Pericardial Effusion Identified During Home Visit Ultrasound

Baxter, 10-year-old male desexed Staffordshire Bull Terrier
Service: Thoracic and abdominal ultrasound
Referring vet: Mobile veterinarian (home visit)

Baxter had been quieter than usual for around two weeks, with his owner noticing a steadily enlarging abdomen and mild changes in breathing effort. During a home visit, the mobile vet found a distended abdomen with a palpable fluid thrill, a mildly increased respiratory rate, and muffled heart sounds – a combination that raised concern for fluid accumulation in both the abdomen and thoracic cavity.

The clinical question centred on why the abdomen was filling with fluid and whether an underlying cardiac mechanism was driving the process. Because Baxter was more relaxed at home and stable enough for gentle handling, the vet arranged an in-home thoracic and abdominal ultrasound to guide the next steps while avoiding the stress of hospital transport.

Thoracic and abdominal imaging were performed on-site under calm, low-stress conditions. The scan revealed:

• Moderate pericardial effusion
• Small pleural effusion
• Large volume of abdominal fluid (ascites)
• No visible masses or additional abnormalities

The pericardial effusion was significant enough to explain Baxter’s clinical picture. The accumulation of fluid within the pericardial sac was impairing right-sided filling, consistent with progression toward cardiac tamponade, and driving the secondary ascites and mild pleural effusion. With no heart base mass detected, the findings immediately clarified the underlying mechanism and guided the next step in management.

Pericardiocentesis was recommended, and referral to an emergency facility was advised as the safest option.

The ultrasound findings provided an immediate and definitive explanation for Baxter’s abdominal distension and respiratory change. The presence of pericardial effusion shifted the plan from broad differential diagnosis to a focused, time-sensitive intervention.

Although SA Veterinary Sonography can perform pericardiocentesis, the home-visit nature of this case meant referral was the most appropriate pathway. The value of rapid, in-home imaging quickly became clear: the mobile vet could provide a firm diagnosis, stabilise the direction of the case, avoid pre-diagnosis transport stress, and ensure Baxter arrived at the emergency clinic prepared for prompt treatment.

This case also demonstrated how home-based ultrasound can expand the capacity of mobile veterinarians, allowing them to manage complex cases with the same diagnostic precision as bricks-and-mortar practices.

Baxter underwent successful pericardiocentesis, with almost immediate clinical improvement. The abdominal fluid resolved over the following days. As no heart base tumour was identified, the most likely diagnosis was idiopathic pericarditis, though very small masses cannot be fully excluded.

A follow-up echocardiogram two weeks later showed no pericardial effusion, no pleural effusion, and no ascites, with a normal-appearing heart and an excellent clinical recovery.

This case was initiated by a mobile veterinarian and highlights the distinct benefits of having a sonographer come directly to the patient’s home:

• Reduced anxiety for both patient and owner
• Ability for mobile vets to offer advanced diagnostics without hospital referral
• Faster diagnostic clarity for unstable or transport-sensitive patients
• Smoother, more supported case flow from first examination to management decision

In Baxter’s case, seamless communication before and after the scan enabled rapid referral and timely, informed intervention, significantly improving the patient’s trajectory.

If you’re working through a similar case or would like imaging support, we’re always happy to assist.