**6. Treatment**

Definitive treatment for pericardial effusion is manual removal of the fluid from the pericardium, i.e. pericardiocentesis. Pericardiocentesis is a method that appears to be of therapeutic value in the management of pericardial effusion patients which are refractory to traditional therapy as the procedure provides immediate relief of cardiac tamponade [8], refer Section 5.4 Pericardiocentesis under Section 5. Diagnosis 5).

Diuretic therapy should be used with caution in cases exhibiting signs of congestive heart failure since their use may result in further reduction in ventricular filling [7]. Mostly, diuretics are not recommended for long-term therapy because diuretics can result in a decrease in preload with a resultant catastrophic decrease in cardiac output if cardiac tamponade recurs.

#### **6.1 Pericardiectomy**

The surgical removal of part or complete pericardium is pericardiectomy. Pericardiectomy can be a definitive treatment of idiopathic pericardial effusion and a palliative treatment of neoplasia. When pericardial effusion recurs after one or more therapeutic pericardiocenteses, surgical treatment becomes an option. Surgery may be used to remove the pericardium and obtain a biopsy specimen or resect a mass of uncertain origin.

#### **6.2 Medical management**

The management of pericardial effusion medically is rarely effective. Antiinflammatory therapy may be used to avoid fluid recurrence. Prednisone in antiinflammatory doses may be used to treat idiopathic effusions. Chemotherapy for pericardial effusions due to neoplasia vary for different tumour types. However, the prognosis may vary based on the nature of the tumour. Adriamycin may be given for therapy with hemangiosarcoma [13].

#### **7. Prognosis**

The prognosis for dogs with pericardial effusion varies depending on the underlying aetiology. In case of neoplastic pericardial effusion, it is poor. Prognosis is very good in idiopathic/infectious pericarditis. The prognosis is good in chronic idiopathic pericardial effusion, but tamponade can occur.
