By Kerry McKinney, DVM

Iris is a 6 month old Borzoi Sighthound, a breed which traces back to the 1600s and Russian nobility. Also known as Russian Wolfhounds, they were originally bred to hunt by sight on cold plains.

Today’s dogs retain the prized characteristics of speed, strength, a luxurious coat, and a courageous yet gentle temperament. With a fine pedigree, field champion parents, and a startling abundance of playful puppy energy, Iris was everything her owner, Meaghan (a Veterinary Assistant at Ann Arbor Animal Hospital), hoped—until she wasn’t quite herself one evening.

By the following morning the usually bouncy pup seemed lethargic and painful and refused her breakfast. A closer look revealed an increased respiratory rate and effort. Suspecting the flu or pneumonia, Meaghan quickly brought Iris to Dr. Critchfield at AAAH for evaluation. A thorough exam revealed a fever of 106.3F, a very painful sternum, and both increased respiratory rate and effort. Chest x-rays hinted at something much worse than pneumonia; it was possible Iris had a pyothorax, a life-threatening accumulation of infected fluid (“pus”) in her chest.

In addition to high doses of intravenous antibiotics and fluid support, standard management of pyothorax includes a CT scan to look for foreign material or an abscess, possible thoracic surgery, placement of chest tubes, and 24-hour advanced nursing care and monitoring. Iris’ best chance was at MSU’s College of Veterinary Medicine, and within the hour she and Meaghan were on their way from Ann Arbor to East Lansing.

Iris arrived at MSU-CVM looking like you might expect for a young pup with a chest filling up with pus. Her increasing effort to breathe and weakness were obvious, and the foul, bloody fluid found via thoracocentesis (chest tap), confirmed the worst. The recommended diagnostics and treatment plan came with a $6-10,000 price tag and no guarantees.

Meaghan had a decision to make.

Since she hadn’t yet purchased health insurance for Iris, MSU’s cost was beyond reach; that’s when she called AAAH and spoke to me.

Even with 29 years of experience, almost 5 of them with the Critical Care and Emergency service at AAAH, I hadn’t fully managed a case of pyothorax. This really was a situation for advanced imaging and boarded specialists—preferably an experienced thoracic surgeon and internal medicine criticalist. So, despite the fact that I immediately agreed to do everything I could to help save Iris, I also shared my trepidation and concerns with Meaghan. The plan MSU had recommended was absolutely correct; without a CT scan we wouldn’t know for sure if Iris required surgery, and if that were the case my experience wasn’t going to be enough.

Continue to Part 2…