{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T21:11:49Z","timestamp":1780434709094,"version":"3.54.1"},"reference-count":62,"publisher":"American Veterinary Medical Association (AVMA)","issue":"5","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["javma"],"published-print":{"date-parts":[[2026,5,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate clinical features and potential risk factors in dogs surgically treated for pyothorax.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Medical records from 41 private referral hospitals were retrospectively searched for dogs that underwent thoracic surgery and had pyothorax diagnosed via cytologic or microbiologic review of pleural fluid samples. Data regarding signalment, clinical factors, perioperative complications, and outcomes were collected. Univariable logistic regressions were used to estimate ORs and test for the effects of risk factors on postoperative hospitalization duration, major complications, and survival to discharge. Log-likelihood\n                      <jats:italic>P<\/jats:italic>\n                      values and ORs with profile-likelihood OR confidence limits were reported.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>157 client-owned dogs were included. A total of 140 dogs (89%) survived to discharge. Neither duration of signs (OR, 0.98; 95% CI, 0.95 to 102) nor preoperative hospitalization (OR, 0.85; 95% CI, 0.66 to 1.13) was associated with survival. Of the 157 dogs, 67 (43%) were noted to have complications requiring additional therapy. Abscessation was associated with shorter postoperative hospitalization duration compared to any other pyothorax etiology. Increased age (OR, 0.81; 95% CI, 0.69 to 0.95), hyperglobulinemia (OR, 0.54; 95% CI, 0.32 to 0.89), and increasing leukocyte count (OR, 0.92; 95% CI, 0.88 to 0.96) were associated with decreased odds of survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Survival outcomes following thoracic surgery were good despite a high complication rate. Chronicity of disease prior to surgery for pyothorax may not have affected outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance<\/jats:title>\n                    <jats:p>Risk factors associated with outcomes of canine pyothorax may guide treatment decisions for clinicians and clients. Careful case selection is indicated to determine which patients may benefit most from surgical intervention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2460\/javma.25.07.0497","type":"journal-article","created":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T20:18:02Z","timestamp":1766002682000},"page":"607-615","source":"Crossref","is-referenced-by-count":1,"title":["Timing to surgery was not associated with outcome in dogs undergoing thoracic surgery for pyothorax: clinical findings and risk factors for survival in 157 dogs"],"prefix":"10.2460","volume":"264","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-5285-1699","authenticated-orcid":true,"given":"Danielle J.","family":"Sigua","sequence":"first","affiliation":[{"name":"BluePearl Pet Hospital, Kirkland, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4606-3632","authenticated-orcid":true,"given":"Steven W.","family":"Frederick","sequence":"additional","affiliation":[{"name":"BluePearl Science, Tampa, FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aidan","family":"Chambers","sequence":"additional","affiliation":[{"name":"BluePearl Pet Hospital, Kirkland, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1272","reference":[{"issue":"9","key":"ref1","series-title":"J Small Anim Pract","first-page":"388","article-title":"Canine and feline pyothorax: a retrospective study of 50 cases in the UK and Ireland","volume":"43","author":"Demetriou JL","year":"2002","unstructured":"Demetriou JL, Foale RD, Ladlow J, McGrotty Y, Faulkner J, Kirby BM. Canine and feline pyothorax: a retrospective study of 50 cases in the UK and Ireland. J Small Anim Pract. 2002;43(9):388-394. doi:10.1111\/j.1748-5827.2002.tb00089.x"},{"issue":"1","key":"ref2","series-title":"J Vet Emerg Crit Care (San Antonio)","first-page":"113","article-title":"A clinical review of the pathophysiology, diagnosis, and treatment of pyothorax in dogs and cats","volume":"25","author":"Stillion JR","year":"2015","unstructured":"Stillion JR, Letendre JA. A clinical review of the pathophysiology, diagnosis, and treatment of pyothorax in dogs and cats. J Vet Emerg Crit Care (San Antonio). 2015;25(1):113-129. doi:10.1111\/vec.12274"},{"issue":"5","key":"ref3","series-title":"Vet Clin North Am Small Anim Pract","first-page":"975","article-title":"Medical and surgical management of pyothorax","volume":"37","author":"MacPhail CM","year":"2007","unstructured":"MacPhail CM. Medical and surgical management of pyothorax. Vet Clin North Am Small Anim Pract. 2007;37(5):975-988, vii. doi:10.1016\/j.cvsm.2007.05.012"},{"issue":"1","key":"ref4","series-title":"J Small Anim Pract","first-page":"12","article-title":"Successful medical treatment of 15 dogs with pyothorax","volume":"48","author":"Johnson MS","year":"2007","unstructured":"Johnson MS, Martin MWS. Successful medical treatment of 15 dogs with pyothorax. J Small Anim Pract. 2007;48(1):12-16. doi:10.1111\/j.1748-5827.2006.00235.x"},{"issue":"24","key":"ref5","series-title":"Vet Rec","first-page":"605","article-title":"Surgical or medical management of pyothorax in dogs?","volume":"174","author":"Lee KC","year":"2014","unstructured":"Lee KC. Surgical or medical management of pyothorax in dogs? Vet Rec. 2014;174(24):605-606. doi:10.1136\/vr.g3817"},{"issue":"1","key":"ref6","series-title":"J Am Vet Med Assoc","first-page":"86","article-title":"Medical and surgical treatment of pyothorax in dogs: 26 cases (1991-2001)","volume":"221","author":"Rooney MB","year":"2002","unstructured":"Rooney MB, Monnet E. Medical and surgical treatment of pyothorax in dogs: 26 cases (1991-2001). J Am Vet Med Assoc. 2002;221(1):86-92. doi:10.2460\/javma.2002.221.86"},{"issue":"11","key":"ref7","series-title":"Can Vet J","first-page":"1140","article-title":"Retrospective comparison of costs between medical and surgical treatment of canine pyothorax. Comparaison r\u00e9trospective des co\u00fbts entre le traitement m\u00e9dical et chirurgical d\u2019un pyothorax canin","volume":"56","author":"Bach JF","year":"2015","unstructured":"Bach JF, Balakrishnan A. Retrospective comparison of costs between medical and surgical treatment of canine pyothorax. Comparaison r\u00e9trospective des co\u00fbts entre le traitement m\u00e9dical et chirurgical d\u2019un pyothorax canin. Can Vet J. 2015;56(11):1140-1143."},{"issue":"6","key":"ref8","series-title":"J Am Vet Med Assoc","first-page":"657","article-title":"Evaluation of outcomes in dogs treated for pyothorax: 46 cases (1983-2001)","volume":"236","author":"Boothe HW","year":"2010","unstructured":"Boothe HW, Howe LM, Boothe DM, Reynolds LA, Carpenter M. Evaluation of outcomes in dogs treated for pyothorax: 46 cases (1983-2001). J Am Vet Med Assoc. 2010;236(6):657-663. doi:10.2460\/javma.236.6.657"},{"issue":"5","key":"ref9","series-title":"Ann Thorac Surg","first-page":"1456","article-title":"Outcomes of operative and nonoperative treatment of thoracic empyema: a population-based study","volume":"108","author":"Nayak R","year":"2019","unstructured":"Nayak R, Brogly SB, Lajkosz K, Lougheed MD, Petsikas D. Outcomes of operative and nonoperative treatment of thoracic empyema: a population-based study. Ann Thorac Surg. 2019;108(5):1456-1463. doi:10.1016\/j.athoracsur.2019.05.090"},{"issue":"5","key":"ref10","series-title":"Eur J Cardiothorac Surg","first-page":"642","article-title":"EACTS expert consensus statement for surgical management of pleural empyema","volume":"48","author":"Scarci M","year":"2015","unstructured":"Scarci M, Abah U, Solli P,  EACTS expert consensus statement for surgical management of pleural empyema. 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J Thorac Cardiovasc Surg. 2017;153(6):e129-e146. doi:10.1016\/j.jtcvs.2017.01.030"},{"issue":"6","key":"ref12","series-title":"Ann Thorac Surg","first-page":"1851","article-title":"Delayed referral and gram-negative organisms increase the conversion thoracotomy rate in patients undergoing video-assisted thoracoscopic surgery for empyema","volume":"79","author":"Lardinois D","year":"2005","unstructured":"Lardinois D, Gock M, Pezzetta E,  Delayed referral and gram-negative organisms increase the conversion thoracotomy rate in patients undergoing video-assisted thoracoscopic surgery for empyema. Ann Thorac Surg. 2005;79(6):1851-1856. doi:10.1016\/j.athoracsur.2004.12.031"},{"issue":"11","key":"ref13","series-title":"Ann Am Thorac Soc","first-page":"1827","article-title":"Comparing initial surgery versus fibrinolytics for pleural space infections: a retrospective multicenter cohort study","volume":"19","author":"Wilshire CL","year":"2022","unstructured":"Wilshire CL, Jackson AS, Meggyesy AM,  Comparing initial surgery versus fibrinolytics for pleural space infections: a retrospective multicenter cohort study. Ann Am Thorac Soc. 2022;19(11):1827-1833. doi:10.1513\/AnnalsATS.202108-964OC"},{"issue":"1","key":"ref14","series-title":"BMC Pulm Med","first-page":"160","article-title":"Pleural infection: a retrospective study of clinical outcome and the correlation to known etiology, co-morbidity and treatment factors","volume":"18","author":"Meyer CN","year":"2018","unstructured":"Meyer CN, Armbruster K, Kemp M, Thomsen TR, Dessau RB; Danish Pleural Empyema group. 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Ann Thorac Surg. 2018;105(6):1589-1596. doi:10.1016\/j.athoracsur.2018.02.027"},{"issue":"3","key":"ref16","series-title":"J Thorac Cardiovasc Surg","first-page":"1288","article-title":"Morbidity and 30-day mortality after decortication for parapneumonic empyema and pleural effusion among patients in the Society of Thoracic Surgeons\u2019 General Thoracic Surgery Database","volume":"157","author":"Towe CW","year":"2019","unstructured":"Towe CW, Carr SR, Donahue JM,  Morbidity and 30-day mortality after decortication for parapneumonic empyema and pleural effusion among patients in the Society of Thoracic Surgeons\u2019 General Thoracic Surgery Database. J Thorac Cardiovasc Surg. 2019;157(3):1288-1297.e4. doi:10.1016\/j.jtcvs.2018.10.157"},{"issue":"7","key":"ref17","series-title":"World J Surg","first-page":"1663","article-title":"Definition and Classification of Intraoperative Complications (CLASSIC): Delphi study and pilot evaluation","volume":"39","author":"Rosenthal R","year":"2015","unstructured":"Rosenthal R, Hoffmann H, Clavien PA, Bucher HC, Dell-Kuster S. Definition and Classification of Intraoperative Complications (CLASSIC): Delphi study and pilot evaluation. World J Surg. 2015;39(7):1663-1671. doi:10.1007\/s00268-015-3003-y"},{"issue":"1","key":"ref18","series-title":"Vet Surg","first-page":"61","article-title":"A systematic review of criteria used to report complications in soft tissue and oncologic surgical clinical research studies in dogs and cats","volume":"49","author":"Follette CM","year":"2020","unstructured":"Follette CM, Giuffrida MA, Balsa IM,  A systematic review of criteria used to report complications in soft tissue and oncologic surgical clinical research studies in dogs and cats. Vet Surg. 2020;49(1):61-69. doi:10.1111\/vsu.13279"},{"issue":"1","key":"ref19","series-title":"J Educ Behav Stat","first-page":"60","article-title":"On the adaptive control of the false discovery rate in multiple testing with independent statistics","volume":"25","author":"Benjamini Y","year":"2000","unstructured":"Benjamini Y, Hochberg Y. On the adaptive control of the false discovery rate in multiple testing with independent statistics. J Educ Behav Stat. 2000;25(1):60-83. doi:10.3102\/10769986025001060"},{"issue":"2","key":"ref20","series-title":"World J Surg","first-page":"266","article-title":"Poor late survival after surgical treatment of pleural empyema","volume":"34","author":"Mikkola R","year":"2010","unstructured":"Mikkola R, Kelahaara J, Heikkinen J, Lahtinen J, Biancari F. Poor late survival after surgical treatment of pleural empyema. World J Surg. 2010;34(2):266-271. doi:10.1007\/s00268-009-0324-8"},{"issue":"5","key":"ref21","series-title":"Am J Respir Crit Care Med","first-page":"1682","article-title":"Predictors of outcome and long-term survival in patients with pleural infection","volume":"160","author":"Davies CW","year":"1999","unstructured":"Davies CW, Kearney SE, Gleeson FV, Davies RJ. Predictors of outcome and long-term survival in patients with pleural infection. 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J Clin Invest. 2002;110(5):615-624. doi:10.1172\/JCI0215704"},{"issue":"5","key":"ref24","series-title":"Vet Surg","first-page":"393","article-title":"Evaluation of the sensitivity and specificity of diagnostic criteria for sepsis in dogs","volume":"26","author":"Hauptman JG","year":"1997","unstructured":"Hauptman JG, Walshaw R, Olivier NB. Evaluation of the sensitivity and specificity of diagnostic criteria for sepsis in dogs. Vet Surg. 1997;26(5):393-397. doi:10.1111\/j.1532-950X.1997.tb01699.x"},{"issue":"6","key":"ref25","series-title":"J Am Vet Med Assoc","first-page":"819","article-title":"Risk factors, prognostic indicators, and outcome of pyothorax in cats: 80 cases (1986-1999)","volume":"221","author":"Waddell LS","year":"2002","unstructured":"Waddell LS, Brady CA, Drobatz KJ. Risk factors, prognostic indicators, and outcome of pyothorax in cats: 80 cases (1986-1999). J Am Vet Med Assoc. 2002;221(6):819-824. doi:10.2460\/javma.2002.221.819"},{"issue":"11","key":"ref26","series-title":"J Small Anim Pract","first-page":"959","article-title":"CT findings, management and short-term outcome of dogs with pyothorax: 101 cases (2010 - 2019)","volume":"62","author":"Eiras-Diaz A","year":"2021","unstructured":"Eiras-Diaz A, Frykfors von Hekkel A, Hanot E,  CT findings, management and short-term outcome of dogs with pyothorax: 101 cases (2010 - 2019). J Small Anim Pract. 2021;62(11):959-966. doi:10.1111\/jsap.13374"},{"issue":"4","key":"ref27","series-title":"J Small Anim Pract","first-page":"203","article-title":"Computed tomographic findings in canine pyothorax and correlation with findings at exploratory thoracotomy","volume":"52","author":"Swinbourne F","year":"2011","unstructured":"Swinbourne F, Baines EA, Baines SJ, Halfacree ZJ. Computed tomographic findings in canine pyothorax and correlation with findings at exploratory thoracotomy. J Small Anim Pract. 2011;52(4):203-208. doi:10.1111\/j.1748-5827.2011.01051.x"},{"issue":"2","key":"ref28","series-title":"J Am Vet Med Assoc","first-page":"317","article-title":"Severe bilateral fibrosing pleuritis associated with chronic chylothorax in five cats and two dogs","volume":"201","author":"Fossum TW","year":"1992","unstructured":"Fossum TW, Evering WN, Miller MW, Forrester SD, Palmer DR, Hodges CC. Severe bilateral fibrosing pleuritis associated with chronic chylothorax in five cats and two dogs. J Am Vet Med Assoc. 1992;201(2):317-324. doi:10.2460\/javma.1992.201.02.317"},{"issue":"1","key":"ref29","series-title":"Vet Clin North Am Small Anim Pract","first-page":"161","article-title":"Exudative pleural diseases in small animals","volume":"44","author":"Epstein SE","year":"2014","unstructured":"Epstein SE. Exudative pleural diseases in small animals. Vet Clin North Am Small Anim Pract. 2014;44(1):161-180. doi:10.1016\/j.cvsm.2013.08.005"},{"issue":"3","key":"ref30","series-title":"J Vet Intern Med","first-page":"1155","article-title":"Etiology and effusion characteristics in 29 cats and 60 dogs with pyothorax (2010-2020)","volume":"37","author":"Johnson LR","year":"2023","unstructured":"Johnson LR, Epstein SE, Reagan KL. Etiology and effusion characteristics in 29 cats and 60 dogs with pyothorax (2010-2020). J Vet Intern Med. 2023;37(3):1155-1165. doi:10.1111\/jvim.16699"},{"issue":"3","key":"ref31","series-title":"J Am Vet Med Assoc","first-page":"359","article-title":"Bacteria associated with pyothorax of dogs and cats: 98 cases (1989-1998)","volume":"216","author":"Walker AL","year":"2000","unstructured":"Walker AL, Jang SS, Hirsh DC. Bacteria associated with pyothorax of dogs and cats: 98 cases (1989-1998). J Am Vet Med Assoc. 2000;216(3):359-363. doi:10.2460\/javma.2000.216.359"},{"issue":"9","key":"ref1","series-title":"J Small Anim Pract","first-page":"388","article-title":"Canine and feline pyothorax: a retrospective study of 50 cases in the UK and Ireland","volume":"43","author":"Demetriou JL","year":"2002","unstructured":"Demetriou JL, Foale RD, Ladlow J, McGrotty Y, Faulkner J, Kirby BM. Canine and feline pyothorax: a retrospective study of 50 cases in the UK and Ireland. J Small Anim Pract. 2002;43(9):388-394. doi:10.1111\/j.1748-5827.2002.tb00089.x"},{"issue":"1","key":"ref2","series-title":"J Vet Emerg Crit Care (San Antonio)","first-page":"113","article-title":"A clinical review of the pathophysiology, diagnosis, and treatment of pyothorax in dogs and cats","volume":"25","author":"Stillion JR","year":"2015","unstructured":"Stillion JR, Letendre JA. A clinical review of the pathophysiology, diagnosis, and treatment of pyothorax in dogs and cats. 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