• Placement of an indwelling chest drain during or after thoracotomy to remove air/fluid or for thoracic lavage.

• Can be used post-operatively after thoracic surgery, eg thymoma removal, lung lobectomy.

⚠️Rarely performed and few descriptions of its use in rabbits (indications rare).

⚠️This technique is not optimized for rabbits (adapted from dogs and cats) and the rate of efficacy/failure has not been studied.

• Rarely used to manage thoracic disease or for thoracic lavage, but can be considered for severe, recurrent pneumothorax, pleural effusions non-responsive to medical therapy, or pyothorax.

Advantages

• Removal of pneumothorax/pleural effusion post-operatively.
• Avoids the need for repeated thoracocentesis.
• Provides an opportunity to instill local anesthetic post-operatively.
• Allows thoracic lavage of pyothorax.

Disadvantages

• Requires anesthesia and can prolong surgical time.
• Prolongs hospitalization and increases
• Requires regular post-operative management and monitoring.

• Increased risk of infection the longer the drain is in place.
• Potential for iatrogenic pneumothorax if improperly positioned or not maintained.
• Risks include phrenic nerve irritation, Horner’s syndrome, and cardiac arrhythmias.
• Risk of lung injury from excessive pressure during drainage.

⚠️Rarely performed and few descriptions of its use in rabbits (indications rare).

• Intermittent needle thoracocentesis should be performed as part of stabilization for an acutely dyspneic patient and may be sufficient alone in many cases of pneumothorax/pleural effusion. It is also a diagnostic procedure.

Preparation

• 10 min.

Procedure

• 15-30 min.

Criteria for choosing test/procedure

• Post-operative ventral sternotomy or prior to closure of lateral thoracotomy, most commonly after thymoma resection/removal Thorax: thoracotomy.

Risk assessment

• Consider the temperament of the patient, as poor post-operative management or removal by the patient can cause pneumothorax and post-operative infection.

Refereed papers

• Recent references from PubMed and VetMedResource.
• Levshin S, Eshar D & Naor A (2016) Idiopathic chylothorax in a pet rabbit (Oryctolagus cuniculus). Comp Anim 21 (9), 534-537 VetMedResource.
• Künzel F, Hittmair K M, Hassan J et al (2012) Thymomas in rabbits: clinical evaluation, diagnosis, and treatment. J Am Anim Hosp Assoc 48 (2), 97-104 PubMed.
• Clippinger T L, Bennett R A, Alleman A R et al (1998) Removal of a thymoma via median sternotomy in a rabbit with recurrent appendicular neurofibrosarcoma. JAVMA 213 (8), 1140-1143 PubMed.

Other sources of information

• Lewis W (2013) Mediastinal Masses and Other Thoracic Surgery. In: BSAVA Manual of Rabbit Surgery, Dentistry and Imaging. Eds: Harcourt-Brown F & Chitty J. BSAVA, UK. pp 257-268.