Successful percutaneous drainage of a refractory caudal mediastinal paraesophageal abscess in a dog

Abstract

Objective: To describe a novel technique for paraesophageal abscess drainage in a dog.Case summary: A 6-year-old dog presented for pyrexia of unknown origin, subsequently confirmed to be due to a paraesophageal abscess. This was managed by the ultrasound-guided placement of a thoracostomy tube into the abscess, allowing drainage to be performed. This led to clinical resolution and, at an 8-month follow-up, the dog continued to do well. New or unique information provided: Paraesophageal abscessation is typically managed with surgical intervention, which carries inherent risks and complications. This report describes a novel technique that did not require general anesthesia or invasive surgical intervention, achieving clinical remission without any adverse effects. It also summarizes the current literature available on this condition. K E Y W O R D Scanine, cyst, thoracostomy, ultrasound A 6-year-old neutered female German Shorthaired Pointer weighing 23.9 kg presented to the primary care veterinarian with chronic weight loss and an acute history of productive coughing that was managed with meloxicam (0.2 mg/kg, SC) and parenteral vitamin B 12 (500 µg/kg, SC). a,b The dog became progressively hyporexic, and a course of oxytetracycline (25 mg/kg, PO, q 12 h) was started. c At re-presentation 72 h later, the dog was pyrexic at 39.9 • C and estimated to be 5-7% dehydrated. A CBC identified a neutrophilia at 17.01 × 10 9 /L (17 010/µL) (reference interval [RI], 2.95-11.64 × 10 9 /L [2950-11 640/µL]) with suspected band neutrophil presence on the automated analyzer and a monocytosis of 2.21 × 10 9 /L (2210/µL) (RI, 0.16-1.12 × 10 9 /L [160-1120/µL]). Right lateral radiographs of the thorax were performed (Figure 1). On the lateral thoracic projection, there was a large, rounded, well-demarcated soft tissue mass in the caudoventral thorax, extending from the 8th to the 12th intercostal space, superimposed on the cardiac silhouette and diaphragm. At this point, the dog was referred for further evaluation.

Medical and surgical management of pancreatic fluid accumulations in dogs: A retrospective study of 15 cases

“…Future attempts should be made to classify acute pancreatic fluid collections, for example as per the guidelines in people. Fine needle aspirate sampling is expected to improve these classifications and could carry therapeutic potential where drainage is performed; reducing an ongoing inflammatory or infectious process in line with minimally invasive approaches in people 7,8,16,19 . This was achieved in 1 of the surgically managed dogs in which a residual pancreatic fluid accumulation was identified on reassessment.…”

“…Fine needle aspirate sampling is expected to improve these classifications and could carry therapeutic potential where drainage is performed; reducing an ongoing inflammatory or infectious process in line with minimally invasive approaches in people. 7,8,16,19 This was achieved in 1 of the surgically managed dogs in which a residual pancreatic fluid accumulation was identified on reassessment. This fluid was drained percutaneously, with a complete resolution on further reassessment 29 days later.…”