|Clinical Trial for the Treatment of Chylothorax in the Dog|
Current Status of the Trial- Update of Results
5/20/2008 The trial is currently closed for new enrollments. However, our clinical service continues to treat dogs with chylothorax. There currently is no further grant support available for new patients with this condition. If you need further information regarding treatment of chylothorax, contact the UW Veterinary Medical Teaching Hospital or Dr. McAnulty through the General Surgery Service at the VMTH.
Two approaches to treat chylothorax (cisterna chyli ablation, CCA; pericardectomy, PC) with thoracic duct ligation (TDL) were prospectively evaluated. 23 dogs with idiopathic chylothorax were randomized to primary treatment by either CCA-TDL (Group I; n=12) or PC-TDL (Group II; n=11) and followed for up to 1 yr. Dogs with chylothorax after 2 months postoperative were offered salvage by the alternative procedure from the initial surgery.
Ten of 12 Group I dogs (CCA-TDL) had resolution of chylothorax (83%). 1 dog was lost to followup after 6 months. Of the 2 that failed, both were re-treated by PC-TDL. One died postoperatively of pulmonary embolism and the second had resolution of chylothorax. 1 group I dog developed significant nonchylous thoracic effusion 11 weeks after surgery. Followup PC in that dog led to significant acute epicardial fibrosis and sudden fatal fibrillation, 5 days postoperatively.
One Group II (PC-TDL) dog died intraoperatively. 6 of the remaining 10 dogs resolved (60%) and 4 did not resolve. 2 of the 4 nonresponders had followup CCA-TDL with 1 death from lung lobe torsion and 1 with complete resolution of the chylothorax.
Pericardial tissue typically had extensive external surface fibrosis but only mild inflammation. This study suggests that CCA-TDL offers improved outcomes over TDL alone with results consistent with previous reports. Results with PC-TDL were not as good as previous reports and were consistent with TDL alone. However PC may have a role in managing chylothorax patients if restrictive pericardial disease is present.
Publications detailing results are in preparation and links will be posted when available.
Copyright 2008 UW School of Veterinary Medicine