Feline pyothorax - a clinical approach: Review

Abstract

Pyothorax is the accumulation of septic purulent material within the pleural space. In felines, no prevalence of breed or sex was demonstrated, but younger animals are usually affected. Cats from shelters are more likely to develop the disease. The main clinical signs are tachypnea, dyspnea, reduced lung and heart sounds, shallow breathing, cough, fever, lethargy, anorexia and weight loss. Sialorrhea and bradycardia associated with hypotension are indicators of poor prognosis in cats. The diagnosis is made through a combination of history, physical examination, image evaluation and pleural fluid analysis. The recommended treatment consists of placement of a thoracostomy tube for drainage and lavage associated with systemic antimicrobial therapy. Exploratory thoracotomy may be indicated if lung or mediastinal abscesses, extensive chest effusion, and cases unresponsive to treatment are diagnosed. The prognosis is considered reserved to good, excluding animals dead or euthanized within the first 48 hours. For prevention, consideration should be given to the use of prophylactic antibiotic therapy when cats are at risk of microbial colonization of the lower respiratory tract. This recommendation is justified by the fact that most cases of pyothorax in cats involve pathogens from the oropharyngeal flora.