Percutaneous balloon pericardiotomy as a treatment for recurrent pericardial effusion in 6 dogs.

Percutaneous balloon pericardiotomy (PBP) has been performed in people and in a small number of dogs as a treatment for recurrent pericardial effusion with tamponade (PET). We performed this technique on 6 dogs with recurrent PET (5 with heart base tumors and 1 with no identifiable mass). Under general anesthesia and fluoroscopic guidance, a balloon-dilating catheter (diameters 14-20 mm) was introduced percutaneously at the 5th intercostal space through a sheath-introducing catheter, positioned across the parietal pericardium, and inflated 3 times. No dog experienced serious complications. The procedure was considered successful in 4 of 6 dogs. One dog is still alive without recurrence of PET 1 year after the procedure. Three dogs died of unrelated disease without recurrence of PET 5. 19, and 32 months after the procedure. The procedure was not beneficial in 1 dog that was euthanized 9 weeks later because of recurrence of pleural and abdominal effusion thought to be secondary to PET. One dog may have temporarily benefited but developed symptomatic PET 6 months after PBP. PBP appears to be a safe, economical, and potentially effective palliative treatment for recurrent PET and is a reasonable, less invasive alternative to surgery for dogs with recurrent PET, especially effusions caused by heart base tumors and possibly idiopathic pericardial effusion. Premature closure of the stoma is a potential cause for long-term failure and was thought to have been responsible for the recurrence of clinical signs in 2 dogs.

Heartworm infection in cats: 50 cases (1985-1997).

OBJECTIVE: To characterize risk factors, clinical findings, usefulness of diagnostic tests, and prognosis in cats with naturally occurring heartworm infection (HWI). DESIGN: Retrospective study. ANIMALS: 50 cats with Dirofilaria immitis infection. PROCEDURE: Medical records, thoracic radiographs, and echocardiograms were reviewed and findings compared with appropriate reference populations. RESULTS: Findings suggested that male cats were not predisposed to HWI, domestic shorthair cats were at increased risk, and indoor housing was only partially protective. Fewer cases of HWI were identified in the final quarter of the year, compared with other periods, and prevalence is not apparently increasing. Signs of respiratory tract disease were most common, followed by vomiting. Infection was diagnosed incidentally in > 25% of cats; conversely, 10% of infected cats died suddenly without other clinical signs. Serologic tests were most useful for diagnosis, followed by radiography and echocardiography. Eosinophilia supported the diagnosis. Overall median survival time was 1.5 years but exceeded 4 years in cats surviving beyond the day of diagnosis. CONCLUSIONS AND CLINICAL RELEVANCE: Sex does not appear to be a risk factor for HWI in cats, and indoor housing provides only incomplete protection. Signs of respiratory tract disease (dyspnea and cough) are the strongest indicators of HWI in cats, and some radiographic evidence of infection is detected in most cases. Antibody screening for HWI in cats is efficacious, and antigen testing and echocardiography are most useful for making a definitive antemortem diagnosis.