Pleural effusion in horses refers to the accumulation of excess fluid within the pleural cavity, the space between the lungs and the chest wall. This condition can result from various causes, including infections, trauma, neoplasia, or heart disease. The presence of pleural effusion can lead to respiratory distress, as the fluid restricts lung expansion and reduces the efficiency of gas exchange. Diagnostic evaluation typically involves clinical examination, imaging techniques such as ultrasound or radiography, and thoracocentesis to analyze the pleural fluid. This page compiles peer-reviewed research studies and scholarly articles that explore the etiology, diagnostic approaches, and management strategies for pleural effusion in equine patients.
Johns I, McParland T, Mair T.Pleural effusion (PE) is reported to occur most commonly secondary to bacterial pneumonia or lung abscesses, with neoplastic effusions contributing the minority of cases. The majority of these reports originate from America and Australia, where long distance transport of horses, a recognised risk factor, appears to occur more frequently. Anecdotally, neoplastic PE is more commonly diagnosed in the UK. Objective: To describe the causes of PE in horses resident in the UK, and to identify potential markers that can help differentiate between infectious and neoplastic causes of PE. Methods: Retros...
Tomlinson JE, Reef VB, Boston RC, Johnson AL.Fibrinous parapneumonic pleural effusions are associated with decreased efficacy of pleural fluid drainage and increased risk of medical treatment failure in people, but similar associations have not been established in horses. Objective: We hypothesized that fibrin deposition in the pleural cavity of horses with parapneumonic effusions increases the risk of poor outcome. Methods: Seventy four horses with bacterial pleuropneumonia diagnosed by culture and cytology of tracheal aspirates, pleural fluid, or both, and pleural effusion diagnosed by ultrasonographic examination. Methods: Retrospecti...
Graubner C, Gerber V, Imhasly A, Gorgas D, Koch C.Three horses (age 17 - 23 years) were referred to the equine clinic of the University of Berne due to colic, fever, tachycardia and tachypnea. All horses showed pleural effusion. Clinical findings in 2 of the horses were highly suggestive of an intra-thoracic esophageal perforation. Severe septic pleuropneumonia without suspicion of an esophageal lesion was diagnosed in the 3rd horse. In addition, an 11 year old stallion was referred to the equine clinic for treatment of a presumptive large colon impaction. The horse was given laxatives after nasogastric intubation. Subsequent dramatic clinica...
Axon JE, Russell CM, Begg AP, Adkins AR.A 10-month-old Thoroughbred filly was presented with a 2-month history of recurrent fever and pleural effusion. Major clinical findings were pyrexia and congested mucous membranes. Clinical pathology tests revealed an erythrocytosis, hyperfibrinogenaemia and hyperglobulinaemia. Pleural fluid was seen on ultrasonographic examination of the thorax and analysis of a thoracocentesis sample indicated a lymphocytic, modified transudate. A transtracheal aspirate was normal. The erythrocytosis persisted despite IV fluid therapy. Arterial blood gas analysis and bone marrow aspirate were normal. These f...
De Clercq D, van Loon G, Lefère L, Deprez P.An ultrasound examination of the thorax of three horses which were performing poorly or had mild signs of colic showed that they had a cranial mediastinal mass and a pleural effusion. A cytological examination of the pleural fluid showed that it did not contain neoplastic cells. A histological examination of an ultrasound-guided core biopsy of the cranial mediastinal mass showed that in each of the three horses it was a lymphosarcoma.
Stoica G, Cohen N, Mendes O, Kim HT.Mesotheliomas are rarely reported in animal species. In this report, the occurrence of a diffuse, metastatic mesothelioma in a 6-year-old gray Arabian mare is described. The mare was presented on clinical examination with ascites, bilateral pleural effusion, and pleural roughening. Necropsy revealed abundant fluid in the abdominal and thoracic cavities. The surface of all organs was thick and fibrosed with multiple raised nodules and hemorrhages. Histology was characteristic of a generalized, biphasic mesothelioma with vascular and lymph nodes metastases. It is believed that the primary tumor ...
Collins MB, Hodgson DR, Hutchins DR.Case records of 43 horses with pleural effusion associated with acute pleuropneumonia, chronic pleuropneumonia, or pleuritis secondary to a penetrating thoracic wound were reviewed to determine the predisposing factors, diagnosis, and treatment of this condition. Acute pleuropneumonia was diagnosed in 36 horses, the majority of which were Thoroughbreds (89%). Of 22 (61%) horses that were in race training at the onset of illness, 11 (31%) had been recently transported a long distance and 4 (11%) had evidence of exercise-induced pulmonary hemorrhage. Physical examination findings and hematologic...
Garber JL, Reef VB, Reimer JM.Sonographic findings correlated with necropsy findings in 8 of 9 horses in which the cranial portion of the mediastinum was evaluated by use of both methods. Cranial mediastinal masses were imaged as multilobular and homogeneously hypoechoic; a complex echogenic pattern was observed with necrosis within the mass. Pleural effusion was a common finding in horses with mediastinal lymphosarcoma. Cytologic evaluation of pleural fluid samples was useful in diagnosis of lymphosarcoma in 10 of 12 horses that had thoracentesis. Sonographic examination of the thorax and cranial portion of the mediastinu...
Reef VB, Boy MG, Reid CF, Elser A.The results of radiography and ultrasonography were compared on 56 horses and cows with lower respiratory tract disease. Ultrasonography was more sensitive than radiography for the detection of small pleural effusions and consolidations in large animals. The side of the thorax affected and the character of the pleural fluid and lung in large animals with pleural effusion can be evaluated ultrasonographically. The periphery of the lung must be affected to characterize pulmonary lesions ultrasonographically. Radiography is the best technique to characterize lesions deep within the lung when the ...
Prater PE, Patton CS, Held JP.Pleural effusion, secondary to a metastasis from a malignant hepatoblastoma, was diagnosed in a 3-year-old Appaloosa gelding. Severe hemorrhagic transudate in both pleural cavities resulted in acute onset of labored breathing, tachypnea, tachycardia, and jugular vein pulsation. Results of ultrasonography and radiography of the ventral lung field and cranial portion of the abdomen initially were nondiagnostic, as were results of cytologic examination of peritoneal fluid and tracheal wash specimens. Moderately high serum gamma-glutamyl transferase and alkaline phosphatase activities, despite nor...
Stadtbäumer G.Pleural effusion in the horse can be caused by diseases such as pneumonia, trauma, pulmonary abscesses and thoracic neoplasms. Besides clinical (auscultation, percussion) and radiographic diagnostic procedures, the ultrasonic examination represents a method that supplies detailed information on quantity and location of fluid in the pleural space. By means of ultrasonic examination the most favourable position for a thoracentesis can be determined. Control of thoracentesis' efficiency as well as exact supervision of the disease's course are made feasible by repeated sonographic examinations.
Mair TS, Lane JG, Lucke VM.The clinical and post mortem features of 11 cases of lymphosarcoma involving the thoracic cavity are reviewed. The clinical findings included inappetence, weight loss, pectoral oedema, dyspnoea, pleural effusion and distension of the jugular veins. Dysphagia was present in three cases. At post mortem examination lesions were found in the abdomen as well as the chest in eight cases; clinical signs of abdominal disease were present in two cases. The features of nine other similar cases recorded in the literature are reviewed.
Morris DD, Acland HM, Hodge TG.An 11-year-old Quarter Horse mare was presented with ventral edema and pleural effusion, secondary to a disseminated ovarian adenocarcinoma. Bilateral thoracocentesis yielded 30 L of thin, blood-tinged fluid, which was a modified transudate. Cytologic examination of the fluid revealed large atypical cells, suggestive of carcinomatous neoplasia. Similar cells were found in the peritoneal fluid. The mare was euthanatized. Necropsy revealed a 35-cm diameter mass in the cranial mediastinum, ventral to the trachea. The left ovary was 25 cm in diameter and most of the parenchyma was replaced by red ...
Raphel CF, Beech J.Of 122 horses with pleural effusion, 90 (73.8%) had pleuritis secondary to pneumonia or lung abscessation. Fifty-one horses died or were euthanatized. The highest prevalence was in Thoroughbred and Standardbred racehorses. Eleven (12.2%) horses were postsurgical patients and 22 (24.4%) horses had been transported over 500 miles. There was no relationship between final outcome and the age, sex, breed, hematologic values, or laboratory findings pertaining to pleural fluid except for the bacterial isolation of Escherichia coli from the pleural fluid, as this was more frequently associated with de...
Smith BP.Pleural effusion in 37 horses, including 15 acutely affected and 22 chronically affected, was found to be due to a variety of causes, including lymphocarcoma, pulmonary granulomas, coccidioidomycosis, equine infectious anemia, pulmonary abscesses, chronic pneumonia, and primary septic pleural effusion. Age, breed, or sex predilection was not found. Horses with chronic disease had weight loss, increased respiratory rate, dull respiratory sounds in the ventral portion of the thorax, and varying degrees of anorexia. Many horses were anemic. Those acutely affected had respiratory distress or signs...
Raphel CF, Beech J.Of 122 horses with pleural effusion, 90 (73.8%) had pleuritis secondary to pneumonia or lung abscessation. Fifty-one horses died or were euthanatized. The highest prevalence was in Thoroughbred and Standardbred racehorses. Eleven (12.2%) horses were postsurgical patients and 22 (24.4%) horses had been transported over 500 miles. There was no relationship between final outcome and the age, sex, breed, hematologic values, or laboratory findings pertaining to pleural fluid except for the bacterial isolation of Escherichia coli from the pleural fluid, as this was more frequently associated with de...
Reef VB, Boy MG, Reid CF, Elser A.The results of radiography and ultrasonography were compared on 56 horses and cows with lower respiratory tract disease. Ultrasonography was more sensitive than radiography for the detection of small pleural effusions and consolidations in large animals. The side of the thorax affected and the character of the pleural fluid and lung in large animals with pleural effusion can be evaluated ultrasonographically. The periphery of the lung must be affected to characterize pulmonary lesions ultrasonographically. Radiography is the best technique to characterize lesions deep within the lung when the ...
Collins MB, Hodgson DR, Hutchins DR.Case records of 43 horses with pleural effusion associated with acute pleuropneumonia, chronic pleuropneumonia, or pleuritis secondary to a penetrating thoracic wound were reviewed to determine the predisposing factors, diagnosis, and treatment of this condition. Acute pleuropneumonia was diagnosed in 36 horses, the majority of which were Thoroughbreds (89%). Of 22 (61%) horses that were in race training at the onset of illness, 11 (31%) had been recently transported a long distance and 4 (11%) had evidence of exercise-induced pulmonary hemorrhage. Physical examination findings and hematologic...
Prater PE, Patton CS, Held JP.Pleural effusion, secondary to a metastasis from a malignant hepatoblastoma, was diagnosed in a 3-year-old Appaloosa gelding. Severe hemorrhagic transudate in both pleural cavities resulted in acute onset of labored breathing, tachypnea, tachycardia, and jugular vein pulsation. Results of ultrasonography and radiography of the ventral lung field and cranial portion of the abdomen initially were nondiagnostic, as were results of cytologic examination of peritoneal fluid and tracheal wash specimens. Moderately high serum gamma-glutamyl transferase and alkaline phosphatase activities, despite nor...
Stoica G, Cohen N, Mendes O, Kim HT.Mesotheliomas are rarely reported in animal species. In this report, the occurrence of a diffuse, metastatic mesothelioma in a 6-year-old gray Arabian mare is described. The mare was presented on clinical examination with ascites, bilateral pleural effusion, and pleural roughening. Necropsy revealed abundant fluid in the abdominal and thoracic cavities. The surface of all organs was thick and fibrosed with multiple raised nodules and hemorrhages. Histology was characteristic of a generalized, biphasic mesothelioma with vascular and lymph nodes metastases. It is believed that the primary tumor ...
Axon JE, Russell CM, Begg AP, Adkins AR.A 10-month-old Thoroughbred filly was presented with a 2-month history of recurrent fever and pleural effusion. Major clinical findings were pyrexia and congested mucous membranes. Clinical pathology tests revealed an erythrocytosis, hyperfibrinogenaemia and hyperglobulinaemia. Pleural fluid was seen on ultrasonographic examination of the thorax and analysis of a thoracocentesis sample indicated a lymphocytic, modified transudate. A transtracheal aspirate was normal. The erythrocytosis persisted despite IV fluid therapy. Arterial blood gas analysis and bone marrow aspirate were normal. These f...
Tomlinson JE, Reef VB, Boston RC, Johnson AL.Fibrinous parapneumonic pleural effusions are associated with decreased efficacy of pleural fluid drainage and increased risk of medical treatment failure in people, but similar associations have not been established in horses. Objective: We hypothesized that fibrin deposition in the pleural cavity of horses with parapneumonic effusions increases the risk of poor outcome. Methods: Seventy four horses with bacterial pleuropneumonia diagnosed by culture and cytology of tracheal aspirates, pleural fluid, or both, and pleural effusion diagnosed by ultrasonographic examination. Methods: Retrospecti...
Mair TS, Lane JG, Lucke VM.The clinical and post mortem features of 11 cases of lymphosarcoma involving the thoracic cavity are reviewed. The clinical findings included inappetence, weight loss, pectoral oedema, dyspnoea, pleural effusion and distension of the jugular veins. Dysphagia was present in three cases. At post mortem examination lesions were found in the abdomen as well as the chest in eight cases; clinical signs of abdominal disease were present in two cases. The features of nine other similar cases recorded in the literature are reviewed.
Smith BP.Pleural effusion in 37 horses, including 15 acutely affected and 22 chronically affected, was found to be due to a variety of causes, including lymphocarcoma, pulmonary granulomas, coccidioidomycosis, equine infectious anemia, pulmonary abscesses, chronic pneumonia, and primary septic pleural effusion. Age, breed, or sex predilection was not found. Horses with chronic disease had weight loss, increased respiratory rate, dull respiratory sounds in the ventral portion of the thorax, and varying degrees of anorexia. Many horses were anemic. Those acutely affected had respiratory distress or signs...
Morris DD, Acland HM, Hodge TG.An 11-year-old Quarter Horse mare was presented with ventral edema and pleural effusion, secondary to a disseminated ovarian adenocarcinoma. Bilateral thoracocentesis yielded 30 L of thin, blood-tinged fluid, which was a modified transudate. Cytologic examination of the fluid revealed large atypical cells, suggestive of carcinomatous neoplasia. Similar cells were found in the peritoneal fluid. The mare was euthanatized. Necropsy revealed a 35-cm diameter mass in the cranial mediastinum, ventral to the trachea. The left ovary was 25 cm in diameter and most of the parenchyma was replaced by red ...
Stadtbäumer G.Pleural effusion in the horse can be caused by diseases such as pneumonia, trauma, pulmonary abscesses and thoracic neoplasms. Besides clinical (auscultation, percussion) and radiographic diagnostic procedures, the ultrasonic examination represents a method that supplies detailed information on quantity and location of fluid in the pleural space. By means of ultrasonic examination the most favourable position for a thoracentesis can be determined. Control of thoracentesis' efficiency as well as exact supervision of the disease's course are made feasible by repeated sonographic examinations.
Johns I, McParland T, Mair T.Pleural effusion (PE) is reported to occur most commonly secondary to bacterial pneumonia or lung abscesses, with neoplastic effusions contributing the minority of cases. The majority of these reports originate from America and Australia, where long distance transport of horses, a recognised risk factor, appears to occur more frequently. Anecdotally, neoplastic PE is more commonly diagnosed in the UK. Objective: To describe the causes of PE in horses resident in the UK, and to identify potential markers that can help differentiate between infectious and neoplastic causes of PE. Methods: Retros...
Garber JL, Reef VB, Reimer JM.Sonographic findings correlated with necropsy findings in 8 of 9 horses in which the cranial portion of the mediastinum was evaluated by use of both methods. Cranial mediastinal masses were imaged as multilobular and homogeneously hypoechoic; a complex echogenic pattern was observed with necrosis within the mass. Pleural effusion was a common finding in horses with mediastinal lymphosarcoma. Cytologic evaluation of pleural fluid samples was useful in diagnosis of lymphosarcoma in 10 of 12 horses that had thoracentesis. Sonographic examination of the thorax and cranial portion of the mediastinu...
Graubner C, Gerber V, Imhasly A, Gorgas D, Koch C.Three horses (age 17 - 23 years) were referred to the equine clinic of the University of Berne due to colic, fever, tachycardia and tachypnea. All horses showed pleural effusion. Clinical findings in 2 of the horses were highly suggestive of an intra-thoracic esophageal perforation. Severe septic pleuropneumonia without suspicion of an esophageal lesion was diagnosed in the 3rd horse. In addition, an 11 year old stallion was referred to the equine clinic for treatment of a presumptive large colon impaction. The horse was given laxatives after nasogastric intubation. Subsequent dramatic clinica...
De Clercq D, van Loon G, Lefère L, Deprez P.An ultrasound examination of the thorax of three horses which were performing poorly or had mild signs of colic showed that they had a cranial mediastinal mass and a pleural effusion. A cytological examination of the pleural fluid showed that it did not contain neoplastic cells. A histological examination of an ultrasound-guided core biopsy of the cranial mediastinal mass showed that in each of the three horses it was a lymphosarcoma.
