Resolution of persistent pneumothorax by use of blood pleurodesis in a dog after surgical correction of a diaphragmatic hernia.

Abstract

CASE DESCRIPTION:

A 15-kg (33-lb) pregnant female mixed-breed dog of unknown age was referred because of a 10-day history of difficulty breathing.

CLINICAL FINDINGS:

Physical examination findings were dyspnea, tachypnea, decreased bronchovesicular sounds (bilateral), muffled heart sounds, and abdominal distention with palpable fetuses. Hematologic abnormalities included anemia, leukocytosis, and thrombocytosis. Abnormalities detected during serum biochemical analysis included decreases in concentrations of albumin, sodium, triglycerides, and total calcium and increases in activities of alkaline phosphatase, alanine aminotransferase, gamma-glutamyltransferase, aspartate aminotransferase, lactate dehydrogenase, and creatine kinase. Thoracic radiography revealed a diaphragmatic hernia with fetuses and a soft tissue or fluid opacity within the thoracic cavity.

TREATMENT AND OUTCOME:

Exploratory celiotomy, ovariohysterectomy, partial sternotomy, placement of a right-sided thoracostomy tube, and herniorrhaphy were performed. After surgery, pneumothorax developed, and the thoracostomy tube was used to remove pleural effusion and free air. The pneumothorax did not resolve after continuous drainage of the thoracic cavity for 4 days. Autologous blood pleurodesis was performed by infusion of 80 mL (6 mL/kg [2.73 mL/lb]) of whole blood. The pneumothorax resolved immediately after injection of the blood.

CONCLUSIONS AND CLINICAL RELEVANCE:

Blood pleurodesis was used for resolution of pneumothorax in a dog after correction of a diaphragmatic hernia. Blood pleurodesis may provide a simple, safe, and inexpensive medical treatment for resolution of persistent (duration>5 days) pneumothorax when surgery is not an option.

• Authors: Yael Merbl, Efrat Kelmer, Anna Shipov, Yael Golani, Gilad Segev, Sigal Yudelevitch, Sigal Klainbart
• Journal: Journal of the American Veterinary Medical Association (J Am Vet Med Assoc) Vol. 237 Issue 3 Pg. 299-303 (Aug 01 2010) ISSN: 0003-1488 [Print] United States
• PMID: 20673111 (Publication Type: Case Reports, Journal Article)

Topics

• Animals
• Blood
• Dog Diseases (therapy)
• Dogs
• Female
• Hernia, Diaphragmatic (surgery, veterinary)
• Pleurodesis (veterinary)
• Pneumothorax (etiology, therapy, veterinary)
• Pregnancy