Question Details
Pericardial Effusion In A Dog
by Carole Nicholson - December 6, 2024    View Case Report
This is my 13 1/2 year old F/S Jack Russell Libby.
History of liver disease of unknown origin in 2020. Completely resolved.
Currently, Libby has seemed fine in recent years except for atopic dermatitis.
I gave her a cytopoint injection on 11-21-24.I've never had any side effects in any of my patients and always considered it pretty safe.
It may be a red herring because it is hard for me to imagine any connection to what happened this week.
2 days after the injection, she started becoming fussy with food. This is a dog who would jump up and down as I prepared their meals.
Her appetite has been down since Sunday Nov 24th.
Blood work on Wed Nov 27th was all normal.
I scheduled an ultrasound this week and on Wed Dec 4th, abdominal ultrasound showed no abdominal masses but she had some ascites.
An echo showed pericardial effusion but no obvious mass.
I got her into a cardiologist a few hours later, the echo was repeated and again, no heart mass. The effusion was removed and it was bloody.
Cardiologist said bloody effusion usually means neoplasia or idiopathic but her positive troponin leans towards occult neoplasia.
I was hoping for some weird infection because she thought she saw some white particles in the effusion on the echo.
She is scheduled for a recheck in 2 weeks.
She is eating somewhat better.
To say I'm devastated is an understatement . She is an earth personality.
Tongue has remained pink thru out.
Her pulses are hard to feel so I guess deep?
I have done rectal ozone on her for the last 5 days, homotoxicology. She is not great for acupuncture.
I have her on turkey tail mushrooms from Adored Beast.
I am not great with herbs but I ordered every herb recommended from A Time to Heal for HSA.
It may be too much, powders will probably be hard to get in her.
The delivery came as I am writing this- . order included HSA compound, Bilberry, Chau Hu Jia Long Gu Mu, Dang Gun Shen, modified Xue Fu Zhu Yu Tang, Yun Zhi.
Of course, as of 2 days ago, no solid tumor on the heart muscle was seen on 2 different ultrasounds.
I feel like I should do something.
Thanks
Replies
by Carole Nicholson
December 10, 2024
I have not heard any comments yet on this post but wondering if it is safe to use the HSA formula when the case is not confirmed neoplasia?
by naturevet
December 11, 2024
Hi Carole,

Sorry about the delayed reply. A little too much on my plate these days. Sorry about the news as well. It's always harder when dealing with your own dog. To answer your question, HSA is safe to try even if not diagnosed yet as having hemangiosarcoma.

Most heart-based tumors I've treated have done well on Modified Xue Fu Zhu Yu Tang and Minor Bupleurum. You could use HSA, I guess, instead of the Minor Bupleurum, but I would use the Modified XFZYT. Yun Zhi is a good idea as well, and of course the Bilberry.

Hopefully it will be idiopathic. I've seen one dog that had that tendency and they did well on mXFZYT and XCHT, but still needed periodic taps. With the herbs in play, the taps were needed less and less frequently. The dog did eventually pass, but not from the effusion. I think it developed a metastatic mammary tumor in the end and it was years later.

Troponin doesn't seem particularly specific as an indicator of a tumor. It also indicates pericardial and cardiac disease, including DCM, so I wouldn't over interpret it. It's not telling you something you don't know already, as far as I can tell.

Let us know what you try and what happens. Hopefully it's all good news from here!

Steve
by Carole Nicholson
December 18, 2024
Hey Steve- I took Libby for a follow up echo today and there was no sign of tumor.
There was still a little fluid in the pericardial sac.
I am hoping it is not new as the cardiologist commented it looked like the same amount as the post tap echo 2 weeks ago.
I'm hoping it takes time to dissipate? Fingers crossed!?
No ascites.
Mostly good news- another follow up Jan 3rd.
My friend Vicki saw you on a YouTube video with Dr Judy Morgan I think?
She mentioned you recommended ginseng, dandelion, hawthorn , and CoQ10.
I have the latter 3 but can not find a source of ginseng.
I guess there is a white or red or American. And I hear people use it in combo products?
Thanks for your help!
by naturevet
December 19, 2024
Hi there,

You have Ginseng on board already if you're using XCHT (Minor Bupleurum) or HSA Combination or CHJLGMLT. The other herbs mentioned on the Dr. Judy program are more for mitral valve disease, CHF, and the like. Not so much for a tumor.

I'm glad the problem seems under control already! That bodes well for the future. Rather than add much that is new in, if anything I would just double up on what you're using, if your dog will accept it.

Please continue to keep us posted! :-)

Steve
by Carole Nicholson
December 19, 2024
Hey Steve- can some herbs cause gas?

I started Libby on Bilberry, Modified Due Fu Zhu You and Xiao Chai Hu Tang a few days ago. She had alot of gas the last few nights, especially last night. She didn't want to eat this morning.
I took her for a repeat echo yesterday and the news was pretty good. Ascites gone, no visible tumor but a little bit of fluid still in the pericardial sac. The images look similar to the post tap images from 2 weeks ago- they obviously can't remove every drop of fluid from the sac and I wonder how long it takes to reabsorb? Hope that's what it is and not new effusion.
Anyway, something that may change the therapy and outlook is that this could be a result of blunt force trauma. I had not thought about it when posting the original on Dec 6th but I looked up causes of tamponade/effusion and troponin abnormalities in humans and animals. Tropoinin can be from any insult to the heart muscle and trauma to the chest can cause effusion.
The day before her appetite started to drop almost 4 weeks ago now, I was taking her to a rally obedience practice in preparation for a big competition she had coming up in Florida last week( we obviously did not go)
I practiced the broad jump with her, a jump she used to do with ease. Dogs her size have to jump horizontally over 2 planks which are angled diagonally up and spaced about 16 inches to clear. The plastic is very hard and not compressible. ( Companies are now making foam ones which is good)
She slammed into that thing so hard and was splayed out with her front legs ABducted. When it happened , I was mortified and thought her muscles would be sore but never thought about what was inside her rib cage.
She took the blow across her sternum and I wonder if it could have caused bruising to her heart?
I did not start yunnan baiyao until the cardiologist suggested it on Dec 4th. I have her on traumeel ( poor dog is getting so many things)
Cardiologist apologized fr not asking about blunt force trauma on Dec 4th. I'm not sure she is convinced that is the cause but she can't say it's not. I have another follow up on Jan 3rd. Libby was pretty happy yesterday and ate well and then this morning...Ugghhh....
Hope it's just the gas...
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