Clinical, Diagnostic and Therapeutic Aspects of Canine Idiopathic Chylothorax: Case Report
B.S. Medeiros1; A. Quadros2; M.A.M. Silva3; M.V. Brun4; R.M.M. Linn5; C.E. Bortolini6; I. Bisognin7
Idiopathic chylothorax is an infrequent condition affecting dogs, presenting challenging etiological establishment. The diagnosis is confirmed if neoplasms, severe cardiac dysfunction, or traumatic causes are discharged.
To report a case of an obese mongrel bitch, age 9 years old, presenting with recurrent chylothorax.
The patient was referred to the veterinary teaching hospital, presenting with severe dyspnea, cyanosis, orthopnea posture and hypophonesis of cardiac and pulmonary bullae. Immediate mask oxygen therapy was performed. Thoracocentesis was carried out. Approximately 600 mL and 400 mL of a milky aspect effusion were drained from the right and left sides, respectively, which were submitted to laboratory for analysis. The patient presented with normal food intake, though the basis of the diet was homemade food. No trauma was reported. Complementary exams included thoracic radiography, electrocardiogram, abdominal echography, urinalysis, hemogram and serum biochemical assays.
No cells suggesting neoplasms were found, and chylothorax was biochemically confirmed. The patient didn't adapt to the hypolipidic diet, and a meat-based diet was given. Large volume of lymph was still being drained daily. The diagnosis of idiopathic chylothorax was established. Due to non-successful conservative approach, the patient was subjected to thoracoscopic ligation of the thoracic duct. Following surgery, the patient was drained a mild amount of air and serosanguineous effusion on the first day. From the second day on, no effusion was drained and no clinical signs were noted.
Idiopathic chylothorax was successfully diagnosed by exclusion criteria and treated surgically. However, the patient's prognosis is reserved, as recurrence may occur.