Peer-reviewed veterinary case report
Chylothorax in cats: is there a role for surgery?
- Journal:
- Journal of feline medicine and surgery
- Year:
- 2001
- Authors:
- Fossum, T W
- Affiliation:
- Department of Small Animal Medicine and Surgery · United States
- Species:
- cat
Plain-English summary
Chylothorax is a condition in cats where fluid builds up in the chest, and it can be caused by various issues like heart disease, tumors, or trauma. For cats with idiopathic chylothorax, which means the cause is unknown, doctors usually start with medical treatment since the problem might go away on its own. It's important for pet owners to know that affected cats could develop a serious condition called fibrosing pleuritis, which can complicate things. If medical treatment doesn't work or isn't possible, surgery might be an option, with certain procedures like thoracic duct ligation being preferred because they can completely resolve the issue. Overall, while there are treatments available, the success rate isn't perfect until we better understand what causes this condition in cats.
Abstract
Chylothorax is a complex disease with many identified underlying causes including cardiac disease, mediastinal masses, heartworm disease and trauma. Management of this disease should be directed at identifying the cause, if possible, and treating the underlying disorder. In cats with idiopathic chylothorax, medical management is recommended initially because the condition may resolve spontaneously. Owners should be made aware of the potential development of fibrosing pleuritis in affected cats. When medical management is impractical or unsuccessful, surgical intervention should be considered. Surgical options include mesenteric lymphangiography and thoracic duct ligation, pericardiectomy, omentalisation, passive pleuroperitoneal shunting, active pleuroperitoneal or pleurovenous shunting, and pleurodesis. Of these, only thoracic duct ligation and pericardiectomy are preferred by the author because, if successful, the result is complete resolution of the chylothorax, thereby reducing the risk of developing fibrosing pleuritis. Omentalisation may be beneficial in some animals as adjuvant therapy, but this procedure may still allow fibrosing pleuritis to occur. Until the aetiology of the effusion in cats with idiopathic chylothorax is understood, the treatment success rate will be less than ideal. Future research needs to be directed at determining the pathophysiologic mechanisms underlying this disease in cats.
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Search related cases →Original publication: https://pubmed.ncbi.nlm.nih.gov/11876620/