Chylothorax...please help me help Butters

[couchcat]

My boy is a 3 year old, 22 pound yellow tabby named Butters.  He's not overweight, he's a very large framed cat.  He was neutered at about 5 months and had his rabies shot.  He looks and acts healthy as an ox up until about 2 weeks ago.  I'd noticed a few times after playing hard his breathing was heavier than it was in my other cats.  I didn't think much about it because it was only a few, occasional times and seemed related to his size and his activity at the time.  About a week and a half ago I was doing the "cat check" before bed and found him on the quest bed breathing very heavily.  My husband was at work and we only have the one car so I phoned a friend and asked for a ride to the emergency vet (which I hate to go to because I've had issues with them and they seem only interested in the cash period, not caring for the animal much at all).  Before my friend arrived Butters had begun to breathe normally and was looking out the window.  My husband would be getting off in about an hour so I felt like we could make it to then so I could go to my regular vet.  Butters had not been in a car or travelled at all since his neutering so he became very scared in the car and his breathing became very labored.  Shortly after arriving at the vet we noticed his nose and mouth getting a blue tint so I went to the desk and asked for immediate attention.  He was taken to the oxygen tank and kept there about 2 to 3 hours before he was able to be examined.  The vet did not think he would even make it at this time.  He was given an xray which showed fluid, his chest was tapped of 300ccs and it was sent off to be tested.  An ultrasound was done and his heart looked at and well as searching for any masses or tumors.  Nothing showed up but of course the fluid hinders getting a very good view.  The "heart" vet felt his heart looked good and saw nothing of concern.  No masses or tumors either.  We are waiting to get a better xray and ultrasound but unfortunately have not been able to yet.  He stayed at the vet all that day and we brought him home that evening.  He seemed tired but not really sick or uncomfortable.  Two days laters I felt his breathing was elevated so I took him back and 75ccs was drained this time.  He seemed to feel even better after this for a couple of days then his breathing was up again and about 170ccs was drained yesterday.  Since then he is very tired, is just resting all the time.  He will get up to eat and drink, to use the litterbox and to be petted.  He wants to drink constantly and seems to be extremely thirsty.  He has been sneezing alot, one eye is having clear drainage and he seems congested in his nose a bit.  I'm taking him back to the vet tomorrow but I'm feeling hopeless here.  It seems like there is not much info on the condition and what I find is all bad.  I tracked down Rutin at a medical supply store and will be picking it up tomorrow.  I'm trying to pick out the best low fat food but I could use some advice on which is best.  Also I have three other kitties and they will have to share the same food.  They are indoors and it's a small house so feeding them all separate would be pretty complicated.  This is all new to me and I really don't know what I can do to help my kitty.  He is only three and he is the sweetest loving cat, it's breaking my heart.  Any info or advice would be so appreciated.  I'm sorry this is so long and thank you for taking time to read it, I just don't know the best course of action to take and I want to do the best I can for him.

 

[ktlynn]

Butters sounds like a love and I'm so sorry you are all going through this.

I didn't know about Chylothorax until I saw your post, so did a search on it.  It's frightening how fast this happened to Butters.

Did your vet do bloodwork?  It seems that if the fluid is being generated because of a diseased organ (liver, kidneys, etc.) the bloodwork will help to determine that.  I can see how even with ultrasound and xrays it's difficult to get a clear image through all the fluid, so it's hard to tell what's going on.

I wish I could help you and your sweet boy.   I'd only suggest what you're doing already - research this as much as you can.  You already know about Rutin and hopefully that will help.  And maybe you can separate Butters at mealtime so he can eat the special diet without the other cats interfering.  I'm sorry I can't be more helpful.  Sending many healing thoughts and blessings to your precious Butters and you.  Please keep us updated if you can.

 

[couchcat]

Thank you for your kind words.  I took Butters to the vet this morning because of his cold-like symptoms.  He was runnng a low grade fever and was given a shot of antibiotics as well as sent home with a bottle.  I haven't had the blood work done yet because he has been to the vet to be drained so many times this week that just getting that under control was the main concern.  I need to have blood work and a repeat xray and ultrasound.  We are going to try to do it at the first of the week hoping he is feeling a bit better and the fluid has been drained enough to be able to see a clearer picture.   The vet says in about 50% of the cases he has experienced it was determined to be ideopathic (may have spelled that wrong), without an underlying cause.  Because of those odds I'm concentrating on trying to get the symptoms under control first then moving onto more testing.  So far this past week has totaled up to about $400 so I have to try and make the best decisions for treatments and tests as I can afford them.  I despise that money is a factor in the life of any creature but people expect to be paid for their service and I can only give what I have.   I also got the rutin today and a prescripton low fat food.  He loves the food but the rutin is going to be a struggle.  It's a powder and I'm mixing it with water in a syringe...he is not impressed.  I'll have to think of a better way to get it in him.  He's been a bit more active today and his breathing seems even and relaxed so I'm hoping he's feeling a bit better.  Sorry for such a long post.  I love him so much and he is such a good cat.  He will come up beside you, lay down and rest his little head right on your hand and he also loves to get under the covers and snuggle against your stomach while you sleep.  He's like a little piece of goodness in everyday and I can't stand that he's sick and there isn't much I can do to help him get better.

 

[couchcat]

sheldon_butters.jpg

• couchcat
• Dec 6, 2012
• 1

This is Butters when he was a baby and that's his big brother Sheldon Snufflebump taking care of him.

 

[farleyv]

Take comfort you are doing all you can for Butters.  What an adorable picture!

I am keeping him in my thoughts and prayers.  Those orange kitties have a special place in my heart.

 

[barbb]

My cat Bell had chylothorax a little over a year ago when she was 12, so I know what you are going through and my heart goes out to you and your sweet Butters. I had to make the very difficult decision to euthanize Bell because she was a kitty who would only let herself be handled on her own terms, so it was horrible for her to be taken to the vet repeatedly, and like your Butters her lungs were filling up rapidly even after being drained. In fact we believe her injury probably happened from a prior vet visit when she was resisting being examined, she was also very overweight which I'm sure contributed to the injury.

I read back when Bell had this, that the progression of this illness involves the impact of the lymphatic fluid on the lungs, it is abrasive and as it abraids, it creates scar tissue and stiffens the lung walls, further impeding breathing.
Also very little is known about this illness which may make it difficult for you to get answers. I think you need to pressure your vet to make this a higher priority and mention the fluid abrading his lungs, since it is you who has to watch Butters struggling to breathe and it is Butters who needs a solution before further damage occurs to his lungs, and the vet is not living your nightmare and not conscious of the time element.

I pray that Butters will recover, one of the things I also read about was a kind of semi permanent drain, this would never have worked for our Bell. We also used Rutin, I don't know how effective it was since there is no way to know how much worse she would have been without it.

The only other thing I remember from reading about this had to do with spontaneous resolution, I think there were some kitties who survive. I will post the info if I can find it again.

 

[barbb]

I took a quick look online and there is a facebook page for chylothorax cats, you should go to that page. If you are not a big facebook person you can still join and use your cats name and fake info. It is worth it for Butters and you will get the benefit of others' research and experience. http://www.facebook.com/ChylothoraxCats.This was not available when Bell was diagnosed.

 

[catsallaround]

Have only had experience with wet FIP.

Far as getting meds I have used cat milk or tuna juice mixed in with the powder/crushed pill meds.  Some gravy from wet food(One cat I used dog food just for the medicine as she will do ANYTHING for a lick of pedigree).

 

[jessy]

My thoughts are with you, I had a wonderful little lady cat, Villy, and she suffered with Chylothorax. I know exactly what you are going through. Sending you, your family and Butters lots of love and get well vibes.

 

[pat]

I also had a kitty with Chylothorax, so I too know what you are going through.  Rutin did help give my kitty some decent quality time with us, but he did not overcome this.

 

[couchcat]

Thank you for the responses.  Butters has been playing a small bit today, eating and drinking well and still loving up to everyone around him.  His breathing is okay, not labored but not as relaxed as a regular breathing pattern should be.  I'm hoping we can go another day at least without a tap since he's already had three.

As it was mentioned above there is concern about the fluid's impact on the lungs...pleuritis, I believe it what happens? and things became thicker, tighter and stickier making it difficult to breathe even without the fluid problem.  There is also the worry of draining too often because of risk of infections, possibility of sticking the lungs but the big problem is scar tissue will build up and the fluid will begin to develop in pockets which is much harder to drain.

I've looked at the surgical options online and from what I can understand they are now performing pericardectomy along with the thoractic duct ligation since previously the ligation alone did not have a very good success rate. My vet is not equipped or experienced for that kind of surgery, I would have to go to an University.  The surgery itself scares me because:  it's highly difficult and extremely invasive, a pericardectomy is removal of the fibrous sac containing the heart, survival rate of the surgery is moderate to high but survival rate of the recovery period doesn't seem so good as it is extensive and painful (hospitalization is required for the recovery period which can be quite long).  For the ones who did survive both surgery and recovery about 10 to 20% had reoccurance of the chylothorax.  From the few people who wrote about their experience in doing this, they chose to put down their cat during the recovery period because well, the kitty wasn't recovering and they felt it was too painful, that they were just prolonging suffering.  I'm not even going to bring up the cost.  So basically, I would have to admit Butters into an University, have a highly risky, very evasive surgery that he may not survive, then hospitalize him for a long recovery period in which I would most likely not be able to see him and his chance of survival would be even more risky, to possibly recovering, to possibly be okay but still a chance of it not being resolved at all or redeveloping.  I don't know, I feel bad to not do everything I can but everytime I read about this surgery I do not feel good about it.  And I also worry about what other complications could arise from ligationing the duct to living without the fibrous sac around the heart.  I just don't feel good about it.  It feels too dangerous, too risky to me.

A shunt can be placed into the kittie's lungs but this is usually done for a few days with the cat being hospitalized as well.  It really just drains the fluid but doesn't seem to be much more beneficial than the tapping.  It has it's risks as well though nothing too alarming.

Unfortunately if an underlying cause is found, most causes of the are the bad things: heart failure, cancer, etc.  We have to do more testing on Butters to see if any of this applies.  Usually it is not something simple.

After the intial visit, Butters has been great with the vet.  He easily gets in his carrier and loves looking around as we drive there.  Once there he checks out the other animals through the carrier holes with the cutest little look on his face.  He's so far (please, please let this continue) been very cooperative with the taps and spends most of the time in the exam room rubbing and loving over his doctor.  I'm thankful for this at least.

I've tried some tricks to get the rutin in but he's outsmarting me on them all.  Next I'm going to attempt mixing with a bit of tuna water.  Does anyone know how long tuna keeps in the fridge so I can hopefully use the same can for several mixtures. 

This is long but I wanted to talk a bit cause I'm still feeling a bit helpless and I also wanted to let you all know where I'm standing on my info so if I'm missing something or misunderstanding something please let me know.  I'm planning on repeat xray (ultrasound if xray shows a clearer picture than before) on Monday as well as a blood chemistry panel.  Possibly a chest tap depending on where he stands.  What else would you recommend?  Or do you think that's a good place to start and go from there with the possible results.  Also keep in mind I'm in debt to the vet now so I have to chose wisely the best steps to take and have the most important and and useful things first.  

 

[barbb]

I think you should go to the chylothorax cats page on Facebook, there are posters there who are sharing treatment information and can probably help you save money. I saw that the longest surviving kitty there has had it for ten months and is still alive.

With the Rutin you might want to follow his syringe squirt with a pat of butter, (awww for Butters) kind of the way kids get a lollipop after their shot to take their mind off what just happened. The oncologist treating my other kitty said not to mix medicine with regular cat food and instead use butter or whipped cream etc. If the Rutin tastes really nasty you can follow up with another syringe with plain water to rinse the bad taste out.

Beyond that, I think your instincts to not take superhuman efforts with this illness are on target. I looked at the same info, and even if Bell had been very easygoing I would not have subjected her to that complicated surgery with high pain and low chance of success. And I just finished doing a full course of chemo for my kitty Toby, who has cancer, and started him on a new round last week. But I would not take him to a university for an obscure risky surgery for chylothorax.

 

[couchcat]

Thanks BarbB

I'm trying to figure the facebook out.  This computer is a company computer given to us from my brother-in-law and I think because of that it has certain "business" related features.  The sound on stays very low even if turned to max and it looks like the social sites are blocked somehow.  I'm trying to figure out how to get past that but it may be something built in and I'll have to use another computer.  Somehow I'll manage to figure it out!

 

[barbb]

They have a website too called www.chylothoraxcats.webs.com. I don't know if the have all the same info but it is the same person! Ok I just looked and she does have the herbal info posted on the website too. And she is the person whose kitty has lasted 10 months.

 

[couchcat]

BarbB, you are awesome!  I've been looking over that site and reading.  There is such a thing as a companion port for at home draining I hadn't even heard of yet so that was very interesting.  I still can't get on facebook from this computer but on the website saw a blurb from facebook that talked about a lady who's cat resolved after she took it to a friend's home.  The household mold was suspected to be the problem.  It was only a blurb but I definitely want to read up on this because we have been having an issue with mold in our house.  Worth looking into I believe.  Thanks so much and I will get on another computer later today and search for the facebook group.

 

[couchcat]

Hello everyone...I'm going to give an update on Butters and his condition, hopefully I'll get some suggestions or help someone else who is going through this with their kitty.  I took Butters back to the vet on Saturday. Another 200ccs was drained.  The vet says he's doing well so far with the draining, he will be very still but after about 10 minutes starts to get antsy and they have to stop.  The fluid was coming slower this time so they did get what they could during the time.  His fever was gone and his eyes have stopped running but he still has the sneezes.  It may just be the congestion in him?  He had blood work and the chemistry panel done and both were fine.  I still have to wait for another xray and such because it's just not clear enough to tell anything.  Since Saturday he has been great.  Playing with the others kittens, jumping onto our laps for pets and snuggles, all the regular stuff he always does.  It seems like he's not even sick so I should be thankful for the good days when he's feeling so well.  I've monitored his breathing rate at random times and until today it has been only two breaths above my other cats.  Tonight it is higher so I'm thinking another vet visit tomorrow might be in order.

I've joined the facebook group and read through the posts as well as searching, searching, seaching the internet reading all I can find.  Butters is starting to get difficult with the rutin, he obviously hates the taste of it.  I've put it in so many things now and he will only take a little.  He is also on antibiotics and is starting to struggle and clamp his mouth when I give them to him.  The only thing that is still working with the rutin is yogurt, he craves strawberry banana yogurt.  Is this bad for him?  I bought a different brand that is organic and fat free hoping that would be better.  Any food suggestions would be great, I've always just feed dry kibble with the moist treats every so often.  I see you all do alot of raw feeding so it seems you know about nutrition much better than I do.  I'm thinking the lowest fat diet possible would be best, including whatever I have to give him to get the rutin down.

I've decided the surgery isn't an option for us.  Even if I could come up with the money I just feel it is too risky.  Also having to take him to an University and leave him there doesn't feel right.  I have a strong belief that a person (and pet) is stronger and heals/does better when they are happier, feel safe and basically in a good, loving emotional state.  He would be frightened in that environment and alone, I think that would only make him weaker and less likely to recover.  My vet also said he doesn't think the surgery is the right decision, he would not have it done on his own cats if in my situation.

The companion port is an option but I have doubts about it as well.  Butters is extremely social with his kitty housemates.  When he comes home from the vet the others hiss and avoid him for about a day.  After a bit of this he seems to get very lethargic and depressed, often going off by himself and just laying there.  When they get over the vet smell and interact with him his entire demeanor changes.  His mood instantly picks up and he becomes his regular active self.  I've wondered how they would react to the port if it was installed, if they would withdrawl from his because of it.  Knowing how my cats react to different situations make me think they might and I know this would really affect Butter's well being.  I also have my doubts if he would tolerate it himself or if he would be trying to get it out or just freaking out about it in general.  Cats can be difficult about stuff like that, dogs not quite as much it seems but cats can be downright stubborn about things.  Also there is no one is my area or very close that does that so it would involve traveling costs as well as the cost of the port itself.  Also for check ups and such I'm not sure anyone around here would be familiar enough with it. 

I'm studying on the herbal remedies and intend to try some of them.  I'm scared of making a mistake with everything I do and hurting him more than helping.  It's hard when it seems so much of this is guess work because the lack of study and knowledge of this disease.  And as always money comes into the picture.  This is a very costly situation and that worries me.  It's not that I won't do whatever I can for my cats.  They are part of my family and I made a commitment to care for them when I brought them into my home.  I love them and they are priceless to me, it's that simple.  But I only have what I have money wise.  It really gets to me sometimes that life comes down to money, my husband and I have had to make sacrifices in our own health care because you can only get what you can buy.  Sorry for that rant but it just really angers me.  But on the good side, so far we are able to pay for the costs and our vet is accepting of payments.  Unfortunately the emergency vet is not so I pray that no after hour problems come up.  They hand you a list of prices and make you sign for them and pay before they will even examine the animal.  You also pay the entrance fee when you come in before you will even be seen, if you don't have it in cash, they will not do anything.  I hate that place with a passion and think they are heartless.

As always, my post is way long.  To all that read it I appreciate you taking the time for Butters, he sends lovings to you all and if he saw you would rub all over you and lick your hand (that's how he greets new people), he's just a total sweetie.  Please say a small prayer for him if you can.

 

[barbb]

I think your decisions re: the port and surgery are the right ones. I couldn't imagine any of my cats walking around with a port let alone Bell who would flip out, and I think the chances of infection or other complications would be high, and the same goes for a surgery.

There are a lot more people on here who can give advice about raw food but I can tell you I got Stella and Chewy's freeze dried raw for cats, half of my kitties really like it and half don't. I like that you can crumble some of it and leave the rest in mounds in a dish the same as crunchies, or reconstitute it with water. I have not bought other raw food yet but my kitties love sushi lol. When I mentioned this to the vet she cautioned me against going out and buying raw fish for my cats due to possibility of contaminants. Also cats need taurine in their diet which is why you would want a commercial brand of raw. We do still give Toby salmon as a treat before we cook it, when we eat it ourselves.

I think it is wonderful that you have done so much for Butters, it is obvious you love him to pieces. I hope there are other people on the site who can give you advice re: raw. Also, I am wondering did the doctor talk to you about keeping Butters from retaining fluid overall? With Bell the vet discussed that but I don't recall much about it.

 

[couchcat]

Hey Barb, thanks for replying.  We did discuss options of fluid bluid up control but agreed to not use any at this time.  Butters (unfortunately) is having to be tapped so often.  He is full of fluid but not the hydrating kind.  The often tapping can dehydrate and Butters has been licking his lips constantly so we know he is feeling the effects.  Considering that, he felt for now that it may do more harm than good to use a diuretic.  Of course that could change depending on if an underlying cause if found that requires one.

Unfortunately last night Butters started having a bad spell and it progressed fairly quickly.  I became too concerned to try to wait until morning and ended up at the emergency vet.  I asked them to do a tap and they kept him for a couple of hours under oxygen.  They said they could not get much fluid out and believed he was beginning to "pocket up".  They kept wanting me to consider a chest tube.  I agreed to let him stay under oxygen for a couple of hours then said I would get him and take him on over to his regular vet.  Dr. Mike (his vet) tried tapping him and could get nothing.  We decided to do another xray to see where we stand at this point.  Butters lungs had expanded (they had been compressed down to an alarming size) about 70% since last week.  He still has fluid but it was decreased and in a lower area from where they were tapping.  I'm so thankful, so so thankful for that but am afraid to get too hopeful, just one day at a time for now.  By this point Butters had been at vet offices for about 5 hours and poked several times, he was very stressed and starting to curl up and not want anyone to touch him.  We felt it was best to go with that info for now and get him home to relax.  He was also starting to run a low grade fever that had started at the emergency vet.  We're home now and he's beginning to mellow out and relax which is what he needs right now, the high stress is no good at all.  So today is for resting and tomorrow will be a call back and discussion of the next step.  He usually does so well after the taps so I'm hoping that is the case this time and maybe the fluid will stay down and we can actually get a better look inside to see if any problems can be located. 

The vet and I discussed the situation for about 30 minutes or more.  We talked about the chest tube, possible benefits and problems.  I also asked about some herbal information and some digestion questions I had.  We agreed that for now unless an underlying cause presents new information that taps as needed, a low fat diet and rutin is his treatment plan.  It's not the most aggressive plan but I've researched and questioned and it's what I feel is best for now.  There is no actual cure for this disease, the best you can hope for is it resolves itself which is possible but the odds aren't high for.  The treatments I've learned of are risky, have some serious side effects and most likely are only a temporary fix.  I want my baby to live a long, happy, healthy life but I also am a firm believer in the quality of life you are living.  If this is something that he cannot get better from then I don't want the time he has left to be painful or uncomfortable with procedures and surgeries.  I want him to be happy, comfortable, loved and spend his days doing things he enjoys.  I pray and pray he gets better, that he beats the odds and that he is one of the lucky ones.  If that is not meant to be then I pray that I can give him comfort and happiness for as long as I can.  He is so special.

 

[barbb]

I completely agree with you and am glad you are doing this for Butters. My Bell had a bad episode the evening before she was to see a cardiologist and have a test. I was so upset, because the vet had said they needed her to have fluid in order to get a good picture for the test, so did not tap her lungs in between appointments. So she was gasping all nite. I sat up with her the entire night crying, trying to help her be comfy, and reading everything possible about this illness. She'd already been thru two taps and the test was only going to show if there was a tumor that may have caused the disease. If we took her to the ER (same place the test was scheduled) they would do nothing. That was when we decided screw this, her life cannot be shuttling to different specialty areas and being handled by people who don't know her or us, and don't care. I could not deliver her to strangers and have her go behind a door, my crabby fatty girl who was so sick and so petrified, not without me, even for a test. And what difference would it have made, when we knew the chances at her age, for recovery. So we decided to let her go. It was terrible but it was the right thing for Bell.
I pray and pray your kitty will get well, he is young and a sweetheart, I would hang in there. You will know if and when it gets to be too much, if he does not recover on his own.

 

[otto]

Just read through your thread. All paws crossed for Butters that he can hang on long enough for this to run it's course. It's clear he couldn't be in better hands than yours. What a beautiful Red Boy he is, that picture is so special.

Much love and hope to Butters.