• 1. Waddle JR, Giger U. Lipoprotein electrophoresis differentiation of chylous and nonchylous pleural effusions in dogs and cats and its correlation with pleural effusion triglyceride concentration. Vet Clin Pathol 1990;19:8085.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 2. Fossum TW, Jacobs RM, Birchard SJ. Evaluation of cholesterol and triglyceride concentrations in differentiation chylous and nonchylous pleural effusions in dogs and cats. J Am Vet Med Assoc 1986;188:4951.

    • Search Google Scholar
    • Export Citation
  • 3. Hodges CC, Fossum TW, Evering W. Evaluation of thoracic duct healing after experimental laceration and transection. Vet Surg 1993;22:431435.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 4. Fossum TW, Mertens MM, Miller MW, et al. Thoracic duct ligation and pericardiectomy for treatment of idiopathic chylothorax. J Vet Intern Med 2004;18:307310.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5. Fossum TW, Miller MW, Rogers KS, et al. Chylothorax associated with right-sided heart failure in five cats. J Am Vet Med Assoc 1994;204:8489.

    • Search Google Scholar
    • Export Citation
  • 6. Thompson MS, Cohn LA, Jordan RC. Use of rutin for medical management of idiopathic chylothorax in four cats. J Am Vet Med Assoc 1999;215:345348.

    • Search Google Scholar
    • Export Citation
  • 7. Casley-Smith JR, Morgan RG, Pillar NB. Treatment of lymph-edema of the arms and legs with 5,6-benzo-[α]-pyrone. N Engl J Med 1993;329:11581163.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 8. Bussadori R, Provera A, Martano M, et al. Pleural omentalisation with en bloc ligation of the thoracic duct and pericardiectomy for idiopathic chylothorax in nine dogs and four cats. Vet J 2011;188:234236.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 9. Donner GS. Use of the pleuroperitoneal shunt for the management of persistent chylothorax in a cat. J Am Anim Hosp Assoc 1989;25:619622.

    • Search Google Scholar
    • Export Citation
  • 10. Clendaniel DC, Weiss C, Culp WT, et al. Salvage cisterna chyli and thoracic duct glue embolization in 2 dogs with recurrent idiopathic chylothorax. J Vet Intern Med 2014;28:672677.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 11. Sicard GK, Waller KR, McAnulty JF. The effect of cisterna chyli ablation combined with thoracic duct ligation on abdominal lymphatic drainage. Vet Surg 2005;34:6470.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 12. Kim M, Lee H, Lee N, et al. Ultrasound-guided mesenteric lymph node iohexol injection for thoracic duct computed tomographic lymphography in cats. Vet Radiol Ultrasound 2011;52:302305.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 13. Lee N, Won S, Choi M, et al. Computed tomography thoracic duct lymphography in cats by popliteal lymph node iohexol injection. Vet Radiol Ultrasound 2012;53:174180.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 14. Kerpsack SJ, McLoughlin MA, Birchard SJ, et al. Evaluation of mesenteric lymphangiography and thoracic duct ligation in cats with chylothorax: 19 cases (1987–1992). J Am Vet Med Assoc 1994;205:711715.

    • Search Google Scholar
    • Export Citation
  • 15. Fossum TW, Forrester SD, Swenson CL, et al. Chylothorax in cats: 37 cases (1969–1989). J Am Vet Med Assoc 1991;198:672678.

  • 16. Hayashi K, Sicard G, Gellasch K, et al. Cisterna chyli ablation with thoracic duct ligation for chylothorax: results in eight dogs. Vet Surg 2005;34:519523.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 17. McAnulty JF. Prospective comparison of cisterna chyli ablation to pericardiectomy for treatment of spontaneously occurring idiopathic chylothorax in the dog. Vet Surg 2011;40:926934.

    • Search Google Scholar
    • Export Citation
  • 18. Staiger BA, Stanley BJ, McAnulty JF. Single paracostal approach to thoracic duct and cisterna chyli: experimental study and case series. Vet Surg 2011;40:786794.

    • Search Google Scholar
    • Export Citation
  • 19. da Silva CA, Monnet E. Long-term outcome for dogs treated surgically for idiopathic chylothorax: 11 cases (1995–2009). J Am Vet Med Assoc 2011;239:107113.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 20. Carobbi B, White RAS, Romanelli G. Treatment of idiopathic chylothorax in 14 dogs by ligation of the thoracic duct and partial pericardiectomy. Vet Rec 2008;163:743745.

    • Search Google Scholar
    • Export Citation
  • 21. Mayhew PD, Culp WT, Mayhew KN, et al. Minimally invasive treatment of idiopathic chylothorax in dogs by thoracoscopic thoracic duct ligation and subphrenic pericardiectomy: 6 cases (2007–2010). J Am Vet Med Assoc 2012;241:904909.

    • Crossref
    • Search Google Scholar
    • Export Citation

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Comparison of thoracic duct ligation plus subphrenic pericardiectomy with or without cisterna chyli ablation for treatment of idiopathic chylothorax in cats

Stephen L. StockdaleSeattle Veterinary Specialists, 11814 115th Ave NE, Kirkland, WA 98034.

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Krista M. GazzolaDepartment of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824.

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Jennifer B. StrouseDepartment of Small Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, TX 77843.

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Bryden J. StanleyDepartment of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824.

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Joe G. HauptmanDepartment of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824.

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Michael B. MisonDepartment of Clinical Studies, College of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104.

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Abstract

OBJECTIVE To compare duration of surgery, recurrence rate, and survival time between cats with idiopathic chylothorax treated with thoracic duct ligation (TDL) plus subphrenic pericardiectomy (SPC) and those treated with TDL, SPC, and cisterna chyli ablation (CCA).

DESIGN Retrospective case series with nested cohort study.

ANIMALS 22 client-owned cats surgically treated for idiopathic chylothorax from 2009 through 2014.

PROCEDURES Patient and surgery data were collected from the medical records. Recurrence of chylothorax and survival time were assessed by medical record review and client interview. Comparisons were made between cats treated with TDL plus SPC (TDL-SPC group) and those treated with TDL, SPC, and CCA (TDL-SPC-CCA group).

RESULTS 15 cats were treated with TDL plus SPC, and 7 were treated with TDL, SPC, and CCA. Median duration of surgery was significantly briefer for the TDL-SPC group (80 minutes; range, 55 to 175 minutes) than for the TDL-SPC-CCA group (125 minutes; range, 105 to 205 minutes). Five cats (2 in the TDL-SPC group and 3 in the TDL-SPC-CCA group) had persistent pleural effusion 4 weeks after surgery. Chylothorax recurred in 2 cats (1/group). Median survival time in the TDL-SPC group was 774 days (range, 3 to 2,844 days) and in the TDL-SPC-CCA group was 380 days (range, 11 to 815 days); these values did not differ significantly.

CONCLUSIONS AND CLINICAL RELEVANCE Addition of CCA to the surgical treatment approach for cats with idiopathic chylothorax was associated with a significantly longer duration of surgery with no better outcome than achieved with TDL plus SPC alone.

Abstract

OBJECTIVE To compare duration of surgery, recurrence rate, and survival time between cats with idiopathic chylothorax treated with thoracic duct ligation (TDL) plus subphrenic pericardiectomy (SPC) and those treated with TDL, SPC, and cisterna chyli ablation (CCA).

DESIGN Retrospective case series with nested cohort study.

ANIMALS 22 client-owned cats surgically treated for idiopathic chylothorax from 2009 through 2014.

PROCEDURES Patient and surgery data were collected from the medical records. Recurrence of chylothorax and survival time were assessed by medical record review and client interview. Comparisons were made between cats treated with TDL plus SPC (TDL-SPC group) and those treated with TDL, SPC, and CCA (TDL-SPC-CCA group).

RESULTS 15 cats were treated with TDL plus SPC, and 7 were treated with TDL, SPC, and CCA. Median duration of surgery was significantly briefer for the TDL-SPC group (80 minutes; range, 55 to 175 minutes) than for the TDL-SPC-CCA group (125 minutes; range, 105 to 205 minutes). Five cats (2 in the TDL-SPC group and 3 in the TDL-SPC-CCA group) had persistent pleural effusion 4 weeks after surgery. Chylothorax recurred in 2 cats (1/group). Median survival time in the TDL-SPC group was 774 days (range, 3 to 2,844 days) and in the TDL-SPC-CCA group was 380 days (range, 11 to 815 days); these values did not differ significantly.

CONCLUSIONS AND CLINICAL RELEVANCE Addition of CCA to the surgical treatment approach for cats with idiopathic chylothorax was associated with a significantly longer duration of surgery with no better outcome than achieved with TDL plus SPC alone.

Contributor Notes

Address correspondence to Dr. Stockdale (stephen.stockdale@bluepearlvet.com).