Greenfield Puppy Mill

What is Chylothorax?

A chylothorax is an accumulation of chyle (milky fluid) in the chest cavity. As the fluid builds up, it leads to diﬃculty breathing. Chyle is a fatty substance present in the lymph vessels which can leak out if the vessel ruptures. Most commonly, Chylothorax is idiopathic with no underlying cause, however sometimes it can occur secondary to trauma, heart disease, or cancer. Testing includes measurement of fat levels in the fluid and blood as well as cytology of the fluid to confirm that the fluid is chyle. It is recommend to test for underlying causes including bloodwork, echocardiogram to look for heart disease, and potentially abdominal ultrasound or CT scan to

look for evidence of cancer. Initial treatment involves draining of the fluid and low-fat diet. Fluid typically will re-accumulate, however, repeat drainage is usually required. If an underlying cause is not found, there are surgical options to try to decrease fluid-accumulation long-term (unfortunately, surgery is not always eﬀective).

4/19/24: 1st Vet Visit (Regular Vet)

Murphy had difficulty breathing and took him to the vet. They told us he had a bunch of fluid in his chest after viewing the X-Ray. The regular vet could not do this so they had us go to the ER vet immediately after this visit. We didn’t realize how serious this was and was told we had to act immediately if we wanted the slightest chance of him surviving. They didn’t think that he would make it through the night if he wasn’t drained and depending on the cause, they weren’t sure if he would make it through the week.

You can see in the above X-Rays that he’s bloated and has a significant amount of milky Chyle fluid filling his body.

4/19/24: 2nd vet visit (ER)

History

Treatment Plan

Visit Summary

Murphy, a five-year-old male neutered golden retriever, was referred to Veterinary Emergency and Critical Care for pleural eﬀusion and dyspnea. It was noted that Murphy had a history of breathing diﬃculties dating back to October. Intermittent labored breathing and coughing had been occurring but had not been investigated further until the recent exacerbation. Radiographs were taken at the primary care vet that revealed a large amount of pleural eﬀusion. Murphy's appetite and behavior remained normal, and he was on a grain-free diet (Taste of the Wild) for two years. Additionally, Murphy had an extensive travel history, having moved across the country two years ago and traveled to various states across the country. No vomiting, diarrhea, lethargy, or exercise intolerance was reported, and Murphy had normal bathroom habits on the morning of the examination.

Visit Summary

Treatment Plan

Visit Summary

On initial physical exam, Murphy's vitals were normal. His respiratory eﬀort moderately increased and his oxygenation level was slightly low. A large amount of free fluid was noted on a brief scan. He was slightly sedated and had 3.3 liters of milky fluid removed without complication. X-rays after the procedure did not reveal an obvious mass but he was slightly crooked. His liver appeared more normal in size in these x-rays. Bloodwork here revealed no significant changes. The triglyceride level of his chest fluid was consistent with a chylothorax (a chest filled with chlye fluid). We consented to sending out further tests of the fluid. His oxygenation level was normal after the procedure so we took him home.