Idiopathic Chylothorax & Rutin

[tysmom]

Hi 4Bears, sorry to hear that your kitty has this ailment. I did all I could for Tigger, but she passed away April 1, 2006. I did all I could for her. I gave her Rutin by mouth, but for her, it didn't help as I think she had this problem for a long time. I hope your vet will be able to help you kitty and I pray the apple cider vinegar will help. When Tigger had her problem, I started reading labels on her canned food and made sure that it was high in protein and less in fat. My vet thought that this might help. Just a thought. Praying Jessie makes it through this.

 

[sheryl13]

I just got a notification in my e-mail that this thread had been updated, so I thought I would update you.

Romeo lived for about 4 months beyond his diagnosis. Subsequent visits to the vet drained less fluid from his chest each time, so we kept a close eye on him, and he was so good about taking his multiple medications, and we also spoiled the heck out of him because we didn't know how much time we had left with him. In February 2012, I had surgery on my foot, so I was basically sleeping on the couch full of Vicodin and it took me a whole day to notice that Romeo hadn't been eating all day. We took him to the vet the next day and he was in liver failure. They kept him overnight on an IV, hoping to perk him up, but there was no improvement so we had to say goodbye to him on February 9, 2012.

We still have Juliet, who will be 9 years old next month.

I've tried to do what I can to help other kitties in Romeo's memory. Caught 3 kitties doing TNR - only returned 2 because one turned out to be a sweetie pie (at least to us!) and we kept her. Juliet seemed lonely from the loss of Romeo, but after a year, she is still not getting along with Gracie. Poor girl, she doesn't understand that Mom & Dad have so much love to give, that spoiling her is simply not enough! Gracie does some silly things that I've only ever seen Romeo do... I believe he whispers to her from Heaven, "Hey, do this, the people will LOVE it!"

 

[jillianmama]

Hello Everyone-

I came across this board while doing a search of Rutin for cats.  I noticed a few weeks ago my cat Gigi breathing like a fish with her mouth open so we took her to the pet ER and she was diagnosed with Pleural effusion.  Since then we have had to have her drained once a week (3 times now) and the vet has performed extensive tests to try to determine the cause of it, all of which have come back uneventful.  Therefore the vet is assuming it is idiopathic and wants to try her on Rutin.   We have spent $3,000 so far on the tests and vet visits, however she does seem to be improving (having to have less fluid drained with longer periods of time in between each draining) and the vet is very positive, so I do not want to give up on her yet.  I guess we will try her on the Rutin and say some prayers. I just hate this as I don't want to put her through the pills and having to be drained weekly if I know it will never end.  

Tysmom - I am so sorry for your loss with Tigger - I am sure making the decision was one of the hardest things you have ever had to do. Thank you for putting your story out there to help others.

4bears - Very sorry to hear about your cat Jessie - he seems very young to be experiencing this  How is he doing lately?

Sheryl13 - I am so sorry for your loss of Romeo.  Did they say if the liver failure was related to the Chylothorax? 

 

[sheryl13]

The vet didn't really have an explanation for Romeo's liver failure, it was just very sudden. We crushed up the Rutin pills in his wet food, after looking online to make sure that it wouldn't harm my other cat if she ate from his bowl. Luckily he was good for devouring canned food, so giving him the Rutin wasn't a problem!

Wishing you and Gigi the best of luck!!

 

[ria79]

Hi folks - I realize this post is three years old, but I have a experience with chylothorax and when my Fitz was first diagnosed I poured over these websites.  Now that Fitz is better I wanted to add our experience to the information.  Fitz is a 9 year-old neutered DLH.  We fought with Chylothorax for 2 months before Fitz came through. Here is the story.

His first chest tap (due to lethargy and general "ain't doing right") was April 2013 the second (open mouth breathing - literally almost died in the car on the way) was in May.  This is before I started keeping a detailed record of his vet visits.  Per my vet's instructions I was monitoring his breathing rate and started to be able to notice long before he was struggling when he needed to go in.  As the disease progressed the taps got closer together.  #3 was 7/1/13 263ccs of fluid, #4 7/9/13 400cc, #5 7/14/13 no amt given by vet, #6 7/21/13 300 cc.  Surgery for thoracic duct ligation and pericardiectomy was scheduled for 7/22/13.  We used a team of a board certified surgeon and a board certified internal medicine specialist.  Cost was quoted at $3400-3600 for the procedure.  We were given an 80% success rate.

We did try Rutin starting in April.  250mg 3 times a day.  It did not work - the volume of fluid was reduced some, but not enough.  The surgeon did comment that he has never seen Rutin work; however, I know that in some cases folks have has success.  We also had Fitz checked for cancer, heart problems (echo with board certified cardiologist), and any other physiological issues that could be causing the chyle accumulation.

The surgeon was cautious after the procedure.  Fitz had chyle coating all internal organs and the surgeon had to manually scrape it off - the surgery took HOURS.  Three months later Fitz is completely cured.  He is fully expanding both lungs and even though we were warned that he may need to be tapped several times after surgery (this is common) he never had to be.  He did have fluid at his first check-up (though not enough to justify a tap), less at the second, and none since the third.

I have heard several comments no one knows anyone who had success with surgery.  I did.  Xrays done 9/18/13 show a thorax completely void of chyle.  He is still in follow-up visits as we had a problem with anemia (his immune system wouldn't shut off after the chylothorax, so we had to use steroid therapy to shut it down); however, our current total cost with the specialists and chest taps sits right around $7800.00 as of now.

I hope this helps as I found little evidence of folks who had done the surgery.

 

[catluvver]

I know that it has been a few months since you last posted about Fitz.  My little boy, Spooky, who is 12 was just diagnosed with a chylous effusion.  He had a good amount of fluid drained which was sent out for evaluation.  Nothing could be seen in the three xrays that were taken so I will have to get an echocardiogram done to see if an underlying cause can be determined.  Currently, Spooky is taking Salix and I plan to start him on Rutin therapy.  Unfortunately, this is not my first experience with chylothorax.  I lost a very beloved kitty to it about seven years ago.  I had considered the surgery at that time but was advised that it would be too risky as the cat was almost 17 years of age.  After being seen by eight different doctors, I had to let him go because of his deteriorating health.

I am devastated that I am facing this nightmare again with another cat.  Your post gave me some hope.  I am so happy that the surgery seems to have been successful for Fitz.  I have some questions.....How is he doing now?  Has any fluid returned?  How long was the recovery process and did he have to be hospitalized for a long time after the procedure?  I would greatly appreciate any feedback you can give me.  Since, Spooky has not yet had an echo, it is still uncertain which path I should take in his treatment but I am certainly open to all options.  Thank you in advance for your advice.

 

[ria79]

Hi- I am so sorry to hear that you are dealing with chylothorax again. I can't even imagine. I am more than happy to give you more info. Fitz is still 100%. He is absolutely perfect. Right after the surgery (1 week follow up) he showed a little fluid, but not enought to justify a chest tap. The next follow up (3 weeks post surgical) he showed less fluid and it was completely gone at the month point. I was told that oftentimes they do have to be tapped a few times post surgical, so that is not unusual. He was only in the hospital overnight. He came home the next day with pain meds and recovered well at home. He was playing for the first time in MONTHS 48 hours post surgery. He was naked for a good long while as they shave A LOT for TDL and periocardectomy. We went thru all of the same tests you are handling now - echo, radiographs to check for scaring, blood work. We have had a lot of extra expense with his anemia, but total for the surgery was at $3500. I am blessed that we had the cash and I would do it all over again the same way if offered another chance. Please feel free to get in touch again if I can answer any other questions. Best wishes to you and Spooky!

 

[catluvver]

Thank you SO much for replying to my post and answering my questions about Fitz and his surgery.  I have been worried sick over my situation with Spooky and after reading so many horror stories that did not end well, I felt a sense of hope when I came across your story about Fitz.  I appreciate your concern and best wishes.  I will certainly let you know how things are going.  May you and Fitz enjoy MANY more happy and healthy years together!

 

[ria79]

Since it would appear that folks are still checking up on this thread I wanted to give a final update.  Fitz remained chylothorax free for the remainder of his life.  The immune mediated hemolytic anemia (which my Internist believes was caused by his immune system getting all worked up as a result of chylothorax and not being able to calm down) continued to persist to the end of his life.  The steroids needed to control the anemia caused diabetes, which remained moderately controlled through the end of his life.  In the past 3 months prior to death he started to show some lower than desired PCV counts (checking for anemia) and we were playing with his meds.  His final PCV count was 20; however, he was dehydrated and that can skew PCV higher than it actually is.  The internist thinks he was likely around 15, which is low (30s are preferred 12=transfusion time).  They checked blood work and it seemed to point to pancreatitis.  I was warned that pancreatitis is a diagnosis of exclusion - he was not eating/drinking well for 36 hours and showed signs of nausea.  They took a peek at his pancreas on ultrasound and it looked suspicious.  He was hospitalized and they started pumping in fluids.  About 12 hours later he had two seizures while in the hospital and passed away on his own within the hour.  I was told than pancreatitis is tricky and with the anemia and diabetes the chances were moderate (the more things going on with pancreatitis the worse it is and there is no cure, only supportive care - they have to recover on their own).  All in all he survived 2 years, 2 months, & 29 days after the surgery.  Obviously the cost was considerate and I personally would recommend taking a very realistic look at your finances prior to agreeing to surgery.  While he did not die of chylothorax, I think one could argue that he died of the complications of chylothorax.  I read a medical article back in 2013 that said most cats die within 2 years of the surgery anyway from other causes or causes contingent to chylothorax, so please take the time to ask lots of questions of your doctor and don't be ashamed or guilty if the surgery isn't for you.  Fitz was able to live a normal and happy, albeit expensive, life.  I would say all-in-all I likely spent (including chest taps, testing prior to surgery, post surgical care, anemia care, diabetes care, and medications) about $30,000 total from the first chest tap to his death.  I am happy to answer any questions anyone has.