Thorax: trauma

Buy now to access the full article, existing subscribers login

Sections available in full article Introduction, Presenting signs, Acute presentation, Cost considerations, Special risks (e.g. anesthetic), Pathogenesis, Etiology, Pathophysiology, Timecourse (incubation, duration), Diagnosis, Presenting problems, Client history, Clinical signs, Diagnostic investigation, Confirmation of diagnosis, Treatment, Initial symptomatic treatment, Standard treatment, Monitoring, Sequelae, Prognosis, Expected response to treatment, Reasons for treatment failure, Sources, Publications, Vetstream contributor(s),
Contributors Ms Penny Watson MA VetMB CertVR DSAM DipECVIM MRCVS
Dr Cheryl Hedlund DVM MS
Dr Elisa Mazzaferro MS DVM PhD DipACVECC

Introduction

  • Cause : usually road traffic accident (RTA)/hit-by-car (HBC) or high-rise fall.
  • Signs : respiratory compromise, may be cardiac compromise (and pain); multiple and segmental fractures   →   'flail chest'.
  • Diagnosis : depends on lesions and systems affected; radiography.
  • Treatment : restore cardiopulmonary function, with initial emphasis on maintaining and supporting respiration and circulation; stabilize fractures; oxygen and analgesia.
  • Always handle chest injury cats with extreme care.
    In all cases of trauma discuss with owner the potential complications at the time of injury.

Diagnosis

Clinical signs

  • Dyspnea/tachypnea.
  • Cyanosis.
  • Hyper-resonant chest with pneumothorax.
  • 'Flail' chest.
  • Muffled heart sounds if fluid or contusion present.
  • Tachycardia and pulse deficits if arrhythmias.

Sequelae

Prognosis

  • Good in mild cases - mild pneumothorax, hemothorax or contusions will resolve with supportive care only.
  • Guarded - damage may be too severe or other life-threatening injuries may be present.

Expected response to treatment

  • Improvement in quality of respiratory pattern.
  • Resolution of cardiac arrhythmias.

Reasons for treatment failure

  • Overwhelming non-survivable damage.
  • Over-zealous restraint of cat to administer medication precipitating acute deterioration.
  • Failure to drain pleural effusion or pneumothorax or stabilize 'flail chest' or treat shock rapidly enough.

Sources

Publications

Refereed papers

  • Recent references fromPubMed.
  • Sigrist N E, Doherr M G & Spreng D E (2004)Clinical findings and diagnostic value of post traumatic thoracic radiographs in dogs and cats with blunt trauma.J Vet Emerg Crit Care14, 259-268.
  • Kraje B Jet al(2000)Intrathoracic and concurrent orthopedic injury associated with traumatic rib fracture in cats - 75 cases (1980-1998).J Am Vet Med Assoc216, (1) 51-4.
  • Lawrence D T, Lang J, Culvenor J, Mischol G, Haynes S & Swinney G (1999)Intrathoracic tracheal rupture.JESFM1, 43-52.
  • Smeak D D (1997)Traumatic separation of the annular cartilage from the external auditory meatus in a cat.JAVMA211(4), 448-450.
  • Fullington R Jet al(1997)Characteristics and management of gunshot wounds in dogs and cats - 84 cases (1986-1995).JAVMA210(5), 658-662.
  • White R N & Milner H (1995)Intrathoracic tracheal avulsion in 3 cats.JSAP36, 43-347.
  • Spencer C Pet al(1980)Thoracic and abdominal radiography of the trauma patient.Vet Clin North Am Small Anim Pract10(3), 541-559.

Sample content only, to unlock the full article login or buy now

Loading...