Ultrasound-guided minimally invasive thoracotomy for removal of migrating grass Awn in a Cat

Abstract

Migrating grass awns are a rare cause of thoracic reactions in cats, resulting in pleural effusion, inflammation, infection and granulomatous responses. Diagnosis and localization are challenging, and treatment commonly requires invasive surgical intervention. We report a case of a 5-year-old, neutered male, domestic shorthair cat referred for pleural effusion and suspected intrathoracic vegetal foreign body. Thoracic ultrasonography confirmed the presence of pleural effusion and a linear hyperechoic structure within the pleural space was visualized. An ultrasound-guided minimally invasive thoracotomy was performed through the right fifth intercostal space and intraoperative ultrasonography was useful to precisely locate and remove the foreign body using a Hartmann ear forceps. Cytological analysis was performed on the pleural fluid and bacteriological analysis was performed on both the pleural fluid and the retrieved foreign body. The cytologic findings were consistent with an exudative effusion but no bacteria were isolated on both direct and enrichment bacterial cultures; empirical antibiotic treatment with marbofloxacin was continued. The patient recovered uneventfully, and follow-up revealed complete resolution of the clinical signs. This case report highlights the effectiveness of ultrasound-guided minimally invasive approach for intrathoracic vegetal foreign body removal in a cat. The transthoracic and intraoperative ultrasound can be useful for visualization and exact localization of the grass awn, minimizing surgical trauma and improving the outcome.

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