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Chapter 12 · Pleural drainage techniques



                  chamber is positioned over the ninth rib. The afferent tubing   Hackett T (1999) Endocrine and metabolic emergencies. In: BSAVA Manual of
                                                                       Canine and Feline Emergency and Critical Care, ed. L King and R Hammond,
                  is  placed  in  the  pleural  space  through  a  hole  created  at    pp. 187–189. BSAVA Publications, Gloucester
        VetBooks.ir  The efferent tubing is inserted into the abdomen behind the   Hodges CC, Fossum TW and Evering W (1993) Evaluation of thoracic duct
                  the seventh or eighth intercostal space, using haemostats.
                                                                       healing after experimental laceration and transection.  Veterinary Surgery  22,
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                  last rib. Purse-string sutures are placed around both
                                                                       Holt D and Wilson J (2012) Preoperative stabilization. In:  BSAVA Manual of
                  afferent and efferent limbs. The cranial skin incision is
                  enlarged as necessary to allow the pump backing to be   Canine and Feline Surgical Principles, ed. S Baines, V Lipscomb and T
                                                                       Hutchinson, pp.88–103. BSAVA Publications, Gloucester
                  sutured to intercostal muscles. Muscle, subcutaneous    Johnson MS and Martin MWS (2007) Successful medical treatment of 15 dogs
                  tissue and skin are closed routinely.                with pyothorax. Journal of Small Animal Practice 48, 12–16
                     Postoperatively, the pump chamber is pumped 100–200   Kagen KG and Breznock EM (1979) Variations in the canine thoracic duct system
                                                                       and  the  e ects  of  surgical  occlusion  demonstrated  by  rapid  aqueous
                  times every 4–6 hours initially; this is varied in the sub-  lymphography  using  an  intestinal  lymphatic  trunk.  American Journal of
                  sequent weeks to provide control of the clinical signs asso-  Veterinary Research 40, 948–958
                  ciated with the pleural effusion. Potential complications   Kovak JR, Ludwig LL, Bergman PJ, Baer KE and Noone KE (2002) Use of
                                                                       thoracoscopy to determine the aetiology of pleural e usions in dogs and cats:
                  include dislodgement and flipping of the pump chamber,
                                                                       18 cases (1998–2001). Journal of the American Veterinary Medical Association
                  and obstruction of the pump chamber with fibrin.     221, 990–994
                                                                       Lappin  MR  (1998)  Polysystemic  viral  diseases.  In:  Small Animal Internal
                                                                       Medicine, 2nd edn, ed. R Nelson and G Couto, pp.1290–1294. Mosby, St Louis
                  Prognosis                                            Lisciandro GR, Lagutchik MS, Mann KA  et al. (2008) Evaluation of a thoracic
                                                                       focused assessment with  sonography for  trauma  (TFAST) protocol to detect
                  In  spite  of  the  encouraging  results  of  surgical  treatment
                                                                       pneumothorax and concurrent thoracic injury in 145 traumatized dogs. Journal
                  reported recently, the prognosis for dogs and cats with   of Veterinary Emergency and Critical Care 18, 258–269
                  chylothorax must remain guarded. It is vital to identify    Mayhew PD, Culp WTN, Mayhew KN et al. (2012) Minimally invasive treatment of
                  an underlying cause and treat this condition whenever    idiopathic  chylothorax  in dogs by thoracoscopic thoracic duct ligation and
                                                                       subphrenic pericardiectomy: six cases (2007–2010).  Journal of the American
                  pos sible. Animals with chylothorax secondary to a poten-  Veterinary Medical Association 241, 904–909
                  tially treatable condition (e.g. mediastinal lymphoma) have a    McAnulty JF (2011) Prospective comparison of cisterna chyli ablation to
                  better prognosis than those with, for example, diffuse    pericardectomy for treatment of spontaneously occurring idiopathic chylothorax
                                                                       in the dog. Veterinary Surgery 40, 926–934
                  carcinoma invading the TDS lymphatics. In truly idiopathic
                                                                       Mellanby RJ, Villiers E and Herrtage ME (2002) Canine pleural and mediastinal
                  cases treated by thoracic duct ligation and pericardectomy,   e usions: a retrospective study of 81 cases. Journal of Small Animal Practice
                  chylothorax resolved in 10/10 dogs and 8/10 cats (Fossum   43, 447–451
                  et al., 2004).                                       Neath PJ, Brockman DJ and King LG (2000) Lung lobe torsion in dogs: 22 cases
                                                                       (1981–1999). Journal of the American Veterinary Medical Association 217, 1041–1044
                                                                       Papsouliotis   and Dewhurst E (    ) Body cavity e usions. In: BSAVA Manual
                                                                       of Canine and Feline Clinical Pathology, 2nd edn, ed. E Villiers and L
                                                                       Blackwood, pp. 340–354. BSAVA Publications, Gloucester
                  References and further reading                       Radlinsky MG (2012) Thoracic cavity. In: Veterinary Surgery Small Animal, ed. K
                                                                       Tobias and S Johnston, pp. 1787–1812. Elsevier Saunders, St Louis
                  Birchard SJ, Smeak DD and Fossum TW (1988) Results of thoracic duct ligation   Reetz JA, Caceres AV, Suran JN  et al. (2013) Sensitivity, positive predictive
                  in 15 dogs with chylothorax.  Journal of the American Veterinary Medical   value, and interobserver variability of computed tomography in the diagnosis of
                  Association 193, 68–71                               bullae associated with spontaneous pneumothorax in dogs: 19 cases (2003–
                  Boothe HW, Howe LM, Boothe DM et al. (2010) Evaluation of outcomes in dogs   2012). Journal of the American Veterinary Medical Association 243, 244–251
                  treated for pyothorax: 46 cases (1983–2001). Journal of the American Veterinary   Reichle JK and Wisner ER (2000) Non-cardiac thoracic ultrasound in 75 feline
                  Association 236, 657–663                             and canine patients. Veterinary Radiology and Ultrasound 41, 154–162
                  Bussadori R, Provera A, Martano M et al. (2011) Pleural omentalization with en   Rooney MB and Monnet E (2002) Medical and surgical treatment of pyothorax in
                  bloc ligation of the thoracic duct and pericardectomy for idiopathic chylothorax   dogs: 26 cases (1991–2001).  Journal of the American Veterinary Medical
                  in nine dogs and four cats. The Veterinary Journal 188, 234–236  Association 221, 86–92
                  Davies C and  orrester SD (1996) Pleural e usions in cats: 8  cases (1987 to   Scott JA and Macintire DK (2003a) Canine pyothorax: pleural anatomy and
                  1995). Jourmal of Small Animal Practice 37, 217–224  pathophysiology.  Compendium on Continuing Education for the Practicing
                  Demetriou JL, Foale RD, Ladlow J et al. (2002) Canine and feline pyothorax: a   Veterinarian 25, 172–178
                  retrospective study of 50 cases in the UK and Ireland. Journal of Small Animal   Scott JA and Macintire DK (2003b) Canine pyothorax: clinical presentation,
                  Practice 43, 388–394                                 diagnosis, and treatment.  Compendium on Continuing Education for the
                  Dempsey  SM  and  Ewing  PJ  (2011)  A  review  of  the  pathophysiology,   Practicing Veterinarian 25, 180–193
                  classification, and analysis of canine and feline cavitary e usions. Journal of the   Smeak DD,  Birchard  SJ, McLoughlin MA  et  al.  (2001)  Treatment  of  chronic
                  American Animal Hospital Association 47, 1–11        pleural  e usion  with  pleuroperitoneal  (Denver)  shunts:  14  dogs  (198  1999).
                                                                       Journal of the American Veterinary Medical Association 219, 1590–1597
                  Dewhurst  E  (  16)  Body  cavity  e usions.  In:  BSAVA  Manual of  Canine  and
                  Feline Clinical Pathology, 3rd edn, ed. E Villiers and J Ristic, pp. 435–451.   Staiger BA, Stanley BJ and McAnulty JF (2011) Single paracostal approach to
                  BSAVA Publications, Gloucester                       thoracic duct and cisterna chyli: experimental study and case series. Veterinary
                  Fossum TW and Birchard SJ (1986) Lymphangiographic evaluation of   Surgery 40, 786–794
                  experimentally induced chylothorax after ligation of the cranial vena cava in   Steyn PF and Wittum TE (1993) Radiographic, epidemiologic and clinical aspects
                  dogs. American Journal of Veterinary Research 47, 967–971  of  simultaneous  pleural  and  peritoneal  e usions  in  dogs  and  cats:  48  cases
                  Fossum TW, Evering WN, Miller MW  et al.  (199 )  Severe  bilateral  fibrosing   (1982–1991). Journal of the American Veterinary Medical Association 202, 307–312
                  pleuritis associated with chronic chylothorax in five cats and two dogs. Journal   Valtolina C and Adamantos S (2009) Evaluation of small-bore wire-guided chest
                  of the American Veterinary Medical Association 201, 317–324  drains for management of pleural space disease.  Journal of Small Animal
                                                                       Practice 50, 290–297
                  Fossum TW, Jacobs RM and Birchard SJ (1986) Evaluation of cholesterol and
                  triglyceride  concentrations  in  di erentiating  chylous  and  nonchylous  pleural   Waddell LS, Brady CA and Drobatz KJ (2002) Risk factors, prognostic
                  e usions  in  dogs  and  cats.  Journal of the American Veterinary Medical   indicators, and outcome of pyothorax in cats: 80 cases (1986–1999). Journal of
                  Association 188, 49–51                               the American Veterinary Medical Association 221, 819–824
                  Fossum TW, Mertens MM, Miller MW  et al. (2004) Thoracic duct ligation and   Walker AL, Jang SS and Hirsch DC (2000) Bacteria associated with pyothorax of
                  pericardectomy for treatment of idiopathic chylothorax.  Journal of Veterinary   dogs and cats: 98 cases (1989–1998).  Journal of the American Veterinary
                  Internal Medicine 18, 307–310                        Medical Association 216, 359–364








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