Effusion Types and Characteristics
Posted: Sunday, February 2nd, 2020 | Updated: Monday, February 7th, 2022
Posted: Sunday, February 2nd, 2020 | Updated: Monday, February 7th, 2022
Transudate
1. Passive process usually due to low oncotic pressure. It has a lower nucleated cell count. Example: protein losing disease
2. Protein concentration is less than 2.5 g/dL
3. Color is clear to pale
4. Effusion is transparent
Modified Transudate
1. Chronic process due to increased hydrostatic pressure or increased capillary/lymphatic permeability. Example: CHF
2. Protein concentration is 2.5 to 5.0 g/dL
3. Color is yellow to pink
4. Effusion is transparent to cloudy
Exudate
1. Inflammatory process due to compromised blood vessel integrity. It has a higher nucleated cell count. Exudate may be septic or non-septic
1a. Non-septic effusion: non-degenerate neutrophils predominate
1b. Septic effusion: degenerate neutrophils predominate, microorganisms are visualized, glucose levels in the effusion will be lower than that of the serum levels, and lactate levels in the effusion will be higher than that of the serum levels. Example: FIP, intestinal perforation, puncture wound
2. Protein concentration is greater than 3.0 g/dL
3. Color ranges from yellow to pink or red
4. Effusion is cloudy
Hemorrhagic
1. Active hemorrhage is occurring if the PCV/TS of the effusion is increasing or greater than the peripheral blood
2. Protein concentration is greater than 3.0 g/dL
3. Color is red
4. Effusion is opaque
Urine
1. The effusion creatinine and K+ will be greater than the serum creatinine and K+. Example: bladder rupture
2. Protein concentration is variable
3. Color is variable
4. Effusion is semi-transparent
Bile
1. The effusion bilirubin will be greater than the serum bilirubin. Example: gallbladder rupture
2. Protein concentration is variable
3. Color ranges from green to brown or black
4. Effusion is semi-transparent
Chylous
1. The effusion triglycerides will be greater than the serum triglycerides. Example: feline CHF, mediastinal mass
2. Protein concentration is variable
3. Color ranges from white to pink
4. Effusion is opaque
1. Passive process usually due to low oncotic pressure. It has a lower nucleated cell count. Example: protein losing disease
2. Protein concentration is less than 2.5 g/dL
3. Color is clear to pale
4. Effusion is transparent
Modified Transudate
1. Chronic process due to increased hydrostatic pressure or increased capillary/lymphatic permeability. Example: CHF
2. Protein concentration is 2.5 to 5.0 g/dL
3. Color is yellow to pink
4. Effusion is transparent to cloudy
Exudate
1. Inflammatory process due to compromised blood vessel integrity. It has a higher nucleated cell count. Exudate may be septic or non-septic
1a. Non-septic effusion: non-degenerate neutrophils predominate
1b. Septic effusion: degenerate neutrophils predominate, microorganisms are visualized, glucose levels in the effusion will be lower than that of the serum levels, and lactate levels in the effusion will be higher than that of the serum levels. Example: FIP, intestinal perforation, puncture wound
2. Protein concentration is greater than 3.0 g/dL
3. Color ranges from yellow to pink or red
4. Effusion is cloudy
Hemorrhagic
1. Active hemorrhage is occurring if the PCV/TS of the effusion is increasing or greater than the peripheral blood
2. Protein concentration is greater than 3.0 g/dL
3. Color is red
4. Effusion is opaque
Urine
1. The effusion creatinine and K+ will be greater than the serum creatinine and K+. Example: bladder rupture
2. Protein concentration is variable
3. Color is variable
4. Effusion is semi-transparent
Bile
1. The effusion bilirubin will be greater than the serum bilirubin. Example: gallbladder rupture
2. Protein concentration is variable
3. Color ranges from green to brown or black
4. Effusion is semi-transparent
Chylous
1. The effusion triglycerides will be greater than the serum triglycerides. Example: feline CHF, mediastinal mass
2. Protein concentration is variable
3. Color ranges from white to pink
4. Effusion is opaque
Sources:
Ford, Richard B., and Elisa M. Mazzaferro. Kirk and Bistner's Handbook of Veterinary Procedures and Emergency Treatment. 8th ed., Saunders Elsevier, 2006.
Poli, Gerardo. MiniVet Guide: Companion Animal Medicine. InHouse Publishing, 2016.
Ford, Richard B., and Elisa M. Mazzaferro. Kirk and Bistner's Handbook of Veterinary Procedures and Emergency Treatment. 8th ed., Saunders Elsevier, 2006.
Poli, Gerardo. MiniVet Guide: Companion Animal Medicine. InHouse Publishing, 2016.