Feline Peritoneal Effusions—A Poor Prognosis?

TL;DR

This study found that 55% of cats with abdominal fluid survived hospitalization, with survival rates varying based on the type of fluid and other factors.

Contribution

The study provides updated prognosis data for feline ascites using a large population and identifies factors affecting survival.

Findings

55% of cats with ascites survived to hospital discharge with a median survival time of 30.5 days.

Uroperitoneum cases had the highest survival rate (77%), while hemoperitoneum had the lowest (40%).

Effusion volume and type can be assessed with simple tests to guide prognosis.

Abstract

Feline ascites, an accumulation of fluid in the abdominal cavity, can be caused by many different underlying disease processes. The aim of this study was to provide information on the prognosis associated with this finding and help guide first-opinion practitioners to make further decisions for feline patients that are found to have ascites. We found that 55% of cases with ascites survived to discharge from hospital with an average survival time of 30.5 days after discharge. Some types of abdominal fluid were also found to be associated with a higher rate of survival to discharge, with 77% of cases with urine in the abdominal cavity (uroabdomen) surviving to discharge. Conversely, cases with blood in the abdominal fluid (hemoperitoneum) and had a lower chance of surviving to discharge (40%). This is important information, as the type of abdominal fluid can be determined using relatively simple and inexpensive diagnostic tests and can be used to help guide the prognosis of patients and their families on possible outcomes.

Feline ascites has been reported to have a poor prognosis, with a median survival time of 21 days (considering all etiologies). However, previous studies included relatively small populations (<100 cases) and there is no literature evaluating the prognosis of all causes of feline ascites within the last 20 years. This study aimed to assess the survival times of a large population of cats presenting with ascites and assess the effect of the effusion cause, signalment, clinicopathological and imaging findings on survival. Data was acquired from the medical record system of a referral hospital (including both referrals and first-opinion emergency cases). Four hundred and ninety-eight cats met the inclusion criteria and 55% of all cases survived to discharge. Median survival time post-discharge was 30.5 days. The cause of the effusion was significantly associated with survival to discharge (p = 0.002). Common etiologies of ascites included neoplasia, septic peritonitis, sterile inflammatory disease, uroperitoneum, hemoperitoneum and cardiac disease. Uroperitoneum cases had the highest rate of survival to discharge (77%), while hemoperitoneum cases had the lowest percentage surviving to discharge (40%). Subjectively assessed effusion volume on imaging was significantly associated with survival to discharge (p = 0.012). Subjective assessment of the effusion volume and effusion assessment via abdominocentesis to help obtain a diagnosis can help guide prognosis and are diagnostics that do not require advanced techniques or specialist equipment, which can provide important prognostic information for cats presenting with ascites.

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