Monday, December 27, 2010

Canine Spontaneous Pneumothorax

I am going to depart from this blog's theme and style to post, in detail, about my dog's spontaneous pneumothorax. After it happened, the nerdy scientist in me immediately started doing research online, only to discover there is not a lot of information on this condition in dogs out there in cyberspace. A lot of websites have the same information cut and pasted from somewhere else. Human websites are available, but not necessarily helpful. As her surgeon told me, a lot of things they can do in  human patients, they cannot do in dogs. The two legitimate veterinary journal abstracts published online dealt with 12 and 64 dogs respectively. I can assure you as a scientist that, even together, these do not equal a statistically valid sample upon which to base any kind of inferences. So I add here my experience. It may be anecdotal, but it may help someone else if they ever have to research this terrifying incident after it happens to their dog.

There is no medical advice offered herein. Your experience of canine spontaneous pneumothorax will depend on a number of parameters, not the least of which is your dog and his or her general health and the cause of their pneumothorax. This is simply offered to present one dog's experience. It may help you to formulate some of the questions you have for your vet. Remember, you are responsible for your dog, and you have every right to ask as many questions as you want, and to have your dog treated by the vet you want. Be proactive in your pet's care as you would with your own health. 

On Wednesday, 1 December, 2010, my 9 year 10 month old spayed female Samoyed had a spontaneous pneumothorax, or in plain language, somehow blew a hole in her lung that started leaking air into her pleural cavity. When I left for work at 6:30 a.m, she was fine; had her breakfast, got her daily eye drop (a hang over from eye surgery she had to undergo at age 2), did her business, was completely normal. My mother, who thankfully was visiting for the holidays and therefore was able to provide the sequence of events, reported that at around 8:00 a.m, she became very restless and started pacing and would not settle down. Online symptoms of a pneumothorax are lethargy, vomiting, etc., but she evinced none of these, just restlessness, pacing, and a refusal to sit or lay down. My mother thought at first that she needed to go out, but she did nothing once outside, just continued pacing. She was reluctant to lay down or sit down or put pressure on her chest.

This went on for several hours, and my mother got increasingly worried. She looked for evidence that the dog had eaten something that was stuck or making her sick, but found nothing. She looked outside for anything that might be unusual--nothing. Unfortunately, I am a field scientist and I happened to be working that day out in the field, about 50-60 miles from town.  Mom called my cell phone at 2:21 p.m. to tell me about the dog, but I didn't get the call. Even if I had, without my vehicle, I couldn't have left the field without somehow convincing the rest of the team to call the day short. We left the field at 3:18 p.m., and arrived back at the office just before 5 p.m. Mom called again while I was driving home. Regardless, I still feel guilty at not checking my phone for messages or missed calls.

My first thought and fear was that she had bloated, as the symptoms--restlessness, pacing, refusal to put any weight on her stomach/abdomen--sounded like that. As soon as I got into the house, I examined her stomach, but it had neither the tightness nor the sound of a bloated stomach. Then I looked at her tongue and saw that it was blue, and knew immediately that she was having breathing difficulties. I put her in the car, and she started coughing and gasping. Each pant would end in a gasp for air.

At 5:00 p.m., the vet specialty hospital is a good 45-60 minutes from my home through rush hour traffic, so I took her to the emergency clinic literally around the corner. They x-rayed her and immediately told me it was a spontaneous pneumothorax, which was easily seen on the radiographs even by a lay person. Then the emergency room doctor told me something very scary; she pointed to a spot on the film and called it a lesion, and added her suspicion that the pneumothorax had been caused by neoplasia/cancer (although other causes, such as valley fever and bullous emphysema, were a possibility).

Of course, my heart sank and I got all queasy, wondering if I was going to have another animal with cancer. And the doctor didn't reassure me that she could either heal naturally or have surgery to resolve the pneumothorax--I had to find that out for myself online. I went home, cried hysterically, and wondered if I'd lose my dog to this. She had been leaking air probably for almost 9 hours.

An hour later the emergency room called to say that they had immediately removed 2 liters of air from her by needle, and would continue to draw air from her. If needed, they would put a tube in her to facilitate air removal (this had been discussed while I was there). A later call reported that they had taken another liter of air (so 3 liters in total) from her, and inserted a tube into her lung. If she did not stop leaking air after 3 or 5 days, she would have to have surgery to remove that affected portion of her lung.

She was in the emergency room 5 days, on a tube until Sunday morning. She stopped leaking air sometime between 3:00 p.m. and 8:00 p.m. on Friday, two of the times at which I called for updates and asked if she was still leaking, so the time is bracketed accurately even if I don't know exactly when she stopped (so at least 50 hours, perhaps 55 hours total of air leaking). She was improving the whole time, eating well, alert, and very loving (as is her nature). In order to keep her quiet so the tube was not endangered, I didn't visit her (in fact, I wasn't even given the option until Saturday, when the doctor cautioned that I knew my dog, and if she was going to get excited, it would be best not to visit. I know my dog--she would not only get excited, she would want to leave, so as hard as it was not to be able to see her in person, I stayed away). On Saturday, the doctor told me she might be the one in a million dog who heals naturally, and she did. On Sunday morning, the tube was removed, but she needed to be observed until Tuesday, when they had made an appointment for her to see a surgeon at another hospital. This was the same hospital where she had had her eye surgery with the then only canine opthomology department in the city, but I had never heard of this surgeon. I called her vets to ask them their opinion of which surgeon she should see.

Over the 4 and half days she was in the hospital, she had 7 x-rays taken to determine if the pneumothorax was resolving itself. No other emergency room doctor with whom I spoke over that time ever mentioned that lesion identified by the first doctor. The surgeon did not see anything that was a lesion. I now believe that it was the lung folded on itself or some other perturbation of tissue, perhaps even the initial rupture spot.

I had been in touch with both her regular vet (who has taken care of her since she was 11.5 weeks) and her acupuncture vet (who also practices Western medicine in a holistic approach). Her holistic vet knew of the named surgeon, but had had no personal experience with her and recommended that if she need surgery, it be done by a different surgeon, Dr. Boulay. On Monday, when I was able to speak with her regular vet, he insisted she be released that morning and sent to a different veterinary hospital in town, where the best veterinary surgeon in town practiced. This was Dr. Boulay, the same surgeon her holistic vet had named. (My years of pet ownership meant I had heard of him, but had never had to use him before, so I was already aware of his reputation before this all happened.) My regular vet called over to the hospital (luckily, he and the surgeon are very good friends, and in fact, my vet attended the surgeon's wedding last year in Hawaii and had offered the surgeon space in his own hospital for a year while his new offices were being built; thank God for personal favors), and made arrangements for her to be admitted and for Dr. Boulay specifically to see her (there are two other surgeons in the practice).

Monday morning was the first time I had seen my dog since Wednesday night. She was so tired of the hospital and so eager to go home that she made a beeline straight past me to the door. She had been shaved almost completely around the middle for the tube. I carefully drove her over to the vet specialty hospital owned by the surgeon. I timed it--45 minutes during the middle of the morning (post rush hour). They examined her, did another x-ray to compare with the series taken at the other hospital, and decided to keep her overnight in order to do a CT scan the next day (the radiologist worked Tuesday to Friday). It was very hard to leave her again, but I knew she was in the best possible hands.

FYI, when they brought her back from the x-ray they had taken the large bandage off, and I found a just starting to embed itself tick on her non-tubed side, which could only have come from the other hospital. You can imagine how disgusted I was; and yes, I did call the other hospital and tell them of this.

The three surgeons at the vet specialty center disagreed on the immediate next course of action; Dr. Boulay, the surgeon in charge of her case, wanted to do the CT scan right away; Dr. Shields was concerned that the anesthesia required would cause the newly formed seal to burst, causing another pneumothorax; and Dr. Gores appears to have been the mediator, as well as insisting that I be told they disagreed so that it was my decision on which course of action we took. Ultimately, Dr. Boulay agreed to wait two weeks for the CT scan to allow maximum internal healing. I was instructed to keep her quiet at home.

It wasn't until the following Sunday, Dec. 12, almost 2 weeks after the incident and 5 days after she was released from the hospital, that she started to behave like her normal self. That day, also, a huge bruise became visible around the staples where the tube had been (these needed to be left in 2 weeks, and were to be removed when she had the CT scan). Almost 4 weeks later, the bruise is still visible, although with her fur starting to grow back, it's difficult to tell how dark it remains.

The CT scan was taken two weeks later, on Dec. 21, and I picked her up at 5 o'clock that evening. I was supposed to meet then with the surgeon, but he had to go into a "complicated" surgery until 7 p.m., and knowing how things can run longer than planned, I made arrangements to meet with him on Thursday morning before the hospital was open to go over the scan. A CT scan requires that the dog be anesthetized, and the scan takes about 15 minutes. I had expected her to bounce back from such a short anaesthetic pretty quickly, but at almost 10 years old, she is the equivalent of a 55-year-old human, and she was groggy and not herself until well into the next morning. But she was relieved to be home, and I was relieved to have her home.

The CT scan revealed that both of her lungs are full of bullous emphysema, or little blisters that form on the lung (both inside and outside). I counted at least a dozen, ranging from pinpricks to 1.0 and 1.5 cm bullae on her left lung. Scarily, she has an enormous bulla that measures approximately 4.5 by 6 + cm across on the outside of her right lung. These bullae are three-dimensional spheres full of air that can form in the honeycomb interior surface of the lung. No one knows why they form. The CT showed no indication that she had ever had valley fever, a fungal infection endemic to humans and dogs here in the desert (it's caused by fingal spores we inhale and that cause lesions on the lungs, which are visible on an x-ray) and which I had thought may have caused this. The CT scan also showed absolutely no signs of lung cancer (or cancer elsewhere in her upper body; I do not know if a full body scan was done, or just a scan of her thorax as we concentrated on looking at her lungs on the computer).  The surgeon spent 45 minutes repeatedly moving the imagery up and down her lungs. Unfortunately, she has about a dozen (at least) bullae in both her lungs, so surgical removal of the affected lobe or lobes is impossible.There would not be enough intact lung left for her to survive. He went on to say that bullous emphysema is very frustrating for vets, because they don't know what causes it. Although his practice sees quite a few dogs with this in their lungs, they only see 2-3 spontaneous pnuemothorax patients every year. Although the Web suggests that large-chested dogs and possibly northern breeds are susceptible, he was not sure, and said that at his practice, they had seen this in German shephards more than in other dogs, for what that might suggest. However, his hospital is one of only two in the city that has a CT scanner, so it remains unclear to me how common this condition is, how often and in what kinds of dogs it occurs, does this practice see more because they have to ability to do so (bullous emphysema is not visible on an x-ray), etc. There are so many parameters that are involved and about which there is no or little information.

If she has another pneumothorax, it will likely be this large bulla that erupts. The surgeon, who has been practicing at least 25-30 years, said he had never seen a bulla this large. Her holistic vet had told me that if she has another incident, they will have to do surgery. I asked him what was now the option if she has another spontaneous pneumothorax, and he said "what we just did: insert a needle to remove the air, and if necessary, a tube." He went on to say that he prefers not to use the tube unless necessary (and outlined what those necessary situations were) and to let the dog heal on its own.

This last was reassuring, since my big fear, having seen the CT scan and realizing the extent of the bullae in her, was what would happen if she had this again. I flatly asked him if she would die, and he said no. I asked him what would happen if the large bulla burst, as opposed to a smaller one; would the rate of air loss be faster and would she therefore get sicker, faster. He said the rate of air loss depended on her respiration rate, which would not change regardless of the size of the bulla that burst; I found this reassuring, too, in a way. We have no way of knowing the size of the bulla that burst, but we at least know how many hours it appears it took for her to get comprised in her breathing.

Dr. Boulay said that it may have been something as innocuous as a sneeze that caused the initial rupture. He also told me both lungs had had a leak, which no one told me before. He pointed out a lot of scar tissue that has formed on her left lung and said that was where he suspected the initial leak appeared. He is hoping her mediastinum, a membrane between the two lungs, has also been scarred by this as it would then form a a barrier that would allow one lung to be unaffected if the other should develop a leak. He also discussed a pleurodesis, where they create a slurry and glue the lung to the cavity wall so there is no way for a bulla to erupt through the lung wall, but he is cautious of doing this and wants to do some research. He also said he is going to contact various other vets around the country, including Dr. Foss, a soft tissue surgery specialist, to see if they have ever had a patient with multiple scattered bullae that precluded surgery, or if anyone has ever seen such a massive bulla as hers (he said it was the size of a plum; but what is the size of a dog lung?).

It is possible that another bulla may burst, and it may be tomorrow or in two years, or it may never happen again. We will live on tenterhooks now, wondering. She can no longer jog or run or do any activity that will cause her to want to bring in large amounts of air quickly into her lungs. Not a problem as I hate to run and jog and she never did these anyway, but it does mean that dog park visits will no longer happen as she liked to chase balls and other dogs, and I don't want to risk it. He said I could begin exercising her normally, but to take it slow (we literally walked only around the block until yesterday, when I increased it to two blocks). He also cleared her to resume her Pet Therapy Program visits at the hospital when she's ready. Although seeing her in her funny shaved appearance might actually be a good thing for some kids, I don't want her to do anything that requires long walks for a while yet. She cannot undergo any procedure requiring anesthesia unless it is critical. And as the hospital has all kinds of specialists associated with it, if she does require it, it will be done there where Dr. Boulay can keep an eye on her at all times.

I still fear this is a death sentence, even though it doesn't appear to be so and Dr. Boulay said they can do the same thing again should she have another pneumothorax. I still fear leaving her alone. Today I left her alone for an hour and a half and was anxious the whole while. She acts normally sometimes and other times is a little quiet or depressed. The weather has been a bit damp, and it may be that her arthritis is bothering her. It may be that she feels the cold a little more than normally without one-third of her coat. It may be that certain movements cause a twinge in her lungs, or pull the muscles the tube went through, or something like that. I still watch her breathing, and check to make sure she's breathing every few hours. I still check her gums and tongue a lot. We're both not quite over this yet. I am still scared. I will be for a long time.



64 comments:

  1. K and M are such beauties! Best wishes for a happy & healthy 2011 to all of you!

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  2. my dog has this also.. thank you for sharing... i brought her home to rest instead of the vet icu... this is day 3..

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    1. How did your dog make out with this...we are on day 3 of home rest too.

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    2. It has now been over a year and my dog is alive :) she has had some bad days...but over came. the vet icu only gave me a 0-25% chance of life. go with your heart. our dogs do best in our care sometimes..

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  3. Thank you for sharing this information. My dog has this - most likely caused from coughing (he had been diagnosed with kennel cough ahead of the spontaneous pneumothorax) and trying to get information has been a challenge.

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  4. Thank you for this. My dog developed a Pneumothorax and I am doing all of the research I can.

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  5. Thank you for posting this. My 2 year old german shepherd mix has just been diagnosed and I'm curious as to anyone's long term caring for their dog's with this disease. Would love to see some more posts. This was very informative....we are resting at home and waiting out the 2 weeks to then decide what action we take.

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  6. Thank you for this, my 16-year old German Shepherd mix was diagnosed today with spontaneous Pneum and is in emergency care. Glad you blogged about your experience.

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  7. My dog was just in the vet today and I was told she had this too...She is having me come back tomorrow and check xrays again.They got 1 liter of air from her cavity when they tapped it today. They are talking removing her lung :-(

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  8. Our 5 year old female samoyed "princess" just had surgery today to repair a bulla in her left lung, at Iowa State in Ames IA. The surgeon says that this recurrs in about 20 per cent of the dogs that are diagnosed and go through surgery, but the rate without is MUCH higher. Our local vet in Omaha,had never seen this in over 40 years of practice,and we treated her for about everything he could think of until we discovered that her coughing was in fact because her lungs had partially collapsed. Thank you for sharing your experience with us.

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  9. Thank you for all the info. My two year old German Shepherd is suffering from this right now also. I am laying next to him monitoring his breathing, color and resp. rate. Info is very hard to come by so thanks!

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  10. Thank you for your post. My 11yr old anatolian shepherd was just diagnosed with this after a visit to a third vet. First vet kept saying it was Valley Fever. 2nd Vet thought heart disease. Xrays showed a blister type and its assumed one prior burst creating his present condition. He is in guarded condition waiting to see if he'll heal himself and next week will undergo more xrays and then possible tap to release excess air. Vet didn't want to do the tap now because his fear is if you release the excess air, it'll expand the lungs and the bleb/bulla thingie would then burst as it could expand as well with the new air space given. He is in good condition, normal behavior, normal everything other than the labored breathing, some dry heaves, some white eye discharge and the wheezing which is the first thing that caught my attention that he was not right. I also believed he had bloat with his symptoms of pacing and being uncomfortable. He has been like this for 1.5 wks. Going from one vet to the next and finally finding the one that knew the correct diagnosis. My dog is not in an emergency condition right now and hopefully is healing naturally. But my specialized vet said this would reoccur and reoccur. He could have lung surgery, but my dog is older and has other medical issues. I asked him how long did he have to live and he said few weeks to a few months... I'm confused by this as I research online, so many dog's seemed to have been in worse condition and are doing find months later. I understand it will reoccur each time a bleb/bullae bursts and we dont know how he'll handle it. But to give him a death sentence already seems strange. I'm searching for herbal remedies to help keep lungs healthy and strong... Thank you so much for your post, as it helps me to understand better. This condition is very confusing... Best of luck to everyone here dealing with this.

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  11. My 13 year old female afghan hound was just diagnosed with this. She was just hospitalized with the intention of tapping the excess air and doing a CT scan tomorrow. Thanks to all of you who have listed encouraging information on your dog's course and treatment.

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  12. Our almost 9 yr od Sheltie succumbed to this horrible condition. She had so many bullaes in both her lungs and she kept leaking air even with the chest tubes and vaccum attached to help draw out the air. it was the hardes thing to see her go through as she has always been such a healthy dog. The Dr's at U of I Animal Hospital in Champaign, IL. told us there was nothing that could be done as she would never breath on her own, so we had to say goodbye to our precious girl. I agree that I researched this and not alot of info out there. Thanks to all for sharing..nice to know we aren't the only ones who had to deal with this condition and heartache.

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  13. My male Akita was just diagnosed with this today. He is still at the vet with the chest tube waiting to see what happened. We almost lost him as he went into shock 5 minutes after getting him there. Thank you for blogging about this, there is not a lot of information out there.

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    1. Hi there my male Akita also suffered from spontaneous pneumothorax and was exactly the same went into shock within minutes and had to have the chest tubes inserted to save his life. He spent 3 days in hospital under constant observation and he is now home with us just 2 days after. We are very worried and paranoid tonight as he has been panting quite alot with shallow and fast breathing though once in a rested state (asleep) it has improved and seems more normal. I'm just curious to know how your dog is recovering and what experiences you've had. Any advice would be really appreciated. Thank you :)

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    2. He is doing well. He ended up staying a week at the Emergency vet and had chest tubes on both sides. The CT showed another bulla that had not ruptured and evidence that other small ones had ruptured and healed. We monitor his breathing and log it at least once or twice per day. The vet believes that if we do that we will catch this earlier if it happens again. About a month after we got him home he ended up with a skin infection and that has been a project. The vet thinks that his immune system took a hit when he had this happen so we are using a lot of regular plus more natural things to try to get him back on track. So far so good on the breathing. How is your guy doing?

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  14. My 6 month older lab/ Shepard mix just had surgery yesterday having two removed one 1cm the other had to take a whole lobe of his right sude ... sad day but he is recovering and pick him up tomorrow!!!

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  15. my 4 year old great dane was diagnosed with a spontaneous pneumothorax on wednesday. she had a CT showing one large bullae, which they say had been there for some time. since her lungs were continuing to leak air into her chest, we had to opt for the surgery. she had the surgery yesterday and they went through her sternum; successfully removed the one large bullae and also the middle lobe of her right lung (bc it wasn't inflating), and also two small (1cm) possible bullae. i spoke with the vet a few hours ago and her chest tube will come out today, and ill be able to take her home monday. the vet said after surgery there is a 10-15% chance of this reoccurring again and she will fully recover in about a month. thank you for posting this bit of info about spontaneous pneumothorax in dogs. not much out there and it was reassuring to read other comments too.

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  16. My 14 month standard schnauzer was diagnosed with spontaneous pneumothorax. The surgeon tried chest decompression with a large bore needle and then with a chest tube. She was leaking air so fast that they were forced to do an emergency lobectomy on her to save her life. She was doing well for about 24 hours postoperatively. Then the surgeon called and said she was leaking air again and they were having to aspirate it from her chest tube. I don't want to put her through another surgery if she has developed another bulla. I'm so worried that she is suffering. Does anyone know anything about this or have any experience with this type of scenario?

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  17. It is very reassuring to see your post and everybodys comments, thank you. My 5 year old husky was just diagnosed today (they used a needle to drain the air and I am monitoring him now) and I have been trying to research this online. Initial x rays show presence of multiple bullae but we need a CT scan to properly identify them before proceeding further.

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    1. We had the surgery on July 3rd because our dog kept leaking air. They found and removed two bullae in two of the lobes, one had ruptured. He was monitored for the next 48 hours and there was no further leak. He came back home yesterday and is slowly recovering, but in a lot of pain.

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  18. Just lost our 13+ yr old lab mix to this condition. CT scan showed bullae on 2 lobes, one was leaking and keeping her in critical condition. We opted for surgery as it was her only chance. It was too intense for her. They took 1 more lobe than planned, because it also had bullae on it, leaving her w/just 50% of her lung tissue which is as far as you can go. She woke up but didn't survivie 24hrs. She began to hemmorage. It breaks my heart that she went through all that pain and that I wasn't with her when she passed.

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  19. My 5 yr old Pyrenean Shepherd was diagnosed with spontaneous pneumothorax a few days ago...this following what was believed to be kennel cough although now I am not convinced about the cough. She is currently hospitalized at NC State vet school in Raleigh and will have a CT scan in the morning. This is so very crazy to me as all her tests are clean and she is perfectly healthy except for this condition.

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  20. My 7 year old male Akita died due to spontaneous pneumothorax. Living the in Phoenix area we left him in the house because of the heat outside. When my wife came home he had diarrhea and went in two bedrooms upstairs. When I got home we noticed he would not sit or lie down and heat head was extended, ears turned down and his tongue was turning blue. The day before he was just fine. We took him to the animal emergency room and they diagnosed him with spontaneous pneumothorax. They sucked 8 liters of air out of him which enabled him to breath. They wanted him overnight so when we saw him he knew who we were as his tail curled and moved. Overnight they inserted a chest tube because he would not stop leaking air. The doctor told us he needed surgery and may not pull through. Putting him was one of toughest things I have ever did. We were with him until the end and we are still healing from the shock! I hope they can find some kind of diagnosis to treat this so other don't have to go through what we did.

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  21. My 9 1/2 year old mixed Rottie/Lab was diagnosed with spontaneous pneumothorax and came home from the ER yesterday. She started with a gastrointestinal problem and went downhill rapidly. It was terrifying to watch as she was also convulsive with a fever of 106. Anyway, she had 3 taps on both sides to remove air over a 24 hour period. She was taking 3 antibiotics. I didn't think she'd make it. An xray the next day was clear with no evidence of the pneumothorax. She stayed another 24 hours to be sure of no immediate recurrence. Home now and resting. Will cherish every day I have with her and I still hope there are many but I will take them one day at a time.

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  22. My 5 year lab just passed away from spontaneous pneumothorax per the vet at Va Tech Vet School where I had a necropsey done to find out why he died. He was acting normal all morning and around 3:00 pm - 3:30 pm I took a break painting my kitchen. He came to me with his ball for me to throw outside. We were out for about 25 minutes. I threw it around 8 times and he indicated he was satisfied and done. We went back in the house and he and my other dog jumped on their couches and I went back upstairs to paint. I did hear him coughing but just thought he was coughing no big deal. At 5:00pm I took another break to fix their dinner. I did notice then that he was not upstairs when he heard me fixing dinner along with my other dog. I put my other dogs food down and went to
    take his dinner to him downstairs. When I saw him laying on the couch I thought he was a sleep at first but when he didn't respond when I spoke to him I realize he was gone.

    Looking back the only thing different in him was that we noticed he didn't go after the ball nonstop. We just thought it might be because it was so hot. Someone mentioned bloating. Day or so I thought he was looking a little overweight. (??). I don't know if any of this was a sign of anything - he had gained some weight. He was extremely happy energetic. Had just taking a good walk either the night before or the night before that and he was great. Some said a sign of this is that they don't lay down on their side but upright. That morning he was napping laying down.

    I have not gotten the final results of the necropsey yet. I don't know if he had any bullea. I'm am broken hearted. If I only hadn't thrown that ball.

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  23. My three year old collie mix was diagnosed with bullae is now 4 days post-surgery. She's on a few different pain medications but her breathing is still very rapid and shallow. The surgeon said her breathing should be normal now. I'm going to call again in the morning but since I'm sitting here unable to sleep...has anyone had this post-operative issue?

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  24. We lost our 4 year old Australian Shepherd to a spontaneous pneumothorax. He was fine one minute, the next I noticed him breathing from his abdomen. He was very restless and uncomfortable and not wanting to lie down or sit. Called my friend who works at the emergency clinic and she said to bring him in right away. That was at 5:30. On the way, he got progressively worse with drooling and trouble breathing. We got to the clinic at 5:45 and he was dead by 6:00. He was very active his entire life (sheep herding, agility, just an all around mad man!) and his xray showed nothing that would explain his condition.

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  25. My 13 yr old Shih-Tzu, Shady was also breathing from his abdomen, took him to vet and was told their was in his body pushing his organs out of position. Then immediately to ICU where the diagnosis was collapsed lung. They tapped it and let air out but the lung butit did not reinflate. Because they could not find anything on the X-rays, the drs could give me NO guarantees that surgery would work. Shady was also blind so in less that 48 hrs after initial symptom, I elected to put him to sleep. Hardest decision I ever made.

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  26. My belgian malinois is in surgery right now for a spontaneous pneumothorax. He turned 4 last week. He also has Inflammatory Bowel Disease. I know how all of the other posters here feel. I am biting my nails waiting on the surgeon to call. Will update the board on results.

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  27. I just posted 3/4 @ 1:30 pm about my malinois. Update on his pneumothorax:
    Surgery revealed multiple areas of thick , flattened lung tissue. No bullae as was suspected. Multiple biopsies were sent off for pathology. My boy did well through the surgery and is currently off the vent with a chest tube in place, small amount of air draining. The surgeon thinks this part is normal. She also said my boy had tan fluid in and around his lungs. This fluid was sent for a culture.
    So my situation is currently a mystery to the specialty vets....... will update with more info as it becomes available.

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  28. We just lost our Shiba "Tigger" to this on Tuesday 3/11/14. He was Only 6 months old :( We originally noticed it on 2/28, he had surgery on 3/3 to repair his lung and removed 2 spots they sent for biopsy and fungal culture. Biopsy results were due to come back 3/10 and his follow up appt was actually on 3/11.......but we never made it there :(
    I took him outside to the bathroom when we woke up, he barked once or twice at a bird and then I heard that terrible cough again (same as when we first took him to the ER).....I knew it was not good. He passed away in the car with me on the way to the Vet ER.
    Heartbreaking doesnt even begin to describe how I feel right now.
    The vets said it was congenital on the biopsy results and it would have happened again anyway.
    Sounds to me like this is more of a common issue than some of these vets are aware of in this breed.
    I miss him so much, my buddies. RIP Tigger 8/28/0213 - 3/11/2014 - I know he is breathing better now and playing like a puppy should.
    I hope and pray that you all have better results, I would never wish this on any innocent pup, nor the pain it puts thier owners through.

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  29. Thank you for posting your story. I just found out my Golden Retriever, who will be 4 in August, has a pneumothorax and the vet doesn't know why. Complicating the situation is he won't eat and the vet is concerned about that.

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  30. My 6 year old shih tzu mix is having a lobectomy/bullaectomy tomorrow morning. This is the 3rd time he's had a spontaneous pneumothorax and conservative measures worked all the other times. This time the Bulla is leaking too quickly.

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  31. My 8 year old Goldendoodle Beau, is in the Specialty Hospital now with Pneumothorax. They removed a liter and a half of air last night, a small amount of air had returned by early this morning and he is having difficulty breathing again. Waiting results from scan and ultrasound before they re-tap his lungs.
    I'm so thankful for your article! The Vet did not tell me that it could resolve on its own- in fact, I was told his lungs would continue to leak and he would require surgery at some point. This is without knowing the cause.
    Thank you, thank you, thank you

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  32. Thank you so much for producing this article and for all the comments. My 11 year old Labrador, Jet, has just passed away from a spontaneous pneumothorax, and to say I am devastated doesn't even come close! I went to work and he seemed fine, maybe a little sleepy but I just put that down to his age. He had been playing around and even being puppy-like again only a few days before. Luckily my mum was staying and she had noticed he had tried to be sick, retching a few times but not bringing anything up. She took him out for his morning walk and he was very slow and got out of breath much more than usual. When she got back he was heavily panting and did not want any food, he did drink some water but continued to retch and try to be sick. She called me and we took him to a vets, they diagnosed him with kennel cough, gave his some anti-inflammatory and anti-biotics and sent us away. Even in the car park we knew that it wasn't kennel cough. Still questioning the diagnosis, we went back home and within 10 minutes he was worse, breathing heavily and would not lie or sit down - when he tried he started retching again. His tongue was starting to go a blue-ish colour and his body had swelled a little. We took him straight to another vets. There they straight away picked up it was a respiratory issue. They took him in and x-rayed him, they saw a large bullee and air in the chest cavity, the lung had collapsed. The vet tried to tap his chest and did release some air, apparently is was filling with air as quickly as it was being removed. Unfortunately Jet passed away on the table. I just wish I had not wasted my time at the first vets and taken him to the other one straight away. Also regret not making as much of a fuss of him when he got taken away, I never got to say goodbye as I did not think that something that could come on so sudden could be so devastating. I have lost my best friend to this disease.

    This article has actually helped me grieve a little. I was blaming myself for not noticing earlier, not going to the correct vets. Even if he had been able to get his lungs back and working I am not sure he would have survived surgery afterwards or whether I could have taken the decision to go ahead with it or not at his age.

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  33. My 8 year old Samoyed had a span Pneumo 4 days ago, they removed 1 liter of air then it recurred 4 day later (today) he is home resting. They do not know why. CT is clean, X-Rays are good. We are now just watching and waiting.

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    1. THe CT scan doesn't always show everything. To know for sure they would have top do surgery and look. The xrays and CT showed nothing with my dog, but we opted for surgery to get answers as obviously something was leaking somewhere, and they found an area of ruptured bullae.

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  34. My 5 year old Hungarian Vizsla, started breathing very heavy one Saturday morning 3 weeks ago, she started coughing and symptoms were like kennel cough, but as her breathing got more laboured, we rushed her into the vets, where they put a drain in her to allow normal breathing, diagnosed then as a type of Pneumothorax. She got referred to a specialist, who kept a drain in her over a good few days to see if it healed itself, Xrays & CT Scan done, diagnosed as Spontaneous Pneumothorax. This did not heal itself, so surgery was agreed, which is major. Unfortunately, no holes were found or any sign of bullae, so stiched up and the poor girl had to start recovering from that, dogs are amazing with their pain thresholds and getting on with things aren't they! after 5 more days recuperating, then home for 7 days, there had been no sign of any leakage. Took her in to have staples removed last Thursday morning, and by mid afternoon I couldn't believe our luck, when her breathing became laboured, got her back in quickly and the next day (after being emptied of 2 Litres of air)we opted for the next plan of attack, which was "autologous blood collection and injection into thorax" a tested and fairly good resulting option, we are waiting to hear tomorrow some firm facts and results, but air had to be drained off again Saturday morning. So as you can imagine we are dredding what is coming! Has anyone had similar scenario's or advice or thoughts please? Mr H

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  35. we have a 7 yr old german shepard/husky mix, just came down with this on friday March 11, 2016. He's still with the vet. It was also strongly suggested that we not visit because he got very excited the first time we saw him. Today we thought he would be coming home since he somehow removed the chest tube himself and held his own for at least 6 hours, but he is leaking air on his left side now, they are talking about setting up surgery for him tomorrow....

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  36. I have a 6 six year old Great Pyrenees, Duncan, we was diagnosed with Pneumo 3 days ago. His chest has been tapped 3 times and we have gotten three opinions on treatment. I finally found a surgeon who can possibly do the chest tubes at a somewhat reasonable cost compared to the $7500 that we were initially quoted. I'm researching like crazy and hoping the spontaneous Pneumo will heal with rest. He has a followup in a few days to determine whether we need to get more aggressive with chest tube treatment. Fingers crossed. Prayers are appreciated. Does anyone on here have long term prognosis stories from their own experience?

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  37. I'll add my story here as well to help gather more experiences on this.

    My Husky mix was diagnosed with spontaneous pneumothorax 4 days ago. Like the dog in the story, his sealed by itself while under the care of the veterinary Doctors. We didn't do the tubes, just the taps.

    The information available is essentially nonexistent. It's hard to make an educated plan for your pet without knowing how long these bullae take to grow. You could go in and have surgery to remove the ones that are there, but there are reports of dogs suffering another pneumothorax only weeks later. So a new bullae can grow and pop within a matter of weeks? Or did the surgeon miss one? Did they not check for air leaks before completing the surgery and the leak got worse? Etc etc. There are too many possible variables and no real data out there, it's hard.

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  38. So in my initial response I say my dog has healed on his own, that is what it appeared to be at the time, but the day he was supposed to come home, he started leaking again. Long story short, he was in the ICU for about 5 days. He had a ct scan done and it was unremarkable ... meaning that, there was nothing to be said of it. No bullae/blebs could be seen. It doesn't mean they aren't there, but given the fact that CT scans have about an 84%(I believe?) accuracy rate, I feel confident that my dog very likely is in the clear. Thus, we progressed with this method of treatment:

    He had 2 thorocastomy tubes placed in his chest to drain the air every few hours. He was sent home 24 hours later like this, and I drained the air myself. No resolution occurred, but he remained stable. In an effort to avoid surgery, 2 blood pleurodeses were performed (Note, I said BLOOD pleurodesis, NOT the same type of pleurodesis outlined in the post about Mossy!) Blood pleurodesis is done by flooding the chest cavity with blood in hopes it will form a clot on any and all leaks. It worked. He was no longer leaking air, and after 72 hours we repeated the xrays and they were all clear.

    My dog is now home and as normal as ever. unfortunately, no one seems to know how quickly these bullae form in humans and in dogs. My dog was lucky in that his lungs were not riddled with blebs/bullae. I highly suggest anyone facing this to have the CT scan performed. It is costly, but it is a very good tool necessary to understanding what you are dealing with, as every case is different.

    My total bill amounted to about $7500.

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  39. Our previously healthy 8 year old German Shepherd was diagnosed with this last night. Took her to our local vet who didn't see anything definitive on the x-ray. 6 hrs later we were rushing her to the closest ER, an hour away. She had been having sxs for 24 hrs at this point. They tapped her and removed 2 liters of air. We transported her back this morning to be observed locally and is now resting at home. It's now 15 hours post thoracentesis. The nearest CT is 2 hours away and we do not have the funds to explore further testing/hospitalization at the University. My heart is breaking. All we can do is watch and wait. I continue to watch for signs of digressing again. I couldn't find much info on the web, and so appreciate everyone sharing their stories. I pray she will heal and recover, but fear she will not. As I don't know anyone else that has personally experienced this, your stories have given me hope that she can get through this. Thank you for sharing.

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  40. Our previously healthy 8 year old German Shepherd was diagnosed with this last night. Took her to our local vet who didn't see anything definitive on the x-ray. 6 hrs later we were rushing her to the closest ER, an hour away. She had been having sxs for 24 hrs at this point. They tapped her and removed 2 liters of air. We transported her back this morning to be observed locally and is now resting at home. It's now 15 hours post thoracentesis. The nearest CT is 2 hours away and we do not have the funds to explore further testing/hospitalization at the University. My heart is breaking. All we can do is watch and wait. I continue to watch for signs of digressing again. I couldn't find much info on the web, and so appreciate everyone sharing their stories. I pray she will heal and recover, but fear she will not. As I don't know anyone else that has personally experienced this, your stories have given me hope that she can get through this. Thank you for sharing.

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    1. Hello, any update on your German Shepard?

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    2. Hello, any update on your German Shepard?

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  41. My little dog, a Yorkie/Shnauzer X started laboured breathing 2 days ago and after an X ray it was found that his right lung had collapsed and there was a shadow on this lung. The recommendation was for him to go for a CT scan to determine what was going on. The results have now shown that there are 4-5 bullae in his right lung and that they cannot tell which one is leaking. Surgery has been ruled out because it will be too invasive and all we can hope for is that now the lung has been rested & inflated there may be a chance that this bullae may heal itself. He is staying overnight at the vets tonight and if he is holding his own tomorrow, then we can take him home. In the short term we have been advised that if he starts to struggle with his breathing after 2 days, then we should consider euthanasia, but if he lasts 2 weeks and he starts having breathing difficulties, then it might be worth another air drain at the vets. I am in the UK and just like the other comments I have struggled to find much information about spontaneous pneumothorax. We are absolutely devastated with the diagnosis especially as it is supposed to affect old and larger breeds of dogs. Dill is 7 years old, he is only small and usually a bouncy lad, but we will take care of him and hope and pray that he can pull through this and have a decent quality of life.

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  42. Tremendously informative blog! I have a large breed mix of some kind, understand this is not common but I will always watch her breathing.

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  43. The comment 2 posts above mine is upsetting. You don't eithanice after a single chest tap! Put chest tubes in and take your dog to a vet and have them perform a analogous blood patch.

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  44. Sorry for the spelling errors (Euthanize*) above, auto correct from photo.

    "Surgery has been ruled out because it will be too invasive"

    The surgery to be performed on an animal suffering from spontaneous pneumothorax is known as a lobectomy via median sternotomy. Is it invasive? Sure. Should it be ruled out? Absolutely not. The animal tends to heal up pretty nicely in 3 days, and in a week they should be fine. They are unlike humans, needing much down time and self-pity.

    "He is staying overnight at the vets tonight and if he is holding his own tomorrow, then we can take him home. In the short term we have been advised that if he starts to struggle with his breathing after 2 days, then we should consider euthanasia, but if he lasts 2 weeks and he starts having breathing difficulties, then it might be worth another air drain at the vets"

    I am sorry, but you need a new vet. The above information makes very little sense. Sometimes, usually in traumatic pneumothorax, upon having 3 chest taps, pneumothorax may heal up and resolve. This is unlikely with spontaneous pneumothorax. Thus, chest tubes should be placed via surgery into the dog's chest cavity. The air should be withdrawn every 2-4 hours, depending on leak severity. It is highly unlikely that your animal is going to "hold it's own" with a hole in it's lung. How much air did the vet draw out during the chest tap? You can gauge how long you can go before another chest tap is needed based on the draw #s.

    Ultimately, a dog with spontaneous pneumothorax needs to have the air constantly and consistently removed from the chest cavity. Still, it is unlikely that the pneumothorax will resolve, thus, an analagous blood patch (blood pleurodesis) should be performed. This will close the hole absent of surgery.


    Please feel free to view my documentation album here: http://imgur.com/gallery/hkmfm

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    1. Hi Cole, thank you for your response.

      Maybe in the UK they do things differently, but the reason the Vets said an operation would be too invasive is because Dill has multiple bullae, therefore too many for a small dog (the size of a yorkie) to have removed. We were given the option for a chest drain and then for him to be hospitalised for 3 weeks, but the cost is too much £6000 (around $8500)and we don't have insurance. The only other option was for him to come home with us and for us to wait and see the outcome.

      it is now 3 weeks since his lungs collapsed and his breathing is OK. I have been keeping him quiet and constantly measuring his respiratory rate and so far he has been staying below 30 breaths per minute - so he is in the safe zone. Dill originally had 75% of air drained after the CT scan, please can you explain how you can guage how long you can go before another chest tap is needed? I have spoken to 2 other vets about this condition and they have all told me the same - basically we have to wait and see, but if he has to have too many chest taps, then his quality of life will be affected and we should consider having him put down. So far he seems to have lasted longer managing on his own than any vet has expected.

      One point you mentioned above regarding an analagous blood patch has not been given to me as an option, so I will now ask about this procedure for Dill.

      Thank you for your input, it is much appreciated.
      Best regards
      karen

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    2. Dill Contin/- To ensure there is no confusion when I mention in the first paragraph 'We were given the option for a chest drain and then for him to be hospitalised for 3 weeks' I am meaning chest tubes and not the routine chest drain.

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  45. You said the scan showed 4 bullae on a single lung? A dog, and humans too, can live with 50% of their lung. Why has the vet determined this isn't okay in your dog? Also note the ct scan may not have picked up all the bullae.

    Yes, if your dog is getting thoracotomy tubes put in, have your vet perform a blood pleurodesis. This should seal the hole within 24 hours. Dog should remain calm for 4 weeks post blood patch.

    I don't understand why the vet wants to keep your dog for 3 weeks. Does he want to express the air over the course of 3 weeks and hope the leak stops?

    Feel free to contact me on Facebook by clicking my name on the comment link.

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  46. How many mL of air did they drain from your dog when they did the chest tap?

    I assumed he had tension pneumothorax, spontaneous; but now I'm curious what he was actually diagnosed with? Open pneumothorax? That could explain why it has been 3 weeks and he has not succumbed.

    In tension pneumothorax the air builds and builds with nowhere to escape. The dog suffocates to death. If your dog has tension pneumothorax the leak must be incredibly small to not have collapsed his lungs 3 weeks later. Or it is possible his right lung is collapsed and he is utilizing his left lung to stay alive. No bullae seen in the left lung correct?

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  47. My 5 yr old Siberian Husky was diagnosed with spontaneous pneumothorax, two days ago. Her only symptoms were shallow, rapid respirations and appearing as if gasping for air. My vet drained one and a half liters of air from her chest cavity. She is due for another chest x-ray tomorrow. She didn't have a cough, her gums remain a healthy pink, and she can lie in any position, without discomfort. She is eating and wants to be as active as before, but I am restricting her activity, constantly monitoring her respirations and breath sounds. The vet wants me to have surgery soon as possible for 'possible' bullae in her lungs, after consulting with a specialist. After much researching on my own, I am not in such a hurry to rush her a possibly dangerous surgery. I cannot bear for anything to happen to my furry companion, for my heart would break if I lost her. I don't want her to be used as an experiment. The surgery is incredibly expensive, but I would go into debt for the rest of my life, if I was sure of a cure. I am on disability and everything I had saved for retirement was spent on surgery for myself. My Siberian Husky is the love of my life, and I'll do whatever it takes to save her. I just don't know whether I should rush into this, or just continue to monitor. I am a retired RN, but I'm not a vet. I would love to hear from anyone else on this subject.

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    1. Please read my responses above, as they are relevant to all animals suffering a spontaneous pneumothorax.

      Furthermore, please have your dog seen by a specialist who has experience treating cases like these.

      I would not let anyone, but a board certified surgeon, treat an animal with this condition. Have them put a chest tube in if it doesn't go away on it's own and do a blood patch.

      CT scan can be used to detect bullae.

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    2. Im sort of in the same spot as you. My 11 year old had 1 liter drawn last night and its the day after. How did it end up going for your dog?

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  48. My four-years old Lab/Huskey mix was diagnosed with Spontaneous Pneumothorax at the end of November. His symptoms started with vomiting and labored breath. We took him to his vet right away and they suspected pancreatitis (feared he are a bite of turkey). He visited the vet three times that day and they never found that his,lungs had collapsed.

    After the third visit, we went to bed that evening and he refused to lay down. My husband took him to the emergency clinic and they found his lungs had collapsed. Long story short, they tapped his lungs twice in 48 hour period. This all started on a Saturday, and by Monday morning they told us he needed surgery. That their recommendation was to bypass the CT scan and operate on him. They said ultimately, they really wouldn't be able to know whether it was cancer or blebs until they got in there. That if they found him full of cancer they would call us while he was in surgery to make the decision to euthanize. If they found bless, and removing them alllowed him to keep,50% of his lung tissue, then he could recover and live a normal life. Ultimately, they removed the affected part of the lungs and he is now going into his fifth week post op.

    I too am struggling to find information about how long it takes for blebs to form, and anything statistical about their reoccurrence. Note, he came down with kennel cough a couple weeks after surgery. That was really scary, as he could tear the stitches and do damage to the fragile lungs.

    I know that ultimately, it is now a wait and see. I am so afraid of the blebs reoccurring. If they do, should we consider doing the blood patch? Is that an option after they have already had the surgery?

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  49. My 7 year old Newfoundland was diagnosed with spontaneous pneumothorax. We did tubes at our local vet and hoped it may seal on its own. He was there for two days under their care and home at night. The second night home we removed more air then they originally removed when we brought him in. We knew this wasn't healing on its own.
    We were sent to the top emergency clinic for a CT scan. It showed nothing. As he was sedated for the scan the vet recommended going straight into surgery to open him up and find the source. We agreed as we felt there were no further options and we wanted to have an answer. He proceeded and found a ruptured bullae. He repaired ( removed) it and searched for any other bullae or areas of concern and found none. They stitched him up and he is currently on his third day of recovery at the hospital which they say he is healing really well. Just BC an x-ray or scan doesn't show anything doesn't mean it isn't there... This clinic is ranked #1 in Canada and 4th in the world with state of the art equipment and it didn't show the source. He will be back home with us tomorrow or the next day, and we hope this has completely fixed the issue. Our bill which includes two days at our local vet and the surgery scan and after care of the hospital is about $8000.

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    1. If you are fortunate to still have your pet, don't overexert your aging pet during the post-opt recovery or even afterwards. After going through this, and, looking back, I'm wondering if we over-exerted our pet during walks in an effort improve recovery and strength. Too much exertion might lend to the formation of the return of the blebs but no proof of that.

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  50. My dog has just been admitted with his second spontaneous pneumothorax. Each time this has happened it has been about twelve hours after extra exercise including lots of swimming. This seems too much of a coincidence for it not to be ignored. He is currently in the vets and we are waiting for news.

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  51. The stories shared on this blog are very interesting.

    In early March, 2017 my beautiful & precious 13 yr. 5 mo. Siberian Husky "Laika" was sadly diagnosed with this disease (due to blebs), after the vet thought it was initially bronchitis. After a couple attempts & two weeks of trying penicillin didn't work, more detailed x-rays revealed she had a pneumothorax. Time being of the essence, an operation was done by a specialist the following day in Cincinnati (March 16). The surgeon removed 20% of Laika's lung ($6K+). The recovery was very difficult and painful for Laika. To make a long story short, about 15 weeks later (early evening of June 28), her breathing suddenly became labored (off & on) and occasional coughing up clear sputum. We quickly took her to the vet where a detailed x-ray revealed that the pneumothorax had returned, due to the formation of blebs. The family made a very difficult decision to put our beloved family pet to sleep. After the surgery in mid-March of this year, I apologized to Laika over and over for putting her through this and I told her I'd never put her through it again. The pain and suffering was just too much. If I thought Laika would have been able to handle another surgery & carry on a reasonably healthy & mobile life for another 12 months or more, I would have probably opted for another surgery. I pray that a cure, or even improved detection & treatment, is found for this terrible disease. So thankful to have had the wonderful blessing & beauty of Laika for 13 yrs. 8 mo. & 2 days.

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