First Person Experience: My Dog Had Chylothorax

My dog, Shadow, was a healthy one and a half year old Labrador Retriever mix that I had adopted from the local animal shelter. She became part of our family when she was six months old. Although she was wild and energetic, she was great with my twin daughters, who both have autism.

One day last fall Shadow fell into a chair at the kitchen table. I thought she had just had a clumsy moment, but my boyfriend had seen her kind of topple into it. We didn’t think much of the incident as she was right back up playing in seconds.

A few months went by and Shadow had another collapsing episode. This one was obviously not the result of a stumble or slip. She looked scared and confused while she lay on the floor. Again, after a few seconds she was up and looked fine. She began collapsing about once every three or four days. It always happened when she was excited: someone comes to the door, playing chase, or something active.

We took her to the vet, who told us that most likely she was having fainting episodes, or syncope. Our vet did an EKG and some blood work and then referred us to a specialist. Until that time I had never thought about a cardiologist for a dog, but that was who we were to take Shadow to see.

The cardiologist was great. She was very friendly and open to discussion. After an extensive four hour examination we had some more information about Shadow’s syncope. Unfortunately the information we learned led to more questions.

Shadow’s right lung lobe was “dead”. There was no sound coming from it. In the x-ray the right middle lung lobe looked like a black mass. More tests were needed to find out what was going on inside the lung.

In addition to the lung issue, Shadow also had a congenital heart defect common to labs. The heart defect didn’t explain her syncope though. In addition to that heart problem, Shadow also had both atrial and ventricular tachycardia. The atrial tachycardia was caused by the upper heart valves contracting irregularly, which resulted in a fast heart rate. The ventricular tachycardia also caused her to have a high heart rate. Either of these conditions could possibly be causing her syncope.

We decided on a course of antibiotics, working on the assumption that the lung lobe was filled with bacteria. We also started some Sotalol to try to control her heart rate and rhythm.

After the antibiotics were completed, Shadow’s right lung was still showing as a black mass on the x-ray. We decided to let the doctor try to draw a fluid sample from it.

The cardiologist drew some fluid from the lung and from a pocket of fluid that was next to the lung to see what was present. The results didn’t reveal what was going on with the lung, so we decided to have the lung lobe removed, since this was most likely going to happen sooner or later.

The right lung lobe was removed successfully; unfortunately, her upper right lung was punctured during surgery and had to be removed as well. The surgeon also found a lot of fluid in the chest cavity when he opened it, which wasn’t expected.

Shadow was to be allowed to come home once she quit producing so much fluid in her chest cavity, which isn’t altogether that uncommon after a surgery. Usually two to three days post-op is a normal recovery time.

Shadow spent about six days in recovery before we had to decide whether or not to have another surgery performed. This time it would be to correct her fluid problem, which turned out to be idiopathic chylothorax. I had no idea what this condition was at the time, or that it had such a dismal prognosis. The surgeon described the procedure to us, which would involve lacerating the tubes that drained the lymph fluid into the chest cavity, as well as removing the pericardium, which surrounds the heart. The laceration surgery alone only had about a 50% success rate; the pericardectomy and laceration surgery put the success rate up to roughly 75%.

Shadow came home with us for one night before her second surgery. She was a different dog. She was tired, nervous, and had lost her playful air. I hoped that she wasn’t mad at us for taking her to a place where they did seemingly strange things to her. I think she wasn’t mad, but rather confused and scared.
She had the second surgery and recovered in two days. She was allowed to come home with us. Her staples and stitches made me think of a sort of Franken-dog. We ended up having her wear a t-shirt because it made her more comfortable. She didn’t like anyone looking at or touching near her staples. She became much more confident with the shirt on.

We continued to have follow ups with the cardiologist to try to find out why she continued to have episodes of syncope. We had hoped that the lung and fluid’s pressure on the heart had caused them, and that they would go away after the surgery. Unfortunately that didn’t happen.

She also continued to have a little fluid build up in her chest, but at a much slower rate than before. After her first surgery she would have died within a couple of days if she had her chest tube removed. Now she would most likely be able to go for several months before it would need drained.

We worked with the cardiologist for a couple of months working on medicine and supplement cocktails to see if they could get rid of the fluid. As a side effect to the diuretic that she was on, Shadow began having issues with incontinence when she slept.

Between March and May we had finally found a way to make Shadow’s chest fluid reduce. We went off of the diuretic and stayed on a supplement to see if we could keep up the progress without the incontinence issues.

Just ten days after our uplifting news, Shadow got sick. She had begun vomiting on a Thursday night. She threw up french fries, so I thought that someone had just fed her too much people food. She continued to get sick through the night. Friday morning she was playing around a little, but she still didn’t want to eat or drink much.

By Friday afternoon she really seemed to be feeling bad, so we decided to take her to the pet emergency room. On the way there she seemed calm and peaceful. She let me hold her head in my hand, and then she put her head on the center console of the car so my boyfriend could pet her.

We were almost at the emergency room when she tried to vomit again, but she mainly dry heaved. The smell was really bad, so I sat up, with my face away from where I had been lying on the back seat so I could be closer to her. When we pulled into the parking lot and tried to get her out of the car she wasn’t moving. It struck me that she might be dead, but I didn’t believe it.

We didn’t want to move her in case it might make things worse, so I went in to get help. I don’t know why I didn’t say, “I think my dog just died,” but I didn’t. I asked for help getting my dog out of the car.

By that point my boyfriend was sure she was either unconscious or dying so he picked her up and brought her in. I can still see the image of her, hanging limply in his arms with the tip of her tongue hanging out of her mouth. I realized then that she was dead.

The emergency room team tried to revive her, but she wasn’t able to make it. The cause of her death was too much fluid in her chest: she couldn’t inflate her lungs to breath and her heart had the pressure of the fluid on it.

We’re not sure what caused her to have such a resurgence of fluid production, especially when just ten days before she had the first marked improvement we had seen. It may have been the vomiting illness she had caused her lymph system to produce more fluid, thus leaking more into her chest faster than she could reabsorb it.

It wasn’t until after she passed away that I learned that most dogs who have the surgery to treat chylothorax don’t survive more than three months after the surgery. Shadow lived for just a week shy of three months past her surgery.