Chylothorax and pleural effusions

• Clinical signs of Cough

  Lethargy

  Inappetence

  Weight loss

  Inability to sleep on brisket

  Dyspnoea
• Pleural effusion presentation

  Has muffled heart sounds and the inability to breathe when lying in lateral recumbency as as dyspnoea and coughing.
• Parameters of pure transudate

  Low cellularity, protein under 25g/l, clear in colour.
• Modified transudate

  Moderate cellularity, slightly hazy in colour, protein 25-40g/l.
• Parameters of exudate

  Typically opaque in colour, protein >30g/l, moderate to high cell count.
• Parameters of Pyothorax

  High cell counts and smells, protein >35g/l, amber red or yellow in colour.
• Parameters of the chylothorax

  High cell count, protein variable, creamy +/- pale pink in colour.
• What imaging do you do in the case of Chylothorax/ pleural effusion

  Perform lateral and DV radiography under sedation or general anaesthesia (anaesthesia depends on how bad the animals breathing is, the demeanour of the dog and whether there are other body systems involved). Radiographs will help quantify the fluid level for further monitoring.

  Ultrasound scan of the thorax - the fluid will be easy to confirm ventrally around the lungs.

  Perform a thoracocentesis to sample the fluid.
• What test can you do to confirm Chylothorax?

  Do a fluid to serum triglyceride ratio check; you would expect the effusion fluid to be higher in triglyceride than the serum.