title: Video-Assisted Thoracoscopic Resection of a Noninvasive Thymoma in a Cat with Myasthenia Gravis Using Low-Pressure Carbon Dioxide Insufflation.
abstract: OBJECTIVE
  To report the use of low-pressure carbon dioxide insufflation during video-assisted thoracoscopic surgery for resection of a noninvasive thymoma in a cat with secondary myasthenia gravis.
  
  
  METHODS
  Clinical case report.
  
  
  METHODS
  Client-owned cat.
  
  
  METHODS
  An 11-year-old castrated male domestic shorthair cat was examined for generalized weakness, voice change, hypersalivation, hyporexia, vomiting, coughing, and gagging. Thoracic ultrasound revealed a cranial mediastinal mass for which cytology was consistent with a thymoma (or lymphoid tissue). Acetylcholine receptor antibody concentration was elevated at 3.16 mmol/L (reference interval < 0.3 mmol/L). Thoracic computed tomography showed two round, contrast-enhancing structures in the cranioventral mediastinum identified as the sternal lymph node and a cranial mediastinal mass (11 × 17 × 24 mm). A presumptive diagnosis of thymoma with paraneoplastic myasthenia gravis was made and surgical resection of both mediastinal masses was recommended.
  
  
  RESULTS
  Video-assisted thoracoscopic resection of the cranial mediastinal mass and sternal lymph node were performed with low-pressure carbon dioxide insufflation maintained at an intrathoracic pressure of 2-3 mmHg. The cat recovered from surgery without serious complications. Nineteen months after surgery, the cat developed hind limb stiffness. Thoracic radiographs ruled out a cranial mediastinal mass or megaesophagus. Acetylcholine receptor antibody concentration remained elevated at 2.72 mmol/L.
  
  
  CONCLUSIONS
  Low-pressure thoracic insufflation facilitated video-assisted thoracoscopic resection of cranial mediastinal masses in this cat.
authors.affiliation: Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, California.
authors.forename: Maureen A
authors.initials: MA
authors.lastname: Griffin
authors.affiliation: Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, California.
authors.forename: Jessie S
authors.initials: JS
authors.lastname: Sutton
authors.affiliation: Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, California.
authors.forename: Geraldine B
authors.initials: GB
authors.lastname: Hunt
authors.affiliation: Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, California.
authors.forename: Bruno H
authors.initials: BH
authors.lastname: Pypendop
authors.affiliation: Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, California.
authors.forename: Philipp D
authors.initials: PD
authors.lastname: Mayhew
mesh_terms: D000818:Animals; D002245:Carbon Dioxide; D002371:Cat Diseases / Q000175:diagnosis / Q000601:surgery*; D002415:Cats; D007327:Insufflation / Q000662:veterinary*; D008297:Male; D009157:Myasthenia Gravis / Q000662:veterinary; D020775:Thoracic Surgery, Video-Assisted / Q000662:veterinary*; D013934:Thymectomy / Q000662:veterinary*; D013945:Thymoma / Q000175:diagnosis / Q000601:surgery / Q000662:veterinary*
chemical_list: D002245:Carbon Dioxide