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Treatment of chronic pleural effusion with pleuroperitoneal shunts in dogs: 14 cases (1985–1999)

Daniel D. SmeakDepartment of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210.

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Stephen J. BirchardDepartment of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210.

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Mary A. McLoughlinDepartment of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210.

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Michelle M. LindseyDepartment of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210.

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David E. HoltDepartment of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104.

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Dennis D. CaywoodDepartment of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN 55108.

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Myron O. DownsDepartment of Small Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA 30602.

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 DVM, PhD, DACVS

Abstract

Objective—To describe complications and outcome associated with chronic nonseptic pleural effusion treated with pleuroperitoneal shunts in dogs.

Design—Retrospective study.

Animals—14 dogs.

Procedure—Medical records at 4 veterinary schools were examined to identify dogs with chronic nonseptic pleural effusion that were treated by use of a pleuroperitoneal shunt between 1985 and 1999. Signalment, history, physical examination and laboratory findings, cause and type of pleural effusion, medical and surgical treatments, complications, and outcome were reviewed.

Results—10 of 14 dogs had idiopathic chylothorax, and 4 had an identified disease. All but 1 dog with idiopathic chylothorax and 1 dog with chylothorax from a heart base tumor had unsuccessful thoracic duct ligation prior to pump placement. No intraoperative complications developed during shunt placement. Short-term complications developed in 7 of 13 dogs, necessitating shunt removal in 2 dogs and euthanasia in 1. Eight of 11 dogs with long-term follow- up developed complications; the overall mean survival time and the interval in which dogs remained free of clinical signs of pleural effusion were 27 months (range, 1 to 108 months) and 20 months (range, 0.5 to 108 months), respectively.

Conclusions and Clinical Relevance—Pleuroperitoneal shunts can effectively palliate clinical signs associated with intractable pleural effusion in dogs. Numerous short- and long-term complications related to the shunt should be expected. Most complications can be successfully managed, but even when shunts are functional some treatments fail because of severe abdominal distension or massive pleural fluid production that overwhelms the functional capacity of the shunt. (J Am Vet Med Assoc 2001;219:1590–1597)

Abstract

Objective—To describe complications and outcome associated with chronic nonseptic pleural effusion treated with pleuroperitoneal shunts in dogs.

Design—Retrospective study.

Animals—14 dogs.

Procedure—Medical records at 4 veterinary schools were examined to identify dogs with chronic nonseptic pleural effusion that were treated by use of a pleuroperitoneal shunt between 1985 and 1999. Signalment, history, physical examination and laboratory findings, cause and type of pleural effusion, medical and surgical treatments, complications, and outcome were reviewed.

Results—10 of 14 dogs had idiopathic chylothorax, and 4 had an identified disease. All but 1 dog with idiopathic chylothorax and 1 dog with chylothorax from a heart base tumor had unsuccessful thoracic duct ligation prior to pump placement. No intraoperative complications developed during shunt placement. Short-term complications developed in 7 of 13 dogs, necessitating shunt removal in 2 dogs and euthanasia in 1. Eight of 11 dogs with long-term follow- up developed complications; the overall mean survival time and the interval in which dogs remained free of clinical signs of pleural effusion were 27 months (range, 1 to 108 months) and 20 months (range, 0.5 to 108 months), respectively.

Conclusions and Clinical Relevance—Pleuroperitoneal shunts can effectively palliate clinical signs associated with intractable pleural effusion in dogs. Numerous short- and long-term complications related to the shunt should be expected. Most complications can be successfully managed, but even when shunts are functional some treatments fail because of severe abdominal distension or massive pleural fluid production that overwhelms the functional capacity of the shunt. (J Am Vet Med Assoc 2001;219:1590–1597)