Decortication, thoracic omentalization, and pericardiectomy for treatment of severe fibrosing pleuritis in a cat

• DOI: 10.2460/javma.21.01.0018
• Publication Date: 2021-12-01T16:45:44Z
• Authors: Danny Sack; Philip Hyndman; Melissa Milligan; Daniel Spector
• Keywords: Decortication; Thoracostomy; Pericardiectomy; Atelectasis; Thoracotomy

A 5-year-old spayed female domestic shorthair cat was evaluated because of an acute onset dyspnea and open-mouthed breathing.Thoracic radiography revealed pleural effusion signs consistent with restrictive pleuritis, results preoperative CT were diffuse, severe bilateral effusion, pulmonary atelectasis. Thoracocentesis yielded a red, turbid fluid that identified as chylous chronic inflammation.Exploratory thoracotomy fibrous adhesions between the mediastinum, heart, lung lobes, thoracic wall, thick capsule enveloping all lobes. Surgical treatment consisted complete decortication, pericardiectomy, omentalization. The remained hospitalized for 6 days, receiving oxygen supplementation, multimodal analgesia, supportive care. Long-term home care prednisolone administration, rutin provision low-fat diet. At recheck examinations 3-, 7-, 20-weeks postoperatively, tachypneic, but otherwise clinically normal without or respiratory distress. Follow-up improved expansion, decreased resolved pneumothorax.Surgical management fibrosing pleuritis secondary to idiopathic chylothorax in cats has historically resulted poor outcomes. This report details first successful use decortication surgical cat.