Nursing the feline patient following surgical management of idiopathic pericardial effusion by subtotal pericardiectomy

This patient care report highlights and discusses the veterinary nursing interventions implemented postoperatively following a feline undergoing a pericardiectomy. The pericardium is a thin sac surrounding the heart, which is attached to phrenicopericardial ligaments to fix the position of the heart to aid in maintaining cardiac shape (French, 2010). The pericardium also plays an important role in protecting the heart (French, 2010). Pericardial effusion can occur; this is the accumulation of fluid in the pericardial cavity, located between the visceral and parietal layers of the pericardium. Pericardial effusion is a life threatening condition, therefore emergency interventional procedures are vital to the survival of the patient. Pericardial effusion is associated with peritoneopericardial diaphragmatic hernias, neoplasia, cardiomyopathies, uraemia, systemic infection, concurrent feline infectious peritonitis (FIP) and idiopathic pericarditis (Hall et al, 2007).

The patient presented as an emergency referral following a 10-day history of lethargy, hyporexia, urethral obstruction which was previously resolved and dyspnoea due to pleural effusion. 90 ml of serosanguinous pleural fluid was aspirated by bilateral thoracocentesis to relieve dyspnoea by the referring veterinary surgeon. On arrival and physical examination, cardiac auscultation revealed a grade two (II) heart murmur, with muffled heart sounds and no presence of arrhythmias or gallop sounds. He was bright and responsive with a respiration rate of 36 breaths per minute (bpm) and mild inspiratory and expiratory effort. Rectal temperature was normal.