Blood in the Chest in Cats

Hemothorax can either develop rapidly (acute) or slowly over time. In most cases, hemothorax is a medical emergency that requires a prompt diagnosis and treatment in order to save the cat's life.

Blood that has gathered in the thorax, or chest cavity, of the cat is a condition known as hemothorax. The amount of blood that pools in the chest cavity typically has a packed cell volume that is similar to that of a drawn blood sample. The condition is most likely to occur due to trauma, though it can occur in other cases.

Symptoms may slightly vary depending on whether the hemothorax is acute or has developed gradually due to another condition.

• Breathing difficulty
• Increased panting
• Pale mucous membranes in the gums or inner lining of the mouth
• Rapid, weak pulse
• Fainting or collapse
• Dull-sounding breathing
• Weakness
• Bruising or lacerations in the case of trauma

There are several causes of hemothorax, which include:

• Trauma that caused a blood vessel to become lacerated within the pleural lining of the lungs or thorax
• Tumor within the thorax, lungs or chest wall that begins to bleed
• Rodenticide ingestion
• Herniated spleen or liver
• Blood clotting disorder (coagulopathy)
• Liver failure
• Platelet disorder
• Inflammation of the bile ducts and gall bladder (cholangiohepatitis)
• Hemorrhage of the thymus gland
• Lung lobe twisting

The veterinarian will gently examine the cat, looking for signs of trauma. The veterinarian will listen to the cat's breathing, heart and lungs with a stethoscope and examine its mucous membranes. Labs will be taken, which include a complete blood count, a blood chemical profile, a urinalysis and an electrolyte panel. These tests can help rule out other disorders that are causing the symptoms, such as liver failure.

Ultrasounds and x-rays will be taken of the thorax, lungs, and heart. These tests will look for the amount of fluid that has built up in the chest cavity, any masses or tumors in the lung cavity and the collapse of any lung lobes.

Depending on the results of the other tests, an arterial blood gas analysis and clotting test may also be performed in order to correctly diagnose the condition causing the hemothorax.

Treatment options vary the nature and severity of bleeding and may include:

• Thoracentesis: Fluid from the pleural cavity will be removed in order to allow the cat to breathe properly. This procedure is known as a thoracentesis. The cat will be given a sedative to relax him or her while the needle is inserted into the pleural cavity and the fluid is withdrawn. This fluid sample will be sent to a lab and compared with the peripheral blood to test the platelet levels and check for any abnormalities in the fluid.
• Fluid Therapy: Intravenous fluids will be given to the cat to correct the loss of body fluid that pooled in the chest. Fluid therapy will help keep the cat's blood pressure levels stable during treatment.
• Oxygen Therapy: Because the fluid hinders the cat's ability to breathe, oxygen therapy will be needed to ensure the cat gets the necessary oxygen to function. If the cat's lungs have been bruised due to trauma, a ventilator may be necessary. An oxygen cage, nasal cannula or facemask may be used to administer the oxygen.
• Vitamin K Therapy: Blood clotting disorders require the administration of vitamin K. Vitamin K is a coenzyme that will help the cat's body create the necessary proteins to allow for proper blood clotting.
• Pain Medication: Pain medication will be administered to the cat to relieve any pain he or she is experiencing.
• Surgery: In some cases, the bleeding cannot be stopped and no blood clotting disorders are found in the cat. In this situation, exploratory surgery is necessary to pinpoint the cause of bleeding.
• Blood Transfusion: If the cat has a blood clotting disorder or has experienced a severe loss of blood, a blood transfusion will need to occur. The blood transfusion will allow the blood to clot immediately, stopping the bleeding. Blood transfusions and vitamin K therapy will be given simultaneously to the cat to correct the blood clotting disorder.

After the cat has been released from the hospital, it's important to follow the veterinarian's instructions for home care. These instructions may include keeping the cat warm, not administering aspirin or other blood-thinning medications, and limiting the cat's activity.

Follow-up appointments and further treatment may be necessary to treat the cat's primary condition that caused the bleeding, such as a tumor or blood clotting disorder. Follow up with the veterinarian as recommended.