Pleural Space Disorders Flashcards
What is the signalment for pleural effusion and pneumothorax?
Cats and dogs of any age.
The lungs can’t expand normally with what 2 conditions?
- Pleural effusion
- Pneumothorax
What are 2 common clinical signs seen with pleural effusion and pneumothorax?
- Rapid shallow breathing in a restrictive breathing pattern
- Dyspnea with or without open mouth breathing
What are 4 possible clinical signs that can be seen with pleural effusion and pneumothorax?
- Cyanosis
- Exercise intolerance
- Anorexia
- Lethargy
How does pleural effusion and pneumothorax affect heart and lung sounds?
- Muffled heart sounds
- Diminished and muffled lung sounds ventrally
How does pleural effusion affect dorsal lung sounds?
Increased dorsal lung sounds
How does pneumothorax affect dorsal lung sounds?
Decreased dorsal lung sounds
How does the chest appear with pneumothorax?
“Barrel-shaped” chest
Accumulation of excessive amounts of fluid within the pleural space is known as what?`
Pleural effusion
What are 4 types of pleural effusion?
- Transudate
- Modified transudate
- Exudate
- Hemorrhagic
If pleural effusion is suspected based on auscultation, what should be done right away?
Stabilize the patient
If pleural effusion is suspected based on auscultation which should be done first, radiography or thoracocentesis?
Thoracocentesis first
Where should a thoracocentesis be done?
7-8th ICS caudal to costochondral junction
What are 3 potential sources of pyothorax in cats?
- Penetrating bite wounds
- Oropharyngeal aspiration
- Secondary to upper respiratory tract infection
What are 3 agents that can cause pyothorax in cats?
- Pasteurella
- Bacteroides
- Fusobacterium
What are 3 potential sources of pyothorax in dogs?
- Secondary to inhaled foreign body
- Secondary to penetrating injury
- Pneumonia
What are 2 agents that can cause pyothorax in dogs?
- Actinomyces
- Nocardia
What can be seen on cytology with a pyothorax?
Degenerative neutrophils and bacteria
What are 2 forms of treatment for pyothorax?
- Drainage and lavage via thoracostomy tube (chest tube)
- Long term (months) antibiotics
What could potentially cause chylothorax?
Any disease that increases systemic venous pressure.
Accumulation of chyle in the pleural space is known as what?
Chylothorax
What are 7 possible causes of chylothorax?
- Trauma
- Neoplasia
- Cardiac disease
- Thoracic duct lymphangiectasia
- Lung lobe torsion
- Inflammation
- Idiopathic
What percentage of chylothorax cases are idiopathic?
60-70%
What can be seen on thoracocentesis with chylothorax?
White to pink opaque fluid that does not clear on centrifuge.
What are 2 potential causes for the the type of fluid seen with chylothorax?
- Lymphocytes
- Non-degenerative neutrophils
What are 2 ways to diagnose chylothorax?
- Fluid characteristics
- Triglycerides increase more in fluid than in serum
What is the treatment for chylothorax?
Look for underlying cause and treat it.
Always look for what in cats with chylothorax?
Underlying cardiomyopathy
What are 4 possible treatments for the idiopathic form of chylothorax?
- Low fat diet (RD)
- Thoracic drainage via intermittent thoracocentesis
- Rutin for 2 months
- Ligation of thoracic duct
What is a possible sequelae to chylothorax?
How does this appear on radiographs?
- Restrictive fibrosing pleuritis
- Collapses ling lobes with rounded edges
Air in the pleural space is known as what?
Pneumothorax
What is the most common cause of pneumothorax?
Blunt force trauma
Up to 1/5 of trauma cases have what?
Pneumothorax
What are 4 signs of pneumothorax seen on radiographs?
- Absence of vasculature to chest wall
- Dorsal displacement of heart and trachea
- Retraction of lung from chest wall
- Increased density of collapsed lobe
What are the 2 main causes of pneumothorax?
- Traumatic
- Non-traumatic/spontaneous
How is pneumothorax treated if patient is in respiratory distress?
Emergency thoracocentesis
How is thoracocentesis for a pneumothorax different than that for pleural effusion?
Performed in the 9-10th intercostal space above the costochondral junction
What should be done with a pneumothorax if air continues to accumulate or if pet needs multiple aspirations?
Place a chest tube to allow continuous evacuation.
When should surgical intervention be performed with a pneumothorax?
If pneumothorax persists for more than 72 hours
