• Presence of pericardial effusion:
  • Particularly if cardiac tamponade and cardiovascular and respiratory compromise are present.
  • Secondary to cardiac disease.
  • Secondary to neoplasia: lymphoma.
• Trauma: uncommonly reported in exotic animals.
• Sampling of pericardial fluid for cytology Cytology: fine needle aspirate and/or microbial culture and sensitivity in pericardial disease: pericarditis (bacterial, fungal, inflammatory, migrating foreign body).

Uses

Advantages

• Allows rapid reduction of increased pericardial pressures associated with pericardial effusion:
  • Acute management of clinical signs associated with cardiac tamponade and/or respiratory compromise.
• Relatively non-invasive and low risk with sufficient expertise.

Disadvantages

• Risk of cardiac puncture or pulmonary laceration.
• Chemical restraint (sedation or general anesthesia Anesthesia: protocols) is usually required:
  • Increased anesthetic risk as majority of exotic animals requiring pericardiocentesis present with cardiovascular and/or respiratory compromise.
• Risk of further hemorrhage in cases of hemorrhagic pericardial effusion due to coagulopathy or cardiac trauma.

Technical problems

• Insufficient pericardial fluid volume.
• Distension of the pericardium by solid tumors limiting safe access into the pericardial space.

Alternative techniques

• Pericardiectomy.

Time required

Preparation

• Should be relatively rapid.
• All equipment and consumables should be readily accessible in most modern veterinary services.

Procedure

• Approx. 30 min: exact timeframe would depend on veterinary expertise and level of patient sedation/anesthesia Anesthesia: protocols required.

Decision taking

Criteria for choosing test

• Pericardial disease: identification of underlying etiology.
• As a therapeutic procedure when pericardial effusion is present:
  • Cardiac tamponade and/or respiratory compromise associated with pericardial effusion.
  • Declining clinical status.
• Client consent.

Risk assessment

• Clinical status of the animal:
  • Demeanor.
  • Vital signs.
  • Bloodwork: complete blood count Hematology, serum biochemistry Blood biochemistry: overview, acid-base status, blood gases, coagulation times.
• Evidence of pericardial effusion on echocardiography.
• Demonstration of significant cardiovascular and respiratory compromise as a consequence of pericardial effusion would often necessitate emergency pericardiocentesis.