11/03/2025
ANVH EP-73 Chylothroax in dogs and cats - 犬貓的乳糜胸
Today A Niu would like to share a rare case of Chylothorax in dogs and cats
🩺 What Is Chylothorax?
• Chylothorax is a type of pleural effusion where chyle—a milky fluid rich in triglycerides—leaks abnormally into the pleural cavity, compressing the lungs and causing breathing difficulties.
• Chyle is formed from dietary fat absorbed in the intestines and transported via the lymphatic system through the thoracic duct. If the duct ruptures or becomes obstructed, chyle can leak into the chest cavity.
Commonly Affected Breeds and Causes
• Dog breeds: Shiba Inu and Afghan Hound are predisposed.
• Cats: Can occur at any age.
Common causes:
• Heart disease
• Thoracic tumors
• Lung lobe torsion
• Diaphragmatic hernia
• Venous thrombosis
• Trauma or surgical injury to the thoracic duct
• Idiopathic chylothorax: No identifiable cause; accounts for most cases.
⚠️ Clinical Signs
• Rapid breathing, coughing
• Lethargy, loss of appetite
• Exercise intolerance, hypoxemia
• Thoracocentesis yields milky or pinkish fluid (if blood is mixed)
Diagnostic Methods
• Thoracocentesis: Fluid a**lysis for triglyceride concentration (higher than serum) and protein levels.
• Imaging: Chest X-rays, CT lymphangiography, echocardiography.
• Blood tests: To rule out heartworm, infections, electrolyte imbalances.
Treatment Options
• Preferred surgical approach: Thoracoscopic thoracic duct ligation ± pericardiectomy.
• Severe cases: May require cisterna chyli ablation.
• New techniques: ICG fluorescence imaging helps locate the thoracic duct and improves success in minimally invasive surgery.
• Prognosis: Idiopathic cases have a surgical success rate over 90%. Cases with underlying disease require comprehensive management.
If you suspect your pets have similar symptoms, please contact your family vet ASAP.
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今天阿牛要分享一個比較罕見的病例 - 犬貓的乳糜胸
什麼是乳糜胸?
• 乳糜胸(Chylothorax) 是指乳糜液(富含三酸甘油脂的乳白色液體)異常滲漏至胸膜腔,造成肺部受壓、呼吸困難。
• 乳糜液來自腸道吸收脂肪後,經淋巴系統運送至胸管,正常應流入靜脈系統。若胸管破裂或阻塞,乳糜液便會滲漏。
好發族群與成因
• 犬種傾向:柴犬、阿富汗獵犬有遺傳傾向。
• 貓咪:各年齡皆可能發生。
• 常見原因:心臟病/胸腔腫瘤/肺葉扭轉/膈疝/靜脈血栓/外傷或手術導致胸管破裂以及自發性乳糜胸:無明確病因,占多數病例。
臨床症狀
• 呼吸急促、咳嗽
• 嗜睡、食慾不振
• 運動不耐、低氧血症
• 胸腔穿刺液呈乳白或粉紅色(混血)。
診斷方式
• 胸腔穿刺:抽取液體檢測三酸甘油脂濃度(高於血清)、蛋白質濃度。
• 影像學:X光、CT淋巴管造影、心臟超音波。
• 血液檢查:排查心絲蟲、感染、電解質紊亂等。
治療方式
• 首選手術:胸腔鏡引導下胸導管結紮術 ± 心包膜切除術。
• 部分嚴重病例:可能需乳糜池摘除術。
• 新技術:ICG螢光顯影輔助胸管定位,提升微創手術成功率。
• 預後:特發性乳糜胸手術成功率高達90%以上,若有原發病則需綜合治療。
如您懷疑毛孩有乳糜胸症狀,建議儘早就醫並考慮影像學檢查與手術評估。
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