Medical and surgical treatment of pyothorax in dogs: 26 cases (1991–2001)

Abstract

Results suggest that surgical treatment is associated with a better outcome than medical treatment in dogs with pyothorax. In addition, surgery should be considered if radiographic evidence of mediastinal or pulmonary lesions is detected or if Actinomyces spp is isolated from the pleural fluid.

Mediastinectomy for management of chronic pyogranulomatous pleural disease in dogs

“…This breed distribution is similar to that reported in studies of dogs with pyothorax in which young working breeds also featured prominently (Demetriou and others 2002, Rooney and Monnet 2002, Johnson and Martin 2007, Boothe and others 2010). All patients were found to have pleural changes on diagnostic imaging similar to those described in a recent study of pyothorax in dogs (Swinbourne and others 2011).…”

“…A consistent feature of the thoracic debridement procedures performed in that case series was partial resection of the mediastinal tissue (Rooney and Monnet 2002); we hypothesised, therefore, that the mediastinal pleura is, in fact, the focus of the chronic pyogranulomatous changes that may develop as the sequel to pyothorax, and removal of this would resolve the disease. The purpose of this study was, therefore, to report (1) the technique of mediastinectomy, (2) the intraoperative and postoperative complications and (3) long-term outcome for surgical management (mediastinectomy) of chronic pyogranulomatous pleural disease.…”

“…Although gross or histologic evidence of foreign material was found in only five dogs here, it is possible that a more systematic search of the resected tissue may have provided additional evidence of this aetiology. Both, medical and surgical management strategies have been described for the treatment of pyothorax (Demetriou and others 2002, Rooney and Monnet 2002, Johnson and Martin 2007, Boothe and others 2010). Boothe and others reported favourable treatment effects with surgery for short-term survival in dogs with pyothorax, but failed to demonstrate that invasive (surgical) versus non-invasive treatment of pyothorax in dogs lead to a better long-term outcome (Boothe and others 2010).…”

“…Mediastinitis and mediastinal abscessation have been most commonly reported as a complication of pyothorax (Rooney and Monnet 2002, Schultz and Zwingenberger 2008, Franklin and others 2011, Brissot and others 2012), the underlying cause for which is often suspected to be inhaled or ingested foreign material (Koutinas and others 2003, Brissot and others 2012). Even if there is no single breed predilection, hunting and working-type dogs are reported to be over-represented (Demetriou and others 2002, Rooney and Monnet 2002, Scott and Macintire 2003b, Johnson and Martin 2007). Surgical management has been recommended for the treatment of selected patients with pyothorax (Demetriou and others 2002, Rooney and Monnet 2002, Boothe and others 2010).…”

“…In Boothe and others' study, surgery was associated with a higher short-term survival rate, but they failed to demonstrate that surgery resulted in a better long-term outcome compared to non-invasive treatments for pyothorax (Boothe and others 2010). Rooney and Monnet, however, reported better outcomes with surgery compared to medical therapy, with 85 per cent of patients disease-free six months after surgery (Rooney and Monnet 2002). …”