My cat Pallina has been found with fluids in her chest.
She's 16 years and 5 months old, spayed, regularly vaccinated, mainly indoor cat. She's allowed outdoors only when I can directly supervise her. She has always been healthy, but was diagnosed with hyperthyroidism last year in September and treated with methimazole since.
These fluids were first found when she was admitted at a I-131 clinic in Belgium on last Aug 7. At the admission visit the vet heard a slight heart murmur and did a chest scan which revealed a small amount of fluid. Those vets didn't aspirate it because the amount was too small, but adviced me to have a new ultrasound scan done after a month.
The report said:
There is a mild amount of anechoic pleural effusion, larger in the left hemithorax.
The amount is small to safely puncture it (in very close connection with the heart).
There is no mass detected cranial to the heart.
The sternal lymph node is mildly hypoechoic, but is not enlarged (3,3 mm).
In the conclusions, among other things, it was written
Radiographic and ultrasonographic investigation of the throacic cavity revealed no anomalies that could justify the pleural effusion...[...]... A neoplastic or viral (FIP) cause can not be ruled out.
So, on Sept 12 I took my cat to my vet who did a new ultrasound scan and the fluid was still there. There was more fluid than in the images of the previous scan, my vet aspirated it, 55 ml of orange/pinkish liquid. It was sent it to the lab for a test that came with the result of
Macroscopic description
pink color, turbid appearance, specific weight 1029, total proteins 4 g/dl
Microscopic description
many small lymphocytes, discrete quantities of erythrocytes, few neutrophiles and rare macrophages are detected
Report
Cytological framework compatible with chronic lymphocytic exudate; it is advisable to repeat the cytological examination after about 15 days to assess the evolution of the lymphocyte population in order to safely exclude the presence of a lymphoma.
The advice was to do nothing and wait two more weeks and repeat the scan.
And so we did on past Thursday, 16 days later. The scan said that Pallina's heart is fine, the murmur is minimum, it isn't concerning. But that fluid was there again and when he aspirated it he got 105 ml of fluid, twice as much as the time before.
His comment was that we can rule a heart failure out because the scan was good and the fluid is too orange and cloudy, rather than clear. We can rule FIP out too because the specific weight of this fluid is too low. A FIP should also give much more visible symptoms, especially after two months.
The only idea could be of a lymphoma, but during the scan the vet didn't see any enlarged lymph node in her chest, apart from the sternal lymph node which is mildly reactive, with a size around 1 cm, not so large to justify this situation, so I think we're at a loss.
This time the lab report for this fluid says
Macroscopic description
light orange color, slightly turbid appearance, specific weight 1032, total proteins 4.4 g/dl, cholesterol 184 mg/dl, triglycerides 25 mg/dl. Rare erythrocytes. Cell population is mainly made from small lymphocites and a low number of macrophage-monocyte cells, occasionally in erythrophagocytosis. Rare neutrophiles detected.
Report
Cytological framework compatible with chronic lymphocytic exudate with signs of hemorrhage.
Pallina has suffered (or is suffering) from an IBD that in the last two months hasn't shown any issue, so I think it's well under control.
I have read that in certain cases IBD can turn into an intestinal lymphoma. But abdomen and chest are two different environments, so could an intestinal lymphoma give fluids in the chest? The vet says no.
Pallina is very fine. She's lively and active. As a matter of fact I think she's feeling better than she was before the radioiodine treatment. She eats two 85 grams cans of wet food daily, she eats 70 ml of water on average, she uses her litter tray regularly.
She weighs 3.070 kg (6 lbs 12 oz), 200 grams (7 oz) more than a month ago.
She shows no pain or discomfort, her breathing pattern and rate are regular.
She's been tested for FIV and FeLV twice in the last year, she's negative to both.
She isn't taking any meds since the end of July.
Any thought on this? Any advice on what else we should look for or do? I would like to get a clear answer to this fluid as soon as possible.
Photo taken today!
She's 16 years and 5 months old, spayed, regularly vaccinated, mainly indoor cat. She's allowed outdoors only when I can directly supervise her. She has always been healthy, but was diagnosed with hyperthyroidism last year in September and treated with methimazole since.
These fluids were first found when she was admitted at a I-131 clinic in Belgium on last Aug 7. At the admission visit the vet heard a slight heart murmur and did a chest scan which revealed a small amount of fluid. Those vets didn't aspirate it because the amount was too small, but adviced me to have a new ultrasound scan done after a month.
The report said:
There is a mild amount of anechoic pleural effusion, larger in the left hemithorax.
The amount is small to safely puncture it (in very close connection with the heart).
There is no mass detected cranial to the heart.
The sternal lymph node is mildly hypoechoic, but is not enlarged (3,3 mm).
In the conclusions, among other things, it was written
Radiographic and ultrasonographic investigation of the throacic cavity revealed no anomalies that could justify the pleural effusion...[...]... A neoplastic or viral (FIP) cause can not be ruled out.
So, on Sept 12 I took my cat to my vet who did a new ultrasound scan and the fluid was still there. There was more fluid than in the images of the previous scan, my vet aspirated it, 55 ml of orange/pinkish liquid. It was sent it to the lab for a test that came with the result of
Macroscopic description
pink color, turbid appearance, specific weight 1029, total proteins 4 g/dl
Microscopic description
many small lymphocytes, discrete quantities of erythrocytes, few neutrophiles and rare macrophages are detected
Report
Cytological framework compatible with chronic lymphocytic exudate; it is advisable to repeat the cytological examination after about 15 days to assess the evolution of the lymphocyte population in order to safely exclude the presence of a lymphoma.
The advice was to do nothing and wait two more weeks and repeat the scan.
And so we did on past Thursday, 16 days later. The scan said that Pallina's heart is fine, the murmur is minimum, it isn't concerning. But that fluid was there again and when he aspirated it he got 105 ml of fluid, twice as much as the time before.
His comment was that we can rule a heart failure out because the scan was good and the fluid is too orange and cloudy, rather than clear. We can rule FIP out too because the specific weight of this fluid is too low. A FIP should also give much more visible symptoms, especially after two months.
The only idea could be of a lymphoma, but during the scan the vet didn't see any enlarged lymph node in her chest, apart from the sternal lymph node which is mildly reactive, with a size around 1 cm, not so large to justify this situation, so I think we're at a loss.
This time the lab report for this fluid says
Macroscopic description
light orange color, slightly turbid appearance, specific weight 1032, total proteins 4.4 g/dl, cholesterol 184 mg/dl, triglycerides 25 mg/dl. Rare erythrocytes. Cell population is mainly made from small lymphocites and a low number of macrophage-monocyte cells, occasionally in erythrophagocytosis. Rare neutrophiles detected.
Report
Cytological framework compatible with chronic lymphocytic exudate with signs of hemorrhage.
Pallina has suffered (or is suffering) from an IBD that in the last two months hasn't shown any issue, so I think it's well under control.
I have read that in certain cases IBD can turn into an intestinal lymphoma. But abdomen and chest are two different environments, so could an intestinal lymphoma give fluids in the chest? The vet says no.
Pallina is very fine. She's lively and active. As a matter of fact I think she's feeling better than she was before the radioiodine treatment. She eats two 85 grams cans of wet food daily, she eats 70 ml of water on average, she uses her litter tray regularly.
She weighs 3.070 kg (6 lbs 12 oz), 200 grams (7 oz) more than a month ago.
She shows no pain or discomfort, her breathing pattern and rate are regular.
She's been tested for FIV and FeLV twice in the last year, she's negative to both.
She isn't taking any meds since the end of July.
Any thought on this? Any advice on what else we should look for or do? I would like to get a clear answer to this fluid as soon as possible.
Photo taken today!
