Blood Pleurodesis in a Great Dane with a Persistent, Spontaneous
Pneumothorax
Margaret Winter
April 23, 2014
Clinical Advisor: Dr. Jillian DiFazio
Basic Science Advisor: Dr. James Flanders
A 7 year old, spayed female, Great Dane was referred to Cornell University’s Hospital
for Animals’ emergency service for further work-up and treatment of a spontaneous
pneumothorax. Three days prior to presentation, the patient started to become dyspneic
and tachypneic while at a boarding facility. She was sent to a referral hospital, where
radiographs revealed a bilateral pneumothorax and diffuse interstitial pattern. The
patient had bilateral Mila chest tubes placed, was put on continuous suction, had
bilateral intranasal cannulas placed for oxygen supplementation, was maintained on IV
antibiotics and analgesia over night, and was referred to Cornell the following day.
On presentation, the patient was tachycardic and tachypneic with decreased
bronchovesicular lung sounds dorsally. She was under-conditioned with a BCS of 3/9,
moderate, diffuse muscle atrophy, severe medial buttress bilaterally, was short strided
in all four limbs, had all of her claws scuffed down to distal P3, and severe
pododermatitis in all four paws. Point of care blood work was unremarkable, her SpO2
was 97% on room air, and her tachycardia improved with methadone and removal of a
total of 2.7 liters of air and 20 mL of pleural effusion. Thoracic CT revealed a small
amount of air in each hemithorax and 5-6 small gas filled bullae in the right caudal lung
lobe. An exploratory thoracotomy with several partial lung lobectomies was performed.
Histopathology was consistent with pulmonary emphysema and multifocal bullae. The
patient continued to produce large amounts of air and some suppurative pleural
effusion, but her owner elected to have a pleural port placed for palliative home care.
Prior to discharge, blood pleurodesis was performed as an additional attempt to resolve
the persistent pneumothorax.
This presentation will focus on alternative and experimental treatments of persistent
spontaneous pneumothorax in both companion animals and humans.
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