Subtotal pericardectomy and epicardial excision for treatment of coccidioidomycosis-induced effusive-constrictive pericarditis in dogs: 17 cases (1999–2003)

Abstract
Objective—To determine the history, clinicopathologic findings, and results of surgery for effusive-constrictive pericarditis associated withCoccidioides immitisinfection in dogs.Design—Retrospective study.Animals—17 client-owned dogs that underwent a subtotal pericardectomy and epicardial excision.Procedure—Hospital records from May 1999 to June 2003 were reviewed. Data collected included history, clinicopathologic findings, treatments, and outcome. Follow-up information was obtained via recheck examination and by use of standardized telephone interviews with referring veterinarians and owners.Results—All dogs were of large breeds, and most were male (mean age, 4.66 years). Ten dogs had no prior history ofC immitisinfection, and 7 dogs had chronic infection withC immitis. Having a chronicC immitisinfection reduced the odds of survival, compared with no previous infection. All dogs had clinical signs of right-sided heart failure. All dogs had serum titers (range, 1:8 to 1:256) for antibodies againstC immitisprior to surgery, and titers were not significantly associated with outcome. Predominant echocardiographic findings were thickened pericardium, reduced right ventricular filling, and pleural or pericardial effusion. All dogs underwent a subtotal pericardectomy and epicardial excision and had fibrosing pyogranulomatous pericarditis in biopsy specimens obtained during surgery. The perioperative mortality rate was 23.5%, and the 2-year postdischarge survival rate was 82%.Conclusions and Clinical Relevance—Surgical treatment via subtotal pericardectomy and epicardial excision is successful at relieving right-sided heart failure in dogs with effusive-constrictive pericarditis secondary toC immitisinfection, but long-term treatment with antifungal agents may still be required. (J Am Vet Med Assoc2005;227:435–440)

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