ASK THE VET

Mild chylothorax is best treated with low-fat diet

6/2/2013

I have a 5-year-old indoor cat that had an X-ray and they found fluid between the lungs and chest wall. They removed a milky-pink fluid that was sent to a pathologist who diagnosed the fluid as chyle. His vet does not think it is heart related and recommended a low-fat diet and a supplement rutin. I have been unsuccessful in getting him to take the rutin by mouth or smashed in his food. A month later more fluid was removed from his chest. He has lost weight and is sleeping a lot. Do you have any suggestions?

I am sorry to hear that he is having so much trouble at such a young age. The condition you are describing is a disease called chylothorax. Chyle is a combination of fluid called lymph and emulsified fats from digestion. There are a number of small vessels that channel lymph and chyle that can become blocked. This results in accumulating fluid, most commonly in the chest.

Cats who are severely affected can have trouble breathing from the fluid preventing the lungs from expanding properly. A combination of X-rays and analysis of the fluid routinely leads to a diagnosis. If the fluid accumulation is severe, the fluid can be drained from the chest but it will immediately begin filling up again. Trauma can damage the small vessels in the chest and abdomen, but the majority of cats have no known cause.

Cats who can breathe relatively well are treated with a low-fat diet and supplements. The goal of these treatments is to limit the fats that are digested and rutin is reported to stimulate the cells in the chest to process some of the fluid. Of the two treatments, the low-fat diet has the best chance at managing his condition. Surgical correction can be attempted for more severe cases, but the overall success rate of the procedure is about 30 percent.

Many cats can lead normal lives with minimal disruption if the dietary management is successful or if the leakage of fluid stops. However, a complication of the fluid in the chest cavity can be scarring or fibrosis of the lung tissue. If this develops the long-term prognosis is guarded since breathing will become increasing more difficult. He will need some follow up x-rays and possibly an ultrasound to determine what course his disease is taking. Hopefully, he will not develop any more serious complications, so keep up with the diet. You may also be able to have the rutin compounded into a more palatable option for him. Ask your veterinarian for some suggestions.

Questions for Dr. Gary Thompson can be emailed to askthevet@theblade.com or mailed to The Blade, Attn. Ask the Vet, 541 N. Superior St., Toledo, OH 43660. Dr. Thompson regrets that he cannot answer individual letters.