View Full Version : Trauma/Chylothorax/Lymphoma?

August 23rd 12, 03:54 PM
Hi everyone!

My name is Katya, I'm from Ukraine. I looked for info on Russian vet forums, asked question trying to find out what actually happened with my pour kitty, trying to find some logic in all that nightmare but in vain. So, now I'm here and hope you guys have some strength to tolerate my barbarian English and would help me in solving that terrible puzzle.

My tabby cat was about 1.5 y/o when an accident had happened - she jumped from the balcony on the 10th floor. She was extra-lucky and wasn't injured in any way, just tiny scratches on her nose and several broken whiskers. One week later poor thing was as normal as usual. Vet said if you see anything strange in behavior, come to take some tests etc. But she was OK.

Two months passed and we noticed that our cat's breathing is a little heavy. Radiography revealed liquid in the chest cavity. Thoracocentesis was held and 190 ml of milky liquid was evacuated. No pus, no bacteria, no atypical cells in the chyle. There were three more punctions in two weeks after that and every time it was the same - about 200 ml of white liquid. Then thoracic duct ligation was held. Tubes were installed in the chest cavity. In three weeks-term the cat was fully recovered and became her cheerful self.

9 months passed and everything came back - heavy breathing and liquid in the chest. Vets repeated thoracic duct ligation and drainage of the pleural cavity. But our kitty started vomiting, didn't eat anything, her body temperature was slightly higher than normal, she lost 700 g of weight in 6 days. There was blood in her urine and vomit. The blood analysis revealed hematocrit 30% lower than normal and low lymphocytes as well. The liquid began to accumulate in abdominal cavity, too. Plus peritoneal commissures. In the chest cavity exudate they found lymphocytes and in the abdominal cavity exudate - leukocytes. FelV-test was negative. No swollen lymph nodes. They said it is lymphoma although with the probability of 70% and recommended euthanasia. We - my husband and I - said no and asked to install tubes in the abdominal cavity and proceed steroid therapy and then start chemotherapy. But our beloved kitty stopped breathing two minutes after surgery...

We have several questions:

- What are possible nonviral causes of lymphoma (stuff that was used for lymphangiography maybe)? Could the FelV-test be false negative? Are our survived four adult cats (non-relative to the deceased one) in any danger? Could they develop lymphoma suddenly one day? Could it be prevented somehow?

- Considering that it was a long time after trauma (two months) and any rupture in thoracic duct will heel without medicine, how actually it can break by itself? Weak walls or smth? Why it was a leakage second time, why the lymph vessel tore off in the belly?

- After second ligation everythig just went out of control, the reddish exudate was flowing from everywhere and in the same amount as before the surgery. The surgeon said it's OK because the lymph vessel was the big one - almost like vein - and there would be some tension in the system before lymph will settle evenly. Is he right? What possible steps to prevent/stop massive leakage could be undertaken at that point?

- What is the actual prognosis for cats with mediastinal lymphoma? If the diagnosis is right and our kitty had virus or was initially predisposed for cancer in any way, was the trauma some kind of trigger which boosted the cancer? Are those 9 months just a recession and not full recovery from idiopathic chylothorax as we thought?

- Cytology didn't find differentiated cells, lypmh nodes were OK, too. Is it enough for diagnosis of lymphoma just lymphocytes in chest and leucocytes in abdominal cavity? Biopsy can prove it but it wasn't conducted 'cause there were no palpable or visible tumor. What tests are needed to prove lymphoma finally, with the probability of 100%?

- Theoretically speaking, what are another possible causes of chyle accumulation in the chest cavity besides lymphoma?

Any comments and opinions on the subject are appreciated. Blood and urine tests results and prescriptions on demand.

Thanks in advance for reply!

Odessa, Ukraine