What is Chylothorax?
This condition is often characterised by the inability of the patient to fully inflate their lung due to the buildup of fluid in the thorax. This buildup can lead to inflammation of the lungs and heart. Due to the potential for long-lasting harm, it is essential that your dog receives prompt treatment if you suspect they may be suffering from this condition.
Chylothorax is an uncommon, poorly understood disease in which chyle accumulates in the thoracic cavity. This may be caused by underlying heart conditions, trauma, cancer, fungal disease or blood clots; however, often the cause is idiopathic.
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Symptoms of Chylothorax in Dogs
The symptoms displayed in a pet suffering from chylothorax are commonly seen in other respiratory illnesses such as pneumothorax. Signs may include:
- Non-productive cough
- Lethargy
- Appetite reduction or weight loss in chronic cases
- Breathing difficulties
- Tachypnea
- Cyanosis
When left untreated this condition can cause irritation, inflammation and irreversible damage to the lungs and pericardium.
Causes of Chylothorax in Dogs
Chylothorax is caused by the buildup of the fluid chyle, which is lymphatic fluid, in the thoracic cavity. In a normally functioning canine, chylomicrons are produced following the ingestion of fats, these molecules are absorbed in the cisterna chyli and carried through the thoracic duct to the cranial vena cava. In canines suffering from chylothorax, a dysfunction in the thoracic duct leads to leaking of chyle into the thorax. This can result in difficulty breathing due to reduced lung inflation, weakened immune system, and metabolic disorders. There are many diseases that may cause this dysfunction such as cancer, fungal disease, and heart conditions such as murmurs and blood clots.
Diagnosis of Chylothorax in Dogs
Your veterinarian will perform a full clinical examination. Signs that may indicate fluid in the thoracic cavity are muffled heart or lung sounds on auscultation. If your veterinarian suspects fluid in the thorax radiographs of the thoracic area may be performed. Your veterinarian may be able to visualise fluid in the thorax from the radiograph, allowing a diagnosis of pleural effusion to be made; however, she will not be able to confirm the presence of chyle. In order to determine the type of fluid present in the chest your veterinarian will likely perform a thoracentesis. In order to carry out this procedure sedation may be necessary for your pet. This procedure is performed by the veterinarian inserting a small needle between your dog’s ribs into the thoracic cavity and aspirating in order to obtain fluid. Through visual examination your veterinarian may suspect chylothorax due to the distinct, milky appearance. In addition, it may be sent for laboratory testing for confirmation.
As chylothorax can be a secondary complication of underlying conditions further diagnostics such as thoracic or cardiac ultrasound or computed tomographic scans may be performed.
Treatment of Chylothorax in Dogs
Immediate care
Your veterinarian will initially focus on trying to remove the chyle from the thoracic cavity of your pet in order to allow your companion to breath with full lung expansion. This may require a tube placed into the thorax or or intermittent thoracentesis.
Surgery
Your veterinarian may feel that thoracentesis will not be an effective treatment for your pet and choose to perform surgery to treat this disease. The two surgical options are:
Thoracic duct ligation – This surgical method involves the ligation of the thoracic duct, preventing the chyle flow through this duct and instead forcing the body to develop new lymphatic connections to the venous system in the abdomen.
Ablation of the cisterna chyli – This surgical method involves removing the cisterna chyli, causing the body to create new pathways for the lymph fluid to enter the bloodstream, allowing pressure on the thoracic duct to be relieved, and leaking of chyle into the thorax reduced.
Recent studies have also shown that a pericardiectomy, the removal of the pericardium, may be beneficial in treatment of this condition. Your veterinarian will discuss with you the risks involved with this procedure. The surgery for chylothorax may be time consuming and due to decreased lung capacity and the respiratory effects of anesthesia agents, your dog is at an increased anesthetic risk.
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Recovery of Chylothorax in Dogs
Your dog will likely require hospitalization following the surgery. As anesthetic can cause hypothermia and excitement during the recovery period he will be provided with a warm, quiet environment during the postoperative period, in some cases oxygen therapy may also be indicated during this time. Your veterinarian may continue to drain your pet’s thorax intermittently using the chest tube. Your dog will be carefully monitored and once his chest tube is able to be removed he will be able to be discharged.
Offer regular, palatable meals and encourage food intake during your pet’s recovery. A diet restrictive of fat may be indicated by your veterinarian.
Regular revisit appointments are vital and intermittent, outpatient thoracentesis may be necessary if clinical signs present. The prognosis varies depending on the treatment given, however when successful you can expect full recovery within a few weeks of surgery.
Chylothorax Average Cost
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Chylothorax Questions and Advice from Veterinary Professionals
Labrador Retriever
Liza
7 Years
0 found this helpful
0 found this helpful
My pet has the following symptoms:
Difficulty Breathing
Not Eating
Cant Lay Still
Our perfectly healthy 7 year old lab was bit in the thorax right above her left leg by another dog. She was given antibiotics and pain killers the next day. Two days later her leg swelled up and fluid accumulated under her chest behind the front legs. Her leg was weeping blood and fluid. Went back to vet, stronger antibiotics which were not helping. She died the next day. Is there anyway this could have been chylothorax? Maybe the bite punctured her thoracic duct?
June 13, 2018
0 Recommendations
I understand that you’re trying to make sense of Liza’s passing, but without examining her and performing a necropsy I cannot give you any concrete answers; I also do not want to speculate what the specific cause of death was (besides complications from a dog bite). Regards Dr Callum Turner DVM
June 14, 2018
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Mutt
Lenny
4 Years
6 found this helpful
6 found this helpful
My pet has the following symptoms:
Hot Spots
Random Swelling
I have a large mixed breed dog that I adopted 4 years ago. He was approximately 8 weeks old at the time.
When he was about a year and a half old, he was diagnosed with idiopathic Chylothorax. My veterinarian didn't feel confident in performing the surgery and the nearest place that could, would charge far more than I could afford... So my vet and I decided on a low fat diet and Rutin for treatment.
My vet has seemed satisfied with his development and checks him annually for any changes (bloodwork and exams).
Within the last month, my dog has suddenly developed hot spots and random swelling. He's never had these symptoms before. The first appearance was a hot spot on his hip, which I treated promptly. A few days later his right eye swelled up. It lasted about two days and was gone. My vet checked him out and found nothing out of the ordinary and chalked it up to possible allergies.
About 3 weeks later, another hot spot popped up, this time under the base of his tail. The right side of his muzzle also swelled up (top and bottom lips). Of course, I'll have my vet check him out this week. But, I'm wondering if his immune system could be compromised from the Chylothorax? Has anyone else experienced these sorts of ailments with Chylothorax?
June 7, 2018
Answered by Dr. Michele K. DVM
6 Recommendations
Skin disease and random infections are not related to Chylothorax, in my experience, and may be a different, unrelated problem. I am impressed that you have been able to manage the chylothorax medically, that is not a small feat. I hope that all goes well for him.
June 7, 2018
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Boxer/Bull Terrier
Lugnut
3 Years
0 found this helpful
0 found this helpful
I have a 3.5 year old boxer/bull terrier mix, he was diagnosed with a Chylothorax on March 27, 2018. He under went a Thoracentesis on that date, and again on May 12, 2018. On May 12 the Thoracentesis produced approximately 3000 cc of Chyle. He is scheduled for a few tests on the 17th to check for Cancer. He doesn't act "abnormal" in between the procedures, except when close to needing the Thoracentesis. Is it your opinion this is an idiopathic case, or a concern for Cancer. The first round of blood work and radiography did not point to this diagnosis, the attending DVM's prognosis was it was due to Trauma. The latter prognosis was Cancer, the reason being is that "trauma" would have healed by now. Any thoughts on these differing opinions?
May 17, 2018
Answered by Dr. Michele K. DVM
0 Recommendations
Chylothorax can be a difficult disease to diagnose, as to the cause. An ultrasound of his chest will help to figure out if he has cancer, or if it is idiopathic. I think that you will know more once you have further testing done, and as far as the differing opinions, typically, we start with a list of possible reasons and work out way down based on response to therapy and further diagnostics. I hope that all goes well for Lugnut.
May 17, 2018
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Great Pyrenees
Piper
1 1/2 years old
0 found this helpful
0 found this helpful
My pet has the following symptoms:
Dyspnea,
Fluid In Thoracic Cavity
My dog fell down a 10 ft well and came into contact with some unknown caustic substance. she sustained a puncture wound to her back, r. leg which required amp of two toes. It's healing but final status TBD. as she was getting ready for discharge she presented w/a chylothorax that required they evacuate 3500 mls of fluid. currently shes in the doggie ICU w/bilateral chest tubes, IJ catheter. We're on day 15 and no significant improvement. They added steroids to her care yesterday. They assume the condition is secondary to trauma but really there unsure. I don't know what to do and frankly I'm exhausting my financial resources. They keep telling me she's a mystery of sorts. But that is unhelpful in helping my baby.
Aug. 30, 2017
0 Recommendations
Chylothorax is not really understood well in small animals and trauma is often a contributing factor for the accumulation of chyle in the thorax. Drainage of chyle from the thorax is an initial step, but thoracic duct ligation may need to be performed and movement to a low fat diet. I unfortunately cannot shed more light on this. Regards Dr Callum Turner DVMwww.vin.com/apputil/content/defaultadv1.aspx?meta=Generic&pId=11223&id=3859276http://veterinarycalendar.dvm360.com/chylothorax-proceedings-0www.acvs.org/small-animal/chylothorax
Aug. 30, 2017
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German Shepherd
Daisy
9 Years
2 found this helpful
2 found this helpful
My pet has the following symptoms:
No Symptoms
My GSD had the thoracic duct ligation and pericardectomy surgery done nearly 7 years ago and is still going strong. My question is, does she have to be on a very low fat diet the rest of her life? She has had no complications thus far but I cannot get a straight answer from the specialty center or her regular vet. They both tell me it "wouldn't hurt to keep her on it".
The reason I ask this now is because I lost my other GSD very suddenly in February and since then Daisy hasn't eaten the same and has lost nearly 10#. I have done a full work-up on her to make sure there was nothing else going on with her. I switched her from Blue Buffalo Healthy Weight (she was on this her entire life) to Nutro Wholesome Essentials Healthy Weight. Since switching her, she has started to eat a little better but her stools are starting to become loose. I am finding it difficult to find another low fat diet in the same price range that isn't full of fillers, so if I could cut out the low fat portion (especially because she has lost weight) that would really help in the search.
July 26, 2017
2 Recommendations
A low fat diet is recommended to reduce the flow of chyle through the thoracic duct, if the thoracic duct has been ligated there should be no more flow of chyle. The problem with chylothorax is that we know very little about this condition and there is little reputable scientific evidence of different treatments which leads Veterinarians now wanting to commit to an answer on some questions. You could try moving to another diet which may have more fat but still less in relation to other products on the market. Some over the counter supplements like rutin are reported to help but again there is no scientific evidence published. Regards Dr Callum Turner DVMwww.acvs.org/small-animal/chylothorax
July 26, 2017
My dog was diagnosed with chylothorax almost 6 months ago, there isn't a surgeon in Oklahoma that my vet would trust with surgery so I haven't done the surgery and she said there is only a 50% chance of the surgery working. I take Bart in about once a month to get his chest drained. He is on satiety control from royal canin (he was on the GI low fat one but actually put on weight because he liked the food so much). He takes 3000mg of rutin three times a day, spironolactone 50mg three times a day, and 5mg of prednisone once a day.
Oct. 13, 2017
Laura C.
I was wondering what happened with your pincher as my Australian Sheperd has the fluid in the chest and abdomin as well. She had surgery a week ago and during the follow up today, she has fluid build up in her stomach, but her chest seems clear. Have you had any success?
Nov. 2, 2017
Lisa V.
Trying to get a hold of Alicechick18, I have a 2 year 9 month old Doberman Pinscher who has been diagnosed with chylothorax and they are recommending a thoracic duct ligation as well as a pericardiectomy, I've done a lot of research and have read that chances of survival increase dramatically with this surgery. It sounds like your Daisy has done quite well, thank goodness for that. The reason I'm trying to contact you is that I live in North Florida and it is very expensive for this surgery the first internalist and I won't mention the place said around $10,000. Since that time we have changed to the University of Florida in Gainesville and are seeing an internalist this coming Thursday 8/10/2017. My research has also indicated that prices can vary dramatically from region to region I was wondering if you did not mind, could you tell us where you live, and where you had your procedure done, on your Daisy. We are worried sick about our Ares and since we first took him in to ER on the 6th of July he had quite a bit of fluid drawn from his abdomen and his thorax what they are calling bicavitorial, he has had fluid drawn out one additional time at the University on the 31st of July. He takes Rutin 2000 mg every 8 hours and he takes Clavamox 250 mg one every 12 hours, one folic acid, 1 probiotic, and 1 20 mg prednisone every other day. And it was recommended that he eat a low fat diet as well. Right now he's eating Royal Canin GI but we were wondering was there an equivalent or better, that was maybe not as expensive. I'm not sure you will get this message I really hope that you do and respond to us and we thank you for any information you can give us that may help us save our pal Ares.
djwheels@comcast.net
Aug. 30, 2017
Rose W.
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Chylothorax Average Cost
From 516 quotes ranging from $500 - $3,000
Average Cost
$1,000
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