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Abstract

CASE DESCRIPTION A 7-year-old castrated male Italian Greyhound (dog 1) and an approximately 1-year-old female Labrador Retriever (dog 2) were evaluated because of respiratory distress 8 and 10 days, respectively, after a tornado.

CLINICAL FINDINGS No obvious external injuries were identified auscultation revealed decreased bronchovesicular sounds in the affected hemithorax of both dogs. Clinicopathologic changes were mild, with evidence of inflammation in both dogs. Thoracic radiography of both dogs revealed pneumothorax and pleural effusion with effacement of the diaphragm; findings on CT included severe pulmonary atelectasis of affected lung lobes with normal bronchial tree configurtion and no evidence of diaphragmatic hernia.

TREATMENT AND OUTCOME Exploratory thoracotomy of both dogs confirmed CT findings Pulmonary parenchymal damage consistent with a large rupture was found in both patients. A large hematoma was adhered to the ruptured lung lobe of dog 1. Grossly affected lung tissue was removed; histologic examination revealed atelectasis, pulmonary fib osis, thrombosis, and minimal (dog 1) to marked (dog 2) inflammation Microbial culture of lung tissue yielded no growth for dog 1 and Streptococcus spp and Escherichia coli susceptible to amoxicillin-clavulanic acid for dog 2. Dog 1 had a recurrence of pneumothorax treated by drainage with a thoracostomy tube 1 month after surgery. Eighteen months after surgery, both dogs were reportedly doing well.

CLINICAL RELEVANCE Development of clinical signs after a tornado, together with clinical, diagnostic imaging, surgical, and histologic findings led to a presumptive diagnosis of pulmonary barotrauma for both dogs. Long-term outcome for these dogs, treated at a referral hospital, was good.

Full access
in Journal of the American Veterinary Medical Association

Abstract

CASE DESCRIPTION A 6-month-old sexually intact male domestic shorthair cat was referred for evaluation of a heart murmur and ventricular septal defect (VSD).

CLINICAL FINDINGS Physical examination revealed a grade 5/6 right apical systolic heart murmur. Findings on thoracic radiography were consistent with moderate right and left ventricular enlargement, left atrial enlargement, and enlargement of the pulmonary arteries and veins; an interstitial pulmonary pattern was also evident. Echocardiography revealed a perimembranous VSD with left-to-right shunting combined with trace mitral valve regurgitation. The cat later developed a dry cough, the intensity of the heart murmur increased to grade 6/6, and signs of left-sided congestive heart failure developed.

TREATMENT AND OUTCOME Medical treatment included enalapril maleate and furosemide. When the cat's condition worsened despite medical treatment, palliative pulmonary artery banding was performed. During surgery, blood pressure in the pulmonary artery was measured with a pulmonary artery catheter, and pulmonary artery banding was successfully achieved with a polytetrafluoroethylene band and hemoclips. The pulmonary-to-systemic blood flow ratio was reduced from 3 to 1.5, and signs of congestive heart failure resolved within 2 weeks after surgery.

CLINICAL RELEVANCE Findings suggested that cats with a VSD and pulmonary-to-systemic flow ratio > 3 or with congestive heart failure attributable to a VSD could be considered candidates for palliative pulmonary artery banding to alleviate clinical signs. However, further investigation into long-term prognosis with objective outcome measurements and with multiple cases is needed. (J Am Vet Med Assoc 2019;254:723–727)

Full access
in Journal of the American Veterinary Medical Association