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Objective: To determine signalment, diagnoses, presence of effusions in multiple sites, and outcome in cats with peritoneal effusion., Design: Retrospective case series., Animals: 65 cats., Procedure: Medical records from 1981 to 1997 were reviewed to obtain information on cats with peritoneal effusion identified on physical examination, radiographs, abdominal ultrasonograms, or at necropsy., Results: Conditions most commonly associated with peritoneal effusion in cats, in order of frequency, were cardiovascular disease, neoplasia, hepatic disease, renal disease, feline infectious peritonitis, peritonitis attributable to other causes, and urinary tract trauma. Dilated cardiomyopathy (DCM) was the most common disease associated with peritoneal effusion; however, DCM was diagnosed in most of these cats before taurine deficiency was found to be a primary cause of this form of cardiomyopathy in cats. Neoplasia was the most common cause after 1987. Right-sided congestive heart failure was the most commonly associated disorder in cats < 1 year old, whereas neoplastic disease was more common with increasing age. Most effusions were detected during the initial physical examination and were modified transudates. Peritoneal effusion was commonly accompanied by fluid accumulation elsewhere, particularly pleural effusion. The prognosis for a cat with abdominal effusion in this study was poor (mean survival time, 21 days; range, 1 to 350 days; median, 2.5 days)., Clinical Implications: The primary differential diagnosis for peritoneal effusion in cats is neoplastic disease in older cats and right-sided heart failure in kittens. Diseases associated with peritoneal effusion generally have poor prognoses.

Management of refractory ascites (RA) can be accomplished in many ways. Rapid recurrence will be a problem even with repeated paracentesis. We studied the use of a permanent Tenckhoff catheter (PTC) for drainage of RA in 10 patients. The cause of RA was cardiomyopathy in 7 patients, malignancy with liver metastasis in 2, and end-stage liver disease in 1 patient. The volume of ascites drained (AD) ranged from 0.5-7.0 L, with a mean of 2.6 L. Mean blood pressure pre-AD was 112/68 mm Hg, and post-AD was 109/66 mm Hg (p > 0.05). Heart rate pre- and post-AD was 80 bpm and 81 bpm, respectively (p > 0.05). The number of ADs ranged from two to 63 (mean: 16). There was no fluid replacement during or post-AD. There were no complications or infections from AD. The mean interval between ADs was 7.8 days. Mean duration of survival was six months. All patients eventually expired. In conclusion, PTC can be a useful and safe alternative for draining RA at home in terminally ill patients. Complications of repeated paracentesis are minimized, and the need for hospitalization is avoided. AD with PTC may be preferred to repeated paracentesis in RA.

The results of our investigations revealed that in 68% of cases the treatment of patients with diffuse peritonitis with ampiox, gentamicin and metronidazole led to arresting the infectious process and to a considerable decrease in microbial contamination of the abdominal cavity. The use of cephalosporins and metronidazole proved to be effective in 85% of cases. In this treatment a considerable decrease in the amount of aerobic and anaerobic bacteria in peritoneal exudate was registered. In the process of treatment with cyprophloxacin positive clinical and microbiological dynamics were observed in all patients.

Fifty-four consecutive patients with malignant effusions either pleural or peritoneal were treated by a simple aspiration followed by the administration of bleomycin to prevent a recurrence. All patients were followed up until reaccumulation of the effusion or death, with assessments being made of the patient's response at 30 days, 60 days, 90 days, 6 months, 1 year and then annually. There were 42 evaluable patients at 30 days, when the overall response rate for pleural effusions was 80.5% (21/26) and 62.5% (10/16) for peritoneal effusions. Patients who developed an effusion from primary breast neoplasms responded better than other groups, with an overall rate of 81% and 80% for pleural and peritoneal effusions respectively. Thirty percent (13) of the patients whose effusions was controlled by bleomycin required a further aspiration due to a recurrent effusions 9% (4) within the first 90 days and the remainder 21% (9) between 3 and 45 months after initial treatment. Altogether 19% (8/42) of the evaluable patients were effusion free at 1 year and 12% (5/42) clear at 3 years, but only two patients were still alive at four years. Side effects were minimal as 92% (50/54) patients treated experienced no adverse effects and there was no evidence of myelosuppression. The dose of bleomycin instilled varied between 60 mg and 180 mg, with 60 mg being given to 58% of patients and 90 mg to 30%, but there was no evidence to suggest that doses higher than 60 mg were more effective. The author concludes that the instillation of bleomycin following the simple aspiration of a malignant effusion is a safe, effective treatment which can benefit patients with this distressing complication of their malignant disease.