Constrictive pericarditis in dogs: diagnosis and treatment
7-year-old Labrador with progressive ascites and jugular distension. A year ago it had two pericardiocenteses for idiopathic pericarditis. Normal cardiac silhouette on radiographs. Echocardiogram: thickened, hyperechoic pericardium, minimal effusion, diastolic septal bounce and a dilated caudal vena cava. Valves and contractility normal.
What is the treatment of choice?
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A. Periodic pericardiocentesis
There is hardly any fluid to drain. The problem is a stiff pericardium that limits diastolic filling, and needle drainage does not change it.
B. Furosemide and pimobendan indefinitely
The diuretic may temporarily relieve ascites, but it reduces the preload on which filling depends; pimobendan does not address the cause, as contractility is normal.
C. Immunosuppressive doses of corticosteroids
Constriction is due to established fibrosis. Corticosteroids do not reverse fibrosis and there is no evidence of benefit.
D. Pericardiectomy, with epicardial decortication if the visceral pericardium is also involved
Correct. Removing the fibrous pericardium frees ventricular filling. If constriction involves the epicardium (visceral pericardium), it must be decorticated, which is technically harder and riskier.
lightbulb Key takeaway
Suspect constrictive pericarditis with signs of right-sided heart failure, a normal-sized heart and no significant effusion, especially after recurrent pericardial effusions. It is underdiagnosed because the echocardiogram can look almost normal.
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Updated: October 31, 2026 · Educational content for veterinary professionals. It does not replace current clinical guidelines or the judgement of the attending veterinarian.