Abstract
Julia Beatty and Vanessa Barrs respond: We are grateful to Mr Harper for his comments on our review of pleural effusion in the cat. Our aim in preparing this review was to highlight clinically useful information that can be gained with minimal intervention. As stated, a jugular pulse can be appreciated by wetting the hair overlying the jugular vein and this is demonstrated in the video recording (video 3) accompanying the online version of our article. A point that we hoped to emphasise is that a jugular pulse may not be noticed unless the clinician specifically looks for it. We believe that the primary clinician is best placed to make judgements regarding appropriate interventions for an individual case. We consider that most clinicians would not clip the overlying hair solely for the purposes of assessing a jugular pulse, and we would not advocate this. However, in our experience, many cats have already been clipped at presentation, in which case the head should be gently elevated to assess for a jugular pulse on the clipped side.
Mr Harper's clinical observations regarding displacement of the liver in cases of pleural effusion are interesting. Unilateral inversion of the diaphragm by a large volume pleural effusion resulting in displacement of the liver is documented in the human medical literature, albeit infrequently. 1