Lipoprotein electrophoresis differentiation of chylous and nonchylous pleural effusions in dogs and cats and its correlation with pleural effusion triglyceride concentration

Pleural effusions from 23 dogs and 25 cats hospitalized between November 1986 and April 1987 at the Veterinary Hospital of the University of Pennsylvania (VHUP) were classified as chylous (chylomicrons present) or nonchylous (chylomicrons absent) by the presence or absence, respectively, of a chylomicron band on lipoprotein electrophoresis gels of the effusions. Triglyceride concentrations, cholesterol concentrations, and cholesterol/triglyceride (C/T) ratios were compared between the chylous and nonchylous groups in each species. Cholesterol concentrations were not significantly different between chylous and nonchylous effusions in both dogs and cats. Cholesterol/triglyceride ratios of less than 1 were present in all dogs and cats with chylous effusions; however, 12% of dogs with nonchylous effusions and 50% of cats with nonchylous effusions also had a C/T ratio less than 1. Triglyceride concentrations accurately classified all effusions as chylous or nonchylous in both dogs and cats. Pleural effusions with triglyceride concentrations greater than l00 mg/dl were chylous in all cases, whereas, effusions with triglyceride concentrations less than l00 mg/dl were nonchylous in all cases.     

Evaluation of hemostatic derangements associated with canine anaphylaxis and the relationship to syndrome severity

Objective

To describe hemostatic derangements associated with canine anaphylaxis and to assess for association with syndrome severity.

Design

Prospective observational study.

Setting

University teaching hospital.

Animals

Twenty-seven client-owned dogs, recruited from November 2018 to January 2022, diagnosed with anaphylaxis of varying severity were included. Study inclusion required presentation <6 hours after initiation of clinical signs, no medications or history of illness within the prior 2 weeks, lack of comorbidities expected to affect hemostasis, and lack of a disease state that could alternatively explain the clinical presentation.

Interventions

Blood samples were collected within the first hour of presentation for CBC, serum biochemistry, prothrombin time (PT), activated partial thromboplastin time (aPTT), and viscoelastic coagulation testing for use with a cartridge-based point-of-care device.

Measurements and main results

Clotting time and clot formation time were prolonged, alpha angle and maximum clot firmness were decreased, PT and aPTT were prolonged, and platelet counts were lower in severe cases compared to mild and moderate cases. There were no differences for any parameter between mild and moderate cases. The presence or absence of abdominal effusion was not associated with hemostatic status.

Conclusions

Global hemostatic derangements consistent with hypocoagulability are a prominent feature of severe anaphylaxis in dogs and should be considered for routine evaluation.     

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.     

Thoracoscopic pericardiotomy as a palliative treatment in a cow with pericardial lymphoma

A 5-year-old Holstein cow, pregnant with a valuable calf, was presented with signs of heart failure (tachycardia, peripheral edema, and distended jugular veins) related to pericardial lymphoma and associated cardiac tamponade. In addition, pleural effusion was present in both hemithoraces. Medical treatment, which consisted of repeated pericardiocenteses, placement of indwelling pleural catheters, administration of intravenous fluid therapy, antibiotics and anti-inflammatory drugs, was ineffective in controlling recurrence of clinical signs despite a temporary improvement. A standing thoracoscopic pericardiotomy was performed in an attempt to reduce clinical signs of heart failure and to prolong life. Clinical signs of heart failure abated and no recurrence was seen. Standing thoracoscopic pericardiotomy along with possible corticosteroids can be recommended as palliative treatment in an effort to extend life for reproductive performance in genetically valuable animals.     

Pheochromocytoma Presenting as Acute Retroperitoneal Hemorrhage in a Dog

Objective: This report describes the perioperative management of a dog with a right adrenal pheochromocytoma that presented with acute retroperitoneal hemorrhage, cardiac arrhythmia and hypertension. Additionally, a summary of pheochromocytoma and the idiosyncrasies of perioperative management of a pheochromocytoma are provided.
Summary: A 7-year old male, neutered, Dalmation was presented for acute collapse, abdominal pain and tachycardia. Physical examination findings were consistent with hypoperfusion concurrent with multiple cardiac arrhythmias and hypertension. Abdominal ultrasound revealed retroperitoneal effusion and a right adrenal mass intimately associated with the caudal vena cava. Incomplete right adrenalectomy was performed. Histopathology confirmed a pheochromocytoma.
Unique information provided: To the authors' knowledge, this is the first definitive report of acute retroperitoneal hemorrhage as the initial clinical manifestation of histologically confirmed adrenal pheochromocytoma in the dog. ( J. Vet Emerg Crit Care 2001; 11(3): 221–227 )     

ULTRASONOGRAPHY AS A DIAGNOSTIC AID IN PLEURAL EFFUSION OF HORSES*

Three horses with clinical signs compatible with pleural effusion were examined with diagnostic ultrasound. In one of the three horses, confirmed septic pleural effusion was monitored with ultrasound during a successful treatment regimen. Eficacy of thoracentesis and detection of recurrence of fluid were readily determined. In the second horse, diagnosis of diffuse pleural neoplasia (lymphosarcoma) was made. In the third horse presented for pleural effusion, the effusion was documented and concurrent ascites detected with ultrasound. Carcinomatosis was found at necropsy. Ultrasound examination proved to be a sensitive, noninvasive modality useful in diagnosis and treatment of pleural effusion.