Pyothorax is a potentially recurrent condition that results in systemic illness. Treatment selection presents decision-making challenges to the clinician.
To review the veterinary literature relating to canine pyothorax since 2000 with a focus on treatment and outcome.
Compilation of data from reports of canine pyothorax cases since 2000 identified 240 dogs from 20 reports.
Cytologic data from 7 studies revealed filamentous bacteria in 27% of dogs, sulfur granules in 37% of dogs, and inconsistency between cytologic and microbiologic findings regarding bacterial presence in 50% of dogs. Microbiologic data from 14 studies revealed that 80% of dogs had bacteria isolated. Five bacterial species and over 50% of isolates were obligate anaerobic bacteria. Different empirical antimicrobial regimens were recommended in 10 studies; culture and susceptibility testing results prompted a change in antimicrobial use in nearly 35% of dogs. Foreign body was identified most frequently as a cause. Sixty percent of dogs received medical therapy only, while 38% had surgery. Surgical treatment was provided via median sternotomy in 79%, lateral thoracotomy in 16%, and unspecified or thoracoscopically in 5%.
Long-term survival in 14 studies ranged from 58% to 100%, with medically-treated dogs having an overall 76% survival rate and surgically-treated dogs a 71% survival rate. Recurrence rates ranged from 0% to 23%; overall rates were 5% for medically-treated and 19% for surgically-treated dogs. Complications were reported in 5 studies of 61 dogs. Complication rates were 23% and 41%, respectively, for medically-treated and surgically-treated dogs.