Respiratory disorders: Pleural Space Disease

Question 1

Clinical signs associated with pleural disease include -?

Answer 1

Tachypnea, open mouth breathing, coughing, extended head and neck, crouched sternal recumbency with elbow abduction, synapsids, and short, shallow breathing with increased abdominal effort

Question 2

Pleural effusion can be differentiated based on the fluid aspirated. Identify possible differentials with each of the following?

• Pure transudate
• Modified transudate

Answer 2

Pure transudate = hypoalbuminemia, portal hypertension, lymphatic obstruction

Modified transudate = heart failure, vasculitis, lung lobe torsion, diaphragmatic hernia

Question 3

Exudative pleural effusion can be classified based on their cytological findings. Provide differential diagnoses for the following: Septic vs. Aseptic

Answer 3

Septic = bacteria from hematogenous/ lymphatic spread, penetrating injuries, or infected organs (pyothorax)

Aseptic = inflammation, chylothorax, pneumonia, sepsis

Question 4

FIP is associated with what effusive properties?

Answer 4

High protein, highly viscous, low nucleated cell count, nondegenerate neutrophils

Question 5

Treatment for patients with a confirmed pyothorax include -?

Answer 5

Surgery as needed for penetrating object removal , hospitalization, intravenous antimicrobial therapy (Enrofloxacin, ampicillin sublactam), supportive care (sterile lavage, thoracocentesis)

Question 6

Effusive properties of a chylothorax include -?

What are possible causes?

Answer 6

Small lymphocytes predominate over nondegenerate neutrophils, opaque to white fluid

Cardiomyopathy, CHF, pericardial disease, thoracic duct obstruction, cranial mediastinal mass (thymoma, LSA, aortic body chemodectoma), lung lobe torsion, hernia (DH, PPDH), heartworm disease, cranial vena caval thromboembolism, ligation of the left brachiocephalic vein, or idiopathic

Question 7

Treatment for patients with an idiopathic chylothorax includes -?

Answer 7

Medical management and supportive care (thoracocentesis, low fat diet, and Rutin a macrophage stimulant to breakdown protein in lymph)

Question 8

The most common cause of spontaneous hemothorax in patients with a normal coagulogram is ________.

What are other causes for hemothorax include ->

Answer 8

Neoplasia

Coagulopathy, blunt or penetrating trauma, hernia (diaphragmatic, hiatal), thymus hemorrhage, PTE, lung lobe torsion, Spirocerca lupi, pancreatitis, and heartworm disease

Question 9

Treatment for hemothorax includes -?

Answer 9

Hemodynamic optimization, blood transfusions

Question 10

True or False: Surgery is often indicated in patients with traumatic hemorrhage, and often not necessary for noncoagulopathic spontaneous hemothoraces.

Answer 10

False, surgery is rarely indicated unless a penetrating injury or uncontrolled hemorrhage is present, and it is often necessary for noncoagulopathic spontaneous hemothoraces

Question 11

What can result from chronic pleural effusion? What can this lead to?

Answer 11

Fibrosing pleuritis, which can lead to pneumothorax and reexpansion pulmonary edema

Question 12

Tension pneumothorax treatment includes -?

Answer 12

Thoracocentesis, cage rest for 2 weeks, and close monitoring for signs of respiratory distress