Lungs

Question 1

Latimer, JAVMA, 2017:
Lung lobe torsion
86% of the dogs also had what hematological finding?
Most commonly affected lung lobe?

Answer 1

Latimer, JAVMA, 2017:
86% also had anemia
Most commonly affect lung lobe was the left cranial lung lobe (57%), followed by the right middle (29%) then the right cranial (14%)

Question 2

Park, Vet Surg, 2018:
Lung lobe torsion
Mortality rate?
What % of cases had torsion of the right middle or left cranial lung lobes?
In Pugs, which lung lobe was most commonly affected?
Survival rate was lower for torsion of which lung lobe(s)?
In 25% of the cases, what was identified as a predisposing cause of lung lobe torsion?

Answer 2

Park, Vet Surg, 2018:
Mortality rate: 8%
84% had torsion of the right middle or left cranial lung lobes
In Pugs, the left cranial lung lobe was most commonly affected (91%)
Dogs with concurrent torsion of the right cranial and right middle lung lobes were less likely to survive than those with torsion of the left cranial lung lobe
In 25% of the cases, pleural effusion was identified as a predisposing cause of lung lobe torsion, most of which were chylothorax

Question 3

Bleakley, Vet Surg, 2018:
Short-term outcome following median sternotomy vs intercostal thoracotomy for lung lobectomy?

Answer 3

Bleakley, Vet Surg, 2018:
The median sternotomy group had increased fluid production from the chest tube, a greater A-a pressure gradient (hypoxemia), more complications requiring intervention, and a prolonged hospital stay

Question 4

Cronin, Vet Surg, 2019:
Lung lobectomy
What % leaked?
Incidence of bronchial stump failures for lobectomies performed with a pre-tied ligature loop vs stapler vs suture ligation?

Answer 4

Cronin, Vet Surg, 2019:
0% leaked
Incidence of bronchial stump failures for lobectomies performed with a pre-tied ligature loop vs stapler vs suture ligation did not differ

Question 5

Nylund, Vet Surg, 2019:
Thoracoscopic-assisted lung lobectomy
Outcome of lung lobectomies performed with a TA stapler?
Outcome of lung lobectomies performed with a resorbable self-locking ligation device (LigaTie)?

Answer 5

Nylund, Vet Surg, 2019:
40% of the TA stapled sites leaked at a mean pressure of 22cm H2O when the staple line was >5mm from the hilus, but no leaks occurred when the staple line was up to 5mm from the hilus
All LigaTie sites did not leak at maximum airway pressures

Question 6

Bruckner, JSAP, 2019:
12mm Caiman vessel-sealing device for peripheral lung biopsy and lung lobectomy
What % of the samples leaked below a pressure of 25cm H2O?
Extent of collateral damage in specimens?
Quality of biopsy specimens?

Answer 6

Bruckner, JSAP, 2019:
0% leaked below 25cm H2O
2.7mm collateral damage in all specimens
All biopsy specimens were of good diagnostic quality

Question 7

Dickson
Spontaneous Pneumothorax
JAVMA 2021

Answer 7

13% recurrence of pneumothorax
~median time 9 days

after 30d 3%

Left cranial lung lobe 33%
Right cranial lung lobe 24%

Question 8

Howes
Long term for pneumothorax caused by blebs
JSAP 2020

Answer 8

2y survival 88%
5y survival 84%

Recurrance 14% at 25d

Risk factor:
Giant breed
Increasing body weight

Cranial lung lobes and multiple lesions 41%

Question 9

Bruckner
Vessel sealing in lung lobectomies
JSAP 2019

Answer 9

Pressure of leakage
~Peripheral 39 cmH2O
~Total 38 cmH2O

Largest bronchial diameter 8.84mm

Collateral damage 2.7mm

Question 10

Rossanese
Survival after idiopathic lung lobe torsion
VetSurg 2020

Answer 10

Primary 77%
Secondary 21% (survival 921d)

Post-op complications 14%

Breeds
~Pugs 48%
~Sighthounds 16%

Survival to discharge 95%

Question 11

Park
Lung lobe torsion
VetSurg 2018

Answer 11

92% survival to discharge

Concurrent right cranial and middle: 50% survival
Left cranial 100% survival

MST 1369D

4/52 had >1 episode of lung lobe torsion

Question 12

According to Howes et all JSAP 2020, what is the recurrence rate for spontaneous pneumothorax? How quickly does it recur?

Answer 12

14% recurrence rate
25 days - median time to recurrence

Question 13

Howes et al JSAP 2020 identified which risk factors for recurrence of spontaneous pneumothorax?

Answer 13

Giant breed
Increasing body weight

Question 14

Ruby et al Vet Rad 2020
What radiographic findings can be used to differentiate between pulmonary masses vs mediastinal masses?

Answer 14

Pulmonary - lateral and caudal location
Mediastinal - more likely to displace other mediastinal structures

Question 15

Cronin et al VetSurg 2019
What was the conclusion for a pre-tied ligature loop for canine total lung lobectomy?

Answer 15

No leakage of air at physiologic pressures
- sutures was 3-0 PDS, max loop diameter 15cm

Question 16

Park et al VetSurg 2018
What were the conclusions regarding canine lung lobe torsions?

Answer 16

1) 92% survival to discharge. Not higher for Pugs.
2) Left cranial lung lobe = more likely to survive
3) Right cranial and right middle = less likely to survive
4) Underlying cause identified in 38% of cases - not associated with survival to discharge

Question 17

Lux et al JAVMA 2018
What factors were associated with survival in cats treated for thoracic trauma?

Answer 17

1. Lower animal triage trauma score
2. Cardiopulmonary arrest

Question 18

Lux et al JAMVA 2018
What factors were associated with survival in dogs treated for thoracic trauma?

Answer 18

1. Lower animal triage trauma score (<7)
2. No Cardiopulmonary arrest
3. female

Question 19

Stockdale et al JAVMA 2018
What was the effect of cisterns chyli ablation in cats along with thoracic duct ligation and subphrenic pericardiectomy for the treatment of idiopathic chylothorax?

Answer 19

1. Longer surgery time
2. No improvement in survival
3. 18% of total cats died within 4 weeks

Question 20

Belmudes, VRU 2020

Significant ultrasound finding on lung lobe torsion

Answer 20

thoracic ultrasonography revealed a peripheral hypoechoic band

Question 21

McPhetridge JAVMA 2022

Differentials for pulmonary tumor is this study?

Difference in MST of different tumors?

Did chemotherapy affect MST of ACA?

Answer 21

Differentials for the pulmonary tumors in this study?
-Pulmonary carcinoma 87%
-Sarcoma 7%
-Adenoma 3%
-Pulmonary neuroendocrine 1.5%

What was the difference in MST of different tumors?
-Pulmonary carcinoma 399d
-Histiocytic sarcoma 300d
-Neuroendocrine tumors 498d

Did chemotherapy affect MST of ACA?
No