Severe bilateral fibrosing pleuritis associated with chronic chylothorax in five cats and two dogs.

Severe bilateral fibrosing pleuritis was diagnosed in 5 cats and 2 dogs with chronic chylothorax. All animals were dyspneic on initial examination and remained moderately to severely dyspneic after thoracentesis. Radiographic evidence of fibrosing pleuritis included rounded lung lobes and failure of the lungs to reexpand following effective pleural drainage. Fibrosing pleuritis was also suggested in several animals with radiographic evidence of pleural fluid, in which pleural fluid could not be retrieved. Macroscopically, the lung lobes of all animals were compressed and atelectatic to various degrees, and the pleura appeared to be diffusely thickened and roughened. In several animals, fibrous adhesions were found between the parietal and visceral pleura of some lobes. Lung lobes were markedly constricted and appeared as small, smooth, rounded hilar masses in 4 animals. Mild to moderate pulmonary edema was evident in 3 animals at necropsy. Six of the 7 animals died (2) or were euthanatized (4) within 72 hours after the diagnosis of fibrosing pleuritis. The fibrosing pleuritis developed in 1 animal with lymphoblastic lymphosarcoma and chylothorax after treatment via passive pleuroperitoneal drainage; this animal was euthanatized because of underlying neoplasia. One cat, in which decortication was performed and resulted in marked reexpansion of the lung lobes, died 4 hours after surgery with signs compatible with pulmonary edema. On the basis of our findings, we suggest that animals with chronic chylothorax are at risk to develop fibrosing pleuritis. Furthermore, animals with severe bilateral fibrosing pleuritis should be given extremely guarded prognoses.     

Angiosarcoma in cats

In a survey of 3145 feline necropsies at The Animal Medical Centre, eighteen cases of haemangiosarcoma and one case of lymphangiosarcoma were diagnosed. The haemangiosarcomas were primarily located in the spleen (four), liver (six), mesentery (four), mediastinum (three) and the lungs (one). The lymphangiosarcoma was seen in the skin and subcutaneous tissue of the abdominal wall and thighs. The clinical, macroscopic, and microscopic features of these tumours have been described. The most common clinical signs in the case of haemangiosarcoma were due to the rupture of the primary or metastatic neoplasms (70%). Metastases wese observed in 67% of the cases. Three main histological types (1, cavernous; 2, solid; and 3, capillaries separated by stroma) were observed, although mixtures of more than one histological type were seen in any one particular tumour. Rare cases of pulmonary haemangiosarcoma and lymphangiosarcoma in the cat have also been described.     

Lymphangiosarcoma with systemic metastases in a Japanese domestic cat

A 4-year-2-month-old female Japanese domestic cat was diagnosed with lymphangiosarcoma through tissue biopsy of an amputated leg. Two months later, the cat was euthanized, and postmortem findings revealed edema, and bruising at the caudal region of the trunk, pulmonary hemorrhage, pulmonary nodules and mediastinal lymphadenopathy. Microscopically, neoplastic tissues were observed in the dermis and subcutis of the trunk, lung, mediastinal lymph nodes, diaphragm, omentum and mesentery. The tumor cells were spindle to polygonal-shaped with nuclear pleomorphism aligning along pre-existing collagen bundles and forming irregular vascular channels in which the erythrocytes were rarely observed. These cells were immunopositive for vimentin, von Willebrand factor and CD31. Based on the histopathological and immunohistochemical features, the neoplasia was diagnosed as lymphangiosarcoma with systemic metastases.     

Cutaneous lymphangiosarcoma in a young dog: clinical, anatomopathological and lectinhistochemical description

Lymphangiosarcoma is a rare tumour in domestic animals arising from lymphatic endothelial cells. Occasionally, microscopic differentiation with haemangiosarcoma may be difficult. The aim of the present study was to describe a lymphangiosarcoma in a 1-year-old female Doberman Pinscher dog and to characterize its lectinhistochemical binding pattern as compared with that of haemangiosarcoma. The dog was presented because of a cutaneous painful swelling located in the left axilla. Histological diagnosis confirmed lymphangiosarcoma. The dog was killed. Necropsy revealed mediastinal lymph nodes' involvement. Twenty lectins were tested in tissue sections of this case as well as in four haemangiosarcomas from other dogs. Staining intensity was issued upon optical density determinations. Percentage of lectinhistochemical staining area was also conducted. RCA-I showed the most intense and wide distributed labelling pattern for lymphangiosarcoma. PHA-E was the counterpart for haemangiosarcoma. Should similar results be obtained in further studies, such differences could aid in the differential diagnosis between lymphangiosarcoma and haemangiosarcoma when histological pictures were not conclusive.     

Blastomycosis granuloma involving the cranial vena cava associated with chylothorax and cranial vena caval syndrome in a dog

A four-year-old, sexually intact, male dachshund was diagnosed with pulmonary blastomycosis. Itraconazole was administered for 60 days, and the dog was considered to be disease-free at three- and 12-month reevaluations. Two years following discontinuation of itraconazole, the dog developed a granuloma of the cranial vena cava resulting in chylothorax and cranial vena caval obstruction. To the authors' knowledge, this is the first case of a blastomycotic granuloma involving the vena cava reported in the dog. Blastomycosis should be considered as a differential diagnosis for both chylothorax and cranial vena caval syndrome in the dog.     

The Efficacy of Mechanical Abrasion and Talc Slurry as Methods of Pleurodesis in Normal Dogs

OBJECTIVE: To determine the efficacy of mechanical abrasion and talc slurry as methods for pleurodesis in normal dogs. STUDY DESIGN: Experimental study. ANIMALS OR SAMPLE POPULATION: Ten normal beagle dogs. METHODS: Group I dogs had mechanical abrasion (MA) of the pulmonary and costal pleurae performed in one hemithorax with a dry gauze sponge with a median sternotomy approach. Group II dogs had 100 mL of a 1 g talc slurry (TS) administered into one hemithorax through a tube thoracostomy. Administration of the TS was visualized by using video thoracoscopy. All dogs were evaluated at 2, 10, 20, and 30 days postoperatively by means of thoracic radiography and ultrasonographic thoracic wall measurement. The dogs were euthanatized 30 days postoperatively and a gross necropsy was performed. Hemithoraces were assigned a pleurodesis score (0-4) and an obliteration grade (0-6). Tissues were collected for histopathologic examination of pulmonary pleura, costal pleura, and pleural adhesions. Pulmonary and costal pleurae were graded for the degree of fibrosis (0-4). RESULTS: Obliteration grade and costal pleural fibrosis score were significantly higher for the treated sides in the MA dogs compared with the TS dogs. MA Dogs: Mechanical abrasion dogs had pleurodesis, obliteration, and pleural fibrosis scores that were greater on the treated side than the untreated side, however, the differences were not statistically significant. Only two MA dogs had firm adhesion of the pulmonary pleura to the costal pleura in portions of the cranial and middle lung lobes in the treated hemithorax. Thoracic wall surface area covered with adhesions was 15% and 21% in each of these two dogs. The median pulmonary pleural fibrosis score of all MA dogs for the treated hemithorax was 3 compared to 0 on the untreated side. TS Dogs: There was no statistical difference for pleurodesis scores and obliteration grades between the treated and untreated sides. No dogs showed evidence of pulmonary to costal pleural adhesions. Histopathology showed talc crossover into the untreated side in all five dogs. Median pulmonary fibrosis score of the treated hemithorax was 1 compared with 0 on the untreated side. CONCLUSIONS: Neither method of pleurodesis produced sufficient pleural adhesions to obliterate the pleural space. It is possible that the degree of pulmonary pleural fibrosis present in MA dogs may be sufficient to limit air leakage from pulmonary blebs and bullae resulting in successful treatment of spontaneous pneumothorax.     

A new case of Mycobacterium bovis pulmonary tuberculosis in the dromedary (Camelus dromedarius) in Mauritania]

A case of pulmonary tuberculosis is described in a dromedary from Nouakchott (Mauritania). Gross lesions affected pulmonary parenchyma, diaphragmatic pleura, pericardium and regional lymph nodes: caseo-calcified nodules, miliary tubercles and haemorrhagic "pendeloques". Microscopically lesions were characterised by granulomatous tissue, epithelioid cells, necrotic material in the centre. No Langhans giant cells were seen. Mycobacterium bovis was isolated from these samples.     

Chylothorax associated with blastomycosis in a dog

Respiratory distress caused by pleural effusion resulted from chylothorax. Thoracic drainage and lowfat dietary therapy was effective in removing and preventing significant recurrence of the chylothorax; however, the patient died unexpectedly. At necropsy a blastomycotic granuloma found at the precava was considered the cause of the chylothorax. There had been no recognizable antemortem signs of blastomycosis. Blastomycosis can be considered as a rare cause of chylothorax.     

Chylothorax in 34 dogs

Thirty-four dogs with chylothorax were studied retrospectively. In 24 dogs, chylothorax appeared to be idiopathic, with only 10 dogs having evidence of neoplasia or trauma. Rupture of the thoracic duct secondary to trauma appeared to be a much less common cause for the development of a chylous pleural effusion than that reported previously. The Afghan Hound was the breed most commonly affected, comprising 37.5% of the dogs in the idiopathic category and 26.5% of all dogs with chylothorax. A clear correlation between the cause of chylothorax and age was not apparent, and gender and neutering appeared to have no relationship to the development of chylothorax in the dog.     

Lymphangiographic evaluation of experimentally induced chylothorax after ligation of the cranial vena cava in dogs

Ligation of the cranial vena cava (CrVC) distal to the entrance of the azygous vein resulted in chylothorax in 7 of 10 dogs. Of the remaining 3 dogs, 1 developed a serosanguineous effusion that did not become chylous, and 2 dogs did not develop pleural effusion. In 2 of the 7 dogs developing chylothorax, the pleural effusion became serosanguineous within 2.5 weeks after CrVC ligation. Mesenteric lymphangiography was performed 2 to 6 weeks after ligation of the CrVC. Lymphangiectasia was seen in 4 dogs with chylothorax, but was not seen in the 3 dogs with serosanguineous effusions or the 2 dogs that did not develop effusions. One dog with chylothorax died prior to repeat lymphangiography. Less dye entered the thoracic duct, and alternate lymphaticovenous communications to the caudal vena cava were evident in the dogs without chylothorax. Ligation of the thoracic duct at the lymphaticovenous junction was performed in 3 dogs. These dogs did not develop pleural effusion. Lymphangiography was performed immediately after ligation and indicated filling of abdominal lymphatics but not of the thoracic duct. Lymphangiographic findings 6 weeks after ligation also indicated filling of intestinal lymphatics. Results of the present study indicated that ligation of the CrVC causes chylothorax, and that thoracic lymphangiectasia is a consistent finding in animals with experimental chylothorax. Obstruction of the thoracic duct did not induce lymphangiectasia or chylothorax. Impedence of thoracic duct flow into the CrVC may be a cause of clinical chylothorax in the dog.     

Lymphangiosarcoma in two cats

Lymphangiosarcoma is a malignant neoplasm of the lymphatic endothelium that is rare in cats. This report describes two cases of feline lymphangiosarcoma that originated in the distal limb, causing intractable lymphoedema and serosanguineous discharge with ecchymoses in local and distant sites. In association with the neoplasia, one cat had cortical bone lysis of multiple metacarpal bones of the affected limb and the other had severe immune-mediated haemolytic anaemia (IMHA). The disease in both cases affected young cats and progressed rapidly. Persistent distal limb lymphoedema with serosanguineous discharge is suggestive of lymphangiosarcoma especially when local or distal ecchymoses are evident.     

FAT NECROSIS SIMULATING RECURRENT NEOPLASIA FOLLOWING EXTERNAL BEAM RADIOTHERAPY IN A DOG

A 4.5-year-old neutered male dog was diagnosed with incompletely excised well-differentiated lymphangiosarcoma in the right inguinal subcutaneous region. The mass had metastasized to the right hypogastric and medial iliac lymph nodes. Surgery followed by definitive radiation therapy was administered to the primary site and the sites of metastasis. The dog had a complete response to radiotherapy, and minimal acute side effects. Doxorubicin was administered after radiotherapy. Approximately 4 months following radiation therapy, the dog developed a mass, presumed recurrent tumor, in the original site. In a biopsy only steatitis and fibrosis were found. The mass continued to grow and conservative surgical excision was elected. Histopathologically the diagnosis was fat necrosis and steatitis, with a microscopic focus of lymphangiosarcoma. Fat necrosis is an uncommon sequelum to breast irradiation in people and also appears to be rare in animals. Fat necrosis should be considered as a differential diagnosis when recurrent tumor is suspected in a previously irradiated subcutaneous site in a dog.     

A novel approach to treatment of lymphangiosarcoma in a boxer dog

A five‐year‐old female boxer presented with a swelling in the area of the caudal mammary gland. The mass was surgically excised and histopathological examination revealed a poorly demarcated lesion, extending into mammary tissue and infiltrating the sinuses of adjacent lymph nodes. The diagnosis was lymphangiosarcoma. Full blood work, thoracic radiographs, abdominal and scar ultrasound were unremarkable, apart from possible inflammatory reactions in the latter and reactive/metastatic changes in inguinal lymph nodes. Doxorubicin treatment resulted in a 6‐month recurrence free interval. At relapse, the dog was treated with metronomic chemotherapy using chlorambucil and meloxicam, which failed to adequately control the disease. Toceranib phosphate was introduced and resulted in almost complete regression of the mass, leaving just a skin plaque. To the authors’ knowledge this is the first report describing the use of two novel therapeutic approaches to treat canine lymphangiosarcoma that resulted in a higher than previously described survival time.     

Paresis in an Asian small clawed otter (Aonyx cinereus) associated with vertebral and ischial osteolysis caused by a malignant lymphangiosarcoma

A 10-yr-old male intact Asian small clawed otter (Aonyx cinerus) was presumptively diagnosed by histopathology and immunohistochemistry with lymphangiosarcoma after bony destruction of the ischium and spinal column from local tumor invasion had caused progressive signs of hind limb lameness and paresis/paralysis, which led to humane euthanasia. At necropsy, the primary tumor was identified as a flocculent mass present under the caudal lumbar vertebrae. Multiple nerves were seen to run from the spinal cord into the wall of the mass. This mass had locally invaded the surrounding muscle, vertebral column, and spinal cord, which led to the clinical signs noted at presentation. Bony destruction was severe with almost complete obliteration of the right ischium and osteolysis of L6, exposing the spinal cord beneath. The tumor had metastasized to at least two different sites within the spleen. The abdominal tumor was confirmed to be of endothelial origin by the use of immunohistochemical staining for factor VIII-related antigen and was confirmed as lymphatic origin versus vascular origin because of the lack of red blood cells within the vessels. The length of time from initial presentation with hind limb lameness to euthanasia because of hind limb paralysis was 4 mo. This is the first report of lymphangiosarcoma, an uncommon malignant neoplasm of lymphatic origin, in a mustelid and the first report of neoplastic disease in an Asian small clawed otter. In addition, the presentation of hind limb paresis associated with bony lysis because of local tumor invasion has not been previously reported with lymphangiosarcoma in humans, domestic animals, or nondomestic animals.     

Cisterna chyli ablation with thoracic duct ligation for chylothorax: results in eight dogs

OBJECTIVE: To report use of combined cisterna chyli ablation (CCA) and thoracic duct ligation (TDL) for treatment of spontaneously occurring chylothorax in dogs. STUDY DESIGN: Retrospective study. ANIMALS: Eight dogs with chylothorax. METHODS: TDL was performed through a right caudal intercostal thoracotomy and CCA through a left flank paracostal approach or ventral median celiotomy. Long-term outcome (range, 2-48 months; median, 11.5 months) was evaluated by telephone communication with owners. RESULTS: Seven dogs were free of clinical signs related to chylothorax at last follow-up (range, 4-48 months; median, 15.5 months). One dog was euthanatized 2 months after surgery because of lack of improvement. No major complications occurred from CCA. CONCLUSION: CCA and TDL resolved chylothorax in most dogs (88%). CLINICAL RELEVANCE: CCA combined with TDL may improve the outcome of chylothorax in dogs.     

Diagnostic ultrasonography in cattle with thoracic disease

The pleura and lungs were evaluated by means of sonography in 55 bovine patients with diseases of the thoracic cavity. For these ultrasound examinations, a range of transducers was used. As the lung surface was most often involved in cases of pulmonary disease, it was possible to detect ultrasonographically bronchopneumonia, consolidation, pleural effusion, pulmonary emphysema and pleuritis. Determination of the amount of lung tissue affected provided prognostic information. It was not possible to visualise lesions located deeper within the lungs where peripheral tissue was not affected. A diagnosis of thoracic disease was made on the basis of clinical and ultrasonographic findings and confirmed in 33 cases at necropsy.     

Feline lymphangiosarcoma--definitive identification using a lymphatic vascular marker

Abstract   Three cases of feline exudative dermatitis associated with lymphangiosarcoma are described. The animals, an 11-year-old, neutered male and two 10-year-old, neutered female short hair European cats, presented with a 2-month history of transparent liquid oozing from the skin of the groin and caudal abdomen. On physical examination the neutered male cat and one of the females were slightly depressed and showed loss of weight. Skin lesions were similar in all cats and characterized by the presence of alopecia and moist dermatitis in the ventral abdomen, groin and inner thigh. The hair at the periphery appeared matted by the fluid. In all three cases, histopathological examination of skin biopsies from the abdomen identified poorly defined neoplasia involving dermis and subcutis, characterized by proliferation of spindle cells aligned along pre-existing collagen bundles. The dissection of collagen bundles gave rise to irregular shaped anastomosing, often blind-ending vascular channels and trabeculae. Vascular spaces were mostly optically empty. These histological features were strongly suggestive of lymphangiosarcoma. Neoplastic cells were positive for the blood vascular marker Von Willebrand factor, and a lymphatic vascular marker LYVE-1 (Lymphatic Vessel Endothelial receptor – 1), demonstrating the mixed vascular origin of the tumour. Ultrastructural findings confirmed the final diagnosis of lymphangiosarcoma.     

Sudden death attributable to exercise-induced pulmonary hemorrhage in racehorses: nine cases (1981-1983)

Pathologic changes are described in 11 horses that died during racing or training; 9 died of acute pulmonary hemorrhage (exercise-induced pulmonary hemorrhage), 1 died of exsanguination, and 1 died of CNS trauma. Cardiac lesions were not found in any horse. Severe engorgement of pulmonary vessels, with hemorrhage into alveoli, airways, interstitium, and subpleural tissues, was observed in all 9 horses that died of exercise-induced pulmonary hemorrhage. Infiltration of eosinophils and/or lymphocytes around vessels and airways was seen in 6 horses. Focally extensive fibrosis was observed in the pleura and interstitium of 6 horses, and collections of siderophages were seen in the fibrous tissue and in the airways. Focal occlusion of bronchioles with inspissated mucus, such as that associated with small airway disease, was found in 4 horses. Underlying respiratory tract lesions, particularly those associated with small airway disease or bronchiolitis, may have a role in fatal pulmonary hemorrhage.     

Thoracoscopic Thoracic Duct Ligation and Thoracoscopic Pericardectomy for Treatment of Chylothorax in Dogs

Objective— To report the use of thoracoscopic thoracic duct ligation (TDL) and pericardectomy for treatment of chylothorax.
Study Design— Case series.
Animals— Dogs with chylothorax (n=12).
Methods— Dogs with secondary or idiopathic chylothorax had thoracoscopy performed in sternal recumbency through 3 portals in the caudal right hemithorax for TDL and were then repositioned in dorsal recumbency for pericardectomy. Portals were placed in the 5th and 7th intercostal spaces of the right hemithorax with 1 transdiaphragmatic portal in the right paraxiphoid position. Follow-up was performed by recheck examination or telephone interview to determine outcome.
Results— Seven dogs (58%) had idiopathic chylothorax; 6 dogs (85.7%) had complete resolution of their effusion, whereas only 2 of the 5 nonidiopathic dogs (40%) had complete resolution.
Conclusions— Thoracoscopy is minimally invasive, provides excellent observation, and allows for ligation of the thoracic duct in the caudal thorax. Patients with idiopathic chylothorax may have a better prognosis after TDL and pericardectomy than dogs with nonidiopathic chylothorax.
Clinical Relevance— Thoracoscopy for ligation of the thoracic duct and pericardectomy is an acceptable surgical technique for treatment of chylothorax.     

Probable hypercalcemia of malignancy in a cat with bronchogenic adenocarcinoma

An eight-year-old, neutered male, domestic shorthair cat was referred with a four-day history of acute vomiting. Hypercalcemia was identified on serum biochemical testing. Thoracic radiographs showed multiple pulmonary nodular densities. Postmortem and histopathological examination identified the nodules as bronchogenic adenocarcinoma with metastases to the tracheobronchial lymph nodes, diaphragm, and parietal pleura. To the authors' knowledge, this is the first reported case of hypercalcemia of malignancy associated with bronchogenic adenocarcinoma in a cat.