? Fluid around the lungs. Chyle fluid? undetermined cause

My friend has a cat approx 8 years old. He went to the vet on a checkup with his newly adopted sister. The vet noticed that "Kevin" was breathing a little different that normal cats do. The parents said that he has always breathed with his abdomen. He also is afraid of the vet office. After some testing the vet said he had some fluid on his chest. Note that Kevin was acting ok on the day they took him into the vet office. The vet gave him furoquid for the chest fluid and when they got home he was acting very lethargic. He went back to the vet the next day and they did run some bloodwork and said it was normal but have sent to have a full blood panel done by Kansas State University. They again gave him another furquid shot and Kevin had the same reaction and became lethargic. Also they said they thought he was dehydrated since the scruff of his neck skin stayed up after they pinched it up. They took him in today and the vet wanted to put Kevin down since they had been in three times in a row. Of course they said no and the vet did give him some subfluids for dehydration. Vet sent them home with a shot of furoquid for them to administer. They have not given him the meds thinking he might be having a reaction to it.
Anyone have any ideas for my friends? They are devastated and this is their baby!! Thanks in advance

 

It is possible that Kevin is acting lethargic because of the furoquid, but it would most likely be because it's caused dehydration. The active ingredient in furoquid is furosemide - a 6-hour diuretic that is designed to remove fluid from places it isn't meant to be (like the chest cavity). However, it cannot distinguish between right and wrong locations of fluid so does tend to have a dehydrating effect. This can be offset with sub-q fluids, but the balance can be tricky...you don't want to give enough fluid for it to re-accumulate in his chest cavity, but of course you don't want him dehydrated either. I would treat getting rid of the fluid accumulation as relatively urgent as it can put pressure on his heart and lungs, so I'm not sure I would skip the diuretic medication. However, the vet does need to keep an eye on Kevin's hydration levels and electrolytes while he's on it. Did the vet do any kind of draw on the fluid to send it off for analysis to try to find out the cause? It seems crazy that they would suggest PTS so soon into his treatment - furosemide likely won't fix everything in just a couple of days and they don't even have a diagnosis for why the fluid is there at this point!

 

They did take a fluid sample and sent it off to K State for evaluation but have not heard back the results.

 

I'm very glad they did that - it is a useful diagnostic...plus it helps to relieve the pressure for Kevin at the same time! With any luck they will get the results back quickly and be able to come up with a good treatment plan at that point. I am about to head out for the day, but when I saw your post having dealt with fluid build up combined with a need for sub-q before, I wanted to give you a little information before I left the house. I will be back later on tonight, so if anything else comes up please just add it to this post and I'll look at it when I get home.

 

Thank you so much for your help. They are wondering now if they should give the furoquid since the vet had it every 12 hours and it has been. They did say he has peed a pretty good amount but has not drank much at all.

 

Talked with Kevins Dad and he said they ended up taking him to another vet on Saturday. This vet gave Kevin the furoquid, b-12 vitamins, appetite stimulant and sub fluids. Kevin then again went lethargic and did not want to eat or drink. About 11 hours later Kevin started feeling better and by Sunday morning he was acting a lot better. Sunday noon Kevins parent gave him the furoquid shot as prescribed by vet and again Kevin went back to be lethargic. They stayed home with him today and this afternoon Kevin finally did drink on his own and some food. Now they are worried if they give him another shot he will go down again. Also the fluid is around the lungs and not in them. Hope this info helps some

 

Has Kevin had a cardiac evaluation and/or any form of steroids recently. Generally, cats with undiagnosed cardiac disease can develop pleural effusion especially if any form of steroids have been used.

 

I will ask them but I don't think so on both the cardiac evaluation or steroids. They did say the reason the vet checked him out more was by the way he was breathing but the owner says he does abdomen breathing and has since kitten. But there is a reason for the fluid but he was acting fine until they gave him the medication furoquid. Maybe toxin to Kevin?

 

The vet has just prescribed steroids stating that that would help. They have not given him them yet since he is not wanting to eat. He did drink some on his own. He was given an antibiotic shot that last 14 days.

 

Kevin is at a specialist and they will be doing some cardiac evaluation. Good thoughts for Kevin!

 

I did manage to find a list of possible side effects that include weakness and drowsiness. Is it possible those are being seen as lethargy? If so, then yes, Kevin might do better with an alternative treatment, although I'm not aware of a good alternative for cats...that would definitely be a question for the vet or maybe even the specialist!

Lots and lots of healing vines for Kevin. I hope the cardiac evaluation doesn't turn up anything too difficult to treat. And hugs for Kevin's parents - I'm sure they're in need of some at the moment.

 

Update on Kevin.
Kevin went to a specialist and they did several tests on him. His heart is good, lungs are good on the inside and no cancer.
They have yet determined why the fluid on the chest is accumulating. They call it chyle fluid. Anyone know what that is and have had this happen to a cat they knew. He is eating on his own now and is home which is great news.

 

I haven't had it happen to any of our cats, but I was able to find an explanation of it here that looks as though it might fit - especially with there being no obvious underlying condition. https://www.acvs.org/small-animal/chylothorax It looks as though it may be treatable, but not always by the same method in every cat.

 

I think we are on the right track of Chylothorx idiopathic. Looks like to start with low fat diet and a supplement of rutin. Do you know anything about the rutin? Also maybe a support group like this one for help in this area? I am just trying to help her get her information and they are willing to go the extra for little Kevin.

 

I was able to find a Facebook page, but it doesn't look to be particularly active. This is the link for that one https://www.facebook.com/ChylothoraxCats/

The other group that she could try is the Feline Health Research Facebook group here https://www.facebook.com/groups/605719009473884/ There always seems to be a lot of knowledge about a lot of different conditions there.

I also found this site, which might be of some use, though not having dealt with the condition myself I can't vouch for the quality of information http://chylothoraxcats.webs.com

I've never heard of rutin before, but when I looked it up it's meant to help to remove the fat from the fluid buildup. It sounds fairly safe as a first line of treatment and does seem to resolve the problem for a reasonable proportion of cats. So I would say it's definitely worth trying.

 

I talked with her and mentioned the Rutin and her vet mentioned it. She was going to get some on Amazon. Not sure if there is a doseage chart for it but if I was her I would ask the vet for doesage before she beigns it. I will give her the links you mentioned.
Thanks for sicking with me to help these good cat parents~!!!

 

Don't have any experience or suggestions to share, but I am sending prayers for little Kevin.


Mogs
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I lost one of my babies just after his 10th birthday to chylothorax (last year as a matter of fact). It presented symptoms too late to treat and there was nothing they could do to save him when I took him to the emergency vet for breathing difficulties. He passed within 15 seconds of receiving a shot of furosimide. So much fluid had built up around his lungs that he could no longer compensate for the reduced lung capacity. A month before that he was diagnosed with low blood platelets with a very high risk of bleeding out internally. He was treated with antibiotics and a double whammy of prednisone to resolve the low blood platelets, but it was all in vain. By the time the vets found the real problem it was too late. It can be treated if caught early enough, and rutin is highly recommended, but whoever draws off the fluid will have to be very careful in how much they pull off in one session. From what I understand, the treatment will need to be done infrequently over the course of the animal's life. Definitely give rutin a try. I was reading it's showing great success.

 

http://www.petmd.com/cat/conditions/respiratory/c_ct_chylothorax

 

I had a cat with fluid and he had Cardiomyapathy. He took Lasix 5 mg. Once a day and did very well until his playmate had her teeth cleaned and they cut her throat with the tube. He wouldn't have anything to do with her. Then she passed and he was so upset his lungs just filled right up with fluid. I had to take him to Vet to have euthanuzed because he would have suffocated. Such a loss, both of them. He acted like her mother. He cleaned her and took real good care of her. It broke my heart and I still cry about it and hate myself for what happened to both of them !!!

 

It's difficult. I still cry about so many I've lost.

 

I'm so sorry. That must be such a sad memory for you. My kitty J.D. mothered my kitty Ginger (10 years younger) since she was a kitten. He right way, snuggled with her and bathed her, slept cuddled with her and protected her. I always thought it was weird how J.D., a boy, acted so motherly to Ginger.