Fahey Rachel, Rozanski Elizabeth, Paul April, Rush John E
Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA, 01536.
the Tufts VETS, Walpole, MA, 02081.
J Vet Emerg Crit Care (San Antonio). 2017 Mar;27(2):250-252. doi: 10.1111/vec.12570. Epub 2017 Jan 12.
Pericardial effusion (PE) is common in dogs. Clinical signs may be vague until cardiac tamponade and associated cardiovascular decompensation develops. Vomiting has previously been identified in some dogs, but the actual prevalence of vomiting in dogs with PE is unknown. The purpose of this study is to report the prevalence of vomiting associated with PE, and to determine if vomiting is associated with the underlying cause of effusion, presenting plasma lactate concentration, or volume of PE removed.
The medical records of 49 dogs diagnosed with PE were restrospectively reviewed. Data collected from the medical record included signalment, the presence or absence of vomiting, presenting plasma lactate concentration, and the etiology of the PE. Twenty-five of 49 dogs (51%) identified with PE had recently vomited. Vomiting was more common in dogs with presenting plasma lactate concentration > 5.0 mmol/L (P = 0.02) but was unrelated to the specific etiology of the PE. The volume of PE obtained via pericardiocentesis did not differ (P = 0.79) between dogs with (8.7 ± 3.4 mL/kg) and without historical vomiting (9.1 ± 4.3 mL/kg).
Vomiting is common in dogs with PE, and in particular, dogs with evidence of hypoperfusion. Pericardial effusion should be included as a differential diagnosis in dogs with a history of vomiting that present with weakness or collapse.
心包积液(PE)在犬类中很常见。在发生心脏压塞及相关心血管功能失代偿之前,临床症状可能不明显。此前已在一些犬类中发现呕吐症状,但PE患犬中呕吐的实际发生率尚不清楚。本研究的目的是报告与PE相关的呕吐发生率,并确定呕吐是否与积液的潜在病因、就诊时的血浆乳酸浓度或抽出的PE量有关。
对49只被诊断为PE的犬的病历进行了回顾性分析。从病历中收集的数据包括特征、是否存在呕吐、就诊时的血浆乳酸浓度以及PE的病因。49只被诊断为PE的犬中,有25只(51%)近期有呕吐症状。就诊时血浆乳酸浓度>5.0 mmol/L的犬呕吐更为常见(P = 0.02),但与PE的具体病因无关。通过心包穿刺术获取的PE量在有(8.7±3.4 mL/kg)和无既往呕吐史(9.1±4.3 mL/kg)的犬之间没有差异(P = 0.79)。
呕吐在PE患犬中很常见,尤其是有灌注不足证据的犬。对于有呕吐史且出现虚弱或虚脱的犬,应将心包积液纳入鉴别诊断。