Study of Echocardiography, Radiography and Blood Findings of Dogs with Uremic Pericardial Effusion

Document Type : Original Article

Authors
1 Department of Clinical Science, Faculty of Specialized Veterinary Sciences, Science and Research Branch, Islamic Azad University, Tehran, Iran.
2 Department of laboratory and clinical Science faculty of veterinary Medicine, Ilam University, Ilam, Iran.
3 Department of Clinical Science, Faculty of Specialized Veterinary Sciences, Tehran, University, Tehran, Iran.
10.22034/ijvcs.2023.14405.1048
Abstract
The purpose of this study was to identify and compare echocardiographic, radiographic and blood findings of dogs with uremic pericardial effusion. The study was conducted on 6 terrier dog. After examination, the dogs were equally divided into two groups: patient (uremic pericardial effusion) and control (without any cardiac disorders). All dogs were recorded to evaluate echocardiography, radiography, kidney biochemistry and blood factors. The results of radiography showed that the shadow of the heart of all patient dogs is round and large. There is a statistically significant difference between the echocardiographic factors measured in the two factors of ejection fraction and the pericardial fluid between groups (Respectively P=0.05 and 0.001). The average hematocrit, hemoglobin concentration and MCV in the patient group were significantly lower than the control group (Respectively P=0.04, 0.01 and 0.01). Also, the Mean of Urea and BUN in the patient group was significantly higher than the control group (P=0.02). In addition, the findings revealed that there is a positive and significant statistical correlation between the amount of fluid accumulation in the pericardium and Urea and BUN (P=0.04). Therefore, it can be concluded from the results of this study that, firstly, echocardiography is a suitable tool for diagnosing pericardial effusion disease, and secondly, in the severe state of changes in renal enzymes, the amount of fluid accumulation in the pleural membrane is higher.
Keywords

1.     Aghsaeifard, Z; Firouzi, R. and Alizadeh, R; Predisposing factors and uremic pericardial effusion among ESRD patients undergoing dialysis. Ann. Med. Surg; 2022; 77: 553-579.
2.     Almeras, C. and Argilés À; Progress in uremic toxin research: the general picture of uremia. Semin Dial; 2009; 22: 329333.
3.     Anavekar, NS. and Pfeffer MA. Cardiovascular risk in chronic kidney disease. Kidney Int; 2004; 66: S11S15.
4.     Bataille, S; Brunet, P; Decourt, A; Bonnet, G; Loundou, A; Berland, Y; Habib, G. and Vacher-Coponat, H; Pericarditis in uremic patients: serum albumin and size of pericardial effusion predict drainage necessity. J. Nephrol; 2015; 28: 97-104.
5.     Berg, R; Pericaridial effusion in the dog; A review of 42 cases. J Am Anim Hosp Assoc; 1983; 20: 721-730.
6.     Boaz, M; Smetana, S. and Weinstein, T; Secondary prevention with antioxidants of cardiovascular disease in endstage renal disease (SPACE): randomised placebo-controlled trial. Lancet; 2000; 356: 12131218.
7.     Celona, B; Crinò, C; Giudice, E. and Di Pietro, S; Evaluation of pericardial effusion in dogs and successful treatment using a hemodialysis fistula needle: a retrospective study. Top Companion Anim Med; 2017; 32(2): 72-75.
8.     Chun, R; Kellihan, H. B; Henik, R. A. and Stepien, R. L; Comparison of plasma cardiac troponin I concentrations among dogs with cardiac hemangiosarcoma, noncardiac hemangiosarcoma, other neoplasms, and pericardial effusion of nonhemangiosarcoma origin. AVMA; 2010; 237(7): 806-811.
9.     Côté, E; Schwarz, L. A. and Sithole, F; Thoracic radiographic findings for dogs with cardiac tamponade attributable to pericardial effusion. AVMA; 2013; 243(2): 232-235.
10.  Cumming, G; Pericarditis. Canadian Family Physician; 1981; 27, 643.
11.  Gluck, N; Fried, M. and Porat, R; Acute renal failure as the presenting symptom of pericardial effusion. Internal Medicine; 2011; 50(7): 719-721.
12.  Guglielmini, C; Diana, A; Santarelli, G; Torbidone, A; Di Tommaso, M; Toaldo, M. B. and Cipone, M; Accuracy of radiographic vertebral heart score and sphericity index in the detection of pericardial effusion in dogs. AVMA; 2012; 241(8): 1048-1055.
13.  Hager, E. B; Clinical observations on five patients with uremic pericardial tamponade. NEJM, 273(6): 304-308.
14.  Hall, D. J; Shofer, F; Meier, C. K. and Sleeper, M. M; Pericardial effusion in cats: a retrospective study of clinical findings and outcome in 146 cats. JVIM; 2007; 21(5): 1002-1007.
15.  Hoit, B. D; Diagnosis and treatment of pericardial effusion. U: UpToDate. LeWinter MM, Sexton DJ ur., Downey BC ur. UpToDate (Internet); 2017; 2-61.
16.  Kerstetter, K. K; Krahwinkel, D; Millis, D. L. and Hahn, K; Pericardiectomy in dogs: 22 cases (1978-1994). AVMA; 1997; 211: 736-740.
17.  Klein, A. L; Abbara, S; Agler, D. A; Appleton, C. P; Asher, C. R; Hoit, B.; Hung, J; Garcia, M. J; Kronzon, I. and Oh, J. K; American Society of Echocardiography clinical recommendations for multimodality cardiovascular imaging of patients with pericardial disease: endorsed by the Society for Cardiovascular Magnetic Resonance and Society of Cardiovascular Computed Tomography. JASE; 2013; 26(9): 965-1012. e1015.
18.  MacDonald, K. A; Cagney, O. and Magne, M. L; Echocardiographic and clinicopathologic characterization of pericardial effusion in dogs: 107 cases (1985–2006). JVMA; 2009; 235(12): 1456-1461.
19.  MacGregor, J. M; Faria, M. L; Moore, A. S; Tobias, A. H; Brown, D. J. and de Morais, H. S; Cardiac lymphoma and pericardial effusion in dogs: 12 cases (1994–2004). JVMA, 227(9): 1449-1453.
20.  Merce, J; Sagrista-Sauleda, J; Permanyer-Miralda, G; Evangelista, A. and Soler-Soler, J; Correlation between clinical and Doppler echocardiographic findings in patients with moderate and large pericardial effusion: implications for the diagnosis of cardiac tamponade. Am Heart J; 1999; 138:759–64.
21.  Pepi, M. and Muratori, M; Echocardiography in the diagnosis and management of pericardial disease. J Cardiovasc Med; 2006; 7(7): 533-544.
22.  Pérez-Casares, A; Cesar, S; Brunet-Garcia, L. and Sanchez-de-Toledo, J; Echocardiographic evaluation of pericardial effusion and cardiac tamponade. Frontiers in pediatrics; 2017; 5, 79.
23.  Pupim, LB; Himmelfarb, J; McMonagle, E; Shyr, Y;. and Ikizler, TA; Influence of initiation of maintenance hemodialysis on biomarkers of inflammation and oxidative stress. Kidney Int; 2004; 65: 23712379.
24.  Rehman, K. A; Betancor, J. Xu; Kumar, A; Rivas, C. G; Sato, K; Wong, L. P; Asher, C. R; and Klein, A. L; Uremic pericarditis, pericardial effusion, and constrictive pericarditis in end‐stage renal disease: Insights and pathophysiology. Clin. Cardiol; 2017; 40(10): 839-846.
25.  Reuter, H; Burgess, L. J. and Doubell, A. F; The role of chest radiography in diagnosing patients with tuberculous pericarditis: Cardiovascular topic. CVJA; 2005; 16(2): 108-111.
26.  Roberts, W. C; Pericardial heart disease: its morphologic features and its causes. Paper presented at the Baylor University Medical Center Proceedings; 2005.
27.  Rostand, SG. and Rutsky, E; Pericarditis in end-stage renal disease. Cardiol Clin. 1990; 8: 701707.
28.  Sadjadi, S. A. and Mashhadian, A; Uremic pericarditis: a report of 30 cases and review of the literature. The American journal of case reports. 2015; 16, 169.
29.  Saklayen, M; Anne, V. V. and Lapuz, M; Pericardial effusion leading to acute renal failure: two case reports and discussion of pathophysiology. AJKD; 2002; 40(4): 837-841.
30.  Shaw, S. P. and Rush, J. E; Canine pericardial effusion: diagnosis, treatment, and prognosis. Compendium; 2007; 29: 405-411.
31.  Sisson, D; Pericardial disease and cardiac tumors. Textbook of canine and feline cardiology; 1999; 679-701.
32.  Stepien, R; Whitley, N. and Dubielzig, R; Idiopathic or mesothelioma‐related pericardial effusion: clinical findings and survival in 17 dogs studied retrospectively. JSAP; 2000; 41(8): 342-347.
33.  Tonelli, M. and Pfeffer, MA; Kidney disease and cardiovascular risk. Annu Rev Med; 2007; 58: 123139.