Lecture 15

Question 1

What are some pleural space diseases

Answer 1

Pleural effusions (transudates, modified transudates, hemothorax, pyothorax- septic and nonseptic, chylothorax- neoplastic effusions)

Pneumothorax

Fibrosis

Question 2

What five components result in effusion

Answer 2

Increased intravascular hydrostatic pressure in the vessels
Decreased hydrostatic outside of the vessel
Decreased oncotic pressure in the vessels
Increased oncotic pressure outside the vessels
Increased Permeability

Question 3

Diagnoses of pleural effusion

Answer 3

When you have absent lung sounds ventrally
Thoracocentesis and cytology
Oxygen and calm the patient

If unstable, don’t waste time doing rads

Question 4

Transudates

Answer 4

Low protein concentration and low nucleated cell counts

Question 5

Modified transudate

Answer 5

Slightly higher protein concentration and cell count

Neutrophils might be present

Question 6

When would you see transudate and modified transudates

Answer 6

Increased IV hydrostatic pressure (right sided CHF in dogs; L or R CHF in cats; pericardial disease, volume overload)

Decreased oncotic pressure (severe hypoalbuminemia)

Obstruction of draining lymphatics, neoplasia, diaphragmatic hernia, lung lobe torsion

Question 7

Exudates

Answer 7

High protein content and cell count

Question 8

Non septic exudates

Answer 8

Variable cell types

Macrophages and lymphocytes may be activated by neutrophils are nondegenerate and no organisms are seen

Question 9

Septic exudates

Answer 9

Extremely elevated cell counts
Degenerate neutrophils are prominent
May see bacteria
Bad smell
May see sulfur granules

Question 10

Differentials for no septic exudates

Answer 10

Feline infectious peritonitis
Neoplasia
Lung lobe torsion
Chronic diaphragmatic hernia
Resolving/treated septic exudate

Question 11

Differentials for septic exudate (pyothorax)

Answer 11

Spontaneous/idiopathic
Penetrating wounds
Migrating foreign bodies
Extension/spread of bacterial pneumonia

Question 12

What type of effusion does neoplasia cause

Answer 12

Any type of effusion

*lymphoma is only tumor that readily exfoliates into effusion

Question 13

Chylous effusion

Answer 13

Moderate protein, variable cell count

High triglyceride concentration

Milky white

Question 14

What is the predominant cell type in acute chylous effusions

Chronic chylous effusion?

Answer 14

• Lymphocytes

- Can have non degenerate neutrophils and macrophages in chronic cases

Question 15

What causes chylous effusion

Answer 15

Most cases are idiopathic
Trauma
Neoplasia
Cardiac disease, HW
Lung lobe torsion, diaphragmatic hernia

Question 16

What is hemothorax associated with

Answer 16

Trauma
Systemic bleeding disorders (coagulopathies, thrombocytopenias)
Neoplasic
Lung lobe torsion