Conservative Management of Hemothorax Following Thoracic Surgery in 3 Horses - Abstract
Case description: Hemothorax is rare in horses, most commonly arising from thoracic trauma. Hemothorax has also been reported to be a complication of intrathoracic surgery. This report documents the management of 3 episodes of hemothorax that occurred following thoracic surgery.
Clinical findings: Two horses developed hemothorax following thoracic surgery. Hemothorax occurred twice in one horse with equine pasture asthma (aka summer pasture-associated recurrent airway obstruction, SPARAO) following two identical surgical procedures performed 8 months apart. The second horse, a clinically normal control, also underwent two surgical procedures, and developed hemothorax following the second surgery. Tachypnea was the initial clinical sign of pleural effusion in both horses and was identified within 8 hours of surgery. Bilateral pleural effusion indicative of hemorrhage was confirmed using thoracic ultrasound in all three instances.
Treatment and outcome: All horses were supplemented with oxygen using nasal insufflation. Antimicrobial therapy was initiated and maintained for 14-16 days. Attempts to drain or remove the hemorrhage were not performed. Hemothorax resolved within 14-16 days in all instances and horses were returned to pasture turnout by day 16 without incident. Three to 11 months following ultrasonographic resolution of the effusion, no evidence of complication was identified in either horse.
Clinical relevance: Hemothorax is a complication of thoracic surgery in horses which may be effectively managed conservatively. Clinical improvement occurred rapidly with resolution of effusion and return to normal function within 14-16 days of the inciting event in horses described in this report.