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Hemothorax: Bleeding in the Chest in Cats

By: Dr. Douglas Brum

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Hemothorax is defined as blood within the chest cavity (thorax). The most common cause of hemothorax is chest trauma, although tumors within the thorax can also result in a hemothorax if they rupture, slowly bleed, or invade into a blood vessel causing blood to accumulate within the thorax. Clotting disorders (coagulopathies) may also cause an animal to bleed into the chest cavity. Hemothorax is usually an emergency situation, requiring rapid diagnosis and treatment.

What to Watch For

  • Difficulty breathing
  • Increased panting
  • Weakness
  • Collapse
  • Pale mucus membranes (the best place to check is the gums or inner lining of the lips)

    Your cat may take short, shallow, rapid breaths. Look for any observable bruising under the skin or evidence of external trauma.

    Diagnosis

    A thorough history and complete physical exam, emphasizing lung auscultation (listening with a stethoscope), is essential for prompt and accurate diagnosis. Your veterinarian may also recommend:

  • Thoracic radiographs (X-rays)

  • Thoracentesis – inserting a needle and syringe into the chest cavity through the skin to obtain a sample of fluid for analysis. Fluid analysis is performed on the aspirated fluid sample.

  • Complete blood count (CBC)

    Depending on the animal's condition and initial test results, additional tests that may be required include:

  • Biochemistry profile
  • Arterial blood gas analysis
  • Thoracic or cardiac ultrasound
  • Clotting tests including an activated clotting time (ACT), a prothrombin time (PT), activated partial thromboplastin time (APTT), and platelet count.

    Treatment

    The general approach to treatment varies depending on the clinical condition of the patient.

  • Thoracentesis, while a diagnostic aid, is also an important treatment to remove fluid from the chest
  • Chest tube placement and suctioning of chest fluid
  • Intravenous fluid therapy
  • Blood transfusion
  • Oxygen therapy
  • Analgesic medication (pain medication)
  • Vitamin K therapy
  • Emergency chest surgery (thoracotomy) is occasionally required if the bleeding cannot be stopped and if blood clotting tests are normal. This procedure is most commonly indicated when there are penetrating chest wounds or bleeding tumors.

    Home Care

    Hemothorax is usually an emergency situation. Veterinary care should be sought as soon as possible. Keep your cat calm and comfortable and minimize stress. Keep him warm, and, if a traumatic injury is suspected, be careful moving him, as fractures or spinal injury may be present.

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