The laboratory diagnostic approach to thoracic and abdominal effusions in the dog, cat, and horse


Keywords:
effusion pleural peritoneal laboratory diagnostic approach
L. V. ATHANASIOU
M. SPYROPOULOU
K. MEICHNER
Abstract

Cases involving pleural and peritoneal effusions occur relatively frequently in clinical practice. Determining the underlying etiology in these cases relies mainly on fluid analysis. The technique used for obtaining the pleural or peritoneal fluid can impact greatly the results of the analysis. Most often used diagnostic tools include evaluation of gross appearance, Total Nucleated Cell Count / Total Protein (TNCC/TP) measurement, chemical/biochemical analysis (Lactate dehydrogenase and lactate, cholesterol, triglycerides, glucose, creatinine, pH, pO2, pCO2, and K measurements), cytology (identification of septic and non-septic inflammation and neoplasia), microbiology (Gram stain, culture, molecular techniques), and specific tests for certain clinical conditions and diseases. Classifying an effusion as transudate, modified transudate and exudate is traditionally based on the TNCC and TP values. New diagnostic methods encourage the clinician to approach the effusion etiologically instead of strictly following this traditional classification. Many of the diagnostic tests described in this review are simple and can be performed in-house, providing the clinician quickly with information about the cause of the effusion, essential for an effective treatment plan without wasting valuable time.

Article Details
  • Section
  • Review Articles
Downloads
Download data is not yet available.
References
Alho AM, Silva J, Fonseca MJ, Santos F, Nunes C, Carvalho LM, Rodrigues M, Cardoso L (2016) First report of Cytauxzoon sp. infection in a domestic cat from Portugal. Parasit Vectors 9(1):220.
Assawasaksakul T, Boonsarngsuk V, Incharoen P (2017) A comparative study of conventional cytology and cell block method in the diagnosis of pleural effusion. J Thorac Dis 9(9):3161-3167.
Ben Oz J, Aroch I, Segev G (2016) Increased ratio of peritoneal effusion-to-serum potassium concentration in a dog with gastric perforation. J Vet Emerg Crit Care (San Antonio) 26(6):793-797.
Bohn AA (2017) Analysis of canine peritoneal fluid analysis. Vet Clin North Am Small Anim Pract 47(1):123-133.
Bonczynski JJ, Ludwig LL, Barton LJ, Loar A, Peterson ME (2003) Comparison of peritoneal fluid and peripheral blood pH, bicarbonate, glucose, and lactate concentration as a diagnostic tool for septic peritonitis in dogs and cats. Vet Surg 32(2):161-166.
Boom R, Butler CM, Oldruitenborgh-Oosterbaan M (2010) The usability of peritoneal lactate concentration as a prognostic marker in horses with severe colic admitted to a veterinary teaching hospital. Equine Vet Educ 22(8):420-425.
Bradford K, Meinkoth J, McKeirnen K, Love B (2013) Candida peritonitis in dogs: report of 5 cases. Vet Clin Pathol 42(2):227-233.
Brudvig JM, Swenson CL (2015) Total nucleated cell and leukocyte differential counts in canine pleural and peritoneal fluid and equine synovial fluid samples: comparison of automated and manual methods. Vet Clin Pathol 44(4):570-579.
Cherry NA, Diniz P, Maggi RG, Hummel JB, Hardie EM, Behrend EN, Rozanski E, DeFrancesco TC, Cadenas MB, Breitschwerdt EB (2009) Isolation or molecular detection of Bartonella henselae and Bartonella vinsonii subsp. berkhoffii from dogs with idiopathic cavitary effusions. J Vet Intern Med 23:186-189.
Culp WT, Holt DE (2010) Septic peritonitis. Compend Contin Educ Vet 32(10):10.
Dempsey SM, Ewing PJ (2011) A review of the pathophysiology, classification, and analysis of canine and feline cavitary effusions, J Am Anim Hosp Assoc 47:1-11.
Duesterdieck-Zellmer KF, Riehl JH, McKenzie EC, Firshman AM, ME Payton ME, Gorman ME (2014) Effects of abdominocentesis technique on peritoneal fluid and clinical variables in horses. Equine Vet Educ 26(5):262-268.
Fischer Y, Sauter-Louis C, Hartmann K (2012) Diagnostic accuracy of the Rivalta test for feline infectious peritonitis. Vet Clin Pathol 41(4):558-567.
Fry MM (2011) Diagnosis of uroabdomen. In: Nephrology and urology of small animals, Wiley-Blackwell, Ames, Iowa: pp 73-74.
Glińska-Suchocka K, Sławuta P, Jankowski M, Kubiak K, Spużak J, Borusewicz P (2016) An analysis of pH, pO2 and pCO2 in the peritoneal fluid of dogs with ascites of various etiologies. Pol J Vet Sci 19(1):141-145.
Guieu LVS, Bersenas AME, Holowaychuk Mk, Brisson BK, Weese JS (2015) Serial evaluation of abdominal fluid and serum amino-terminal pro-C-type natriuretic peptide in dogs with septic peritonitis. J Vet Intern Med 29:1300-1306.
Held J, Schmitz R, Linden M, Nuhrenberg T, Hacker G, Neumann FJ (2014) Purulent pericarditis and pneumonia caused by Streptococcus equi subsp. Zooepidemicus. J Med Microbiol 63:313-316.
Hughes KJ, Rendle DI, Higgins S, Barron R, Cowling A Love, S, Durham AE (2016) Effect of storage time and temperature on the results of analysis of synovial and mesothelial fluids. Equine Vet J 49(2):232-237.
Jiménez D, Dıaz G, Garcıa-Rull S, Vidal R, Sueiro A, Light RW (2006) Routine use of pleural fluid cultures. Are they indicated? Limited yield, minimal impact on treatment decisions. Respir Med 100(11):2048-2052.
Kirby BM (2012) Peritoneum and retroperitoneum. In: Veterinary Surgery, Small animal, Volume II, Saunders, St. Louis, Missouri: pp 1391-1424.
Koenig A, Verlander LL (2015) Usefulness of whole blood, plasma, peritoneal fluid, and peritoneal fluid supernatant glucose concentrations obtained by a veterinary point-of-care glucometer to identify septic peritonitis in dogs with peritoneal effusion. J Am Vet Med Assoc 247:1027-1032.
Koksal D, Demirag F, Bayiz H, Koyuncu A, Mutluay N, Berktac B, M Berkoglu M (2013) The cell block method increases the diagnostic yield in exudative pleural effusions accompanying lung cancer. Turk Patoloji Derg 29: 165-170.
Light RW (2013) The Light criteria: The beginning and why they are useful 40 years later. Clin Chest Med 34:21-26.
Lloret A, Addie DD, Boucraut-Baralon C, Egberink H, Frymus T, Gruffydd-Jones T (2015). Cytauxzoonosis in cats: ABCD guidelines on prevention and management. J Feline Med Surg 17:637-641.
Marcos R, Santos M, Marrinhas C, Caniatti M (2017) Cell tube block: a new technique to produce cell blocks from fluid cytology samples. Vet Clin Pathol 46(1):195-201.
Mazan M (2018) Pleural fluid. In: Interpretation of Equine Laboratory Diagnostics, 1st ed, John Wiley & Sons Inc, New Jersey: pp 379-381.
Meakin LB, Salonen LK, Baines SJ, Brockman DJ, Gregory SP, Halfacree ZJ, Lipscomb VJ, Lee KC (2013) Prevalence, outcome and risk factors for postoperative pyothorax in 232 dogs undergoing thoracic surgery. J Small Anim Pract 54(6):313-317.
Piviani M (2014) Cytology of the lower respiratory tract. In: Equine Clinical Pathology, Wiley Blackwell Inc, Ames, Iowa: pp 233-251.
Porcel JM (2013) Pleural fluid biomarkers beyond the Light criteria. Clin Chest Med 34:27-37.
Priestnall S, Erles K (2011) Streptococcus zooepidemicus: an emerging canine pathogen. Vet J 188(2):142-148.
Probo M, Valenti V, Venco L, Paltrinieri S, Lavergne E, Trumel C, Bertazzolo W (2018) Pleural lymphocyte-rich transudates in cats. J Feline Med Surg 20(8):767-771.
Radlinsky MG (2012) Thoracic cavity. In: Tobias KM, Johnston SA, Veterinary Surgery, Small animal, Volume II, Saunders, St. Louis, Missouri: pp 1787-1812.
Rahman NM, Mishra EK, Davies HE, Davies RJO, Lee YCG (2008) Clinically important factors influencing the diagnostic measurement of pleural fluid pH and glucose. Am J Respir Crit Care Med 178:483-490.
Reuss SM, Giguère S (2015) Update on bacterial pneumonia and pleuropneumonia in the adult horse. Vet Clin Equine 31:105-120.
Romero AE, Nieto JE, Dechant JE, Hopper K, Aleman M (2011) Effects of aerobic and anaerobic fluid collection on biochemical analysis of peritoneal fluid in healthy horses and horses with colic. Vet Surg 40(1):40-45.
Rose A, Funk D, Neiger R (2016) Comparison of refractometry and biuret assay for measurement of total protein concentration in canine abdominal and pleural fluid specimens. J Am Vet Med Assoc 248:789-794.
Smuts C, Mills J, Myles R, Gaàl T (2015) Lactate dehydrogenase activity in abdominal fluid from horses with colic. J Equine Vet Sci 36:58-62.
Smuts CM, Mills JN, Gaal T (2016) Transudate or exudate: can lactate dehydrogenase activity in canine and feline effusions help to differentiate between the 2? Vet Clin Pathol 45(4):680-688.
Stillion JR, Letendre JA (2015) A clinical review of the pathophysiology, diagnosis, and treatment of pyothorax in dogs and cats. J Vet Emerg Crit Care (San Antonio) 25(1):113-129.
Tasker S, (2018) Diagnosis of feline infectious peritonitis: Update on evidence supporting available tests (clinical review). J Feline Med Surg 20:228-243.Thomovsky EJ, Johnson PA, Moore GE (2014) Diagnostic accuracy of a urine reagent strip to identify bacterial peritonitis in dogs with ascites. Vet J 202(3):640-642.
Tsompanidou PP, Anagnostou TL, Kazakos GM, Papazoglou LG, Flouraki ES, Patsikas MN (2015) Urothorax associated with uroperitoneum in a dog without diaphragmatic disruption. J Am Anim Hosp Assoc 51:256-259.
Valenciano AC, Arndt TP, Rizzi TE (2014) Effusions: abdominal, thoracic, and pericardial. In: Diagnostic cytology and hematology of the dog and cat, 4th ed, Mosby Inc, Missouri: pp 244-265.
Waddler JR, Giger U (1990) Lipoprotein Electrophoresis Differentiation of Chylous and Nonchylous Pleural Effusions in Dogs and Cats and Its Correlation with Pleural Effusion Triglyceride Concentration, Vet Clin Pathol 19(3):80-85.
Wagner AE, Bennett DG (1982) Analysis of Equine Thoracic Fluid, Vet Clin Pathol 11(1):13-17.
Wallace KA, Goldschmidt MH, Patel RT (2015) Converting fluid-based cytologic specimens to histologic specimens for immunohistochemistry. Vet Clin Pathol 44(2):303-309.
Watton TC, Lara-Garcia A, Lamb CR (2017) Can malignant and inflammatory pleural effusions in dogs be distinguished using computed tomography. Vet Radiol Ultrasound 58:535-54.
Weeden AL, Cherry NA, Breitschwerdt EB, Cheves AG, Wamsley HL (2017) Bartonella henselae in canine cavitary effusions: prevalence, identification, and clinical associations. Vet Clin Pathol 46(2):326-330.
Zanatta R, Abate O, D’Angelo A, Miniscalco B, Mannelli A (2003) Diagnostic and prognostic value of serum lactate dehydrogenase (LDH) and LDH isoenzymes in canine lymphoma. Vet Res Commun (Suppl 1):449-452.
Zoia A, Heller J, Connolly DJ, Church DB (2009) A new approach to pleural effusion in cats: markers for distinguishing transudates from exudates. J Feline Med Surg 11(10):847-855.
Zoia A, Drigo M (2016) Diagnostic value of Light’s criteria and albumin gradient in classifying the pathophysiology of pleural effusion formation in cats. J Feline Med Surg 18(8):666-672.
Most read articles by the same author(s)