Large-bore thoracostomy tube placement in small animals

Objective: To provide a detailed technical tutorial on large-bore thoracostomy tube placement in small animals. The procedure is demonstrated using a veterinary simulation model designed to support safe acquisition of procedural skills and hands-on training. Animals: Any dog or cat requiring therapeutic drainage of the pleural space due to recurrent pleural effusion, pneumothorax, or the need for pleural lavage, such as in cases of pyothorax. Methods: Placement of a large-bore thoracostomy tube is demonstrated, including creation of a subcutaneous tunnel through blunt dissection of the subcutaneous tissue and intercostal musculature, controlled pleural entry with the use of curved hemostatic forceps with trocar guidance, advancement of a fenestrated thoracic drain, and appropriate tube fixation and bandaging. Results: This tutorial provides a clear, step-by-step guide to performing the technique, with the aim of facilitating practice of the critical procedural skills required for accurate execution while minimizing potential complications. Clinical Relevance: Thoracostomy tube placement is a vital procedure that every veterinarian working in small animal emergency and critical care should understand. Performing the technique correctly helps reduce complications such as iatrogenic pulmonary parenchymal injury and rib fractures, which may further compromise patient ventilation.