Idiopathic pleural effusion and pulmonary thromboembolism in a dog with autoimmune hemolytic anemia

Pleural effusion and pulmonary thromboembolism were diagnosed in a dog with autoimmune hemolytic anemia. Clinical signs of tachypnea, then dyspnea in association with pleural effusion, developed after 10 days of immunosuppressive corticosteroid therapy (greater than 2 mg/kg of body weight/d, PO). The diagnosis of pulmonary thromboembolism was made tentatively on the basis of results of a radionuclide lung perfusion scan and was confirmed by exploratory thoracotomy and lung biopsy. Tachypnea and pleural effusion gradually resolved without specific treatment, and additional episodes of anemia or dyspnea have not been observed. The pathogenesis of these findings was suspected to be related to corticosteroid-induced thrombotic tendencies, persistent thrombocytosis (greater than 800,000 cells/microliters), and vascular injury caused by repeated jugular venous catheterization. Pulmonary thromboembolism should be considered in dogs that develop clinical signs of tachypnea and/or pleural effusion during administration of immunosuppressive dosages of corticosteroids.