Pleural Space Disorders

Question 1

What is the signalment for pleural effusion and pneumothorax?

Answer 1

Cats and dogs of any age.

Question 2

The lungs can’t expand normally with what 2 conditions?

Answer 2

• Pleural effusion

- Pneumothorax

Question 3

What are 2 common clinical signs seen with pleural effusion and pneumothorax?

Answer 3

• Rapid shallow breathing in a restrictive breathing pattern

- Dyspnea with or without open mouth breathing

Question 4

What are 4 possible clinical signs that can be seen with pleural effusion and pneumothorax?

Answer 4

• Cyanosis
• Exercise intolerance
• Anorexia
• Lethargy

Question 5

How does pleural effusion and pneumothorax affect heart and lung sounds?

Answer 5

• Muffled heart sounds

- Diminished and muffled lung sounds ventrally

Question 6

How does pleural effusion affect dorsal lung sounds?

Answer 6

Increased dorsal lung sounds

Question 7

How does pneumothorax affect dorsal lung sounds?

Answer 7

Decreased dorsal lung sounds

Question 8

How does the chest appear with pneumothorax?

Answer 8

“Barrel-shaped” chest

Question 9

Accumulation of excessive amounts of fluid within the pleural space is known as what?`

Answer 9

Pleural effusion

Question 10

What are 4 types of pleural effusion?

Answer 10

• Transudate
• Modified transudate
• Exudate
• Hemorrhagic

Question 11

If pleural effusion is suspected based on auscultation, what should be done right away?

Answer 11

Stabilize the patient

Question 12

If pleural effusion is suspected based on auscultation which should be done first, radiography or thoracocentesis?

Answer 12

Thoracocentesis first

Question 13

Where should a thoracocentesis be done?

Answer 13

7-8th ICS caudal to costochondral junction

Question 14

What are 3 potential sources of pyothorax in cats?

Answer 14

• Penetrating bite wounds
• Oropharyngeal aspiration
• Secondary to upper respiratory tract infection

Question 15

What are 3 agents that can cause pyothorax in cats?

Answer 15

• Pasteurella
• Bacteroides
• Fusobacterium

Question 16

What are 3 potential sources of pyothorax in dogs?

Answer 16

• Secondary to inhaled foreign body
• Secondary to penetrating injury
• Pneumonia

Question 17

What are 2 agents that can cause pyothorax in dogs?

Answer 17

• Actinomyces

- Nocardia

Question 18

What can be seen on cytology with a pyothorax?

Answer 18

Degenerative neutrophils and bacteria

Question 19

What are 2 forms of treatment for pyothorax?

Answer 19

• Drainage and lavage via thoracostomy tube (chest tube)

- Long term (months) antibiotics

Question 20

What could potentially cause chylothorax?

Answer 20

Any disease that increases systemic venous pressure.

Question 21

Accumulation of chyle in the pleural space is known as what?

Answer 21

Chylothorax

Question 22

What are 7 possible causes of chylothorax?

Answer 22

• Trauma
• Neoplasia
• Cardiac disease
• Thoracic duct lymphangiectasia
• Lung lobe torsion
• Inflammation
• Idiopathic

Question 23

What percentage of chylothorax cases are idiopathic?

Answer 23

60-70%

Question 24

What can be seen on thoracocentesis with chylothorax?

Answer 24

White to pink opaque fluid that does not clear on centrifuge.

Question 25

What are 2 potential causes for the the type of fluid seen with chylothorax?

Answer 25

- Lymphocytes | - Non-degenerative neutrophils

Question 26

What are 2 ways to diagnose chylothorax?

Answer 26

- Fluid characteristics | - Triglycerides increase more in fluid than in serum

Question 27

What is the treatment for chylothorax?

Answer 27

Look for underlying cause and treat it.

Question 28

Always look for what in cats with chylothorax?

Answer 28

Underlying cardiomyopathy

Question 29

What are 4 possible treatments for the idiopathic form of chylothorax?

Answer 29

- Low fat diet (RD) - Thoracic drainage via intermittent thoracocentesis - Rutin for 2 months - Ligation of thoracic duct

Question 30

What is a possible sequelae to chylothorax? | How does this appear on radiographs?

Answer 30

- Restrictive fibrosing pleuritis | - Collapses ling lobes with rounded edges

Question 31

Air in the pleural space is known as what?

Answer 31

Pneumothorax

Question 32

What is the most common cause of pneumothorax?

Answer 32

Blunt force trauma

Question 33

Up to 1/5 of trauma cases have what?

Answer 33

Pneumothorax

Question 34

What are 4 signs of pneumothorax seen on radiographs?

Answer 34

- Absence of vasculature to chest wall - Dorsal displacement of heart and trachea - Retraction of lung from chest wall - Increased density of collapsed lobe

Question 35

What are the 2 main causes of pneumothorax?

Answer 35

- Traumatic | - Non-traumatic/spontaneous

Question 36

How is pneumothorax treated if patient is in respiratory distress?

Answer 36

Emergency thoracocentesis

Question 37

How is thoracocentesis for a pneumothorax different than that for pleural effusion?

Answer 37

Performed in the 9-10th intercostal space above the costochondral junction

Question 38

What should be done with a pneumothorax if air continues to accumulate or if pet needs multiple aspirations?

Answer 38

Place a chest tube to allow continuous evacuation.

Question 39

When should surgical intervention be performed with a pneumothorax?

Answer 39

If pneumothorax persists for more than 72 hours