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Fenestrated over-the-needle catheter fracture during thoracocentesis in a cat
Brigid K Lemburg1, Julie M Walker1
1Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, USA.
Insights
A fractured catheter fragment was left in a cat's pleural space during treatment for heart failure. No immediate complications were noted, but the cat later decompensated.
Area of Science:
- Veterinary Medicine
- Cardiology
- Surgical Complications
Background:
- A 6-year-old domestic shorthair cat presented with recurrent pleural effusion, atrial fibrillation, and suspected congestive heart failure.
- The cat underwent thoracocentesis for fluid removal.
Observation:
- A fenestrated over-the-needle catheter fractured during the procedure.
- A catheter fragment remained within the patient's left pleural space.
- No immediate complications were observed related to the retained fragment.
Findings:
- The cat acutely decompensated later in its treatment course and was euthanized.
- This case represents a rare event in veterinary medicine, with no prior reports of fractured over-the-needle catheters with retained pleural fragments.
- Human cases demonstrate successful management with and without fragment removal.
Implications:
- The decision for surgical intervention in veterinary medicine requires careful consideration of potential morbidity versus the patient's tolerance for invasive procedures.
- This case highlights the importance of vigilance for iatrogenic complications during invasive procedures.
- Further research may be warranted to establish best practices for managing retained foreign bodies in the pleural space in veterinary patients.
Case Summary:
A 6-year-old castrated male domestic shorthair cat was evaluated for recurrent pleural effusion, atrial fibrillation and suspected congestive heart failure. During thoracocentesis, the fenestrated over-the-needle catheter became fractured and a catheter fragment remained in the patient's left pleural space. Later in the course of treatment, the patient acutely decompensated and was euthanized. There were no immediately observed complications associated with the retained catheter fragment.
Relevance And Novel Information:
To the authors' knowledge, there are no reports of over-the-needle catheter fractures with retained pleural catheter fragments in veterinary medicine. Similar cases in humans have been successfully managed with and without removal of catheter fragments. In veterinary medicine, the decision to attempt removal of a catheter fragment must consider both the likelihood of related morbidity and the patient's ability to tolerate an invasive procedure.
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