Accumulation of Fluid or Air in the Chest Cavity Average Cost

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What is Accumulation of Fluid or Air in the Chest Cavity?

In horses, the chest cavity is also known as the pleural cavity and is referred to as such by the veterinary community. Sometimes fluid or air can fill the cavity when it shouldn’t or may contain more than it should.  If this happens, or you just suspect it, it is a medical emergency that needs to be addressed by a veterinarian immediately. Even in the best case scenarios, prognosis remains guarded due to it being that serious of a condition.

If your horse is having breathing issues, seems to be in pain, or is very weak you need to contact your veterinarian immediately.  Any time the respiratory system is involved, it is a medical emergency, especially if you suspect there is fluid or air in the chest.

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Symptoms of Accumulation of Fluid or Air in the Chest Cavity in Horses

Symptoms may include:

  • Respiratory difficulties
  • Rapid breathing
  • Shallow breathing
  • Labored inhalation
  • Shortness of breath 
  • Noise associated with breathing (grunting, whining)
  • Weakness 
  • Heart sounds may be muffled or absent upon auscultation 


If your horse has air accumulation in his chest, he has what is known as pneumothorax.  In regards to fluid in the chest, there are different terms used depending on the fluid in the pleural cavity.  If there is blood in the chest, it is known as hemothorax.  If the fluid is an accumulation of high-triglyceride lymphatic fluid, it is known as chylothorax.  Hydrothorax is when clear fluid accumulates in the pleural cavity.

Causes of Accumulation of Fluid or Air in the Chest Cavity in Horses

Depending on which fluid is present in your horse’s chest, the cause can differ.  If there is clear fluid in the pleural cavity, it may indicate your horse is experiencing an interference with blood flow or lymph drainage flow.  If there is blood in the pleural cavity, it is typically caused by trauma to the chest, clotting disorders, or tumors.  In the rare case the fluid is high-triglyceride lymphatic fluid, the cause could be from rupture of a chest duct or the cause may remain unknown.  One negative aspect of the chest tube is that it can actually lead to pneumothorax if not monitored carefully. Air in the pleural cavity is typically caused by trauma or may occur acutely without an obvious cause.

Diagnosis of Accumulation of Fluid or Air in the Chest Cavity in Horses

The veterinarian will start by performing a complete physical exam on your horse.  While the problem seems to be in his chest, she will always do a complete check to look for other issues or possible causes.  When auscultating his chest, she will listen how his heart sounds, how his lungs sound, and even how his gut sounds.  When she hears abnormal noises, this will lead her to suggest a radiograph.  The image will allow her to see if there is fluid or air in the pleural cavity.

Depending on what the radiograph shows, it may lead the veterinarian to take a sample of the fluid in your horse’s chest.  The fluid removed from the chest can be used for diagnostics.  It will be cultured to see if any bacteria are found within it, or if any other microorganisms are present.  The veterinary caregiver will also make her own evaluation of the fluid to note the color, consistency, odor, and volume.  She may also look at the sample under a microscope so she can see if and what types of cells are present in the fluid.  

Blood work should be performed to assess possible causes of your horse’s symptoms.  A chemistry panel and complete blood count are the basic tests she will suggest.  The results will give her an idea of what is going on internally in your horse.  It will also give her a guideline of what treatments need to be started.

Treatment of Accumulation of Fluid or Air in the Chest Cavity in Horses

Ultrasonography is one tool the veterinarian may utilize when wanting to remove fluid from the chest.  This will allow her to find the best entrance point for her needle and will ensure she does not puncture anything vital.  Depending on the amount of fluid in your horse’s pleural cavity, the veterinarian may just remove it with a needle and syringe or she make opt to place a chest tube in order to allow for smoother and more controlled fluid removal.  When draining the fluid, she will take a great deal of caution to ensure she does not drain the fluid too quickly.  If this occurs, it can lead to a number of other medical conditions. The drain can be removed or the veterinarian can secure it in place to allow for continual drainage.  She may want to take another radiograph once the fluid has been removed to assess the lungs.  

If there is air in the chest, treatment involves slow evacuation of the air over time.  She may elect to put your horse on oxygen therapy. This may seem counterintuitive, but it will help the body reabsorb and allow the capillaries in the region to work four to six times better. Antimicrobial and antibacterial medication will also be prescribed in either of these conditions.

Recovery of Accumulation of Fluid or Air in the Chest Cavity in Horses

If your suspect your horse has air or fluid in his pleural cavity it needs to be treated as a medical emergency.  Even if you seek immediate veterinary attention, his prognosis is guarded.  The veterinarian will do her best to save your horse, but sometimes it just cannot be done.  If you are unable to load your horse very well, it is always a good idea to have an emergency mobile veterinarian you trust.