Successful Management of Recurrent Pyothorax in a Cat: Clinical Findings with Medical and Surgical Approaches

Abstract

This report describes a case of successful management of recurrent pyothorax in a 10-year-old neutered male American Curl cat, emphasizing the clinical findings, diagnostic evaluations, and medical and surgical treatment approaches. Initially, the cat presented with severe dyspnea, anorexia, lethargy, and weight loss, with laboratory findings indicative of severe inflammation and cardiac compromise. Thoracic radiography and thoracocentesis confirmed septic pleural effusion caused by Fusobacterium russii, which was managed effectively using broad-spectrum antibiotics and thoracostomy tubes. Additionally, transient myocardial thickening (TMT) was diagnosed, which completely resolved after treatment. However, recurrence occurred as caudal mediastinal paresophageal empyema (CMPE), which was unresponsive to antibiotic therapy alone. Surgical interventions, including thoracotomy, debridement, and prolonged thoracic lavage with fibrinolytic agents, resulted in complete resolution. This case highlights the importance of considering surgical approaches and long-term thoracic lavage for the management of complicated or recurrent pyothorax in cats.