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Left lateral (A) and ventrodorsal (B) thoracic radiographies showing retraction of lung lobes away from the thoracic wall. Bullous lesion in the right caudal lung lobe (arrow), sternal and cranial mediastinal lymphadenopathy (arrowheads), and enlarged cranial lobar artery and vein are also evident. A5 artery; V 5 vein.
Source publication
A 5-year-old female spayed Labrador Retriever dog was referred to the Louisiana State University Veterinary Teaching Hospital for treatment of pneumothorax. Thoracic radiographs and computed tomography showed spontaneous pneumothorax, thoracic lymphadenopathy, pulmonary hypertension, and multifocal pulmonary bulla lesions. At surgery, numerous adul...
Citations
... Canine Heartworm Disease (CHD) is a serious cardiopulmonary disease that can cause vascular and pulmonary damages and even death for parasitized animals in the absence of preventive measures and appropriate treatments [1]. The disease is caused by Dirofilaria immitis (D. immitis), a mosquito-transmitted nematode with worldwide distribution that affects dogs, as main host but also cats, ferrets, and several other wild carnivores (e.g., foxes, jackals, and wolves) [2]. ...
Background and objectives:
The present study was carried out to assess the presence of canine Dirofilaria immitis infection in pet dogs in China.
Materials and methods:
From October 2018 to November 2019, a total of 216 sera were collected from pet hospitals in Shandong, Jiangsu, Shanghai, Zhejiang, and Fujian regions of Eastern China. The sera were tested by using a commercial canine heartworm antibody ELISA test kit.
Results:
70.8% of the pets had significant clinical symptoms resembled to heartworm infection; the overall dirofilariosis positivity found was 12.5% (27/216); Significant positive rates differences were observed between symptomatic and asymptomatic dogs (P < 0.05) (i.e. 15.7% and 4.7% respectively).The prevalence of infection in Shandong Province (15.5%) was the highest among the surveyed areas, but the difference among the geographic regions was not statistically significant (P > 0.05). Furthermore, the prevalence detected in summer (28.2%) was significantly higher than in other seasons (P < 0.05). In addition, no significant difference was observed between male and female sex (P > 0.05).
Conclusions:
Altogether, these results suggest that an epidemic of dirofilariosis exists in eastern coastal China, as such preventive measures should be taken to control the spread of dirofilariosis to reduce the risk of human and pet infection with heartworm.
... In contrast to spontaneous pneumothorax in humans, a causative pathology is commonly found in dogs with spontaneous pneumothorax (Holtsinger and Ellison, 1995). Bullae or blebs, as well as pulmonary abscesses, plant migration, bacterial or fungal pneumonia, angiostrongylus vasorum infection, heart worm infection, or neoplasia have been reported in this context (Busch and Noxon, 1992;Puerto et al., 2002;Lipscomb et al., 2003;Au et al., 2006;Oliveira et al., 2010;Gallagher et al., 2012;Boudreau et al., 2013;Spodsberg et al., 2013;Trempala and Herold, 2013). Depending on the underlying disease, complete or partial lung lobectomy is performed and early surgical treatment has been reported to improve survival rate (Puerto et al., 2002). ...
Background: Spontaneous pneumothorax in dogs is characterized by an accumulation of air in the interpleural space without an underlying trauma and consecutive acute onset of respiratory distress. Underlying causes for spontaneous pneumothorax vary with ruptured bullae being one of the main causes. Treatment after initial stabilization often requires partial or complete surgical resection of effected lung lobes. Partial lung lobectomy can be performed with stapling devices or sealing devices e.g. by different surgical approaches including video-assisted thoracoscopic surgery. However, intra-thoracic surgery in small sized dogs using either of the techniques is challenging.
Case Description: A 12 year old Shih Tzu was presented with spontaneous pneumothorax. Further diagnostics with computed tomography and intercostal thoracoscopy revealed a bulla in the right middle lung lobe. Partial lung lobectomy (2,5cm x 2,5 cm x 2cm) of the respective lung lobe was performed by an intercostal approach using the Caiman® 5 Seal & Cut sealing device. The Caiman® 5 Seal & Cut device allowed quick and safe partial lung lobectomy in the treatment of spontaneous pneumothorax without intra- or post-operative complications. The dog was discharged 2 days after surgery in good clinical condition. This report demonstrates the in-vivo efficacy and safety of the Caiman® 5 Seal & Cut sealing device for partial lung lobectomy in a small breed dog.
Conclusion: Using the Caiman® 5 Seal & Cut device lung tissue could be resected without intra- or post-operative complications in a small breed dog. The present case may emphasize the use of the device in fully video-assisted thoracoscopic surgery also in small sized patients. [Open Vet J 2022; 12(6.000): 910-918]
... Other reported infectious causes of pulmonary bullae or similar lesions include Blastomyces dermatidis, 22 Paragnonimus spp., 23 and Dirofilaria immitis. 24 This dog had never left Ireland, a nonendemic area for all of these pathogens. ...
A 9‐week‐old male intact Cavalier King Charles Spaniel was presented for evaluation of acute onset dyspnea caused by left‐sided pneumothorax. Thoracic computed tomography (CT) identified multiple pulmonary bullae and blebs in multiple lung lobes. Rupture of ≥1 pulmonary blebs or bullae, precipitated by low impact trauma, was the suspected cause of pneumothorax. A volume of 7.5 mL/kg of fresh whole blood was collected from a type‐matched donor dog and administered into the left pleural space using a thoracostomy tube. The pneumothorax was successfully resolved and no adverse effects of blood patch pleurodesis were noted. The dog was clinically normal 12 months later.
... Longitudinal evaluation of the nontreated control group illustrates that this model was associated with radiographically detectable changes in the cardiopulmonary system, although most radiographic abnormalities were mild or mild-to-moderate in severity, with the exception of pneumothorax. Spontaneous pneumothorax has been described in dogs with naturally occurring heartworm disease, in which the cause was suspected to be pulmonary parenchymal infarction with subsequent bulla formation and rupture, or rupture of a secondary bacterial abscess.[25][26][27][28] One necropsy-based study of n = 15 naturally-infected heartworm-positive dogs, all dying because of acute, severe respiratory distress and collapse, found that pulmonary lesions leading to pneumothorax were confined almost exclusively to the dorsal, peripheral margin of the right caudal lung lobe, and were characterized as "pulmonary cavities" or scarring emphysema with perforation and formation of a bronchopleural fistula.26 ...
Background
Administration of moxidectin topically and doxycycline PO has been utilized experimentally as an alternative treatment for heartworm disease. However, clinical effects of this protocol remain poorly characterized.
Objective
To evaluate the clinical and postmortem findings associated with administration of doxycycline and monthly 10% imidacloprid + 2.5% moxidectin (IMD + MOX, Advantage Multi/Advocate) to Dirofilaria immitis‐experimentally infected as compared to nontreated control dogs.
Animals
Sixteen purpose‐bred, female, Beagle dogs.
Methods
Prospective, blinded, experimental study. Animals with surgically transplanted adult heartworms were randomized into 2 study groups of equal size: a nontreated control group (n = 8) and an IMD + MOX and doxycycline‐treated group (n = 8). Randomization was performed using a complete block design according to circulating microfilarial concentrations, measured before treatment. Serum biochemical profiles, CBCs, thoracic radiographs and echocardiograms were performed prior to and 3 weeks after transplantation, and monthly for 10 months. Postmortem gross and histopathologic evaluations were performed.
Results
Compared to control animals, mean ± SD serum alanine aminotransferase (181 ± 203 U/L vs 33 ± 7 U/L; P < .0001) and alkaline phosphatase (246 ± 258 U/L vs 58 ± 19 U/L; P < .0001) activities were significantly higher in the treated group on day 28. Radiographic and echocardiographic evidence of heartworm disease was observed in both groups; however, no significant differences in these variables were noted between groups. Mean ± SD pulmonary arterial thrombus score was significantly higher in the treated vs nontreated group (3.9 ± 0.4 and 1.5 ± 2.1, respectively; P = .01).
Conclusions and Clinical Importance
The treatment protocol was well‐tolerated with no clinically relevant adverse effects for any variable evaluated during the observational period.
... Spontaneous pneumothorax can be further classified as either primary or secondary based on history, clinical signs, and whether an underlying cause can be determined from diagnostic tests, such as thoracic radiographs, thoracic computed tomography, or thoracoscopy (Holtsinger et al., 1993;O'Neill, 1987;Tanaka et al., 1993). Reasons for spontaneous pneumothorax in dogs include pulmonary blebs or bullous emphysema, lobar emphysema, bacterial pneumonia, pulmonary abscesses, dirofilariasis, and neoplasia (Busch and Noxon, 1992;Oliveira et al., 2010;Puerto et al., 2002;Saheki et al., 1981). Based on previous reports, the most common cause of spontaneous pneumothorax is pulmonary blebs or bullae. ...
A 3-year-old female Maltese dog was admitted with cough, dyspnea, and gasping. There was no sign of trauma in history taking. It was speculated that pneumothorax occurred in the right pleural space after X-ray examination. Thoracocentesis and chest tube were applied for 5 days. The symptoms of dyspnea and cough were, however, not relieved or recurred. Exploratory thoracotomy was considered to be the most appropriate approach. Spongiform and air-containing tissue was identified in the whole parenchyma in the right middle lobe. Total lobectomy was performed and then a chest tube was inserted. Atrophy of the right cranial lobe and collapse in the right caudal lobe were identified. In histopathological examination, loss of alveolar septa and dilated alveolar ducts were demonstrated. The patient showed no abnormal symptoms, and the X-ray examination showed no signs of recurrence after surgery. This report describes a rare spontaneous pneumothorax case which is associated with lobal emphysema in an adult dog, but not in puppies with congenital lobar emphysema.
... 10 Because radiographic confirmation of the pulmonary bullae in dogs and humans is not reliable, advanced diagnostic techniques like computed tomography need to be considered when pulmonary bullae is suspected. 4 In this patient bullae was not diagnosed by private clinician using thoracic radiographs, while computed tomography revealed the bullae in the affected lung lobe. However thoracic radiographs are essential to rule out other causes of the bullae or pneumothorax like pulmonary neoplasia or abscess. ...
Case description- A two-year-old intact Golden Retriever was affected with the 6-months previous history of blastomycosis and treatment was performed using fluconazole.
Clinical findings- Cough, fever, nasal discharge, dry and harsh lung sounds with peripheral lymphadenopathy was observed. Emphysematous change and large pulmonary bulla was reported in computed tomography of the thorax.
Treatment and outcome-Under general anesthesia using hydromorphone, combination of ketamine and diazepam and isoflurane the dog was prepared for the surgery. Right lateral thoracotomy thorough 5th intercostal space was performed. Following releasing of the pleural and pulmonary adhesions, right cranial lobe was resected. Chest tube was placed and Bupivaciane was injected as costal nerve block to control the post-operative pain. Cefazolin and NSAID were also administered for an overnight. In follow up nasal discharge and lymphadenopathy was resolved and the pulmonary pattern appeared normal in radiographs.
Clinical Relevance-Blastomycosis is a systemic fungal disease that may affect skin and lungs. Surgical treatment and pulmonary lobectomy is recommended in case of pulmonary bulla formation due to blastomycosis.
Four Japanese Spitz dogs between 5 and 11 months old were presented for acute dyspnoea. Thoracic radiographs and CT identified bilateral pneumothorax and pulmonary cavitary lesions. The median lesion size was 30 mm (range 7‒50 mm). After initial stabilisation, one dog underwent median sternotomy, while three dogs underwent intercostal thoracotomy. Surgical exploration found grossly haemorrhagic pulmonary bullous lesions in all cases. Histopathology revealed blood‐filled cavities with interstitial fibrosis and pneumocyte hyperplasia. Dyspnoea recurred in all dogs postoperatively, with recurrence of lesions confirmed either radiographically or via CT in three of four cases. The median time from surgery to recurrence of pneumothorax was 9 days (range 5‒15 days). The mortality rate was 100%, and the median postoperative survival time was 22 days (range 5‒558 days). This report aims to raise awareness of this group of dogs presenting with spontaneous pneumothorax at a young age and with high recurrence rates despite surgery, contrary to the literature.
Three dogs were diagnosed with spontaneous pneumothorax and referred to the Ontario Veterinary College Health Sciences Centre for management. The 3 dogs were diagnosed with secondary spontaneous pneumothorax due to paragonimosis. The diagnosis was made by visualization of adult trematodes during surgical exploration with histopathological confirmation in 1 dog, and detection of trematode eggs via fecal sedimentation in the other 2 dogs. Two of the dogs developed unusual additional lesions, including hemoabdomen, muscle abscess, and abdominal adhesions. These were suspected to be secondary to aberrant fluke larval migration. All 3 dogs lived within a relatively small geographical area of Ontario and were hospitalized between December 2021 and March 2022. Each dog survived to discharge with surgical or medical management of the pneumothorax and treatment with a prolonged course of fenbendazole. Key clinical message: Paragonimosis should be considered as a differential diagnosis for canine spontaneous pneumothorax in areas where Paragonimus kellicotti is, or may be, endemic, or in dogs that have travelled to endemic areas - particularly if the patient has a history of cough or potential exposure to freshwater crayfish. Routine anthelmintic treatment does not prevent infection and standard fecal floatation methods may not detect the eggs. Therefore, diagnostic testing should include a fecal sedimentation test and thoracic radiographs to screen for P. kellicotti.
Spontaneous pneumothorax, which may have an acute or insidious onset in dogs and cats, results in respiratory difficulty and has the potential to be life threatening 1, 2, 3. Dogs commonly develop spontaneous pneumothorax due to bullae or blebs, while cats typically have underlying inflammatory disease, like feline allergic airway disease. Urgent therapeutic intervention is essential in animals with respiratory distress. The recommended therapeutic strategies are typically different in each of these species due to underlying etiology. The first part of this review article will focus on physiology, clinical presentation, and diagnosis of spontaneous pneumothorax in dogs and cats. Advances in diagnostics, especially the recent utility of point of care ultrasound, will be discussed. The second part of the series will provide an overview of therapeutic options and management of patients with spontaneous pneumothorax, as well as information on prognosis.
