Objective—To compare results of thoracic radiography,
cytologic evaluation of bronchoalveolar lavage
(BAL) fluid, and histologic evaluation of biopsy and
necropsy specimens in dogs with respiratory tract
disease and to determine whether histologic evaluation
provides important diagnostic information not
attainable by the other methods.
Procedure—BAL fluid was classified as normal, neutrophilic,
eosinophilic, mononuclear, mixed, neoplastic,
or nondiagnostic. Radiographic abnormalities
were classified as interstitial, bronchial, bronchointerstitial,
or alveolar. Histologic lesions were classified as
inflammatory, fibrotic, or neoplastic, and the predominant
site of histologic lesions was classified as the
alveoli, interstitium, or airway.
Results—The predominant radiographic location of
lesions correlated with the histologic location in 8
dogs. Of 11 dogs with histologic evidence of inflammatory
disease, 8 had inflammatory BAL fluid. Of the
2 dogs with histologic evidence of neoplasia, 1 had
BAL fluid suggestive of neoplasia, and the other had
BAL fluid consistent with septic purulent inflammation.
Two dogs without any histologic abnormalities
had mononuclear or nondiagnostic BAL fluid. Two
dogs with histologic evidence of fibrosis had mononuclear
or mixed inflammatory BAL fluid.
Conclusions and Clinical Relevance—Results suggest
that although thoracic radiography, cytologic
evaluation of BAL fluid, and histologic evaluation of
lung specimens are complementary, each method
has limitations in regard to how well results reflect
the underlying disease process in dogs with respiratory
tract disease. Lung biopsy should be considered
in cases where results of radiography and cytology
are nondiagnostic. (J Am Vet Med Assoc 2001;218:
OBJECTIVE To determine the most common types of injuries in cats surgically treated for thoracic trauma, complications associated with surgical treatment, and factors associated with mortality rate and evaluate the effectiveness of the animal trauma triage (ATT) scoring system for predicting outcome.
DESIGN Retrospective case series with nested observational study.
ANIMALS 23 client-owned cats surgically treated for thoracic trauma at 7 veterinary teaching hospitals between 1990 and 2014.
PROCEDURES Medical records were reviewed to collect data on signalment, medical history, clinical signs and physical examination findings at initial evaluation, clinicopathologic findings, initial emergency treatments and diagnostic tests performed, type of trauma sustained, imaging findings, surgery details, postoperative complications, duration of hospitalization, and cause of death, if applicable. All variables were evaluated for associations with survival to hospital discharge.
RESULTS Types of trauma that cats had sustained included dog bite or attack (n = 8 [35%]), motor vehicle accident (6 [26%]), other animal attack (2 [9%]), impalement injury or fall (2 [9%]), projectile penetrating trauma (1 [4%]), or unknown origin (4 [17%]). Intrathoracic surgery was required for 65% (15/23) of cats. The overall perioperative mortality rate was 13% (3/23). Mean ± SD ATT scores for surviving and nonsurviving cats were 6.4 ± 2.2 and 10.0 ± 1.7, respectively. Nineteen of 20 cats with no cardiopulmonary arrest survived to discharge, compared with 1 of 3 cats with cardiopulmonary arrest. Only these 2 variables were significantly associated with outcome.
CONCLUSIONS AND CLINICAL RELEVANCE The perioperative mortality rate was low in this series of cats with thoracic trauma; however, those with cardiopulmonary arrest were less likely to survive to hospital discharge than other cats. Cats with a low ATT score were more likely to survive than cats with a high ATT score.
OBJECTIVE To determine perioperative mortality rate and identify risk factors associated with outcome in dogs with thoracic trauma that underwent surgical procedures and to evaluate the utility of the animal trauma triage (ATT) score in predicting outcome.
DESIGN Retrospective case series.
ANIMALS 157 client-owned dogs.
PROCEDURES Medical records databases of 7 veterinary teaching hospitals were reviewed. Dogs were included if trauma to the thorax was documented and the patient underwent a surgical procedure. History, signalment, results of physical examination and preoperative laboratory tests, surgical procedure, perioperative complications, duration of hospital stay, and details of follow-up were recorded. Descriptive statistics and ATT scores were calculated, and logistic regression analysis was performed.
RESULTS 123 of 157 (78%) patients underwent thoracic surgery, and 134 of 157 (85.4%) survived to discharge. Mean ± SD ATT score for nonsurvivors was 8 ± 2.4. In the multivariable model, female dogs and dogs that did not experience cardiac arrest as a postoperative complication had odds of survival 6 times and 102 times, respectively, those of male dogs and dogs that did experience cardiac arrest as a postoperative complication. Additionally, patients with a mean ATT score < 7 had odds of survival 5 times those of patients with an ATT score ≥ 7.
CONCLUSIONS AND CLINICAL RELEVANCE The overall perioperative mortality rate was low for patients with thoracic trauma undergoing surgery in this study. However, male dogs and dogs that experienced cardiac arrest had a lower likelihood of survival to discharge. The ATT score may be a useful adjunct to assist clinical decision-making in veterinary patients with thoracic trauma.