What Is Ascites in Dogs?
Ascites, also referred to as abdominal effusion or free abdominal fluid, presents a grave and potentially life-threatening medical situation in dogs wherein fluid accumulates within the abdomen. The abdominal cavity houses vital organs such as the liver, pancreas, stomach, intestines, spleen, and urinary bladder, typically with minimal fluid presence around them. When a dog experiences ascites, these organs become surrounded by fluid, essentially floating freely within the abdomen.
The development of ascites in dogs can stem from various underlying medical issues, often associated with significant organ failure within the abdominal region or originating from elsewhere in the body. Ascites itself represents a secondary condition emerging from an underlying health problem.
The quantity and nature of the fluid accumulating in the abdomen may differ based on the underlying condition. In instances of substantial fluid accumulation, the abdomen expands, exerting pressure on the chest cavity. Consequently, this pressure can impede the full expansion of the lungs, resulting in breathing difficulties or even respiratory failure.
Symptoms
When small amounts of fluid accumulate in the abdomen, the symptoms may resemble those of general discomfort and could be mild. However, as the volume of fluid increases and if there are more serious underlying causes, the symptoms tend to become more pronounced. These symptoms include:
- Lethargy
- Decreased appetite or anorexia
- Vomiting or retching
- Diarrhea, with increased or decreased frequency of bowel movements
- Weakness
- Distended abdomen
- Weight gain
- Restlessness
- Excessive panting
- Increased thirst and urination
- Abdominal pain upon palpation
- Vocalizing when lying down
- Gums appearing pale, blue, or purple
- Fainting (syncope)
- Coughing
- Rapid, shallow breathing
- Difficulty breathing (dyspnea)
Causes
Ascites, characterized by the accumulation of fluid in the abdomen, signifies underlying conditions that warrant immediate veterinary attention. This secondary condition indicates a more serious primary cause. Common primary conditions leading to ascites in dogs include:
- Heart disease: Such as right-sided heart disease (the leading cause of free fluid accumulation in the abdomen), right-sided congestive heart failure, heartworm disease, dilated cardiomyopathy, and pulmonic stenosis.
- Liver issues: Including chronic liver failure, hepatitis, and portal hypertension.
- Protein abnormalities: Low protein concentrations (reduced albumin), protein-losing enteropathy (gastrointestinal protein loss), protein-losing nephropathy (kidney disease), and nephrotic syndrome (kidney disease).
- Trauma: Body trauma may cause organ rupture, leading to fluid leakage into the abdomen. Urine leakage from the bladder or urinary system can cause a uroabdomen, while damage to the liver or spleen can result in free-floating blood in the abdomen.
- Peritonitis: An infection in the lining of the abdominal wall can cause the accumulation of free-floating fluid in the abdomen.
- Poisoning: Ingestion of rat poison can disrupt normal blood clotting in dogs, leading to free-floating blood in the abdomen.
- Cancer: Various factors associated with cancer, such as organ rupture, pressure on major blood vessels, or inflammation due to tumors, can result in the accumulation of free-floating fluid in the abdomen, leading to ascites.
Diagnosis
If your dog exhibits abdominal enlargement or symptoms associated with free-floating fluid in the abdomen, it’s crucial to seek veterinary examination promptly.
Your veterinarian will conduct a thorough physical examination of your dog. Ascites may be identifiable through palpation (touching or feeling) of the abdomen or via abdominal ultrasound or x-rays.
The nature of the fluid in the abdomen varies based on the underlying cause. If your dog is stable and not distressed, your vet may extract a sample of the fluid using a small needle inserted through the abdominal wall. Subsequently, they will examine the fluid under a microscope to determine its composition. This analysis aids in pinpointing the potential primary medical condition responsible for the free-floating fluid in the abdomen. Additionally, baseline lab tests such as complete blood count (CBC), chemistry panel, and urinalysis are essential to assess your dog’s condition and ascertain the underlying cause of the ascites.
Treatment
Upon your veterinarian’s diagnosis of your dog’s condition, the initial step in the treatment plan typically involves the removal of accumulated fluid. While this may not serve as a cure, it aids in identifying the underlying cause of the ascites as the fluid often reaccumulates.
The treatment regimen aims to eliminate the abnormal fluid and address the primary medical condition. In some cases, surgical intervention becomes necessary to address the underlying cause, such as a tumor or organ damage. While not all causes of free-floating abdominal fluid require surgery, most dogs with ascites necessitate hospitalization during treatment.
Intravenous (IV) medications like the diuretics furosemide and spironolactone are commonly administered to facilitate fluid absorption. Diuretics prove especially beneficial when right-sided heart disease or heart failure underlies the ascites. In instances of anemia and low protein levels, a blood or plasma transfusion may be imperative.
Medications aimed at ameliorating liver and kidney dysfunction are also vital if required. Your dog may require a specialized diet for the remainder of their life, particularly in cases of protein loss from gastrointestinal conditions or right-sided heart disease.
Living and Management
The prognosis for ascites can only be determined once an underlying diagnosis is established, considering the wide array of potential causes. Some cases may require surgical intervention to address emergency causes of abdominal fluid, while others can be managed with medication. Certain conditions leading to ascites are manageable or even curable.
Unfortunately, some underlying conditions may remain untreatable. While ascites might not always stem from a life-threatening ailment, it often signals a poor outcome, particularly in older dogs and those diagnosed with cancer.
A distended abdomen should never be overlooked, as it could signify a serious disease. It’s crucial to adhere to your veterinarian’s advice for the possibility of achieving a swift recovery