Extensive pleural abscess associated with congestive heart failure in a pregnant cow: unusual presentation of hardware disease

A four-year-old pregnant Friesian cow was referred to the Veterinary Teaching Hospital of Perugia University for right-sided congestive heart failure signs. Thoracic auscultation revealed decreased lung sounds and absence of heart sounds on the left side. On right site, increased breathing sounds and normal heart sounds were auscultated. Thoracic ultrasonographic examination allowed to visualize an extensive intrathoracic abscess displacing the heart against the thoracic wall with compression of the right atrium and ventricle. Congestive heart failure signs resolved after abscess drainage and the cow delivered a healthy bull-calf. Radiographic examination performed after delivery, showed a thoracic radiopaque foreign body cranial to the diaphragm. Due to worsening of the clinical health condition with subsequent poor prognosis, euthanasia was elected by the cow's owner. At the postmortem examination, a diffuse fibrinous pleuritis with a large abscess extending among thoracic wall, heart, and lung in the left thoracic cavity and containing a metal wire were observed. Multiple adhesions were present in both thoracic and abdominal cavities. This report describes clinical, radiographic and ultrasonographic, and postmortem findings in a cow affected by a traumatic pleural abscess and clinical signs of right-sided congestive heart failure. Pleural abscesses in cows, if particularly extensive, can cause cardiac displacement against the thoracic wall with right heart dysfunction leading to congestive heart failure.