Canis ISSN: 2398-2942

Chylothorax

Contributor(s): Kyle Braund, Serena Brownlie, Alasdair Hotston Moore

Introduction

  • Cause: trauma to thoracic inlet, thoracic neoplasia, lymphatic hypertension, heart failure, dirofilariasis. However, many cases in dogs are considered idiopathic.
  • Signs: depend on volume and rate of chyle accumulation; dyspnea is most common with marked forceful inspiration and delayed expiration; coughing if chronic.
  • Diagnosis: thoracocentesis and fluid/aspirate analysis.
  • Treatment: ideally, attention to underlying cause. However, most are idiopathic and treatment focuses on occlusion of thoracic duct.
  • Prognosis: variable response to both surgical and medical managements limits the prognosis. In addition, longstanding chylous effusion can result in fibrosing pleuritis (lung cortication) and possible restrictive pericarditis.

Pathogenesis

Etiology

Timecourse

  • Acute or chronic.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Enwiller T M, Radlinsky M G, Mason D E, Roush J K (2003) Popliteal and mesenteric lymph node injectin with mthylene blue for coloration of the thoracic duct in dogs. Vet Surg 32, 359-364 PubMed.
  • Williams J M & Niles J D (1999) Use of omentum as a physiologic drain for treatment of chylothorax in a dogVet Surg 28 (1), 61-65 PubMed.
  • Gelzer A R M et al (1997) Accessory lung lobe torsion and chylothorax in an Afghan houndJAVMA 33 (2), 171-176 PubMed.
  • Fossum T W, Evering W M, Miller M W et al (1992) Severe bilateral fibrosing pleuritis with chronic chylothorax in dogs and cats. JAVMA 201 (2), 317-24 PubMed.
  • Birchard S J, Smeak D D & Fossum T W (1988) Results of thoracic duct ligation in dogs with chylothorax. JAVMA 193 (1), 68-71 PubMed.
  • Smeak D D, Gallagher L, Birchard S J & Fossum T W (1987) Management of intractable pleural effusion in a dog with pleuroperitoneal shunt. Vet Surg 16 (3), 212-6 PubMed.
  • Willauer C C & Breznock E M (1987) Pleurovenous shunting technique for treatment of chylothorax in three dogs. JAVMA 191 (9), 1106-9 PubMed.
  • Fossum T W, Birchard S J & Jacobs R M (1986) Chylothorax in 34 dogs. JAVMA 188 (11), 1315-8 PubMed.

Other sources of information

  • Fossum T W (2000) Pleural and extrapleural diseases. In: Textbook of veterinary internal medicine, 5th edn. Eds S J Ettinger & E C Feldman. Philadelphia, PA: W B Saunders Co. pp 1098-1111.


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