Page 195 - BSAVA Manual of Canine and Feline Head, Neck and Thoracic Surgery, 2nd Edition

BSAVA Manual of Canine and Feline Head, Neck and Thoracic Surgery

(Murphy et al., 1997). Bacterial or fungal pneumonia was bronchus with enlargement and emphysema of the affected
less likely to resolve when compared with foreign body lobe (Seiler et al., 2008).
VetBooks.ir lobes were involved. is the treatment of choice. The lung lobe should not be
Thoracotomy with lobectomy of the affected lung lobe
pneumonia, and mortality increased when multiple lung
untwisted or repositioned prior to lobectomy, to prevent

temic circulation. The prognosis for treatment of patients
Lung lobe torsion release of toxins or vasoactive substances into the sys-
with LLT is fair to guarded. Although nearly all patients
Lung lobe torsion (LLT) occurs when a lung lobe rotates on survive the initial surgery, there is a high complication
rate, with only 55% of patients having non-complicated
its longitudinal axis, resulting in twisting of the bronchus
and the pulmonary vessels at the hilus. LLT is a rare condi- recovery (Neath et al., 2000). The prognosis for Pugs is
more favourable (Murphy and Brisson, 2006). There can be
tion that has been reported in both dogs and cats and
occurs most frequently in large, deep-chested dogs such recurrence of LLT in some patients, or persistence of
as Afghan Hounds (the right middle and left cranial lung pleural effusion. The finding of a chylous effusion has been
lobes have a higher incidence of torsion), although one associated with a poor prognosis (Fossum et al., 1985).
atypical breed, the Pug, is apparently also predisposed Adjunctive procedures for treatment of the chylothorax
(left cranial lung lobe more often affected). Reported clini- may be necessary (see Chapter 12).
cal signs are non-specific and include dyspnoea, tachy-
pnoea, lethargy, coughing, anorexia and weight loss. On PRACTICAL TIP
physical examination, dull heart and lung sounds are the
most common clinical abnormalities. Submit excised lung lobe for histopathology and
Pleural effusion is a common finding in dogs with LLT perform culture and sensitivity testing of pleural fluid.
and has been reported to be chylous in nearly one-third Examine the thoracic cavity for any evidence of a
of LLT cases (Neath et al., 2000). Radiographic findings primary disease process (e.g. neoplasia)
of abnormal bronchial position and blunting of the bron-
chial lumen are suggestive of LLT (Figure 14.7). Thoracic
ultrasonography and thoracic CT may also be useful for
diagnosis. CT characteristically shows an abruptly ending
Spontaneous pneumothorax
Spontaneous pneumothorax is defined as a closed pneu-
mothorax resulting from air leakage from the lung paren-
chyma, without any history of trauma. This is a rare
condition in dogs and cats, although there appears to be
a predilection in Huskies (Puerto et al., 2002). The most
common causes of spontaneous pneumothorax in dogs are
pulmonary blebs (Figure 14.8) and bullous emphysema;
other reported causes are neoplasia, pulmonary abscesses,
bacterial pneumonia, heartworm and migration of plant
foreign bodies. Seven cases of spontaneous pneumothorax
have been reported in cats with small airway disease or
asthma (Cooper et al., 2003; White et al., 2003).
In dogs, initial stabilization with thoracocentesis or
(a) thoracostomy tube placement may be necessary. Initial
diagnostics include a complete blood count, chemistry
(a) Lateral and (b)
14.7 ventrodorsal profile, heartworm testing and thoracic radiography or CT.
radiographs of an Afghan Early surgical exploration is recommended for dogs that
Hound with a right middle do not have identifiable non-surgical disease or diffuse
lung lobe torsion. Note the
pleural effusion and
prominent air bronchogram
secondary to congestion of
the affected lobe on the
lateral vie and the
appearance of the right
middle lobe on the
ventrodorsal view.

(b) 14.8 Pulmonary bleb in a 7-year-old Old English Sheepdog.

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