Standing Lateral Thoracotomy in Horses: Indications, Complications, and Outcomes

Objective To describe the indications for, complications arising from, and outcome of horses that had standing lateral thoracotomy for pleural or pericardial disease. Study Design Case series. Animals Horses (n=16). Methods Medical records (January 1990-December 2008) of sedated standing horses that had lateral thoracotomy were reviewed. Clinical and surgical findings, perioperative and short-term complications were recorded. Long-term (> 6 months) outcome was determined through telephone conversations with owners and veterinarians. Results Mean (+/- SD) horse age was 6.6 +/- 5.3 years (range, 1-15 years). Thoracotomy was most commonly for treatment of recurrent or chronic pleural infection (94%). Anaerobic bacteria were frequently isolated from pleural effusion associated with pleuropneumonia (63%). Right lateral intercostal thoracotomy was performed in 13 horses (82%); intercostal muscle myectomy in 5 horses; and rib resection in 1. Perioperative complications were hemipneumothorax (2 horses) and short-term complications included cellulitis and abscessation of the thoracotomy site (6 horses). Fourteen (88%) horses survived to discharge and 46% of horses that survived returned to their previous level of athletic activity. Conclusions Lateral thoracotomy is well tolerated by standing sedated horses with minimal perioperative and short-term complications. Clinical Relevance Standing lateral thoracotomy should be considered for the treatment of complicated pleuropneumonia in horses.