Spontaneous abdominal effusion in dogs with presumed anaphylaxis.

Abstract

OBJECTIVE: To describe patient characteristics of dogs developing spontaneous abdominal effusion in association with anaphylaxis. DESIGN: Retrospective study between 2010 and 2018. SETTING: University teaching hospital and referral specialty private practice emergency departments. ANIMALS: Sixteen dogs presenting to the emergency department for clinical signs suggestive of anaphylaxis with peritoneal effusion documented via ultrasonography. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Dogs presented with clinical signs of anaphylaxis including vomiting 12 of 16 (75%), diarrhea 9 of 16 (56%), and collapse 7 of 16 (44%). Physical examination findings included altered mentation 14 of 16 (88%), erythema 2 of 16 (13%), and urticaria 2 of 16 (13%). Historically, 3 of 16 (19%) had just recently been vaccinated, 1 of 16 (6%) had known contact with an insect, and 8 of 16 (50%) had been outdoors prior to the onset of clinical signs, whereas 5 of 16 (31%) had no known triggering event. At presentation, median systolic arterial pressure was 70 mm Hg (range, 30-210 mm Hg). Venous blood gas revealed an acidemia with a mean pH of 7.24 ± 0.09, a base deficit of 7.15 ± 7.7 mmol/L, and an increased plasma lactate with a mean of 7.35 ± 2.09 mmol/L. Bloodwork abnormalities included an increased alanine aminotransferase activity with a mean of 439.2 ± 404.5 U/L and an increased gamma-glutamyl transferase activity with a mean concentration of 7.29 ± 4.1 U/L. Twelve patients (75%) had gallbladder wall abnormalities on ultrasonography. Eight patients (50%) had abdominocentesis performed. The median PCV of the effusion was 0.29 L/L (29%; range, 4-41) and total plasma protein was 38 g/L (3.8 g/dL; range, 2.4-6.5). Two dogs (12.5%) were euthanized. The remaining 14 dogs (87.5%) survived to discharge, with a mean hospitalization time of 23.7 ± 16.7 hours. CONCLUSIONS: Abdominal effusion should be considered a potential sequela of anaphylaxis in dogs. Therefore, serial monitoring for presence or development of spontaneous abdominal effusion should be considered.