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Lung & Respiratory Disorders / COPD Message Board


Lung & Respiratory Disorders / COPD Board Index


Subpleural blebs
Feb 27, 2008
Does anyone know what subpleural blebs are? I had a ct scan of sinus`s done back in June. I just got my report to take with me to another Dr for sinus trouble and i noticed these were found on my upper left lung...NO ONE can give me an answer to what this means and im scared to death!!

Any info would be great...

-Michelle
a bleb for starters is an air-filled blister that appears on the lung and is one of the causes for a spontaneous pneumothorax (collapsed lung) if the blister ruptures but sometimes they take care of themselves and nothing happens. If it was me I would find out from my doctor the chances of rupture and if there was any threat. I am guessing that if they found them in June and didn't say anything that there is no immediate threat in their eyes. I have had and will continue to get blebs but mine are emphysema related. I had several blebs on my left lung before they formed into 2 large blebs, I had them for nearly a year. I opted to have them surgically removed and didn't experience any difficulties. I am guessing my situation is different than yours. I have had 3 pneumothoraxes from ruptured blebs.

If you aren't currently seeing a pulmonologist I would suggest a referal to get their professional opinion of them.

Does that help any? I know its scary when you know nothing about it but they can be repaired and you shouldn't experience any side effects.
Michelle,

I have what they call scattered larger "bullae" throughout my lungs. I believe these are a larger version of the "blebs".
I too have emphesema like Jeff stated.(Young onset, Im 43 and being tested for a genetic deficiency to see if thats the cause for the early emphesema) I have NOT suffered from spontaneous pneumothorax at this point. I did just have part of my right lung removed, being told I had Lung cancer, When they got in there and did a (wedge resection) they discovered It WASNT cancer,(By the GRACE of GOD) but was a rare type of infection called MAC (Mycobacterium avium complex) or MAI (Mycobacterium avium intracellular infection). Let me add this point, I DO NOT have ANY symptoms reguarding the emphysema, and my PFT's(pulmonary function is STILL within normal limits). So you CAN have lung issues without having symptoms as well.

I agree with Jeff, that at this point you should have them evaluated by a pulmonolgist. Many people with these defects DONT ever suffer pneumothorax, but certiantly they should be evaluated.

Jeff,

Do you have symptoms other than the pneumothorax? Any indications there were lung issues? Are or DO you Fly in a airplane? Have heard this can cause spontanous pneumothorax as well? Any truth to that?

Wish you both well, and Michelle, Please let us know how you make out.

Take care and GOd bless,
Annette
My pulmo told me that I should not fly because the change in pressure can cause the lung to collapse. He has grounded me until further notice.

I noticed a discomfort in my chest, a tightness feeling. The doc said I should not be able to feel them but I know I could because once the surgery was completed (loss 1/3 of the left lung) I couldn't feel it anymore. I was short of breath a lot but that was a combination of the blebs and emphysema.

I too am young for the diagnosis, 38, but was a heavy smoker for 20 yrs.

Michelle,
Do keep us posted. I would like to hear when everything works out for you. Keep positive, as Annete stated.... most people go on without any complications from blebs


Jeff
Hi...
I just posted a question about spontaneous pneumothorax. I want to talk to someone like you, who have been through the surgery. My beloved pet, a 6 year old Yellow Lab we call Mickey just had surgery last Friday to remove the right cranial lubg lobe. He said there were multiple bullae in there..He is still having a little bit of a hard time breathing, and tires very easily, which is understandable. I would like to know firsthand if this is normal, and if I can expect a gradual improvement in breathing.
I can't imagine going thru anyting like this...and being that he can't tell me how he feels, perhaps you can tell me what it was like for you. Thank you for your time.
Karen
Wow, It amazes me how much animals and humans have in common, and also raises the question .....are bullae, and blebs really caused by emphysema and smoking? Sure dose'nt appear that way.

Anyway, as I had posted in a previous post, I have had a right upper lobe wedge resection. My experience was this...I had an epidural while in the hospital for pain control, also had a chest tube to remove any fluid post op for 3-4 days. It sounds like to me if your dog is still having difficulty breathing its one of two things going on. Either he has some residule fluid built up in there which is something the vet should be able to check...or he isnt getting adequate pain control and he is using "Guarded breathing" technic because its too painful to breath deaply and fully. Which in turn will collaps his lung. This happened to me because I wasnt doing my breathing exercises faithfully with the spirometer, well...because it hurt.. and because I also suffer from sleep apnea, I wasnt breathing fully and deaply while sleeping, by morning it hurt like crazy to even attempt to take a full breath, which made my lung particaly collaps. The only way to re-inflate the lung in that situation is to breath deeply, until it finally fully expands, which again HURTS like crazy.

Given the fact we are talking about an animal here, and he wouldnt understand all this my only suggestion would be better pain control so he CAN BREATH fully without feeling any pain. Of course also suggest he is re-checked by his vet to make sure there isnt any fluid coming into play here.
When it comes to lung surgery good pain control makes for a MUCH BETTER outcome for the obvious reasons, being able to take a full breath without any pain....guarding ones self to reduce pain is a natural human, AND animal instinct....Just as limping on a broken leg would be...In MY opinion of course.

I will certiantly pray for your best friend "Mickey", I can't imagine going through that and not being able to verbaly communicate my needs. I sure hope this information helps in some way. Please let us know how he makes out!

Take care, and GOd bless.
Annette
Thank you so much Annette for your reply. Mickey had tubes until Sunday, so for 3 days he did have the tubes in, and they said that there was no leakage when they removed them. They had a suction device they told me on the tube to suck out any air that might have been in there. The drugs they gave him are an opium type which knocks him out. He had his dose every 12 hours as prescribed. One morning tho, his tongue was kind of purpleish, and I freaked out..but once he got up and started moving around a bit, the color returned to a more normal pink. I don't see him taking deep breaths often...only once in a while. It's been a week and one day, and I don't know if I should be continuing to give him so much pain meds, but i just gave him some after reading your post. He wants to play, his appetite is great, and the only problem is that he gets winded so easy..Do the lungs need to take time to adapt to filling up without the section that was removed? It's so good to hear from you, so that I can get an idea of what he is feeling. Thank you so much.
Karen,

Your very welcome! I'm and animal lover too so I do understand your concern, and I think its wonderful your trying to help him this way.

Hmm...something you said I find interesting...when you said his tounge was blue(which of course is a lack of oxygen) but once he started moving around it turned back to pink...makes me wonder..again, could be one of two things..either the pain meds are making him TOO TIRED, and the effort to breath is too exausting, causing him not to breath properly, as if a "sleep apnea" sort of thing...and once he starts moving around he breaths more normaly...Or, the guarded breathing thing...Wonder if they can try a different pain med, or even some type of non-narcotic anti-inflammatory med..might be worth asking about? While in the hospital in my epidural was 25% maracain, which is like a lidocaine, for numbing, I have alot of drug allergies and have adverce effects from most pain meds, so they gave me a non-opid anti-inflammatory by way of IV for pain controll. I didn't need any narcotics while in there, just makes me wonder if Mickey would do better with that type of drug (anti-inflammatory) which wouldnt have those side effects?
With me, after about two weeks, I started suffering extreem nerve pain, which the pain meds didnt touch at all, so my primary care told me to double the dose, well when I did that it caused my blood pressure to drop too low, and made my sleep apnea worse..so obviously I couldnt do that. Ultimatly she put me on "neurotin" which is specificaly for nerve pain, which helped tramendesly for that pain. But side effects with that are pretty bad, I tollerated that for about a week, then stopped taking them...it took the edge off this nerve pain enough so I could again tollerate it. Nerve pain you get from the fact they had to cut the nerves to do the surgery, well when they begin to regenerate, it made my whole chest go on fire..I had surgery in late November of last year, and still have some nerve pain, its more of a neusence at this point and I dont take anything at all. Healing fully does take quite awhile after this surgery being an "open thorocotomy". But, as far as my breathing capasity after, I see no change in that..UNLESS I over due it, as in lifting heavy objects, or bending over doing something will get me also. I admit, I couldnt "run" to save my life, but I also have a muscle disease that comes into play. My pulmonary function tests are STILL within normal limits even after surgery.
The fact it's only been a little over a week, certiantly would explain him getting so winded if he is over doing it. It's difficult to keep a dog down, when they want to play. It sure sounds like he has wonderful spirit! As you know Its a major surgery, and he does need to stay quite for awhile to have a chance to heal. As long as my pain was under control I didnt have any problems breathing after surgery, except the whole sleep apnea thing and not doing my breathing exercizes. Its got to be hard , how do you make an animal understand? Did he suffer a spontanous pnemothorax and that was the reason for his surgery, or had he been having breathing problems prior? What orders did the vet give you as far as recovery time? Animals can be so much more resilant than we humans, just curious as to what a vet thinks recovery time would take.

Take care, and GOd bless.
Annette
I'm sure that the blueish color was lack of oxygen...I think he was trying to breathe as little as possible without pain and it just wasn't enough to keep enough oxygen in his lungs...It only happend one time in a week, and then again it might have been the meds...knocking him out too much, and being unable to even move.
He had an episode last April of 07..where his lungs collapsed, and they suspected bullae in there, but at the time, we didn't want to put him thru the surgery, so opted to bring him home, and hope for the best...and that was just what we got..the best from him...For a year he was great..until June this year. I contacted a chinese herbalist out in the state of Washington and decided to put him on an herbal tea...I cooked raw herbs for him, and he got 1/2 cup every day for a year..perhaps that's what helped him recover last time. He was doing so well, I took him off the herbs in March, one year later, and Bingo...he has this again, but i beleive it was brought on by excitement. He had a play date with another dog friend, and altho there was no horseplay, the car ride alone was exciting for him, and then meeting a new friend, just pushed him over the edge. If it was the herbs that kept him safe, I dont' know. I have him back on them again now tho.
He has to go in Wed or Thurs to have the staples removed..and the vet can check him then. He said that about 3 weeks he should be ok....the at home directions is to keep him quiet and out only on a leash...and after 2 weeks to start short walks...
Mickey never had the stamina to run and play like a normal dog. Labs are quite active, and need lots of room. Room we have, but stamina he hasn't got. He was purchased in a pet shop that bought ( and probably still buys) puppies from puppy mills. He was born in the midwest where mills are notorious. Mickey, altho supposedly is a full bred Yellow Lab, has many genetic defects. He was born with elbow dysplasia, for which he had surgery when he was 7 months old. He also has right hip dysplasia, for which I give him supplements for. Along with that he has enamel hypoplasia, which means he has no enamel on his teeth, and one of his canine teeth is impacted. He has been to hell and back...I had a class action lawsuit with the shop that sold him to me along with many others who bought sick puppies. After 4 years, there was a settlement, and many dropped out..so all we got was the cost of the dog, and nothing else...I have already spent tens of thousands of dollars on this member of our family, and don't regret a penny of it. What I should have done was sued for a health insurance policy for future problems...and this would have been covered...a lesson to be learned.
The nerve pain you mentioned is interesting.
Mickeys back legs jump, but I don't think it's from nerve damage. He started jumping like that after his first episode with this. I thought maybe it was from pain...just like a jerk every now and then.
God bless him, he is doing well, and I think that if he were in a lot of pain I would see it. I beleive that God gives them a higher tolerence..and takes care of his animal kingdom in a special way.
His breathing is fast paced at times, and other times like at night when he is sleeping, it's just right...breathing normally. Then there's the open mouth breathing, not panting from being out of breath, just tounge out, breathing..Hard to explain . His rib cage is wired together...so I would imagine that he is in pain..definately..but how severe..I don't know.
The vet told me that the chest tubes that were inserted are more painful than this surgery according to people he has spoken to about it.
His rib cage is wired together...I can't imagine the pain involved. Is yours wired too?

Getting back to his gentics...I think that this could very well be genetic...He has never been hit by a car, or had anything to cause this. From the time he was a puppy, he could never run like other dogs do without getting totally exhausted...and I have pictures of his little beet red tongue...which proves to me that he was born with this condition...I asked the vet, and he doesn't know.
Thanks again for your correspondence..It is very helpful to me and Mickey.
karen
Karen,

The nerve pain I discribe hits you like electric shocks, and burns, so with the jumping you mention could be possible that is what he is feeling because the that pain does make you jump, hits you unexpectedly?

Well, when I had my surgery I was fortunate enough that they didnt have to cut the ribs, they used a rib spreader to gain access and none fractured in the process Thank God. But I have had unstable rib fractures in the past, from a horse accident, and they are extremly painful to breath, being that his are wired would make them more stable for him, so hopfully not so painful. Poor little man, I do feel for him!

Another thing that could have caused his breathing troubles may have been from a lack of oxygen at birth causing early lung damage. You just never know what happened to him then. I know I developed early lung issues and I also had a lack of oxygen at birth as well as during some severe reactions to anesthesia, and ventilator lung damage. I know when I did see the pulmonologists at Mayo clinic they were suprised at the amount of damage in my lungs for someone my age being 43. First question was did I have asthma as a child . So many things can cause the issues, but alot seem to center around lack of oxygen of some sort. We will never know what happened to Mickey, but one thing is for sure, that he is blessed having ending up with a wonderful owner as yourself!

Yes unfortunatly puppy mills are abundant all across the country! Which totaly discusts me! I think these people should be thrown into the same situation as they are treating these defenceless animals! The "all mighty dollar" is what its all about! Makes me sick.

Anyway, I sure hope Mickey recovers quickly and will pray for him for sure.
Take care, and God bless.
Annette





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