Clinical Outcome following Pneumonectomy for Management of Chronic Pyothorax in Four Cats

Abstract

Pneumonectomy is the resection of all lung lobes from one side of the thorax. The clinical findings, treatment and outcome of four cases of feline chronic pyothorax managed with exploratory thoracotomy and pneumonectomy are reported. All cases were initially medically managed with thoracic drain placement and antibiosis. However, resolution was not achieved with medical therapy and diagnostic imaging findings consistent with an area of abscessation or marked lung lobe consolidation were identified, supporting a decision for surgical management. Surgical exploration was performed via median sternotomy and, on the basis of gross inspection, non-functional lung was removed. A left-sided pneumonectomy was performed in three cats and a right-sided pneumonectomy in one. All cases survived to discharge and an excellent quality of life was reported on long-term follow-up. Pneumonectomy appears to be well tolerated in the cat.

Lung

“…79 It has been described in cats with chronic pyothorax, 79 pulmonary neoplasia, 54,81 and pneumonia. 79 It has been described in cats with chronic pyothorax, 79 pulmonary neoplasia, 54,81 and pneumonia.…”

“…79 It has been described in cats with chronic pyothorax, 79 pulmonary neoplasia, 54,81 and pneumonia. 79,81 Care must be taken when considering pneumonectomy to ensure that the remaining lung lobes are healthy enough to support respiratory functions. 79,81 Care must be taken when considering pneumonectomy to ensure that the remaining lung lobes are healthy enough to support respiratory functions.…”

“…74,79,80 Disruption of a staple line can result in pneumothorax and hemothorax and may be due to placing too much tissue within the staple thus preventing normal firing, failure of the staples to fire, or residual disease at the staple line. 74,79,80 Disruption of a staple line can result in pneumothorax and hemothorax and may be due to placing too much tissue within the staple thus preventing normal firing, failure of the staples to fire, or residual disease at the staple line.…”

“…79,81 In studies of normal dogs, where less than 50% of lung is removed, compensation occurs by recruitment of existing mechanisms, such as remodeling the alveolar-capillary network. Lung lobes can be removed individually or en mass more proximally, with ligation and transection of the right or left main stem bronchus and lobar pulmonary artery/vein.…”

Postoperative Respiratory Function and Survival After Pneumonectomy in Dogs and Cats

“…A case study of 3 dogs and 1 cat undergoing pneumonectomy reported respiratory, cardiac, and gastrointestinal complications, with 1 dog treated for pyothorax dying postoperative of suspected acute pulmonary insufficiency . Another case series of 4 cats with chronic pyothorax reported all survived to discharge, had an excellent quality of life on long‐term follow‐up, and concluded pneumonectomy was well‐tolerated in these cats . Both case series were small with limited information on postoperative respiratory function.…”