Video-assisted thoracoscopic-guided reduction and external stabilisation of traumatic rib fractures in a cat

Case summary An 11-year-old male neutered domestic longhair cat was presented to an emergency referral hospital after sustaining severe injuries isolated to the thorax after a dog attack. Initial stabilisation included oxygen supplementation, intravenous fluid therapy, point-of-care ultrasound (POCUS), serial blood gas analyses, thoracic and abdominal radiographs, opioid analgesics and broad-spectrum antibiotics. CT revealed multiple internally displaced rib fractures that punctured through the mediastinum and were in intimate proximity to the cranial vena cava and proximal aortic arch. Video-assisted thoracoscopic surgery (VATS) was performed using a 2.7 mm 0° short laparoscope to place a custom-made fibre glass splint via percutaneous suturing to accurately reduce the rib fracture fragments without further damage to the intrathoracic structures. The splint remained in place for 6 weeks. At the 8-week recheck, the cat had no evidence of cardiovascular or respiratory compromise and was able to resume normal activity. A long-term follow-up phone call was conducted at 14 months postoperatively. The owner reported that the patient has continued to do well without any complications. Relevance and novel information To the authors’ knowledge, this is the first report using VATS for the reduction of traumatic rib fractures in a cat. This case highlights the feasibility and success of this method and is a viable option in future clinical cases.