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Medical management of idiopathic chylothorax in a crossbreed cat with octreotide and Rutin use: A case report

Year 2024, , 148 - 154, 31.08.2024
https://doi.org/10.30704/http-www-jivs-net.1488928

Abstract

This case report describes the diagnosis and treatment of idiopathic chylothorax in a 5-year-old female crossbreed cat who presented with respiratory distress, tachypnea, cyanosis, exercise intolerance and weight loss over a short period of time. Based on the clinical examination, blood results, radiological and echocardiographic findings, the patient was diagnosed with chylous effusion. Chylothorax was considered idiopathic because there was no underlying trauma or disease etiology. Effusion drainage was performed by thoracocentesis to reduce respiratory stress. After thoracocentesis, followed by using medical octreotide- a somatostatin analogue (Sandostatin™, 0.1 mg/ml ampoule, Novartis, USA) and rutin - a flavone benzo-γ-pyrone plant fruit extracted from the Brazilian plant Fava D'anta (Dimorphandra mollis) (Rutin - Plant-Based Bioflavonoid, 500 mg tablet, Solgar™, USA), were administered in addition to supportive treatment. Rutin and ocreotide have been used successfully in humans, dogs and cats to the treatment of pleural effusions as presented various studies. It is hoped that these drugs may also be useful for decreasing pleural effusion in cats with chylothorax. In this represented case; partial resolution of pleural effusion was observed after octreotide usage and complete resolution of pleural effusion was observed after rutin (plant-based bioflavonoid) usage. No recurrence was observed during 7 months of regular follow-up.It was determined that the use of octreotide and rutin after thoracocentesis gave successful results in the medical management of idiopathic chylothorax in cats.

References

  • Beatty, J., & Barrs, V. (2010). Pleural effusion in the cat: a practical approach to determining aetiology. Journal of Feline Medicine and Surgery, 12(9), 693-707.
  • Birchard, S. J., & Fossum, T. W. (1987). Chylothorax in the dog and cat. Veterinary Clinics of North America: Small Animal Practice, 17(2), 271-283.
  • Birchard, S. J., McLoughlin, M. A., & Smeak, D. D. (1995). Chylothorax in the dog and cat: a review. Lymphology, 28(2), 64-72.
  • Brink, P., Wilkins, L. P., & Spano, J. S. (1996). Chylothorax due to primary thoracic haemangiosarcoma in a horse. Equine Veterinary Journal, 28(3), 241-244.
  • Chinnock, B. F. (2003). Chylothorax: case report and review of the literature. The Journal of Emergency Medicine, 24(3), 259-262.
  • Esme, H. (2019). The use of octreotide in the treatment of chylothorax. Journal of Contemporary Medicine, 9(4), 432-435. Fossum, T. W., Forrester, S. D., Swenson, C. L., et al. (1991). Chylothorax in cats: 37 cases (1969–1989). Journal of the American Veterinary Medical Association, 198, 672-678. Fossum, T. W. (2001). Chylothorax in cats: is there a role for surgery?. Journal of Feline Medicine and Surgery, 3, 73-79.
  • Fossum, T. W. (2006). Chylothorax: surgery is effective!. Ghiringhelli, M., Brizzola, S., Barella, G., Lodi, M., Faverzani, S., & Acocella, F. (2016). Octreotide as medical therapy of idiopathic chylothorax in 3 cats after surgery. Conference: BSAVA Congress 7-10 April 2016 Birmingham UK. Gould, L. (2004). The medical management of idiopathic chylothorax in a domestic long-haired cat. The Canadian Veterinary Journal, 45(1), 51.
  • Gupta, B. N., & Faith, R. E. (1977). Chylothorax in a rat. Journal of the American Veterinary Medical Association, 17, 973-974. Hambrook, L. E., & Kudnig, S. T. (2012). Lung lobe torsion in association with a chronic diaphragmatic hernia and haemorrhagic pleural effusion in a cat. Journal of Feline Medicine and Surgery, 14(3), 219-223.
  • Kato, Y., Asano, K., Namiki, M., Kutara, K., Sasaki, Y., Teshima, K., Edamura, K., & Tanaka, S. (2005). Use of rutin for successful management of feline idiopathic chylothorax. Journal of the Japan Veterinary Medical Association, 58(1), 54-57.
  • Kopko, S. H. (2005). The use of rutin in a cat with idiopathic chylothorax. The Canadian Veterinary Journal, 46(8), 729.
  • Litvin, R., Razok, A., Dasgupta, M., Trevino, E. M., Eldin, M. S., & Fakhran, S. (2023). Nontraumatic chylothorax: a case series from a safety-net hospital. Annals of Internal Medicine: Clinical Cases, 2(9), e230119.
  • Mclane, M. J., & Buote, N. J. (2011). Lung lobe torsion associated with chylothorax in a cat. Journal of Feline Medicine and Surgery, 13(2), 135-138.
  • Nikiphorou, X., Chioti, R., Patsikas, M. N., & Papazoglou, L. G. (2016). Peritoneopericardial diaphragmatic hernia in the dog and cat. Journal of the Hellenic Veterinary Medical Society, 67(3), 189-194.
  • Sack, D., Hyndman, P., Milligan, M., & Spector, D. (2022). Decortication, thoracic omentalization, and pericardiectomy for treatment of severe fibrosing pleuritis in a cat. Journal of the American Veterinary Medical Association, 260(3), 335-340.
  • Sicard, G. K., Walker, K. R., & McAnulty, J. F. (2005). The effect of cisterna chyli ablation combined with thoracic duct ligation on abdominal lymphatic drainage. Veterinary Surgery, 34, 64-70.
  • Singh, A., Brisson, B., & Nykamp, S. (2012). Idiopathic chylothorax: pathophysiology, diagnosis, and thoracic duct imaging. Compendium: Continuing Education for Veterinarians, 34(8), E2.
  • Spencer, A. J., & Karen, M. T. (2012). Thoracic cavity: veterinary surgery small animal volume two. Elsevier Saunders, Missouri, pp: 1787-1812.
  • Stockdale, S. L., Gazzola, K. M., Strouse, J. B., Stanley, B. J., Hauptman, J. G., & Mison, M. B. (2018). Comparison of thoracic duct ligation plus subphrenic pericardiectomy with or without cisterna chyli ablation for treatment of idiopathic chylothorax in cats. Journal of the American Veterinary Medical Association, 252(8), 976-981.
  • Thompson, M. S., Cohn, L. A., & Jordan, R. C. (1999). Use of rutin for medical management of idiopathic chylothorax in four cats. Journal of the American Veterinary Medical Association, 215(3), 345-348.
  • Yılmaz, Z., & Kocatürk, M. (2023). The effect of octreotide in medical treatment of idiopathic chylothorax in a cat. Türk Veteriner Cerrahi Dergisi, 1(2), 19-22.

Medical management of idiopathic chylothorax in a crossbreed cat with octreotide and rutin use: A case report

Year 2024, , 148 - 154, 31.08.2024
https://doi.org/10.30704/http-www-jivs-net.1488928

Abstract

BThis case report describes the diagnosis and treatment of idiopathic chylothorax in a 5-year-old female crossbreed cat who presented with respiratory distress, tachypnea, cyanosis, exercise intolerance and weight loss over a short period of time. Based on the clinical examination, blood results, radiological and echocardiographic findings, the patient was diagnosed with chylous effusion. Chylothorax was considered idiopathic because there was no underlying trauma or disease etiology. Effusion drainage was performed by thoracocentesis to reduce respiratory stress. After thoracocentesis, followed by using medical octreotide- a somatostatin analogue (Sandostatin™, 0.1 mg/ml ampoule, Novartis, USA) and rutin - a flavone benzo-γ-pyrone plant fruit extracted from the Brazilian plant Fava D'anta (Dimorphandra mollis) (Rutin - Plant-Based Bioflavonoid, 500 mg tablet, Solgar™, USA), were administered in addition to supportive treatment. Rutin and ocreotide have been used successfully in humans, dogs and cats to the treatment of pleural effusions as presented various studies. It is hoped that these drugs may also be useful for decreasing pleural effusion in cats with chylothorax. In this represented case; partial resolution of pleural effusion was observed after octreotide usage and complete resolution of pleural effusion was observed after rutin (plant-based bioflavonoid) usage. No recurrence was observed during 7 months of regular follow-up.It was determined that the use of octreotide and rutin after thoracocentesis gave successful results in the medical management of idiopathic chylothorax in cats.

References

  • Beatty, J., & Barrs, V. (2010). Pleural effusion in the cat: a practical approach to determining aetiology. Journal of Feline Medicine and Surgery, 12(9), 693-707.
  • Birchard, S. J., & Fossum, T. W. (1987). Chylothorax in the dog and cat. Veterinary Clinics of North America: Small Animal Practice, 17(2), 271-283.
  • Birchard, S. J., McLoughlin, M. A., & Smeak, D. D. (1995). Chylothorax in the dog and cat: a review. Lymphology, 28(2), 64-72.
  • Brink, P., Wilkins, L. P., & Spano, J. S. (1996). Chylothorax due to primary thoracic haemangiosarcoma in a horse. Equine Veterinary Journal, 28(3), 241-244.
  • Chinnock, B. F. (2003). Chylothorax: case report and review of the literature. The Journal of Emergency Medicine, 24(3), 259-262.
  • Esme, H. (2019). The use of octreotide in the treatment of chylothorax. Journal of Contemporary Medicine, 9(4), 432-435. Fossum, T. W., Forrester, S. D., Swenson, C. L., et al. (1991). Chylothorax in cats: 37 cases (1969–1989). Journal of the American Veterinary Medical Association, 198, 672-678. Fossum, T. W. (2001). Chylothorax in cats: is there a role for surgery?. Journal of Feline Medicine and Surgery, 3, 73-79.
  • Fossum, T. W. (2006). Chylothorax: surgery is effective!. Ghiringhelli, M., Brizzola, S., Barella, G., Lodi, M., Faverzani, S., & Acocella, F. (2016). Octreotide as medical therapy of idiopathic chylothorax in 3 cats after surgery. Conference: BSAVA Congress 7-10 April 2016 Birmingham UK. Gould, L. (2004). The medical management of idiopathic chylothorax in a domestic long-haired cat. The Canadian Veterinary Journal, 45(1), 51.
  • Gupta, B. N., & Faith, R. E. (1977). Chylothorax in a rat. Journal of the American Veterinary Medical Association, 17, 973-974. Hambrook, L. E., & Kudnig, S. T. (2012). Lung lobe torsion in association with a chronic diaphragmatic hernia and haemorrhagic pleural effusion in a cat. Journal of Feline Medicine and Surgery, 14(3), 219-223.
  • Kato, Y., Asano, K., Namiki, M., Kutara, K., Sasaki, Y., Teshima, K., Edamura, K., & Tanaka, S. (2005). Use of rutin for successful management of feline idiopathic chylothorax. Journal of the Japan Veterinary Medical Association, 58(1), 54-57.
  • Kopko, S. H. (2005). The use of rutin in a cat with idiopathic chylothorax. The Canadian Veterinary Journal, 46(8), 729.
  • Litvin, R., Razok, A., Dasgupta, M., Trevino, E. M., Eldin, M. S., & Fakhran, S. (2023). Nontraumatic chylothorax: a case series from a safety-net hospital. Annals of Internal Medicine: Clinical Cases, 2(9), e230119.
  • Mclane, M. J., & Buote, N. J. (2011). Lung lobe torsion associated with chylothorax in a cat. Journal of Feline Medicine and Surgery, 13(2), 135-138.
  • Nikiphorou, X., Chioti, R., Patsikas, M. N., & Papazoglou, L. G. (2016). Peritoneopericardial diaphragmatic hernia in the dog and cat. Journal of the Hellenic Veterinary Medical Society, 67(3), 189-194.
  • Sack, D., Hyndman, P., Milligan, M., & Spector, D. (2022). Decortication, thoracic omentalization, and pericardiectomy for treatment of severe fibrosing pleuritis in a cat. Journal of the American Veterinary Medical Association, 260(3), 335-340.
  • Sicard, G. K., Walker, K. R., & McAnulty, J. F. (2005). The effect of cisterna chyli ablation combined with thoracic duct ligation on abdominal lymphatic drainage. Veterinary Surgery, 34, 64-70.
  • Singh, A., Brisson, B., & Nykamp, S. (2012). Idiopathic chylothorax: pathophysiology, diagnosis, and thoracic duct imaging. Compendium: Continuing Education for Veterinarians, 34(8), E2.
  • Spencer, A. J., & Karen, M. T. (2012). Thoracic cavity: veterinary surgery small animal volume two. Elsevier Saunders, Missouri, pp: 1787-1812.
  • Stockdale, S. L., Gazzola, K. M., Strouse, J. B., Stanley, B. J., Hauptman, J. G., & Mison, M. B. (2018). Comparison of thoracic duct ligation plus subphrenic pericardiectomy with or without cisterna chyli ablation for treatment of idiopathic chylothorax in cats. Journal of the American Veterinary Medical Association, 252(8), 976-981.
  • Thompson, M. S., Cohn, L. A., & Jordan, R. C. (1999). Use of rutin for medical management of idiopathic chylothorax in four cats. Journal of the American Veterinary Medical Association, 215(3), 345-348.
  • Yılmaz, Z., & Kocatürk, M. (2023). The effect of octreotide in medical treatment of idiopathic chylothorax in a cat. Türk Veteriner Cerrahi Dergisi, 1(2), 19-22.
There are 20 citations in total.

Details

Primary Language English
Subjects Veterinary Surgery
Journal Section Case reports
Authors

Burcu Ezgi Eregar 0000-0002-7624-2685

Elçin Emiroğlu 0009-0008-8029-8607

Özlem Güzel 0000-0002-3832-4233

Publication Date August 31, 2024
Submission Date May 23, 2024
Acceptance Date June 7, 2024
Published in Issue Year 2024

Cite

APA Eregar, B. E., Emiroğlu, E., & Güzel, Ö. (2024). Medical management of idiopathic chylothorax in a crossbreed cat with octreotide and Rutin use: A case report. Journal of Istanbul Veterinary Sciences, 8(2), 148-154. https://doi.org/10.30704/http-www-jivs-net.1488928

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