Blood in the Chest (Hemothorax) in Dogs

A case of blood in the chest can quickly escalate to an emergency. The accumulation of blood between the lung and the chest wall can cause pressure on the lungs along with respiratory distress because of the reduction in lung volume. Canines with blood in the chest can also experience accompanying pneumothorax (air or gas in the pleural space causing collapse of the lung), which leads to serious breathing difficulties. Removing fluid from the chest is the required treatment for this condition.

When blood accumulates in the chest (pleural cavity), it is called hemothorax. There are many causes for this condition, including coagulation disorders and trauma to the chest.

If your dog has blood in the chest, they will have obvious symptoms that mean a visit to the veterinarian or a trip to the emergency clinic is imperative.

• Labored breathing (dyspnea)
• Rapid breathing (tachypnea)
• Lethargy
• Low tolerance to exercise
• Bluish skin and gums (cyanosis) due to poor oxygenation of the blood
• General malaise

Your pet could go into hypovolemic shock, which is when the heart is unable to pump an adequate amount of blood throughout the body. This can cause the organs to stop working. This typically happens when there is a loss of more than 1/5th of the blood or fluid supply for the body.

The build up of blood or fluid in the chest can lead to a life-threatening situation for your dog. Some of the causes that could lead to him becoming seriously ill are listed here.

• Trauma to the chest which causes the blood to flow freely into the pleural cavity
• Neoplasia (an abnormal growth of cells and tissues)
• A dysfunction in the process of stopping blood flow after injury
• A systemic coagulation disorder
• Ingestion of rat poisoning
• An interference with venous blood flow
• A problem with lymph drainage

When you arrive at the veterinarian, you will be asked several questions in order to determine the problem. A thorough evaluation of your pet’s medical history is necessary.

• Has your dog been ill recently?
• How has his appetite been?
• How long has he been breathing abnormally?
• Have you travelled out of state or out of country lately with your pet?
• Has he had access to garbage, or has he free roamed in recent hours or days whereby he could have ingested a harmful substance?

The interview on the health and wellness of your canine family member will be followed by a clinical examination that will include the veterinarian  listening to your dog's chest with a stethoscope in order to hear the sounds of the heart, lungs, and chest cavity.  A series of tests and procedures will be in order, including a coagulation profile, a complete blood count, and hematology and biochemistry tests. Verification of PCV (packed cell volume) and  TP (total protein) are normally done after trauma or ingestion of poison, for example, and will give information on anemia, dehydration and red blood cell damage. Also to be looked at will be electrolytes, urea and creatinine. Radiographs or ultrasound imaging may be necessary in order to view the lungs and chest.

Once your veterinarian has examined your pet, she will know the condition of your dog and whether he requires emergency treatment. In most cases, hospitalisation, to ensure the animal is in stable condition is needed.

Thoracocentesis is a tool veterinarians use to diagnose blood in the chest; it is also used to treat the condition. Inserting a needle into the chest will help remove fluid and blood. This procedure is generally tolerated well by canines, without the need for sedation. This procedure can resolve the issue of the blood in the chest, and at the same time, fluid that has been withdrawn can in turn, be analysed in the cytology lab. This may help to determine the cause and give an indication as to whether there is an underlying problem.

Dogs that have been admitted in a crisis situation will need intensive care that could include the following approaches.

• Intravenous fluid therapy
• Blood transfusions
• Oxygen therapy
• Pain medication 
• Vitamin K therapy (in the case of rodenticide poisoning)
• Surgery (often in times of a traumatic injury)

Once your pet has been released from the hospital, he will be sent home with strict instructions for rest. The oxygenation and thoracocentesis received in the clinic should have resolved the problem, but there is a chance of recurrence. In the case of rodent poisoning, the prognosis is usually very positive. Treatment for an underlying problem such as neoplasia may require follow- up as part of the protocol because drug therapy and surgery could be in order.