Outcome and complications associated with correction of pectus excavatum using external coaptation in cats less than 20 weeks of age: 25 cases (2010-2024).

External coaptation effectively corrects pectus excavatum in cats under 20 weeks with excellent survival and clinical resolution.

This retrospective case series evaluated outcomes and complications in 25 cats aged less than 20 weeks treated for congenital pectus excavatum (PE) via external coaptation (sternal splinting) at a small animal referral hospital between 2010 and 2024. The majority of cats (76%) presented with tachypnea or exercise intolerance, and all had a palpable sternal defect. External coaptation achieved significant radiographic improvement, with the frontosagittal index decreasing from a mean of 5.44 to 2.09 and the vertebral index increasing from 4.45 to 8.47 (both p < .001), indicating meaningful correction of thoracic conformation. Clinical signs resolved in all surviving cases by recheck examination. The overall survival rate was 96% (24/25). Splint duration ranged from 21 to 43 days (median 28 days). Reported complications included pneumothorax, suture breakage, contact dermatitis, persistent defect, and one death. Notably, splint duration was significantly inversely associated with dermatitis severity (p = .036), suggesting that longer splinting periods may reduce dermatitis risk, possibly by allowing more gradual correction. No significant associations were identified between preoperative defect severity and breed, pneumothorax occurrence, or suture breakage. These findings support external coaptation as a safe, effective, and minimally invasive first-line treatment for PE in young cats, with an excellent prognosis when performed in cats younger than 20 weeks. Clinicians should counsel owners regarding potential complications, particularly dermatitis and pneumothorax, while emphasizing the high likelihood of clinical resolution.

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