Health
Tyron’s Story
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Pneumothorax
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 puppyhood. 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 Pnuemathorax 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 pnuemothorax. (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
Footnote: Just a few words about Tyron before he became ill. He was a very
healthy baby weighing in at 1lb 2oz, lively, happy and very well. He had a good
show career, never carried a lot of weight but had a noticeable weight loss
before he had obvious problems, also bouts of sickness and some diarrhoea. Tyron
was adored and is still deeply mourned by his owners. Tyron was aged just under
7 years old at the time of his death. On speaking to the vets at
the hospital myself I was told they had expected Tyron to eventually make a good
recovery.
Hazel Cranham.
© Irene Gurney 2007 - all rights reserved