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Medical and surgical treatment of pyothorax in dogs: 26 cases (1991–2001)

Matthew B. RooneyDepartment of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523.

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Eric MonnetDepartment of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523.

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 DVM, PhD, DACVS

Abstract

Objective—To compare outcomes of dogs with pyothorax treated medically versus surgically and to identify prognostic indicators for dogs with pyothorax.

Design—Retrospective study.

Animals—26 dogs.

Procedure—Medical records were reviewed to obtain information regarding signalment, results of physical and laboratory evaluations at the time of initial examination, results of bacterial culture of pleural fluid, radiographic abnormalities, treatment (surgical vs medical), complications, whether the disease recurred, disease-free interval, survival time, and cause of death.

Results—Calculated proportions of dogs free from disease 1 year after treatment were 25 and 78%, respectively, for dogs treated medically and surgically. Treatment was 5.4 times as likely to fail in dogs treated medically as in dogs treated surgically. Two regression models relating treatment group (medical vs surgical) to disease-free interval were found to be significant. The first contained terms for medical treatment and isolation of Actinomyces spp from pleural fluid; the second contained terms for medical treatment and radiographic detection of mediastinal or pulmonary lesions at the time of initial examination.

Conclusions and Clinical Relevance—Results suggest that surgical treatment is associated with a better outcome than medical treatment in dogs with pyothorax. In addition, surgery should be considered if radiographic evidence of mediastinal or pulmonary lesions is detected or if Actinomyces spp is isolated from the pleural fluid. (J Am Vet Med Assoc 2002; 221:86–92)

Abstract

Objective—To compare outcomes of dogs with pyothorax treated medically versus surgically and to identify prognostic indicators for dogs with pyothorax.

Design—Retrospective study.

Animals—26 dogs.

Procedure—Medical records were reviewed to obtain information regarding signalment, results of physical and laboratory evaluations at the time of initial examination, results of bacterial culture of pleural fluid, radiographic abnormalities, treatment (surgical vs medical), complications, whether the disease recurred, disease-free interval, survival time, and cause of death.

Results—Calculated proportions of dogs free from disease 1 year after treatment were 25 and 78%, respectively, for dogs treated medically and surgically. Treatment was 5.4 times as likely to fail in dogs treated medically as in dogs treated surgically. Two regression models relating treatment group (medical vs surgical) to disease-free interval were found to be significant. The first contained terms for medical treatment and isolation of Actinomyces spp from pleural fluid; the second contained terms for medical treatment and radiographic detection of mediastinal or pulmonary lesions at the time of initial examination.

Conclusions and Clinical Relevance—Results suggest that surgical treatment is associated with a better outcome than medical treatment in dogs with pyothorax. In addition, surgery should be considered if radiographic evidence of mediastinal or pulmonary lesions is detected or if Actinomyces spp is isolated from the pleural fluid. (J Am Vet Med Assoc 2002; 221:86–92)