Pneumothorax in Dogs
Supplemental oxygen administration is given to all dogs that are showing signs of difficulty breathing. In cases of mild pneumothorax, oxygen administration and cage rest may be the only treatments required while the body heals itself. Thoracocentesis is indicated to remove moderate to large volumes of air from the chest cavity when the pet is exhibiting signs of difficulty breathing. By removing air from the chest cavity, the lungs are able to inflate normally and the pet breathes more easily. A chest tube is placed when the volume of air removed via thoracocentesis is excessive. Chest tubes allow larger volumes of air to be removed more quickly or continuously. Tubes may be aspirated by hand, every few hours, or aspirated continuously by attaching the chest tube to a suction unit. The circumstances that dictate chest tube placement include the following:
– No endpoint is reached during thoracocentesis indicating a large continuous leak in the airways
– An endpoint was reached during thoracocentesis but thoracocentesis must be repeated more than two to three times, indicating a slow but continuous leak in the airways
– The volume of air removed during thoracocentesis was excessive for the patient’s size.
Chest tubes are also placed following chest surgery to allow removal of residual air for the first 24 to 48 hours post surgery. Chest tubes are placed using sterile techniques, and require that the pet be heavily sedated or anesthetized. The tubes are held in place by sutures in the skin where the tube exits the chest, and with a bandage placed around the chest. Tubes are removed when minimal volumes of air or negative pressure are obtained during aspiration over a 6 to 12 hour period, indicating the leaky airway has sealed. Surgery is indicated when the pneumothorax does not resolve over a period of 48 hours or longer despite the use of a chest tube and continuous suction. Surgery is also indicated to repair damage to the chest wall following traumatic injuries. If the pneumothorax involves only one side of the chest, a lateral thoracotomy is performed, which involves approach to the chest between the ribs on the affected side. If the source of the airway leak is unknown or the pneumothorax is evident on both sides of the chest in X-rays, a median sternotomy is performed, which is an approach to the chest through the sternum or midline of the chest. Pneumothorax caused by trauma rarely requires surgery whereas spontaneous pneumothorax often requires surgery.
Follow-up Care for Dogs with Pneumothorax
Dogs that show signs of difficulty breathing should be taken to your veterinarian immediately. Restrict exercise following discharge from the hospital. Dogs that are recovering from a pneumothorax should be rested for at least one week following discharge from the hospital and then gradually reintroduced to their regular activities. Dogs that are allowed to exercise too soon may cause a sealed leak to re-open or may tire easily and prolong their recovery.