This includes PTX (open, closed, tension), hemothorax (HTX), and diaphragmatic hernia. A restrictive breathing pattern is the classic presentation—shallow, rapid respiration with muffled lung and/or heart sounds. Auscult the chest for decreased lung sounds over most of the thorax, which suggests either fluid (blood) or air in the pleural space, pulmonary contusions, or diaphragmatic hernia.
Figure 29. Location for Needle Thoracocentesis.
Figure 29 shows anatomic location for needle thoracocentesis in dogs, with the dog in lateral or sternal recumbency, and the needle inserted generally on the mid-lateral thorax between the 6th to 8th intercostal space. Count forward from the last rib (#13; red dotted line) to find the insertion site.
Table 8. Needle Thoracocentesis.
Immediate placement of a thoracostomy tube is indicated if negative pressure cannot be achieved with needle thoracocentesis, if large amounts of blood are aspirated, or if repeated thoracocenteses are required to maintain negative pleural pressure.
Figure 30. Anatomic Orientation for Chest Tube Placement.
Figure 30 shows correct placement of a chest tube on the lateral aspect of the chest in a dog, with the tube penetrating the skin at the 9th to 11th intercostal space (ICS), tunneling cranioventrally to penetrate the chest wall at the 7th to 8th ICS, directed toward the olecranon of the elbow. Photo courtesy of Dr. Tim Hackett.