What Is A Pleural Effusion
Pleural effusion refers to an accumulation of fluid within the pleural cavity. This fluid is usually located within the pleural sac which is a serous membrane covering the lungs. The pleural sac can be thought of as a “plastic wrap” around the lungs that can potentially hold fluid or air . It normally contains only a small amount of fluid, sufficient to keep the lung surfaces slippery and prevent them from sticking to the chest wall.
“…pleural effusion involves fluid on the outside or surrounding the lungs…”
When excess fluid enters this space, it compresses the lungs so that they cannot fully expand and results in impaired breathing. It must be emphasized that a pleural effusion involves fluid on the outside or surrounding the lungs, not within the lung tissues. Fluid accumulation within the lungs is generally called pulmonary edema.
Congestive Heart Failure In Cats When To Euthanize
If your cat is suffering congestive heart failure, when to euthanize is a question you may be faced with having to answer. Your cats heart provides oxygenated blood and nutrition to all body parts on a repeat cycle. Consequently, when the heart struggles to deliver enough blood, fluid can back up into the lungs. This can be caused by a failure on either or both sides of the heart.
Congestive heart failure is the medical term used to describe this life-threatening condition. Following diagnosis to determine the cause, a number of tests need to be carried out. Find out more about congestive heart failure in cats and when to euthanise here.
Can Lymphoma In Cats Spread
Average survival with this type of lymphoma is only 3-6 months, though there are isolated reports of cats surviving far longer. Renal lymphoma has a tendency to spread to the brain and central nervous system this occurs in approximately 40% of renal lymphoma cases and worsens the prognosis for this disease.
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What Are The Clinical Signs Of Pleural Effusions
Clinical signs are related to the specific cause of the fluid accumulation but most commonly include:
- Dyspnea
- Tachypnea
- Lethargy
“Many cats will present with open-mouth, rapid breathing.”
Many cats will present with open-mouth, rapid breathing. It is often more difficult for them to breathe in than it is to breathe out. Most cats have “abdominal breathing”, where their abdomen is moving in and out in an attempt to maximize the expansion of the lungs. The lung sounds are often decreased or muffled on auscultation of the chest . When the chest is percussed , there is dullness present in the areas of fluid accumulation.
Can A Feline Have Pleural Effusion With Lymphoma
Mediastinal lymphoma is the most common form of lymphoma to be linked to the Feline Leukemia Virus , making that virus a major factor for the eventual development of pleural effusion. If your veterinarian determines there is an effusion, either with scans or by listening to the chest region, he may try to drain the fluid.
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How Is The Condition Diagnosed
Diagnosis is based on medical history and clinical signs, the presence of fluid in the chest cavity on thoracocentesis , chest radiographs and chest ultrasound. Blood and urine tests are often performed to look for any underlying infectious or systemic disease that is causing the fluid accumulation. The fluid removed from the chest cavity is analyzed for clues as to the origin or cause.
Treatment Of Fluid In The Chest In Cats
Fluid in the chest is an emergency and life-threatening for your cat. This condition should be treated as soon as you notice symptoms. Many cats that develop fluid in the chest have trouble breathing and deteriorate rapidly. The most important thing in treating this condition is removing the fluid quickly to restore free breathing. This is done by draining the fluid from the cats chest with a needle. Certain conditions such as chylothorax can cause as much as a quart of fluid to build-up in the chest. Once the fluid is gone, the lungs can expand normally and breathing returns to normal. If fluid continues to build-up after it is initially removed, veterinarians may perform surgery to install a shunt. This device removes the fluid from the chest automatically.
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Infection In The Pleural Space Is Complicated
Veterinarians know, no matter what the original cause of infection getting into the pleural space, once its in there, the best chance of getting it out is open-chest surgery. Because the pleural space is immunoprivileged, oral antibiotics rarely, if ever clear the infection.
Some causes of Pleural Space Infection
- Plant awns being breathed in and then working their way through the lining of the trachea into the pleural space
- Swallowing fish hooks, toothpicks, pins, needles, or other objects that puncture the esophagus
- Tracheal worms eating through the lining of the trachea and letting bacteria into the pleural space
- Foreign Body obstruction in the windpipe or the esophagus eroding through the wall and letting bacteria in
How Long Can A Cat Survive Without Eating Or Drinking
Like people, cats can go longer without food than water. Cats can survive for about two weeks without eating but only three days without drinking. The longer your cat goes without proper nutrition, however, the weaker they become, so its important to contact your vet if you suspect they havent eaten in a day or more.
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What Are The Clinical Signs
The main clinical sign of chylothorax is labored breathing. However, this finding is common to all cases of pleural effusion. Some cats appear to be holding their breath because there is a delay between inspiration and expiration. Interestingly, coughing is the first sign of chylothorax in some cats it is not typically found with other causes of pleural effusion. This can be important because there are relatively few causes of coughing in the cat as compared to the dog.
In some situations, clinical signs of the underlying disease may overshadow those of the pleural effusion. Occasionally, owners note no abnormalities other than depression or exercise intolerance. This is because fluid gradually accumulates in the pleural space, and the cat is able to adapt for awhile.
Is Pleural Effusion Serious
The seriousness of the condition depends on the primary cause of pleural effusion, whether breathing is affected, and whether it can be treated effectively. Causes of pleural effusion that can be effectively treated or controlled include an infection due to a virus, pneumonia or heart failure. Two factors that must be considered are treatment for associated mechanical problems as well as treatment of the underlying cause of the pleural effusion.
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How Long Can Pleural Effusion Last
Most people recover within a few days or weeks. Minor complications from more invasive treatments can include slight pain and discomfort, which often go away with time. Some cases of pleural effusion can have more serious complications, depending on the severity of the condition, cause, and treatment used.
Pleural Space Infection Can Become Permanent
Castiel after chest tap, top to bottom X-Ray
The infection not only pockets not the connective tissue lining, not only infects the tissues themselves, but also coats the outside of the lungs and the lining of the chest wall. Also, possibly, whatever injected the infection into the pleural space could still be in the body causing a nidus of infection, or a constant source of new infection. Eve with open chest surgery, placement of a chest drain tube to take out ongoing pus accumulations, and infusion of antibiotics into the pleural space, some cats so not survive the surgery, and some cats do not clear the infection. Or they clear the infection, but there is significant scar tissue left in the pleural space that causes pulling and restriction on the movement and expansion of the lungs that compromises breathing anyway, even if the fluid is all gone.
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What Is The Treatment
Measures to improve the cats respiratory capacity are usually the first steps in therapy. Fluid can be drained from the pleural space with a syringe and needle. In almost all cases, the fluid will reform and a drain tube will need to be surgically implanted to facilitate daily drainage. This tube may be left in place until chyle accumulation stops. If fluid is still accumulating after 1-2 weeks, thoracotomy may be recommended to search for the underlying cause or to repair a torn thoracic duct which will not heal. When the cause is trauma, most cats will heal on their own and surgery will not be needed.
Feline chylothorax is a disease under active research. Some new treatment modalities may be on the horizon. Regardless, the most successful therapy will be directed toward treating the underlying disorder.
What Causes Pleural Effusion
Pleural effusion can have a number of causes. The most common causes include the following:
- Pyothorax. This term refers to pus within the chest cavity. A pyothorax forms as a response to a severe bacterial infection within the chest cavity, either due to a blood-borne infection or a penetrating chest wound.
- Chylothorax. This term refers to the accumulation of lymphatic fluid within the chest cavity. Chylothorax occurs when lymphatic fluid, or chyle, leaks into the pleural space from a lymphatic duct that runs within the chest. Possible causes of chylothorax include trauma and increased pressure on the duct . Many cases of chylothorax are idiopathic, meaning that no cause can be identified.
- Heart failure. When cats experience heart failure, the heart can no longer pump fluid throughout the body as it is intended to do. This can result in the accumulation of excess fluid in the chest.
- Cancer. Tumors in the lungs or chest wall can lead to pleural effusion.
- Feline infectious peritonitis . This syndrome is caused by infection with a mutated form of a feline coronavirus. In some cats, infection with mutated coronavirus can lead to blood vessel damage, which results in fluid leakage. When FIP affects the chest cavity, pleural effusion results.
- Hemorrhage. Bleeding within the chest cavity may occur due to trauma, but can also be associated with the ingestion of anticoagulant rodenticides and other potential blood clotting disorders.
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When To Consider Euthanasia For An Old Cat
If the prognosis is poor or gave and your cats quality of life is declining, euthanasia may be suggested. When a cat ages, a greater burden is placed upon its internal organs. Old age is not so much the killer as are the complications that arise during your cats last years. When your cat is aging, you may find:
How Is Pleural Effusion Treated
In the emergency treatment of pleural effusion, cats are often first placed into an oxygen cage. Cats presenting for pleural effusion are often experiencing shortness of breath and decreased oxygen intake placing them into an oxygen cage provides some degree of immediate relief and will allow your cat to calm down enough for a thorough exam and diagnostics.
In many cases, thoracocentesis is used to remove accumulated fluid. Removing the fluid that surrounds the lungs will allow your cat to breathe more readily. In some cases, a chest tube may be placed to allow repeated fluid drainage in order to help your cat breathe more effectively.
“In many cases, thoracocentesis is used to remove accumulated fluid.”
Once your cat is stabilized, your veterinarian will begin working to determine the cause of the pleural effusion. Long-term treatment of pleural effusion varies, depending on the underlying cause of the effusion.
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About Dr Joanna Woodnutt Mrcvs
Dr. Joanna Woodnutt is a small animal veterinarian and writer who is passionate about helping owners to learn more about their pets in order to improve animal welfare. She loves to write and wants to empower owners to make the best decisions for their pets by giving them all the information they need. In her spare time, she takes consultations on the small island of Guernsey.
Is There A Positive Test For Fip Fluid
A positive Rivalta test was once believed to be highly specific for FIP fluid. In a study of 497 cats with effusions, 35% of which had confirmed FIP, the Rivalta test had a sensitivity of 91% and a specificity of 66%, with a positive predictive value of 58% and a negative predictive value of 93% .
FIP effusions are clear to moderately cloudy, viscous and high in protein . They often form partial clots when placed in a serum tube. FIP fluids are frequently labeled modified transudates based on their perceived lack of cellularity.
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What To Give A 12 Year Old Cat With Megacolon
Megacolon in a 12-year-old cat. Garfield, a 12-pound, 8-year-old domestic shorthair cat, had become constipated in the past few months. His family veterinarian initially prescribed psyllium fiber . Then, a few weeks later, the vet prescribed methylcellulose fiber .
We took her to the vet, and after a blood test that showed no health concern, the vet asked for poop sample to have it tested. The cat was isolated because we have three more cats, but she did not poop. The vet gave her an appetite stimulant, a worm infestation liquid to pour on her back and an antibiotic in case she had an infection.
Congestive Heart Failure Facts
When your cats heart is unable to pump adequate amounts of blood, the body normally compensates. This means that tissues continue to receive the required oxygen and blood.
As the heart disease becomes more severe it overwhelms the abilities of these compensatory mechanisms. As fluid backs up into the lungs this results in congestion of the lung tissue.
In some cases, such as hypertrophic cardiomyopathy, the muscular walls of the heart become unable to stretch. This then prevents them from pumping the blood needed around the body. As a result, the fluid back-up makes breathing extremely difficult.
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What Causes Pleural Effusion In A Feline With Lymphoma
When lymphoma occurs in this area, it is much more likely to cause a dangerous fluid buildup simply because of its proximity to the lungs and heart. Mediastinal lymphoma is the most common form of lymphoma to be linked to the Feline Leukemia Virus , making that virus a major factor for the eventual development of pleural effusion.
What Is Fluid In The Chest
Fluid in the chest is also known as pleural effusion. This occurs when fluid is present outside the lungs, in the space between the lungs and the chest wall. Normally, this area only has a small amount of fluid simply to keep the lungs from adhering to the chest wall. When excessive amounts of fluid accumulate, serious complications can arise because the cats lungs cannot expand properly. This is a potentially life-threatening situation for your cat and emergency treatment is necessary.
While most cats are generally healthy, some can develop conditions that can compromise their health and well-being. Cats can develop fluid in the chest as a result of various conditions. Regardless of the cause, fluid in the chest in cats can be very serious.
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Should A Cat With Pleural Infection Be Put Down
Many veterinarians would recommend humane euthanasia at this point in the care process. They would not be wrong. Massive infection, over 600 mL of pus, and a possibility of dying through not being able to breath are compelling reasons to try and prevent Cas from suffering in the future.
However, let me share my point of view. Me, Doc Truli. And tell you what we did for Cas.
Lung Cancer In Cats Treatment
Unfortunately, the prognosis for lung cancer is often poor, meaning that treatment may be palliative rather than focused on curing the disease.
Unfortunately, lung cancer in cats carries a poor prognosis, and treatment is often palliative- to reduce symptoms, rather than cure the disease. Your veterinarian will discuss the treatment options with a veterinary oncologist to determine the best course of action for your cat.
Surgical removal of the primary lung tumour or lung lobe is possible, especially if no metastases have been detected. This involves a thoracotomy- major open-chest surgery that is usually only offered at specialist centers due to the high risks involved. If metastases are present, surgery like this is unlikely to bring enough benefit to make the high-risk procedure worthwhile.
Chemotherapy and radiotherapy is sometimes recommended, especially where metastatic spread has already happened.
If the tumour has caused a pleural effusion, this can be drained to provide some relief.
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Whats The Prognosis For Mediastinal Lymphoma In Cats
Typically, this period of remission lasts only 2-9 months, and then cats become ill again. Mediastinal lymphoma in cats with feline leukemia carries a poor prognosis, with an average survival time of 3 months. In cats without feline leukemia, mediastinal lymphoma often shows at least a partial response to chemotherapy.
Recovery Of Fluid In The Chest In Cats
The overall prognosis for cats that have fluid in the chest ranges from poor to fair. Recovery depends largely upon the cause of the condition. Many cats do not live long enough for the fluid to be removed from the pleural space. If your cat withstands the diagnostic process and fluid is successfully removed, his outlook is guarded but fair. Your cat also has a better chance of recovery and long-term management if your doctor is able to diagnose the cause of the condition. Cats with chylothorax have a favorable outlook if fluid production is resolved and is controlled. Many conditions will not return once the fluid is removed.
Your doctor will provide you with detailed instructions regarding your cats care. Be sure to follow all his instructions exactly. Always report any changes in your cats condition or behavior as soon as it arises, especially if your cat begins to breathe with an open mouth. This is a sign he is having trouble breathing and he must be evaluated by a doctor quickly. Depending on the treatment provided, your doctor may want to re-evaluate your cat every few weeks until he is stable. If your cat has any underlying diseases or conditions that may cause fluid to build-up again, your doctor will treat him accordingly.
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