Primary Spontaneous Pneumomediastinum, Pneumothorax and Subcutaneous Emphysema in a Cat with Urethral Obstruction

Authors: Parsons B, Doolin K, Franklin A
Publication: Australian Veterinary Practitioner, Volume 53, Issue 5, pp 192-200, Dec 2023
Publisher: Australian Veterinary Association

Animal type: Cat
Article class: Clinical Article

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Abstract:

Objective: To describe a case of pneumomediastinum, pneumothorax and subcutaneous emphysema in a cat with urethral obstruction.

Case summary: A seven-year-old indoor-only male neutered domestic shorthair presented obtunded with severe metabolic derangements secondary to urethral obstruction. Subcutaneous emphysema over the head and dorsum were identified on physical exam. The patient was sedated without endotracheal intubation for urethral unblocking and placement of an indwelling urinary catheter. Radiography revealed pneumomediastinum, pneumothorax, subcutaneous emphysema and pneumoretroperitoneum, with no history of anesthesia or trauma. Computed Tomography (CT) was unable to identify a cause of the aberrant air migration and confirmed a moderate amount of cystic calculi within the bladder. A cystotomy was performed following six days of stabilization and supportive care, at which time there were no anaesthetic complications.

New or unique information provided: This case report describes a novel complication of lower urinary tract obstruction in cats. As far as the authors are aware, this is the first case report of concurrent urethral obstruction and spontaneous pneumomediastinum in a cat and represents an important reminder that pneumomediastinum can occur as a result of extra-thoracic aetiology and in the absence of trauma.

Keywords; feline, pneumomediastinum, spontaneous, pneumothorax, urethral obstruction

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