My cat has a grave prognosis-Chylothorax (LONG)

"Candace" wrote in message
oups.com...
Phil P. wrote:

Speak to your vet about Rutin (available from the Solgar Vitamin Co.,
Lynbrook, NY- and probably your local pharmacy) at about 50 to 100
mg/kg
orally every 8 hr. I can't say with absolute certainty that Rutin
cured
our chylo cats by itself or if the chylo resolved spontaneously- but
after a
few months of low-fat diets and thoracentesis as necessary to relieve
dyspnea and limit fibrosing pleuritis, both cats pulled through.

A U of Minn study done on 4 chylo cats showed clinical improvement in 3
and
*complete* resolution in 2 of the 4 cats-- So, I'd say its definitely
worth
a shot.

Best hopes & wishes for you and Abbey.

Phil

Thanks, Phil. Yes, we got some Rutin today. I had read about it and
the vet said it wouldn't hurt. They're big horse pills but we'll cut
them down and try to find a smaller pill meanwhile.


Cut 'em down and put the pieces in small gelcaps.


We're also going
to do Vitamin E to help the scarring.


Great idea!


A few months of thoracentesis? Wow, I hope I can afford that.

Actually, trying to remember- it was about 2 months- and only 3 or 4 times-
it was awhile ago.


Were
these cats diagnosed with idiopathic chylo or was there an underlying
cause determined?

We never found the cause. One vet thought it might have been caused by
trauma- but the thoracic duct heals pretty fast- usually within a week a two
and the chylo effusion usually resolves by itself without any treatment.
So, I don't think it was caused by trauma. There are many other possible
causes, but neither cat had any evidence of any of them.


That study makes me more determined to continue on
with the taps. Maybe my vets will work something out with me...

Before Abbey has another thoracentesis, you might want to do an ultrasound-
the chyle actually *helps*- it acts like an "accoustic window" and enhances
the images. Plus, you can tilt the body to move the chyle where you want it
to get a really good image. You might find the 'leak' or at least from
where the chyle is seeping. It might not be a hole but rather seeping
through the TD wall. If you can pinpoint the location of the seepage- TD
ligation wouldn't be that difficult.



Do you have an opinion about Vitamin E for the scarring? The vet said
that wouldn't hurt either so we're trying that, too. I guess at this
point nothing much "hurts."


I didn't try it- but it sure sounds like a good idea! I wish one of us
would have thought of it!



Did your chylo cats stay on lasix, too? Did they remain on it
permanently?


No. The chylo resolved completely.


Do you have a link to the U of Minn study? That is very
encouraging as is the fact that your 2 chylo cats resolved.

Here's the abstract with the journal citation. Your vet should have the
original journal with the full text study.

"J Am Vet Med Assoc 1999 Aug 1;215(3):345-8, 339



Use of rutin for medical management of idiopathic chylothorax in four cats.



Thompson MS, Cohn LA, Jordan RC



Department of Veterinary Medicine and Surgery, College of Veterinary
Medicine,

University of Missouri-Columbia 65211, USA.



Four cats with idiopathic chylothorax were given rutin. Three of the 4 cats
had clinical improvement, and complete resolution of chylous effusion was
evident in 2 cats. Idiopathic chylothorax in cats is a condition that may be
difficult to resolve with medical or surgical treatment. Currently, thoracic
duct ligation is considered the preferred technique, but expense and a
guarded prognosis for

resolution may make this procedure undesirable to cat owners. Rutin
administration may offer an alternative to traditional treatments or may be
useful as an adjunctive treatment.



PMID: 10434971, UI: 99363829"





The one vet was going to give theophylline orally but the other vet
kind of talked him out of it and said it wouldn't really help.

Theophylline is a bronchial dilator and may also dilate veins and the TD-
which may not be such a good idea. Removing even a tiny amount of chyle
improves ventilation dramatically.



Right now, I have to coax her to eat with a/d and I know that's high
fat. Do you know of any tasty low fat diets?


"Tasty low fat-fat diet"?? I don't know of any. I mixed a little catnip in
r/d- the cats ate enough of it.


Keep the faith!

Best hopes & wishes,

Phil

Mary wrote:

I wonder if the Rutin and the other things you need to give her
could be ground into a favorite food for the 18 days you will be
alone? Rutin and the other citrus bioflavonoids are present in
the white stuff inside an orange peel, so it should not taste bad.
(I ground my cat's Tapazole for about a week and put it in her
cat food but it tastes so bad she detected it and would not eat
it all.)

I'm worried about you trying to pill her by yourself for nearly
three weeks.

Me, too. It makes me sick thinking about it. It takes 2 of us to drag
her out from wherever she's hiding as, of course, she *knows* when
we're getting ready to pill her. I already have half the house blocked
off from her but it's impossible to get rid of all the hidey holes.
Then we have to burrito wrap her so her paws are restricted. Even
sick, she's a fighter.

I'll have to taste the Rutin and see if it tastes citrus-y. Hope not.
The thing is she's not eating much right now and only eats a/d if I
spoon feed her so hiding the pills is hard as she is just licking at
the spoon. Once she has her appetite back, I can try to stick it in
something but cats are just smarter than dogs and harder to trick.

I may have to get my neighbor to come in and help me round her up but I
think that would scare Abbey plus I really can't expect this woman to
do it in the mornings, maybe for the evening dose, but not the morning
one.

Candace

I guess at some point, TBD, when/if it happens again, when I take her
in, I will have to choose euthanasia instead of the draining. If you
feel so inclined, she is accepting prayers, good thoughts, and positive
energy here in Phoenix, if you want to send some her way.

Candace

Hang in there Candace. I have been thinking about Abbey and hoping for
a miracle. I'm really glad you posted her story--I was really hoping
Phil would have some answers for you.

Sherry

"Phil P." wrote in message
...

"Mary" wrote in message
...

"Phil P." wrote in message
...
Candace,

Speak to your vet about Rutin (available from the Solgar Vitamin Co.,
Lynbrook, NY- and probably your local pharmacy) at about 50 to 100
mg/kg
orally every 8 hr. I can't say with absolute certainty that Rutin
cured
our chylo cats by itself or if the chylo resolved spontaneously- but
after
a
few months of low-fat diets and thoracentesis as necessary to relieve
dyspnea and limit fibrosing pleuritis, both cats pulled through.


It this the rutin that is, along with hesperidin, part of C-complex?


Yup. Its an OTC.


And if I recall correctly its primary function is to strengthen the small
blood vessels--like the capillaries?

Phil P. wrote:

"J Am Vet Med Assoc 1999 Aug 1;215(3):345-8, 339

Thanks!

Theophylline is a bronchial dilator and may also dilate veins and the TD-
which may not be such a good idea. Removing even a tiny amount of chyle
improves ventilation dramatically.

Ew, I hope the aminophylline injection they gave didn't dilate the TD.

Please see my other question to you uinder Hopitus' reply. Thank you
for your help.

Candace

"Phil P." wrote in message
...

"Mary" wrote in message
...

"Candace" wrote :

Thanks, Phil. Yes, we got some Rutin today. I had read about it and
the vet said it wouldn't hurt. They're big horse pills but we'll cut
them down and try to find a smaller pill meanwhile. We're also going
to do Vitamin E to help the scarring.


I wonder if the Rutin and the other things you need to give her
could be ground into a favorite food for the 18 days you will be
alone? Rutin and the other citrus bioflavonoids are present in
the white stuff inside an orange peel,


Cats *hate* oranges and orange peels. People put orange peels in flower
pots to keep the cats away.


I knew that, I guess I was just thinking that anything must
taste better than Tapazole judging from Buddha's reaction to it when I did
put it in her food.

Phil P. wrote:

Chylo is caused by leakage or extravasation of chyle from a thoracic duct
or one its tiny branches- that's why surgical correction is so difficult.
Chylo is a real sneaky disease that's usually not detectable with routine
yearly exams- until its well established and the cat shows difficulty
breathing and weight loss.

I was sweating bullets during the entire Rutin therapy because the longer we
waited to see if the Rutin was working the greater the risk of the cat
developing irreversible fibrosing pleuritis from the constant exposure of
chyle. I was sure glad it all worked out- I never would have forgiven myself
if I made the wrong call.

Phil, what does this mean? Can't she be tapped once she's on Rutin?
Or did you just mean that you couldn't *know* if the chyle was building
up? Because if she's on Rutin and her breathing gets bad, I would want
her tapped again. Nothing about Rutin contraindicates tapping, does
it?

Candace

wrote:

Hang in there Candace. I have been thinking about Abbey and hoping for
a miracle. I'm really glad you posted her story--I was really hoping
Phil would have some answers for you.

Yes, and he did. I feel a little encouraged. I wanted to see what
other people said; I guess I was ready to get feedback now and everyone
has been nice.

Thank you, she'll gladly accept a miracle.

Candace

"Mary" wrote in message
...

"Phil P." wrote in message
...

"Mary" wrote in message
...

"Phil P." wrote in message
...
Candace,

Speak to your vet about Rutin (available from the Solgar Vitamin
Co.,
Lynbrook, NY- and probably your local pharmacy) at about 50 to 100
mg/kg
orally every 8 hr. I can't say with absolute certainty that Rutin
cured
our chylo cats by itself or if the chylo resolved spontaneously- but
after
a
few months of low-fat diets and thoracentesis as necessary to
relieve
dyspnea and limit fibrosing pleuritis, both cats pulled through.


It this the rutin that is, along with hesperidin, part of C-complex?


Yup. Its an OTC.


And if I recall correctly its primary function is to strengthen the small
blood vessels--like the capillaries?

Eggzakly!

P.

"Mary" wrote in message
...

"Phil P." wrote in message
...

"Mary" wrote in message
...

"Candace" wrote :

Thanks, Phil. Yes, we got some Rutin today. I had read about it
and
the vet said it wouldn't hurt. They're big horse pills but we'll
cut
them down and try to find a smaller pill meanwhile. We're also
going
to do Vitamin E to help the scarring.


I wonder if the Rutin and the other things you need to give her
could be ground into a favorite food for the 18 days you will be
alone? Rutin and the other citrus bioflavonoids are present in
the white stuff inside an orange peel,


Cats *hate* oranges and orange peels. People put orange peels in flower
pots to keep the cats away.


I knew that, I guess I was just thinking that anything must
taste better than Tapazole judging from Buddha's reaction to it when I did
put it in her food.

As much as cats hate oranges- it still probably tastes better than Tapazole!