Journal of Veterinary Clinics (한국임상수의학회지)

The Korean Society of Veterinary Clinics (한국임상수의학회)
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Computed Tomography for Diagnosing Chylothorax Associated with Cranial Vena Cava Thrombosis in a Dog

  • Jin-Yoo Kim (Institute of Animal Medicine, Department of Veterinary Medicine Imaging, College of Veterinary Medicine, Gyeongsang National University) ;
  • Gunha Hwang (Institute of Animal Medicine, Department of Veterinary Medicine Imaging, College of Veterinary Medicine, Gyeongsang National University) ;
  • Sumin Kim (Institute of Animal Medicine, Department of Veterinary Medicine Imaging, College of Veterinary Medicine, Gyeongsang National University) ;
  • Chi-Oh Yun (Institute of Animal Medicine, Department of Veterinary Medicine Imaging, College of Veterinary Medicine, Gyeongsang National University) ;
  • Seunghwa Lee (Institute of Animal Medicine, Department of Veterinary Medicine Imaging, College of Veterinary Medicine, Gyeongsang National University) ;
  • Na-Young Eom (Centum Animal Medical Center) ;
  • Joong-Hyun Song (Department of Veterinary Internal Medicine, College of Veterinary Medicine, Chungnam National University) ;
  • Tae Sung Hwang (Institute of Animal Medicine, Department of Veterinary Medicine Imaging, College of Veterinary Medicine, Gyeongsang National University) ;
  • Hee Chun Lee (Institute of Animal Medicine, Department of Veterinary Medicine Imaging, College of Veterinary Medicine, Gyeongsang National University)
  • Received : 2024.03.15
  • Accepted : 2024.05.01
  • Published : 2024.06.30
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Abstract

A 13-year-old male neutered Miniature Pinscher presented with coughing and dyspnea. The dog had been coughing for the past 4 weeks. The patient had mild dehydration on physical examination, and muffled heart sounds were detected. Thoracic radiographs revealed pleural effusion, which was consistent with chylous effusion based on cytological and biochemical evaluations. Computed tomography (CT) lymphangiography, which was performed via intrametatarsal pad injection, revealed no evidence of thoracic duct rupture or obvious leakage. On CT angiography (CTA), an intraluminal filling defect was identified in the cranial vena cava (CrVC). CrVC thrombosis with secondary chylothorax was diagnosed based on CT lymphangiography and CTA. Clopidogrel, rivaroxaban, and recombinant tissue-plasminogen activator were prescribed. The follow-up CTA, 4 months after diagnosis, revealed a decrease in the thrombus, and no pleural effusion was identified. Although CrVC thrombosis is an uncommon presentation in veterinary patients, thrombus in the CrVC should be considered as a differential diagnosis of chylothorax in dogs. CT lymphangiography and CTA could be helpful in identifying and differentiating the underlying etiologies of chylothorax.

Keywords

Acknowledgement

This study was supported by a grant from the Cooperative Research Program for Agriculture Science and Technology Development (Project No. RS-2023-00231792), RDA, Republic of Korea.

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