Septic pericarditis in a cat with pyometra.
ABSTRACT OBJECTIVE: To describe a unique cause of septic pericarditis in a cat and detail the successful case management strategy. CASE SUMMARY: A 6-year-old sexually intact female Ragdoll cat was evaluated for a 7-day history of progressive lethargy, anorexia, and vaginal discharge. Thoracic radiographs revealed a markedly globoid cardiac silhouette and pleural effusion while the initial echocardiogram showed moderate volume pericardial effusion. Following pericardiocentesis, cytologic evaluation of the pericardial effusion revealed septic suppurative inflammation with intra- and extracellular Gram-negative rod-shaped bacteria. Abdominal ultrasound demonstrated a moderate amount of echogenic uterine fluid accumulation with a right-sided uterine horn mass. After stabilization with pericardiocentesis, IV fluid therapy and IV antimicrobials, the cat underwent ovariohysterectomy and partial pericardiectomy. Histopathology confirmed a diagnosis of pyometra and septic pericarditis. Uterine and pericardial fluid bacterial culture yielded Escherichia coli with identical antimicrobial sensitivity spectrums. NEW OR UNIQUE INFORMATION PROVIDED: Septic pericarditis is a rare cause of pericardial effusion in the cat. Previous reported cases have either suggested the cause to be secondary to transient bacteremia resulting from a local infection seeding the pericardium or for the cause to remain unknown. To the authors' knowledge, this is the first veterinary report of septic pericarditis resulting from hematogeneously spread bacteria originating from a urogenital infection. It is also the first report of successful surgical management of septic pericarditis in the cat.
Article: Pericardial Disease[Show abstract] [Hide abstract]
ABSTRACT: Acute pericarditis typically is a self-limited disease, usually idiopathic or of viral origin, that responds to treatment with NSAIDs. The recent COPE Trial indicates a better outcome if all patients receive a 3-month course of colchicine. The use of steroids to treat acute pericarditis should be avoided because they increase the risk of recurrence. Cardiac tamponade is a life-threatening condition caused by a pressurized pericardial effusion. Doppler echocardiography plays a key role in its recognition, and echocardiogram-guided pericardiocentesis has become the treatment of choice in most instances. Pericardial constriction is a potentially treatable cause of chronic heart failure that must be distinguished from restrictive cardiomyopathy. This can be accomplished with a combination of Doppler echocardiography, Doppler tissue imaging, MRI, and cardiac catheterization. In effusive constrictive pericarditis, the cardiac compression is due to both a pressurized pericardial effusion and pericardial restriction. Pericardiocentesis converts the hemodynamics from tamponade to constriction.Circulation 04/2006; 113(12):1622-32. DOI:10.1161/CIRCULATIONAHA.105.561514 · 14.95 Impact Factor
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ABSTRACT: Records were reviewed from 83 cases to determine the main causes and clinical significance of feline pericardial effusion. The most common causes included hypertrophic cardiomyopathy with congestive heart failure, neoplasia, and systemic infection. Most cases had concurrent or secondary pleural effusion or pulmonary edema, with clinical signs of respiratory disease. However, several cases appeared to be affected solely by pericardial effusion rather than pulmonary pathology. Feline pericardial effusion remains an infrequent diagnosis, but its clinical relevance and association with severe cardiac and extracardiac disease warrant diagnostic evaluation.Journal of the American Animal Hospital Association 01/2008; 44(1):5-9. DOI:10.5326/0440005 · 0.78 Impact Factor
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ABSTRACT: Pericardial effusion (PE) in dogs most often is associated with neoplasia or idiopathic pericarditis, and frequently causes cardiac tamponade. Studies of PE in the cat are limited. Congestive heart failure (CHF) is the most common cause of PE in the cat. All cats diagnosed with PE on echocardiographic examination at the Matthew J. Ryan Veterinary Hospital of the University of Pennsylvania (MJR-VHUP) from 2000 to 2005. The clinical and pathologic findings in 146 cats with PE were reviewed. Records were examined retrospectively to identify additional underlying conditions. Follow-up status and cause of death were determined by review of the medical records or phone interviews with the owners. The most common cause of PE in this study was CHF (75%). Biochemical abnormalities were uncommon, but aspartate aminotransferase (AST) activity frequently was increased (85%). Follow-up information was available on 108 cats (74%). Median survival time (MST) was 144 days for cats that were not euthanized within 24 hours (n = 85). The MST of cats with heart failure was 41 days, whereas the MST of cats without heart failure was 361 days, when those euthanized within 24 hours were excluded. Survival time of cats with heart failure in this study was significantly shorter than previously reported, and significantly shorter than in cats without heart failure as a cause of PE.Journal of Veterinary Internal Medicine 09/2007; 21(5):1002-7. DOI:10.1892/0891-6640(2007)21[1002:PEICAR]2.0.CO;2 · 2.22 Impact Factor