Thoracic duct ligation for the treatment of idiopathic chylothorax in a dog

Abstract

Madison, a 5 year old diabetic female spayed mixed breed dog, presented to Cornell University Hospital for Animals soft tissue service with a history of idiopathic chylothorax and gastric dilation. A physical examination disclosed muffled heart sounds, decreased lung sounds, tachycardia and gastric dilation. Madison was admitted to the hospital for a thoracic duct ligation and a prophylactic gastropexy. During the days following surgery, a moderate amount of modified transudate was collected from her chest, which increased in quantity over time. Madison remained anorexic and weak following surgery, and her blood work showed evidence of infection. Madison’s antibiotic plan was then changed, the chest tube was removed, and the tip of the tube was submitted for culture and sensitivity. Due to economic concerns, Madison was discharged that afternoon to the care of her owners and referring veterinarian 6 days after surgery. At the rDVM, Madison remained weak and anorexic, continued to produce fluid in her chest and developed abdominal effusion. Her rDVM continued tapping her chest and took her to surgery for an abdominal explore, where diffuse peritonitis was observed. Necrotic omentum was resected and the abdomen was lavaged with several liters of saline. Unfortunately, Madison passed away 5 hours after recovering from anesthesia. That afternoon, we received the culture and sensitivity result which described a highly resistant, well encapsulated E.coli, only susceptible to Amikacin and Imipedem.