Chylothorax is secondary to leakage from the thoracic duct or one of its main tributaries which allows a rapid and large accumulation of fluid in the chest. Its cause is usually leakage from the thoracic duct or one of the main lymphatic vessels that drain to it. The most common causes are lymphoma and trauma caused by thoracic surgery.
Chest radiographs or X-rays are done to confirm the presence of fluid in the chest cavity and to help determine how much fluid is present. Our girl Dawn had displayed no clinical signs or symptoms of Chylothorax and had been healthy until her passing, so there was no need to do an x-ray prior to her spay surgery. The most common presenting signs in both dogs and cats are dyspnea and coughing. Other clinical signs and historical findings include weight loss, anorexia, gagging, lethargy, gagging, regurgitation, vomiting, exercise intolerance, and salivation. Abnormal physical findings most commonly include dyspnea, muffled heart sounds, increased bronchovesicular sounds, and tachycardia.
Chylothorax is the presence of lymphatic fluid in the chest that leads to difficulty breathing because the lungs cannot expand normally to take in oxygen. It is fairly uncommon in dogs and cats, is usually secondary to other conditions or diseases, and can be difficult to treat.
Diagnostic tests that your veterinarian may wish to perform to diagnose Chylothorax include a chest radiograph, a chest tap (needle thoracentesis) to remove some fluid to allow your pet to breathe easier and also to obtain some fluid for analysis, fluid analysis and Cytology (examination of the fluid under a microscope). Additional tests may be done to help determine the cause of the Chylothorax and the overall condition of your pet. These tests might include ultrasonography of the chest, an echocardiogram (ultrasound of the heart) to evaluate heart function and various blood tests such as a heartworm test.
Chylothorax is most common in middle-aged and older animals, but can occur in very young animals as well. The cause of the Chylothorax in many animals idiopathic, which means the cause is not determined. However, some animals are determined to have tumors, heart disease or blood clots that elevate pressures in the bloodstream and cause the chyle to leak from the lymphatic vessels in the chest. It is important that underlying causes be identified and treated whenever Chylothorax is diagnosed. Some animals do resolve the condition on their own, probably because they reroute the chyle (a milky white fluid that contains a high concentration of triglyceride) into alternate lymphatics and blood vessels in their abdomen.
Chylothorax can be life-threatening, and in our poor girl Dawn's case it was after her spay surgery. Fluid had accumulated to such a point that her lungs could not expand. She was not able to get enough oxygen to survive. She was suffocating to death which caused her to collpase and then have heart failure. The last time Dawn was seen by anybody that loved her she was gasping for air.
She had been given a thorough physical examination, routine blood work had been done, she had a heartworm test, was on heartworm preventative like she was supposed to be, and she had all of the necessary pre-operation tests done prior to her spay surgery. She was cleared for surgery because she was healthy! The only test that was not done was a chest x-ray because there was no reason to suspect that Dawn had Chylothorax prior to her death.
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