In today's VETgirl podcast, Dr. Lisa Powell, DACVECC, reviews pneumomediastinum in cats. This original study was published by Thomas et al out of University of Pennsylvania School of Veterinary Medicine, and characterizes the incidence, causes, presenting complaint, clinical course, and outcome of cats diagnosed with pneumomediastinum. So what did this study find? 69% of cats had a secondary (e.g., obvious inciting) cause, with 38% of the cases having had endotracheal intubation and positive pressure ventilation (PPV). In approximately a quarter of the cases, trauma was the cause, while in 4% of the cases, a tracheal foreign body caused the pneumomediastinum. Interesting to note? The clinical signs and diagnosis of spontaneous pneumomediastinum was due to emesis in 6 of 14 cats. Regardless, this study found that the prognosis is good with supportive care, so a) don't give up on these, and b) stop over inflating your endotracheal tubes under dental procedures. References: 1. Thomas EK, Syring RS. Pneumomediastinum in cats: 45 cases (2000-2010). J Vet Emerg Crit Care 2013;23(4):429-435. Errata:OK, once in a while, we all mess up. In this podcast, Dr. Powell stated that a pneumothorax can progress to a pneumomediastinum. That's wrong. A "pneumomediastinum may progress to pneumothorax if mediastinal pressure results in tearing of the mediastinal parietal pleura, thus establishing communication between the mediastinum and the pleural space. Pneumomediastinum can also progress to pneumothorax if gas dissects through fenestrations in the mediastinal pleura. Conversely, pneumothorax does not progress to pneumomediastinum. Dyspnea usually is not seen with pneumomediastinum unless it results in pneumothorax." (Thanks to the super smart, book savvy veterinary student for pointing this out from page 568 of Textbook of Veterinary Diagnostic Radiology by Donald E. Thrall, DVM, PhD).