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lung problems


Eileen Stein
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This is somewhat O/T, because it's not about a border collie. A friend just wrote me that her borzoi was referred to the U Pa Emergency Veterinary Hospital overnight by our local emergency vet. "He has a collapsed lung with air in the chest cavity pushing on his heart. He will likely have surgery. Do you know anything about lung disease, problems or treatments?"

 

I have no knowledge at all about lung collapse in the absence of trauma. Does anyone else?

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I took my cat Punkin in to get his teeth cleaned over a year ago and both of his lungs collapsed. The vet called and told me he would not breath on his own (he was still under the anesthesia) and to come say "goodbye". He gave him virtually no chance. He said we could fly him off for surgery but the chances of success were not very good.

 

By the time we got there he had taken a couple breaths on his own and the doc gave him a 10% of making it. I told him to wake him up and give him a chance, and let God decide. I went out and smoked a cigarette.

 

I came back in to a barely awake but breathing cat!

 

He had to syringe out a bunch of air from his insides but he still had air under his skin for something like two weeks. It was extremely strange to pet him on top of his head or back and feel all the air bubbles under his skin.

 

They don't know why his lungs collapsed. He was in ICU for a few days and recovered completely. His teeth need cleaning again and I think I'll dope him up some and do it myself.

 

Don't know if any of this helps, but miracles can happen. I hope one happens for your friend.

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I'm not sure exactly what is going on in this case... dogs have completely separated lung lobes, which arise off of different mainstem bronchi like a cluster of balloons branching off of the trachea. Any tear in the respiratory tree at any point along the line would potentially lead to a pneumothorax. In a deep-chested sighthound there's maybe a little more vulmerability based on anatomy. We do sometimes see lung lobe torsions (for no apparant reason) in dogs; it's possible that one of those "no apparant reason" events occurred in this dog, leading to the pneumothorax, or it's possible that underlying pulmonary disease is present which eroded through or otherwise compromised the airway at some point (infections and tumors could both do that, as could an aspirated foreign body, such as a plant awn.) A complicating factor in all this is that dogs sometimes do and someimtes do not have a complete mediastinum (the structure that runs down the center of the chest and contains "center organs" of the chest, like the heart, the esophagus and the great vessels; it sort of separates the two "halves" of the chest, but this may be a complete, airtight and watertight division - or it may not). You could conceivably have air enter the chest cavity via the esophagus (via perforation) as well as the airways, and in a dog with an incomplete mediastinum, this could create a pnuemothorax as well. If the mediastinum is complete, it's "just" a penumomediastinum, which is a different (but still significant) problem.

 

My understanding (though I am not an MD) is that in humans the "bleb" effect is cause primarily by smoking or other exposures which lead to emphysema. This is not commonly encountered in companion dogs, though it's not impossible. Respiratory disease does occur more frequently in dogs who live with smokers than in dogs who do not. However, if emphysema is present, there should be radiographic changes (and I'm assuming Xrays were taken to diagnose the pneumothoax in the first place).

 

I'd be curious to hear what the upshot was in this case; although I could not begin to suggest a diagnosis from this distance, sometimes the anecdotal cases end up as useful experience for those cases which I DO actually get to see in person. At any rate, I hope the dog did well. And sorry for the late reply, just got back to town and still a bit jet lagged.

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Didn't mean to leave you guys hanging -- thanks very much to all of you. The news is good so far. He was kept under observation with tubes in all day Wednesday and overnight, but the lung continued to leak air. He was operated on Thursday, the hole was repaired. The surgeon said the tissue did not look as he had expected, but what that means I don't know, except that there was no mass and no obvious cancer. He took tissue for a biopsy, and the path report is expected back on Tuesday. (Actually, I was intending to post as soon as I learned the results from that.) The rest of the lungs away from the immediate area look good. The patient is still hooked up to tubes and drains, but there is no bleeding, no air leakage, and pain control seems to be adequate, so things look good. He actually got to his feet yesterday.

 

Poor guy, I hope he will be all right. He is only two, and is really my little pup's best playmate. It was so comical to see them playing together when Salt was only four months old and looked about 1/8 the size of the borzoi -- still they managed.

 

Thanks again for all your good wishes.

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  • 2 weeks later...

Here's what I hope is the final word on this dog:

 

He had his two week post surgery check up at U PA Vet Hospital on Thursday. Essentially, all is well and he is healing and progressing as he should. He must be slowly reintroduced to normal life over the next two months. We will likely never know what caused the hole in his lung. The pathology report raised more questions than it provided answers. It showed that there was calcified lung tissue surrounded by inflammation of blood vessels. They have never seen anything like it, apparently. A hand surgeon friend of ours has said that perhaps he was born with primitive lung tissue--that he is a one-off. The good news from the pathology report is confirming that there is no cancer. We must watch him closely still and keep him him from chasing squirrels, playing with other dogs and flying into the air after birds.

 

I visited him Sunday and he is doing great! So it all looks good. His people are VERY high on the U of PA Vet Hospital -- really singing its praises.

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