Pleural port: any experience?

Hello!

I have posted about Old Dog before, so some of you may be familiar with his various travails. To give a brief recap: pericardial effusion, after a couple of drains surgery performed to remove most of the pericardium-- sorted.

Now: more effusion, into the chest cavity, constraining the lungs. The diagnosis is idiopathic effusion, but the surgeon is pretty sure it's coming from what's left of the pericardium, and the flesh in his chest wall is just not able to absorb the amount of fluid being produced any more, possibly due to inflammatory tissue or something else but it would be impossible to say without opening him up to have a look. Bottom line is that there is fluid building up in his chest, and it needs getting rid of on a regular basis.

So, after consultation with his cardiologist and her preferred surgeon (she gets to prefer surgeons-- she's That Good) we have opted for a surgical procedure to place a port in his chest. It's basically a tube that goes into his chest cavity with a button on the end that sits just under his skin. It has a silicon bit through which you can insert a special needle, and drain the fluid out. This means we'll be able to do it at home, without subjecting him to vet visits and sedation every time he is poorly. In his case, it'll probably be about every three weeks. It's not a very invasive operation-- basically they just have to poke a hole in him to insert the tube and then situate the button.

I'm just wondering if anyone has any experience with this, and any advice?

I do know that Old Dog is pretty old, and believe you me, we would never consider subjecting him to such a procedure if he was not bright, happy, alert and healthy in all other respects. He has a touch of arthritis, he's deaf as a post, and he has slowed down, as you might expect from a 15 year old Collie-sized mutt. He is loving his life and we want him to hold on to it as long as he wants to.

Your dedication makes me feel a little guilty, as we had an (minimum) 14 year old Lurcher pts with this condition, seven years ago. Mia had been a starvation case, and was never a really robust dog. She was having to be drained weekly, and would begin to lose consciousness when it needed doing. Our vet said that she strongly suspected a tumour in the heart muscle, and did not offer any surgical treatment.
I hope everything goes well for your oldie, and you have a little more time together. Best wishes.

I'm sorry to hear about Mia, Carole. It sounds like our situations are quite different. The vets did say that they wouldn't consider putting a dog Berkeley's age through surgery if there was much else wrong with him, and if he wasn't as strong as he is... he's always been a very healthy dog. Mia's condition sounds like it was much worse. I think in your situation I would have had to make the same decision, sad and horrible though it is to have to do that.

Hello SC I have no experience of this particular procedure but it sounds painless and pretty straightforward. I would think the main consideration (as with any similar opening) it keeping the bacteria out and I am sure your vet will advise on this.

Yes, infection is the main consideration. That's the point of keeping the button under the skin: nothing is exposed, so as to minimise that risk as much as possible, at least of things getting in from the outside. There's also a chance of the tube getting gunked up, and if that happens it will need to be flushed, but the vets can do that without needing to remove it or do any further surgery, knock on wood. They'll give us full training and we don't live far from the hospital, at least while we're in Scotland, and they're awesome... they'll be able to help if we need it. We're very lucky to have them so close by.

I haven't experience with dogs and this procedure but it sounds similar to what my sister in law had. They implanted a porto cath in her chest. Like you say it could be drained or injections given much easier than any other means.

Yes, probably so! It's commonly used in humans, but the surgeon said that they can even do it for mice!

Hello again!

Berkeley had his pleural port inserted yesterday. He's back home today, having spent the night in intensive care just to make sure everything was okay, as he is old and needs special consideration; also there was a little accidental prick to his left lung which left some air in the chest cavity, but that has completely resolved. All in all the surgery went very well. They gave him some mild sedation overnight, just because he gets himself overly worked up at the vet's, but at home he has settled and is fine. He has been hopping into chairs and up onto the bed no problem. He's had two meals so far and seems to be in no pain at all, though he is walking a little stiffly (could be after-effects of the methadone). The sutures are of the self-absorbing type, so he won't need a trip in to get them out, nor will he need to wear the Cone of Shame. He doesn't even seem to notice the port.

The port itself is just a little button under his skin, and the surgeon showed us the scans of exactly how the tube goes into his chest, and showed us how to feel for where the tube is right under his skin before it goes into his chest. This is obviously something we'll need to know in case we need to visit other vets who don't know that this has been done-- we'll have to alert them to the fact that that tube is there and that it must not be interfered with. There is a length of tube before the chest cavity with no holes in it-- this is to allow for the flushing fluid to get all the way in, and to stop any fluid coming out back into the body that could release fluid that should be drained-- it needs to be kept clear.

All in all we are hoping that this will buy Berkeley another year or more of good life! He is a very happy dog. There is no curing whatever is causing the effusion, but if we can alleviate the symptoms and give him as much time in the sun as possible, good. It is not his time yet. Everything about him screams that.

That is all sounding good Strange Child

Unlike humans dogs don't have the psychological hang up that comes with having a port of any kind and that is a bonus .

I hope you have many happy months with Berkeley ahead...

Hi Strangechilde

Sounds as if Berkeley is in good hands and I truly hope that you and Berkeley get to enjoy many more months together.

Hugs to you both

Kenny & Harvey