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Prospective Comparison of Cisterna Chyli Ablation to Pericardectomy for Treatment of Spontaneously Occurring Idiopathic Chylothorax in the Dog

Authors

  • Jonathan F. McAnulty DVM, PhD

    Corresponding author
    • Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI
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  • Funded by a grant from the Morris Animal Foundation.

  • Presented in part at the annual scientific meeting of the American College of Veterinary Surgeons, San Diego, CA, 2008.

Corresponding Author

Jonathan F. McAnulty, DVM, PhD, School of Veterinary Medicine, University of Wisconsin-Madison, 2015 Linden Dr. W., Madison, WI 53706

E-mail: mcanultj@svm.vetmed.wisc.edu

Abstract

Objective

Prospective comparison of cisterna chyli ablation (CCA) or pericardectomy (PC) for chylothorax.

Study Design

Randomized prospective study.

Subject Population

Dogs with idiopathic chylothorax (n= 23).

Methods

Dogs were treated by thoracic duct ligation (TDL) with either CCA (n = 12) or PC (n = 11). Long-term outcomes, intraoperative central venous pressures (CVPs) and pericardial histology were assessed. Dogs with persistent chylothorax were offered retreatment by the alternative procedure.

Results

Ten (83%) dogs treated by CCA-TDL and 6 (60%) treated by PC-TDL resolved their chylothorax. Retreatment in 4 dogs resulted in resolution in 2 dogs and 2 perioperative deaths. Four dogs developed nonchylous effusions; 2 of which resolved after initiating steroid therapy, 1 of which was unsuccessfully treated by PC, and 1 continues to be managed by thoracocentesis 6.5 years later. CVPs were normal in most dogs and unaffected by PC. On histology, pericardial tissues had extensive external surface fibrosis with mild inflammation. On follow-up (≤6.5 years), no recurrence of pleural effusions occurred after initial resolution.

Conclusions

CCA-TDL appears to offer improved outcomes over historical results with TDL. Results with PC-TDL were more variable for unknown reasons. Venous pressure measurements did not support the hypothesis that venous hypertension was involved in chylothorax or response to therapy in these dogs.

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