Canada West Veterinary Specialists and Critical Care Hospital, Vancouver, British Columbia, Canada.
J Vet Emerg Crit Care (San Antonio). 2022 Sep;32(5):670-674. doi: 10.1111/vec.13198. Epub 2022 Apr 20.
To describe the successful management of a cat with an intrathoracic sewing needle foreign body and septic pericardial effusion.
A 10-year-old neutered female domestic longhair cat was referred for an intrathoracic metallic foreign body identified via thoracic radiography. Two weeks prior, the cat may have ingested a sewing needle. She was presented hemodynamically unstable; point-of-care thoracic ultrasound identified pericardial effusion with right atrial tamponade. Pericardiocentesis stabilized hemodynamic parameters. The effusion was grossly purulent, and bacterial culture grew an Actinomyces sp. The cat underwent a median sternotomy to remove the foreign body, debride associated mediastinal abscesses, and perform a partial pericardiectomy. Over the next 10 days, the cat was managed in hospital with a left unilateral thoracostomy tube and intermittent lavage of the pleural cavity. The cat was discharged, and follow-up at 7 days showed no evidence of pericardial or pleural effusion.
Contrary to previous reports, this case shows that extra-gastrointestinal, specifically intrathoracic, sewing needle foreign bodies can cause significant morbidity in cats. To the authors' knowledge, this report is the first to describe septic pericardial disease resulting from documented foreign body ingestion in the cat. It is also the first case report of successful surgical management of mediastinal abscessation in the cat.
描述一例成功治疗猫胸腔内缝针异物和化脓性心包积液的病例。
一只 10 岁已绝育的雌性家猫，因胸部 X 光片发现胸腔内金属异物而被转诊。两周前，该猫可能吞食了一根缝衣针。就诊时，它表现为血流动力学不稳定；即时床旁超声检查发现心包积液并伴有右心房填塞。心包穿刺术稳定了血流动力学参数。积液呈明显脓性，细菌培养出放线菌属。猫接受了正中开胸术以取出异物、清创相关纵隔脓肿，并进行部分心包切除术。在接下来的 10 天里，猫在医院接受了左侧单侧开胸管和胸腔间歇性冲洗治疗。猫出院，7 天后随访无心包或胸腔积液的证据。
与之前的报告不同，本病例表明，非胃肠道，特别是胸腔内，缝针异物可导致猫出现明显的发病率。据作者所知，这是首例有记录的猫因异物摄入导致化脓性心包疾病的报告。这也是首例成功治疗猫纵隔脓肿的手术病例报告。
