Pericardial Disease in Cats

Pericardial Disease in Cats

By: PetPlace Veterinarians

Section: Veterinary Care In-depth

Diagnosis In-depth

Various diagnostic tests are necessary to diagnose pericardial disease and determine the underlying cause.

  • A complete blood count (CBC) is performed to evaluate the red blood cells, white blood cells, and platelets. In some cats, the red blood cell count may be low, indicating anemia. If the white blood cell count is elevated, it may indicate infection.

  • Serum biochemistry profile is performed to evaluate electrolyte levels and organ function. Various abnormalities may be detected, including kidney disease or liver disease.

  • Radiographs (X-rays) of the chest are performed to help determine if pericardial disease is present. When there is pericardial effusion, the heart will appear larger than normal and globoid. If a hernia is present, loops of intestine may be seen overlying the heart.


  • A barium contrast X-ray may be recommended if peritoneopericardial hernia is suspected and cannot be confirmed on plain radiographs. Barium is a liquid that, when ingested, shows up readily on X-rays. If intestinal loops are present within the pericardium, barium will help confirm their presence.

  • Ultrasound is the best way to diagnose pericardial disease. Ultrasound of the heart, called an echocardiogram, shows if a hernia is present or if fluid is present. With the help of ultrasound, fluid around the heart can be removed with a needle and subsequently evaluated. The heart can also be evaluated to determine if a tumor is present.

    Treatment In-depth

    Treatment varies on the type and severity of pericardial disease. Treatments may include the following:

  • For most cases of peritoneopericardial diaphragmatic hernia, no treatment is necessary since most cat are clinically unaffected. If the cat becomes ill or has difficulty breathing, surgery is necessary to repair the hernia.

  • Treatment for pericardial effusion involves removal of the fluid (pericardiocentesis) and treatment of the underlying cause. Once a significant amount of fluid is removed with a catheter or needle, additional therapy can be administered. Sometimes, repeated removal of fluid is necessary.

  • Medical therapy is rarely indicated for treatment of pericardial effusions. If the cat has collapsed, or has profoundly low blood pressure, intravenous fluids may be needed for resuscitation. Furosemide or other medications supposed to reduce fluid in the pericardium have not been shown effective.

  • Surgery may be necessary for successful management of pericardial diseases. Removal of the pericardial sac may be indicated where there is recurrent effusion of unknown cause. Treatment for infective pericardial disease involves catheter drainage of the pericardium, subsequent surgical removal and drainage of the pericardial space (to prevent constriction), and specific antibiotic therapy based on culture.

    Surgery is also indicated if constrictive pericardial disease is diagnosed or highly suspected. If a tumor is suspected but cannot be confirmed on ultrasound, surgery may be needed to determine whether a tumor is present or to attempt to remove the tumor. In some cases in which hemorrhagic pericardial effusion is caused by a tumor, a small window may be cut into the pericardium to allow the blood to leak out of the sac and into the chest cavity, where it can be absorbed.

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