Page 20 - Spring 19

continued from page 17
Fig.4 Ecography: Right hemithorax
• Right thorax: Accumulation of fluid in a small amount, anechoic, fibrin is not observed (normal finding, since there is no fluid, it does not allow to observe the possible presence of fibrin).
A new echography had no particularities, so the drainage catheter was removed.
5 days later the fever returns (higher than 40° C even though antibiotic therapy was continued) and anorexia is observed.
Echography: Right thorax with accumulation of fluid, hyperechoic areas and areas with fibrin.
Drainage: Extraction of 4 litres of pus (thick, caseous).
The hemithorax is washed with 2% acetylcysteine (fibrinolytic) for 10 days, obtaining liquid and fibrin. Continued treatment with Sulfas and Metronidazole.
The patient improves his general condition, "docile animal for a stallion" (sic). The drainage continues.
10 days later, the patient relapses again with the same symptoms.
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Fig.5 Echography: Left hemithorax
Fig.7 The doctor decided to perform a rib section to manually remove exudates
Repositioning of drains and extraction of 4 litres of pus, washing as before, the probe is covered with fibrin.
The doctor decided to perform a rib section to manually remove exudates and fibrin, 20 litres of pus and fibrin is extracted. The patient lose a lot of blood (approximately 5 lires) in the proces
Treatment
• Procaine penicillin 10 mill.UI /12 hs.
• Butorphanol 0.2 mg/kg/12 hs. for 48 hs., then passes to • Phenylbutazone 4.4 mg/kg/12 hs.
• Omeprazole 4 mg/kg/24 hs.
Good general development, but the liquid does not stop building up in the thorax. The liquid has the same characteristics.
10 days after the rib section the clinic considers the pos- sibility of euthanasia. The doctor decided to consult me.
Fig.6 20 litres of pus and fibrin is drained