Octreotide as medical therapy of idiopatic chylothorax in 3 cats after surgery

Idiopathic chylothorax is a rare disease that a ects cats. Dif- ferent therapeutical options both surgical and medical have been described without a clear standard protocol and posi- tive outcome. The use of Octreotide in cats have been described previ- ously (for the medical therapy of hyperinsulinemia in cats a ected by insulinomas, gastrinomas, acromegaly and acute pancreatitis) but its usefulness as de nitive treatment to cure chylothorax its unclear. This preliminary data describe the clinical features of three cats treated with Octreotide after a partial surgical resolution of idiopathic chylothorax. Three cats presenting a moderate amount of chylous e usion one week after surgical closure of thoracic duct with transdiaphragmatic approach were selected for our study. The Octreotide started seven days after surgery at the dose of 20 ug/kg/sc/tid (dose proposed in literature 10–20 ug/kg/ sc/tid for maximum 2–3 weeks). Standard clinical, radio- graphic and ultrasonographic evaluations were performed twice a month and together blood cell count, seroum bio- chemistry, cytological,chemical-physical evaluation of tho- racic e usion were performed at each control. Clinical, imaging and laboratory abnormalities were reported. The Octreotide administration was interrupted one month later by the end of the pleural collection and each patients was re-evaluated one year after surgery. Cat one: (DSH, 5 years old, neutered male) presented pleural e usion from day one to day 146 of therapy. Octreotide was interrupted at day 176. Cat two: (DSH, 6 years old, neutered male) presented pleural effusion from day one to day 143 of therapy. Octreotide was interrupted at day 173. Both cats were discharged with- out clinical symptoms and they were rechecked six month later without any clinical problems, except the di use pleural thickening observed at the ultrasonographic examination. Cat three: (DSH, 9 years old, neutered male) presented pleural effusion from day one to day 182 of octreotide ther- apy. At day 182 the cat was euthanised according to the owners due to respiratory insu ciency. Necropsy confirmed a severe constrictive pleuririts. In all the subject thoracentesis were performed during controls if necessary. No adverse e ects were observed even considering that this drug was used for 6 months therapy. In our experi- ence on three cats the use of Octreotide turned out useful and safe as complementary therapy of the idiopathic chylothorax.