Nonsurgical resolution of caudal mediastinal paraesophageal abscess in a cat

Jung, Jongwan; Choi, Mincheol

doi:10.1292/jvms.14-0518

Cited by 5 publications

(10 citation statements)

References 12 publications

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“…The condition has been reported in 2 cats. One cat was treated successfully with conservative medical management after developing sepsis associated with rupture of the abscess 8 . The other cat was euthanized without treatment.…”

Section: Discussionmentioning

confidence: 99%

Successful percutaneous drainage of a refractory caudal mediastinal paraesophageal abscess in a dog

Breheny¹,

Thomas²,

Hall³

et al. 2021

J Vet Emergen Crit Care

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Objective: To describe a novel technique for paraesophageal abscess drainage in a dog.Case summary: A 6-year-old dog presented for pyrexia of unknown origin, subsequently confirmed to be due to a paraesophageal abscess. This was managed by the ultrasound-guided placement of a thoracostomy tube into the abscess, allowing drainage to be performed. This led to clinical resolution and, at an 8-month follow-up, the dog continued to do well. New or unique information provided: Paraesophageal abscessation is typically managed with surgical intervention, which carries inherent risks and complications. This report describes a novel technique that did not require general anesthesia or invasive surgical intervention, achieving clinical remission without any adverse effects. It also summarizes the current literature available on this condition. K E Y W O R D Scanine, cyst, thoracostomy, ultrasound A 6-year-old neutered female German Shorthaired Pointer weighing 23.9 kg presented to the primary care veterinarian with chronic weight loss and an acute history of productive coughing that was managed with meloxicam (0.2 mg/kg, SC) and parenteral vitamin B 12 (500 µg/kg, SC). a,b The dog became progressively hyporexic, and a course of oxytetracycline (25 mg/kg, PO, q 12 h) was started. c At re-presentation 72 h later, the dog was pyrexic at 39.9 • C and estimated to be 5-7% dehydrated. A CBC identified a neutrophilia at 17.01 × 10 9 /L (17 010/µL) (reference interval [RI], 2.95-11.64 × 10 9 /L [2950-11 640/µL]) with suspected band neutrophil presence on the automated analyzer and a monocytosis of 2.21 × 10 9 /L (2210/µL) (RI, 0.16-1.12 × 10 9 /L [160-1120/µL]). Right lateral radiographs of the thorax were performed (Figure 1). On the lateral thoracic projection, there was a large, rounded, well-demarcated soft tissue mass in the caudoventral thorax, extending from the 8th to the 12th intercostal space, superimposed on the cardiac silhouette and diaphragm. At this point, the dog was referred for further evaluation.

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Section: Discussionmentioning

confidence: 99%

Successful percutaneous drainage of a refractory caudal mediastinal paraesophageal abscess in a dog

Breheny¹,

Thomas²,

Hall³

et al. 2021

J Vet Emergen Crit Care

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“…2018). However, a paraoesophageal abscess has been successfully medically managed in a cat (Jung & Choi 2015). While a complicated mediastinal cyst, mediastinal empyema or abscess remains other possible differential diagnoses for case 4, the response to medical treatment indicates that conservative management may be appropriate in some patients with a cavitated caudo‐dorsal mediastinal lesion.…”

Section: Discussionmentioning

confidence: 99%

Dorsal mediastinal haemorrhage in dogs: 4 cases (2010–2018)

Peak¹,

Walker²,

Agthe³

2021

J of Small Animal Practice

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Objective This retrospective case series describes the clinical presentation and CT findings of dogs with presumed mediastinal haemorrhage with no apparent identifiable underlying cause. Materials and Methods Medical records were searched for dogs with presumed or suspected mediastinal haemorrhage of non‐thymic origin. For all dogs, data on signalment, history, physical examination, treatment and outcome were collected by reviewing the medical records. Follow‐up information was collected by telephone interviews with the owners and/or their primary‐care veterinarians. Results Four dogs were included. All survived to discharge with apparent resolution of the mediastinal haemorrhage (based on repeat imaging and/or clinical signs) with supportive treatment alone. Follow‐up information was available from 2 months to 5 years following discharge, and none of the patients showed a recurrence of clinical signs during this period. Clinical Significance This case series highlights that presumed haemorrhage into the mediastinum can occur in dogs without an obviously identifiable cause and, whilst rare, should be considered as a cause of dorsal mediastinal masses and may be successfully managed with supportive care alone.

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“…Some case series have been described in dogs, but only two cases have been described in cats. 1,[3][4][5][6] Diagnostic imaging is necessary to diagnose CMPE. Radiography is usually performed first when a thoracic lesion is suspected.…”

Section: Discussionmentioning

confidence: 99%

“…A suspicion of CMPE can be raised if a well-delineated round soft tissue or ovoid mass compressing the oesophagus is observed within the caudal mediastinum. 1,[3][4][5][6] However, differentiation of a centrally located pulmonary lesion and a mediastinal mass can be difficult on radiographs. 7 Ultrasound evaluation of the thorax could have been performed instead of x-rays in an emergency owing to the valuable acoustic window to the mediastinum provided by the pleural effusion and because it represents a less stressful technique.…”

Section: Discussionmentioning

confidence: 99%

“…9 CMPE in this patient was consistent with previous reports. 10,1,3,6 It appears as a hypoattenuating ovoid mass with rim contrast enhancement at its circumference. The lesion was located in the caudal mediastinum, adjacent to the ventral and right lateral aspect of the oesophagus, extending from the tracheal bifurcation to the cranial aspect of the diaphragm.…”

Section: Discussionmentioning

confidence: 99%

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Description of the CT evolution of pyothorax and a caudal mediastinal paraesophageal empyema in a cat

Gruget¹,

Cabon²,

Gory³

2021

Vet Record Case Reports

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A 15-year-old domestic cat presented with restrictive dyspnoea and pyrexia. Thoracic radiographs and computed tomography (CT) revealed a caudal mediastinal paraesophageal empyema associated with pyothorax, pleuritis and pericardial effusion. No foreign body was visible. The bacteriology was positive for Fusobacterium nucleatum. Medical treatment was initiated and consisted of bilateral drainage/lavage of the pleural cavity and intravenous amoxicillin/clavulanic acid followed by oral administration.A second CT scan performed on Day 7 showed regression of the lesion and confirmed the effectiveness of the medical treatment. Thoracic drains were removed on Day 8, and antibiotic treatment stopped 3 weeks postdiagnosis. A CT scan performed at 6 weeks postdiagnosis revealed complete regression of the lesions.

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Nonsurgical resolution of caudal mediastinal paraesophageal abscess in a cat

Cited by 5 publications

References 12 publications

Successful percutaneous drainage of a refractory caudal mediastinal paraesophageal abscess in a dog

Successful percutaneous drainage of a refractory caudal mediastinal paraesophageal abscess in a dog

Dorsal mediastinal haemorrhage in dogs: 4 cases (2010–2018)

Description of the CT evolution of pyothorax and a caudal mediastinal paraesophageal empyema in a cat

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