegaly on the radiograph. Conservative therapy+ pericardiocentesis is most effective in combating tamponade, but the main method of treatment, and sometimes the only way to make a final diagnosis, is pericardiotomy.
In cats, pericarditis is usually associated with viral peritonitis or lymphoma, less often it is a consequence of heart failure and in this case the prognosis is not favorable since the risk of developing pulmonary edema is extremely high.
The article was prepared by doctors of the cardiology department of "MEDVET"
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