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Right atrial sarcoma in a 3-year-old English Pointer with Pericardia! Effusion

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A three-year-old male castrated English Pointer presented to Cornell's Emergency Service as a referral for pericardial effusion seen on thoracic radiographs by the primary care veterinarian. Owners reported that the clinical signs of dry coughing, loss of appetite, lethargy and intermittent vomiting appeared roughly three weeks prior to presentation. The dog was taken to the referring veterinarian (rDVM) who empirically treated him for kennel cough with doxycycline. He then had an episode of collapse and was referred to Cornell. On presentation, the patient was quiet, but alert and responsive. Physical examination revealed sinus tachycardia ( ~ 180 bpm) with muffled heart sounds, tachypnea ( 42 bpm) with harsh lung sounds, pale mucous membranes and pulsus paradoxus. A thoracic focused assessment with sonography for trauma (T-FAST) was perfonned which displayed severe pericardial effusion with cardiac tamponade. Ultrasound guided therapeutic pericardiocentesis yielded 330mL of unclotting hemorrhagic fluid. An abdominal focused assessment with sonography for trauma (A-FAST) was also performed which showed a mild amount of peritoneal effusion. A diagnostic abdominocentesis revealed ~ 1.5 mL of yellow fluid, suspected secondary to right sided heart failure from cardiac tamponade. The patient's problem list included pericardia] effusion and peritoneal effusion. The patient was transferred to the cardiology service the following day, and an echocardiogram revealed a right atrial intrusive mass. Because the mass was highly suspect for neoplasia, a poor prognosis was discussed with the owners. The patient was euthanized and submitted for necropsy. On necropsy there was a 5.5 cm x 3.0 cm x 3.5 cm red, in-egularly shaped, firm mass involving the atrial free wall bulging into and nearly filling the entire atrial chamber; although the mass was initially predicted to be hemangiosarcoma, it was diagnosed as a pleomorphic sarcoma.

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2018-12-05

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pericardia! effusion, hemangiosarcoma, right atrial mass

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