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Ascites in Dogs

By: Dr. Douglas Brum

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Ascites is the abnormal accumulation of fluid in the abdominal cavity. The volume of the fluid can be quite subtle, or it may be significant, causing distention of the abdomen. Ascites has many causes, most of which can be very serious. Ascites is caused by the leakage of fluid into the abdomen from blood vessels, lymphatics, internal organs or abdominal masses.

Causes

  • Hypoalbuminemia or a decrease in the blood albumin level
  • Severe liver disease
  • Right sided heart failure
  • Abdominal masses
  • Trauma
  • Peritonitis or inflammation of the inner lining of the abdomen
  • Bleeding disorders
  • Diseases of lymphatics
  • Obstruction of the hepatic vein or caudal (lower) vena cava causing compromises in blood circulation

    What to Watch For

  • Abdominal distension
  • Breathing difficulty or increased respiratory effort
  • Abdominal discomfort
  • Lethargy
  • Cough
  • Vomiting
  • Diarrhea
  • Fever
  • Anorexia
  • Weakness

    Diagnosis

    Certain diagnostic tests must be performed for a definitive diagnosis of the underlying cause of ascites. The following tests should be considered:

  • A complete history and physical exam should always be performed
  • Complete blood test (CBC)
  • Biochemical profile
  • Urinalysis
  • Chest and abdominal x-rays
  • Abdominocentesis or peritoneal lavage with fluid analysis and culture. This involves sampling of the fluid from the abdomen for analysis and cultured if infection is suspected

    Based on the results of these initial tests, further diagnostics might include:

  • Bile acid measurements
  • Serum lipase
  • Abdominal ultrasound and ultrasound guided biopsies
  • Echocardiogram
  • Endoscopy (a fiber optic scope that is placed through the mouth and into the stomach and small bowel. The mucosa can be visualized and biopsies obtained)

    Treatment

    An accurate diagnosis is needed for proper therapy. Pending a definitive diagnosis, certain treatments may be appropriate:

  • Therapeutic abdominocentesis (removing a larger amount of fluid from the abdomen) if the amount of abdominal distention is compromising the animal's ability to breath

  • Diuretics to promote fluid excretion

  • Oxygen therapy if the animal is in respiratory distress

  • Intravenous fluids in cases of shock or dehydration

  • Transfusions of blood products

  • Antibiotic therapy if infection is suspected

    Home Care

    Keep your pet calm and minimize stress. Make sure your pet stays warm and provide fresh water if your pet wants to drink. Seek veterinary care immediately if your pet is having trouble breathing or is extremely weak.

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