AFGHANS ARE US -HEALTH

Pneumothorax

TYRON'S STORY

Tyron's story has been reproduced here with the kind permission of his owner Irene Gurney

The following article is taken from the notes of Dr Christopher J Little BVMS. PhD. DVC. MRCVS. RCVS. Veterinary Cardiology Specialist. To whom Tyron had been referred to by the owners own vet.

I first saw ‘Tyron’ on the 1st July 2003. ‘Tyron’ had been in the owner’s possession since puppy hood. He was vaccinated as a puppy and never given any boosters. He had no previous history of breathing problems. There was one other Afghan in the house who is well. ‘Tyron’ had been vomiting once or twice a week for a few weeks, he had always been a slightly finicky eater. He had had diarrhoea for a short spell a few weeks ago. On Friday the 27th June the dog had been taken for a walk and was frightened by a quad bike, he seemed ok afterwards but didn’t eat that evening which was very unusual. On Saturday morning he was very tired and not interested in exercise. He was taken to the Pets Emergency Service in Maidstone who discovered that the heart rate was 138 beats per minute. Respiratory was elevated at 68 breaths per minute and the dog was having increased inspiratory effort. They took some radiographs which showed a pneumothorax and he was treated repeatedly by thoracocentesis over the following two days. He appeared to improve. Radiographs taken on these days were sent to me showed definite bilateral pneumothorax. (the owner was told the heart was understandably very enlarged)

When I saw ‘Tyron’ he was quite quiet, heart rate was quite low at 68 to 82 beats per minute. Pulses were fairly slow but strong. Body temperature was 101.1 F. Respiratory rate was 60 breaths per minute with hyperpnoea. The mucosae appeared slightly dry but colour and capillary refill time were normal. I could hear audible respiratory sounds all over the chest and these were not abnormal. Percussion resonance of the chest was not particularly increased or decreased.

Based on these findings I felt it important to repeat radiographs and evaluate ‘Tyron’ for other disease.

Haematology from Tyron was unremarkable although occasional basophils were seen and the neutrophil count was just above normal. Biochemistry from Tyron, including electrolytes was unremarkable.
Radiographs of the dog indicated that there was still extensive pneumothorax. A pneumothorax drainage tube was placed under light anaesthetic and the chest itself was drained of approximately 3.5 litres of air. A Chinese finger trap and chest bandage were applied. On the following day ‘Tyron’ was very bright indeed and was breathing normally. There was slight subcutaneous emphysemia present but I drained only 5mls of air and approximately 2mls of fluid from the chest. The drainage tube was kept in place and resealed. On the following day however Tyron’s breathing was much worse and radiography showed marked pneumothorax together with pneumomediastinum (air escaping into the chest cavity). The drain was moved and repositioned and approx another 3 litres of air were removed. At this point the dog also started to develop bloody urine which dripped from his penis at intervals. On the following day another litre or so of air was removed from the chest but the dog remained very bright. Bacteriology from the urine was unremarkable with no significant growth. I discussed Tyron’s case with the owner and warned her that we had no definitive cause for the pneumothorax but there could be a leak occurring either around the trachea, the osophagus or the lungs themselves and that the only way to investigate this further and treat it appropriately might be by endoscopy, general anaesthesia and thoracotomy. As Tyron had been been vomiting spasmodically and appearing to have been losing weight before this incident these findings suggested that the pneumorthorax might have occurred because of another systematic disease.

However on Saturday 5th July at 7pm Tyron suddenly developed marked respiratory difficulties and died.

A post mortem examination was carried out which diagnosed bilateral pneumorthorax and pneumomediastinum. Both lungs were collapsed. No evidence of any external trauma apart from the drainage tract at the site of the pneumorthorax drain. There were no obvious macroscopic lesions on the lungs but when the lungs were inflated and placed under water three small holes were found were found on the medial dorsal aspect of the left diaphragmatic lung lobe and dorsal-lateral aspect of the right diaphragmatic lung lobe. Occasionally pneumortharax develops spontaneously particularly if the animal has some underlying serious systemic disease. Based on the findings we made we cannot rule out the probability that Tyron had some underlying systemic disease, particularly in view of the fact of the recurring vomiting, weight loss and haematuria (recent blood in urine). I am sorry we could do nothing for this poor dog.

[Dr] Christopher J Little. BVMS.PhD.DVC.MRCVS.RCVS Dated 8th July 2003

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