Pyothorax, or thoracic empyema, is an infection of the pleural space, characterized by the accumulation of purulent exudate. It is a life-threatening emergency in dogs as well as in cats, with a guarded prognosis. Dyspnea and/or tachypnea, anorexia and lethargy are the most typical clinical signs. Diagnosis is usually straightforward, based on the clinical symptoms combined with pleural fluid analysis, including cytology and bacterial culture. Most commonly, oropharyngeal flora is isolated in the pleural fluid. Treatment can be medical or surgical, but needs to be immediate and aggressive. In this article, an overview of the various causes of both feline and canine pyothorax with its similarities and differences is provided. Epidemiology, symptoms, diagnosis, treatment and prognosis are discussed.
Pyothorax is a rare disease in cats. Underlying causes and treatment recommendations vary greatly between cases. In this case series, the management of two challenging cases of feline pyothorax is discussed. In the first case, a nine-year-old female spayed European shorthair cat with pyothorax caused by Bacteroides fragilis is described. At the time of presentation, she was diagnosed with feline immunodeficiency virus as well. The pyothorax was succesfully managed medically. Unfortunately, the cat relapsed after three months and the owner elected euthanasia. The second case involved a ten-year-old male castrated British shorthair cat with identification of filamentous bacteria on pleural fluid cytology. This cat underwent surgical intervention because thoracic drainage was very difficult. Eventually, he recovered well and did not relapse up to two months postoperatively. The challenges in the decision process and treatment complications are discussed.
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