Computed tomography lymphangiography via intrametatarsal pad injection is feasible in cats with chylothorax

Am J Vet Res. 2021 Nov 30;83(2):133-139. doi: 10.2460/ajvr.21.10.0163.

Abstract

Objective: To evaluate the feasibility of CT lymphangiography via intrametatarsal pad injection in cats with chylothorax.

Animals: 7 client-owned cats.

Procedures: This was a multicenter, retrospective, descriptive study. Medical records and imaging data from 4 veterinary hospitals were reviewed to identify cats with chylothorax that had undergone intrametatarsal pad injection via CT lymphangiography. In total, 7 client-owned cats were included in the study. Signalment, history, image findings, and follow-up data were recorded. Descriptive statistics were used to analyze the success rate of thoracic duct (TD) enhancement and describe relevant clinical findings.

Results: Enhancement of TDs was successful in 6 of the 7 cats within 5 to 15 minutes after initiating intrametatarsal pad injection under general anesthesia. Successful migration of contrast medium into the lymphatic vessels cranial to the popliteal lymph nodes was observed in all cats within 5 minutes after injection. The recommended dose of contrast medium to achieve TD enhancement was 1 mL/kg (0.5 mL/kg/pad; concentration, 350 mg of iodine/kg). Only 1 cat had mild swelling of the paws after the procedure, and it recovered quickly without pain medication; no cats experienced lameness. Similar to dogs and unlike in previously published reports, 72% of TD branches were located in the right hemithorax.

Clinical relevance: CT lymphangiography via intrametatarsal pad injection is a feasible and safe procedure for cats with chylothorax. This technique provides detailed information regarding the unique TD anatomy and cisterna chyli location. It also contributes to surgical planning.

Publication types

  • Multicenter Study

MeSH terms

  • Animals
  • Cat Diseases* / diagnostic imaging
  • Cats
  • Chylothorax* / diagnostic imaging
  • Chylothorax* / veterinary
  • Lymphography / veterinary
  • Retrospective Studies
  • Thoracic Duct / diagnostic imaging
  • Thoracic Duct / surgery
  • Tomography, X-Ray Computed / veterinary