Video-assisted thoracoscopic-guided reduction and external stabilisation of traumatic rib fractures in a cat.

Abstract

Case summary: An 11-year-old male neutered domestic longhair cat was presented to an emergency referral hospital after sustaining severe injuries isolated to the thorax after a dog attack. Initial stabilisation included oxygen supplementation, intravenous fluid therapy, point-of-care ultrasound (POCUS), serial blood gas analyses, thoracic and abdominal radiographs, opioid analgesics and broad-spectrum antibiotics. CT revealed multiple internally displaced rib fractures that punctured through the mediastinum and were in intimate proximity to the cranial vena cava and proximal aortic arch. Video-assisted thoracoscopic surgery (VATS) was performed using a 2.7 mm 0° short laparoscope to place a custom-made fibre glass splint via percutaneous suturing to accurately reduce the rib fracture fragments without further damage to the intrathoracic structures. The splint remained in place for 6 weeks. At the 8-week recheck, the cat had no evidence of cardiovascular or respiratory compromise and was able to resume normal activity. A long-term follow-up phone call was conducted at 14 months postoperatively. The owner reported that the patient has continued to do well without any complications.

Relevance and novel information: To the authors' knowledge, this is the first report using VATS for the reduction of traumatic rib fractures in a cat. This case highlights the feasibility and success of this method and is a viable option in future clinical cases.