Page 2532 - Cote clinical veterinary advisor dogs and cats 4th

Pleural Effusion Pneumonia, Aspiration 1269

Pleural Effusion
VetBooks.ir Cause Appearance Total Protein* Cytologic Examination Other Tests

Pyothorax (septic exudate) Cloudy, tomato soup >4 g/dL Degenerative neutrophils, intracellular and Aerobic and anaerobic C&S
appearance, malodor extracellular bacteria, macrophages, RBCs
Idiopathic chylothorax (modified Milky white † 3 g/dL Mature lymphocytes, few RBCs, few Effusion and serum triglyceride
transudate) macrophages, few neutrophils levels
Right-sided (± left-sided in cats) Clear 2 g/dL Very few cells: RBCs, lymphocytes Echocardiogram
heart failure (modified transudate)
Lymphoma (modified transudate Clear, milky, 2-4 g/dL Immature lymphoblasts, few mature Thoracic radiographs, thoracic
or nonseptic exudate) serosanguineous lymphocytes, few RBCs ultrasound, aspirate/cytologic
examination of mass
Thymoma (modified transudate or Clear, milky, 2-4 g/dL Mesothelial cells, mature lymphocytes, Thoracic radiographs, thoracic
nonseptic exudate) serosanguineous few RBCs, few macrophages ultrasound, aspirate/cytologic
examination of mass
Other neoplasia (e.g., carcinoma) Clear, cloudy, 2-4 g/dL Clumps of neoplastic cells Thoracic radiographs, thoracic
(modified transudate or nonseptic serosanguineous, bloody ultrasound
exudate)
Hypoalbuminemia (pure Clear, watery <2.5 g/dL Mononuclear cells (mesothelial cells, Serum albumin, urine protein/
transudate) lymphocytes, macrophages) creatinine ratio, bile acids
FIP (cats) (nonseptic exudate) Straw-colored, cloudy >4 g/dL Macrophages, lymphocytes, RBCs, fibrin FIP PCR on fluid
*To convert from g/dL to mg/mL, multiply g/dL by 10.
† Occasionally translucent; definitive diagnosis via triglyceride concentration, which is higher in chylous effusions than in blood.
C&S, Culture and susceptibility; FIP, feline infectious peritonitis; PCR, polymerase chain reaction; RBCs, red blood cells. Differentials, Lists, and Mnemonics
Modified with permission from King L: Textbook of respiratory disease in dogs and cats, St. Louis, 2004, Saunders, p 16.

Pneumonia, Aspiration

Conditions Predisposing an Animal to Aspiration of Stomach Contents
Impairment of Protective Airway Reflexes Large Volumes of Intragastric Food/Fluid Impaired Function of Gastroesophageal
Coma Delayed gastric emptying: Sphincter
Head trauma Ileus Presence of a nasogastric feeding tube
Metabolic derangements Bowel obstruction Achalasia
Central depressant medications (sedation, Pain Esophageal obstruction
general anesthesia) Anxiety Abnormalities of esophageal function:
Muscle relaxants Opioid medication Megaesophagus
Seizures Peristaltic abnormalities Reflux esophagitis
Airway trauma Pregnancy Myasthenia gravis
Laryngeal dysfunction (including laryngeal Obesity Esophageal dysmotility
paralysis before and after surgical treatment) Overfeeding by enteral tube
Pharyngeal dysfunction Recent meal (before emergency anesthesia/
General anesthesia surgery)
Modified from King L: Textbook of respiratory disease in dogs and cats, St. Louis, 2004, Saunders, p 423.

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