Sam

Sam – a seven-year-old, male neutered springer spaniel – presented to us with lethargy, a soft cough and an increased breathing rate. When listening to Sam’s chest, there was a large region on the right-hand-side where breathing sounds were not audible, making us concerned for something pushing the lungs away from the ribcage – such as fluid, a mass or air.

In-house blood testing was consistent with a marked inflammatory process, increasing the concern for infection (e.g. a pneumonia or a pyothorax) within the chest cavity. Sam was deemed stable enough to then undergo a computed tomography (CT) scan which is an excellent option to thoroughly assess the chest cavity. This revealed a large pneumothorax (air in his chest compressing around his lungs) and mild pleural effusion (liquid in his chest compressing around his lungs). While waiting for the full radiologist’s report, a chest drain was placed in Sam’s right chest wall allowing the air and fluid to be drained and his lungs to be able to expand again. A total of 850ml of air and 70ml of pink fluid was drained on the first go! The fluid was sent for analysis which confirmed a chest infection, or ‘pyothorax’, which in this case was caused by a Pasturella bacteria, and Sam was started on broad coverage intravenous antibiotics to start getting this under control.

The CT report confirmed the findings as above and provided greater detail regarding the abnormal structure with the radiologist describing it as a thin longitudinal structure measuring 5cm x 1mm – can you guess what it was?

A thoracoscopically-guided surgery was then performed to remove this structure. This involved placing a camera into the chest cavity via keyhole surgery to allow visualisation of the abnormal material – which turned out to be part of a thorny stick! - to then enable careful removal.  Surgery went well, and the chest drain was able to be removed after four days. Sam was discharged on a prolonged course of antibiotics to clear the residual infection, and is now back to racing through the undergrowth with his furry friends.

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