Journal of Veterinary Clinics (한국임상수의학회지)

The Korean Society of Veterinary Clinics (한국임상수의학회)
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Non-surgical Treatment for Secondary Spontaneous Pneumothorax Associated with Bacterial Pneumonia in a Beagle Dog

비글견에서 세균성 폐렴으로 인한 속발성 자발 기흉의 비외과적 치료

  • Han, Hyun-Jung (Department of Veterinary Surgery, College of Veterinary Medicine, Chungbuk National University) ;
  • Yoon, Hun-Young (Veterinary Medical Teaching Hospital, University of Missouri-Columbia) ;
  • Kim, Jun-Young (Department of Veterinary Surgery, College of Veterinary Medicine, Kon-kuk University) ;
  • Jang, Ha-Young (Department of Veterinary Surgery, College of Veterinary Medicine, Kon-kuk University) ;
  • Choi, Seok-Hwa (Department of Veterinary Surgery, College of Veterinary Medicine, Chungbuk National University) ;
  • Jeong, Soon-Wuk (Department of Veterinary Surgery, College of Veterinary Medicine, Kon-kuk University)
  • 한현정 (충북대학교 수의과대학 수의외과학 교실) ;
  • 윤헌영 ;
  • 김준영 (건국대학교 수의과대학 수의외과학 교실) ;
  • 장하영 (건국대학교 수의과대학 수의외과학 교실) ;
  • 최석화 (충북대학교 수의과대학 수의외과학 교실) ;
  • 정순욱 (건국대학교 수의과대학 수의외과학 교실)
  • Published : 2008.02.29
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Abstract

One year old, male beagle dog was presented with acute onset of severe dyspnea, cyanosis, and anorexia. He had no trauma history. Five days earlier, the dog had been diagnosed as bacterial pneumonia caused by Pseudomonas aeruginora and E. coli. He exhibited a restrictive respiratory pattern and at admission, immediately oxygen supplementation given. On a ventrodorsal(VD) radiographic view, right lung was collapsed and contrasted with the air-filled pleural space. The mediastinum, heart, and great vessels were shifted to the left. On a right-lateral radioraphic view, the heart appeared to be elevated from the sternum. The dog was diagnosed as secondary spontaneous pneumothorax resulting from bacterial pneumonia. The chest tubes were placed on the right and left pleural cavity under general anesthesia. At 3 days after treatment, on a VD radiograph, air of right pleural cavity disappeared while left pleural cavity showed radiolucent area filled with air, and the heart was shift to the right. Therefore, the left tube thoracostomy was performed too. The right chest tube was maintained for 5 days and the left chest tube was maintained for 45 days. During the period, antibiotics and vitamin I were used for managing of bacterial pneumothorax and preventing of retroinfection through the tubes. As the result, bacterial pneumonia was well managed by medicines and secondary SP was completely treated that air in bilateral pleural cavity disappeared on radiographs. During the follow-up for 2 years, patient showed normal condition without recurrence.

1년령 수컷 비글견이 심한 호흡곤란, 청색증, 식욕감소로 내원하였다. 외상의 병력은 없었으며, 내원 5일전에 Pseudomonas aeruginosa와 E. coli로 인한 세균성 폐렴의 진단을 받았다. 제한적인 호흡 양상을 보여 즉각적으로 산소를 투여하고 방사선검사를 실시하였다. 배복 촬영상에서 우측 흉강에 공기가 차 있었고, 우측 폐엽의 허탈, 종격, 심장과 대혈관의 좌방 변위가 관찰되었다. 외측상에서는 심첨이 흉골로부터 떨어져 있는 것이 관찰되었다. 이상의 결과로 세균성 폐렴으로 인한 속발성 자발 기흉으로 진단하고, 우측 흉강에 흉강 튜브를 삽관하였다. 삽관 3일후에 방사선 배복 촬영상에서, 우측 흉강의 공기는 제거되었으나 좌측 흉강에 기흉이 발생하여 심장이 우방변위된 것이 확인되었다. 따라서, 흉강튜브를 좌측 흉강에도 삽관하였다. 기흉이 완전히 회복되기까지, 우측 흉강 튜브는 5일간, 좌측 흉강튜브는 45일간 유지하였다. 추가로 세균성 폐렴의 치료와 튜브로 인한 역행성 감염을 방지하기 위해 항생제와 비타민 E를 처치하였다. 결과적으로, 환자는 완전히 회복되었고, 2년동안의 관찰기간 동안 재발증상 없이 정상 생활을 유지하였다.

Keywords

References

  1. Boudrieau RJ, Fossum TW, Birchard SJ. Surgical correction of primary pneumothorax in a dog. J Am Vet Med Assoc 1985; 186:75-78
  2. Bright RM, Birchard SJ. Pneumothorax in the dog. Canine Pract 1981; 8: 39-50
  3. Bright RM, Bright JM, Richardson DR, Sims J. Clinical and radiographic evaluation of a median sternotomy technique in the dog. Vet Surg 1983; 12: 13-19 https://doi.org/10.1111/j.1532-950X.1983.tb00695.x
  4. Brissot HN, Dupre GP, Bouvy BM, Paquet L. Thoracoscopic Treatment of Bullous Emphysema in 3 Dogs. Vet Surg 2003; 32: 524-529 https://doi.org/10.1111/j.1532-950X.2003.00524.x
  5. Busch DS, Noxon JO. Pneumothorax in a dog infected with dirofilaria immitis. J Am Vet Med Assoc 1992; 201: 1893
  6. Dallman MJ, Martin RA, Roth L. Pneumothorax as the primary problem in two cases of bronchioloalveolar carcinoma in the dog. J Am Anim Hosp Assoc 1998; 24: 710-714
  7. Ferrier FL. Spontaneous pneumothorax. J Magn Reson Imaging 1984; 73: 681-684
  8. Forrester SD, Fossum TW, Miller MW. Pneumothorax in a dog with a pulmonary abscess and suspected infective endocarditis. J Am Vet Med Assoc 1992; 200: 351-354
  9. Fossum TW. Surgery of the Lower Respiratory System: Pleural Cavity and Diaphragm. In: Small animal surgery, 2nd ed. St. Louis: Mosby Inc. 2002: 788-805
  10. Holtsinger RH, Beale BS, Bellah JR, King RR. Spontaneous pneumothorax in the dog: A retrospective analysis of 21 cases. J Am Anim Hosp Assoc 1993; 29: 195-210
  11. Holtsinger RH, Ellison GW. Spontaneous pneumothorax. Comp Cont Edu Pract Vet 1995; 17: 197-210
  12. Jerram RM, Fossum TW, Berridge BR, Steinheimer DN, Slater MR. The efficacy of mechanical abrasion and talc slurry as methods of pleurodesis in normal dogs. Vet Surg 1999; 28: 322-332 https://doi.org/10.1111/j.1532-950X.1999.00322.x
  13. Kramek BA, Caywood DD, O'Brien TD. Bullous emphysema and recurrent pneumothorax in the dog. J Am Vet Med Assoc 1985; 186: 971-974
  14. Kramek BA, Caywood DD. Pneumothorax. Vet Clin North Am: Small Anim Pract 1987; 17: 285-300 https://doi.org/10.1016/S0195-5616(87)50028-6
  15. Leung H-W, Vang MJ, Mavis RD. The cooperative interaction between vitamin E and vitamin C in suppression of peroxidation of membrane popholipids. Biochim Biophys Acta 1981; 664: 266-272 https://doi.org/10.1016/0005-2760(81)90049-7
  16. Lipscomb VJ, Hardie RJ, Dubielzig RR. Spontaneous pneumothorax caused by pulmonary blebs and bullae in 12 dogs. J Am Anim Hosp Assoc 2003; 39:435-445 https://doi.org/10.5326/0390435
  17. Mitchell SL, McCarthy R, Rudloff E, Pernell RT. Tracheal rupture associated with intubation in cats: 20 cases (1996-1998). J Am Vet Med Assoc 2000; 216: 1592-1595 https://doi.org/10.2460/javma.2000.216.1592
  18. Monnet E. Pleura and Pleural Space. In: Slatter D eds, Text book of small animal surgery, 3rd ed. Philadelphia: Saunders Co. 2003: 387-405
  19. Nelson RW, Couto CG. Diagnostic Tests for the Pleural Cavity and Mediastinum. In: Small animal internal medicine, 2nd ed. St Louis: Mosby Inc. 1998:319-326
  20. Puerto DA, Brockman DJ, Lindquist C, Drobatz K. Surgical and nonsurgical management of and selected risk factors for spontaneous pneumothorax in dogs: 64 cases (1986-1999). J Am Vet Med Assoc 2002; 220: 1670-1674 https://doi.org/10.2460/javma.2002.220.1670
  21. Saheki Y, Ishitani R. Acute fatal pneumothorax in canine dirofilarisis. Jpn J Vet Sci 43:315-328, 1981 https://doi.org/10.1292/jvms1939.43.315
  22. Schaer M, Gamble D, Spencer C. Spontaneous pneumothorax associated with bacterial pneumonia in the dog-two case reports. J Am Anim Hosp Assoc 1981; 17: 783-788
  23. Smith JW, Scott-Moncrieff C, Rivers BJ. Pneumothorax secondary to Dirofilaria immitis infection in two cats. J Am Vet Med Assoc 1998; 213: 91-93
  24. Valentine A, Smeak DD, Allen D, Mauterer J, Minihan A. Spontaneous pneumothorax in dogs. Comp Cont Edu Pract Vet 1996; 18: 53-62
  25. Yoshioka MM. Management of spontaneous pneumothorax in twelve dogs. J Am Anim Hosp Assoc 1982; 18: 57-62
  26. Yu X-Y, Takahashi N, Croxton TL, Spannhake EW. Modulation of Bronchial Epithelial Cell Barrier Function by in vitro Ozone Exposure. Environ Health Perspect 1994; 102: 1068-1072 https://doi.org/10.2307/3431994