{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T15:45:07Z","timestamp":1792424707040,"version":"4.5.0"},"reference-count":35,"publisher":"American Veterinary Medical Association (AVMA)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["javma"],"published-print":{"date-parts":[[2022,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n<jats:sec>\n<jats:title>CASE DESCRIPTION<\/jats:title>\n<jats:p>A 5-year-old spayed female domestic shorthair cat was evaluated because of an acute onset of dyspnea and open-mouthed breathing.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CLINICAL FINDINGS<\/jats:title>\n<jats:p>Thoracic radiography revealed pleural effusion and signs consistent with restrictive pleuritis, and results of preoperative CT were consistent with diffuse, severe restrictive pleuritis, bilateral pleural effusion, and pulmonary atelectasis. Thoracocentesis yielded a red, turbid fluid that was identified as chylous effusion with chronic inflammation.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>TREATMENT AND OUTCOME<\/jats:title>\n<jats:p>Exploratory thoracotomy revealed diffuse, severe fibrous adhesions between the mediastinum, heart, lung lobes, and thoracic wall, with a thick fibrous capsule enveloping all lung lobes. Surgical treatment consisted of complete pleural decortication, pericardiectomy, and thoracic omentalization. The cat remained hospitalized for 6 days, receiving oxygen supplementation, multimodal analgesia, and supportive care. Long-term home care consisted of prednisolone administration, rutin supplementation, and provision of a low-fat diet. At recheck examinations 3-, 7-, and 20-weeks postoperatively, the cat remained tachypneic, but was otherwise clinically normal without dyspnea or respiratory distress. Follow-up thoracic radiography revealed improved pulmonary expansion, decreased pleural effusion, and resolved pneumothorax.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CLINICAL RELEVANCE<\/jats:title>\n<jats:p>Surgical management of fibrosing pleuritis secondary to idiopathic chylothorax in cats has historically resulted in poor outcomes. This report details the first successful use of complete decortication in the surgical management of severe fibrosing pleuritis in a cat.<\/jats:p>\n<\/jats:sec>","DOI":"10.2460\/javma.21.01.0018","type":"journal-article","created":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T16:45:44Z","timestamp":1638377144000},"page":"335-340","source":"Crossref","is-referenced-by-count":6,"title":["Decortication, thoracic omentalization, and pericardiectomy for treatment of severe fibrosing pleuritis in a cat"],"prefix":"10.2460","volume":"260","author":[{"given":"Danny","family":"Sack","sequence":"first","affiliation":[{"name":"Animal Medical Center, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Hyndman","sequence":"additional","affiliation":[{"name":"Department of Surgery, Animal Medical Center, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Milligan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Animal Medical Center, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Spector","sequence":"additional","affiliation":[{"name":"Department of Surgery, Animal Medical Center, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1272","reference":[{"issue":"9","key":"ref1","series-title":"In Pract","doi-asserted-by":"publisher","first-page":"506","DOI":"10.1136\/inpract.23.9.506","article-title":"Diagnosis and management of chylothorax in dogs and cats","volume":"23","author":"Sturgess K","year":"2001","unstructured":"Sturgess K. Diagnosis and management of chylothorax in dogs and cats. In Pract. 2001;23(9):506\u2013513.10.1136\/inpract.23.9.506"},{"key":"ref2","series-title":"Consultations in Feline Internal Medicine","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1016\/B0-72-160423-4\/50043-3","article-title":"Section V: cardiology and respiratory disorders","author":"Fossum TW","year":"2006","unstructured":"Fossum TW. Section V: cardiology and respiratory disorders. In: August JR, ed. Consultations in Feline Internal Medicine. 5th ed. Elsevier; 2006:369\u2013375.10.1016\/B0-72-160423-4\/50043-3"},{"issue":"4","key":"ref3","series-title":"Vet Surg","doi-asserted-by":"publisher","first-page":"523","DOI":"10.1111\/j.1532-950X.2011.00984.x","article-title":"Use of the Ligasure vessel-sealing device for thoracoscopic peripheral lung biopsy in healthy dogs","volume":"41","author":"Mayhew PD","year":"2012","unstructured":"Mayhew PD, Culp WTN, Pascoe PJ, Vapniasky Arzi N. Use of the Ligasure vessel-sealing device for thoracoscopic peripheral lung biopsy in healthy dogs. Vet Surg. 2012;41(4):523\u2013528.10.1111\/j.1532-950X.2011.00984.x"},{"issue":"12","key":"ref4","series-title":"J Am Vet Med Assoc","first-page":"1699","article-title":"Reexpansion pulmonary edema after surgery to repair a diaphragmatic hernia in a cat","volume":"203","author":"Stampley AR","year":"1993","unstructured":"Stampley AR, Waldron DR. Reexpansion pulmonary edema after surgery to repair a diaphragmatic hernia in a cat. J Am Vet Med Assoc. 1993;203(12):1699\u20131701."},{"issue":"11","key":"ref5","series-title":"J Am Vet Med Assoc","doi-asserted-by":"publisher","first-page":"1230","DOI":"10.2460\/javma.245.11.1230","article-title":"Anesthesia Case of the Month","volume":"245","author":"Melis SM","year":"2014","unstructured":"Melis SM, de Rooster H, Waelbers T, Polis I. Anesthesia Case of the Month. J Am Vet Med Assoc. 2014;245(11):1230\u20131234.10.2460\/javma.245.11.1230"},{"issue":"3","key":"ref6","series-title":"Ann Thorac Surg","doi-asserted-by":"publisher","first-page":"340","DOI":"10.1016\/S0003-4975(10)62480-0","article-title":"Reexpansion pulmonary edema","volume":"45","author":"Mahfood S","year":"1988","unstructured":"Mahfood S, Hix WR, Aaron BL, Blaes P, Watson DC. Reexpansion pulmonary edema. Ann Thorac Surg. 1988;45(3):340\u2013345.10.1016\/S0003-4975(10)62480-0"},{"issue":"8","key":"ref7","series-title":"Can Vet J","first-page":"610","article-title":"Hyponatremia and hyperkalemia associated with chylous pleural and peritoneal effusion in a cat","volume":"43","author":"Thompson MD","year":"2002","unstructured":"Thompson MD, Carr AP. Hyponatremia and hyperkalemia associated with chylous pleural and peritoneal effusion in a cat. Can Vet J. 2002;43(8):610\u2013613."},{"issue":"8","key":"ref8","series-title":"Can Vet J","first-page":"729","article-title":"The use of rutin in a cat with idiopathic chylothorax","volume":"46","author":"Kopko SH","year":"2005","unstructured":"Kopko SH. The use of rutin in a cat with idiopathic chylothorax. Can Vet J. 2005;46(8):729\u2013731."},{"issue":"9","key":"ref9","series-title":"J Am Vet Med Assoc","first-page":"1106","article-title":"Pleurovenous shunting technique for treatment of chylothorax in three dogs","volume":"191","author":"Willauer CC","year":"1987","unstructured":"Willauer CC, Breznock EM. Pleurovenous shunting technique for treatment of chylothorax in three dogs. J Am Vet Med Assoc. 1987;191(9):1106\u20131109."},{"issue":"2","key":"ref10","series-title":"J Am Vet Med Assoc","first-page":"317","article-title":"Severe bilateral fibrosing pleuritis associated with chronic chylothorax in five cats and two dogs","volume":"201","author":"Fossum TW","year":"1992","unstructured":"Fossum TW, Evering WN, Miller MW, Forrester SD, Palmer DR, Hodges CC. Severe bilateral fibrosing pleuritis associated with chronic chylothorax in five cats and two dogs. J Am Vet Med Assoc. 1992;201(2):317\u2013324."},{"issue":"3","key":"ref11","series-title":"J Vet Intern Med","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1111\/j.1939-1676.2004.tb02550.x","article-title":"Thoracic duct ligation and pericardectomy for treatment of idiopathic chylothorax","volume":"18","author":"Fossum TW","year":"2004","unstructured":"Fossum TW, Mertens MM, Miller MW, . Thoracic duct ligation and pericardectomy for treatment of idiopathic chylothorax. J Vet Intern Med. 2004;18(3):307\u2013310.10.1111\/j.1939-1676.2004.tb02550.x"},{"issue":"2","key":"ref12","series-title":"J Feline Med Surg","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1053\/jfms.2001.0113","article-title":"Chylothorax in cats: is there a role for surgery?","volume":"3","author":"Fossum TW","year":"2001","unstructured":"Fossum TW. Chylothorax in cats: is there a role for surgery? J Feline Med Surg. 2001;3(2):73\u201379.10.1053\/jfms.2001.0113"},{"issue":"3","key":"ref13","series-title":"J Am Vet Med Assoc","first-page":"345","article-title":"Use of rutin for medical management of idiopathic chylothorax in four cats","volume":"215","author":"Thompson MS","year":"1999","unstructured":"Thompson MS, Cohn LA, Jordan RC. Use of rutin for medical management of idiopathic chylothorax in four cats. J Am Vet Med Assoc. 1999;215(3):345\u20138, 339."},{"issue":"5","key":"ref14","series-title":"J Am Anim Hosp Assoc","doi-asserted-by":"publisher","first-page":"312","DOI":"10.5326\/0460312","article-title":"Chylothorax treated via thoracic duct ligation and omentalization","volume":"46","author":"Stewart K","year":"2010","unstructured":"Stewart K, Padgett S. Chylothorax treated via thoracic duct ligation and omentalization. J Am Anim Hosp Assoc. 2010;46(5):312\u2013317.10.5326\/0460312"},{"issue":"4","key":"ref15","series-title":"J Am Vet Med Assoc","first-page":"672","article-title":"Chylothorax in cats: 37 cases (1969\u20131989)","volume":"198","author":"Fossum TW","year":"1991","unstructured":"Fossum TW, Forrester SD, Swenson CL, . Chylothorax in cats: 37 cases (1969\u20131989). J Am Vet Med Assoc. 1991;198(4):672\u2013678."},{"issue":"5","key":"ref16","series-title":"J Am Vet Med Assoc","first-page":"711","article-title":"Evaluation of mesenteric lymphangiography and thoracic duct ligation in cats with chylothorax: 19 cases (1987\u20131992)","volume":"205","author":"Kerpsack SJ","year":"1994","unstructured":"Kerpsack SJ, McLoughlin MA, Birchard SJ, Smeak DD, Biller DS. Evaluation of mesenteric lymphangiography and thoracic duct ligation in cats with chylothorax: 19 cases (1987\u20131992). J Am Vet Med Assoc. 1994;205(5):711\u2013715."},{"issue":"1","key":"ref17","series-title":"J Am Anim Hosp Assoc","doi-asserted-by":"publisher","first-page":"74","DOI":"10.5326\/0380074","article-title":"Omentalization of the thorax for treatment of idiopathic chylothorax with constrictive pleuritis in a cat","volume":"38","author":"LaFond E","year":"2002","unstructured":"LaFond E, Weirich WE, Salisbury SK. Omentalization of the thorax for treatment of idiopathic chylothorax with constrictive pleuritis in a cat. J Am Anim Hosp Assoc. 2002;38(1):74\u201378.10.5326\/0380074"},{"issue":"10","key":"ref18","series-title":"J Am Vet Med Assoc","doi-asserted-by":"publisher","first-page":"1299","DOI":"10.2460\/javma.234.10.1299","article-title":"Thoracic omentalization for long-term management of neoplastic pleural effusion in a cat","volume":"234","author":"Talavera J","year":"2009","unstructured":"Talavera J, Agut A, del Palacio JF, Mart\u00ednez CM, Seva JI. Thoracic omentalization for long-term management of neoplastic pleural effusion in a cat. J Am Vet Med Assoc. 2009;234(10):1299\u20131302.10.2460\/javma.234.10.1299"},{"issue":"1","key":"ref19","series-title":"Vet Surg","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1053\/jvet.1999.0061","article-title":"Use of omentum as a physiologic drain for treatment of chylothorax in a dog","volume":"28","author":"Williams JM","year":"1999","unstructured":"Williams JM, Niles JD. Use of omentum as a physiologic drain for treatment of chylothorax in a dog. Vet Surg. 1999;28(1):61\u201365.10.1053\/jvet.1999.0061"},{"issue":"2","key":"ref20","series-title":"Vet J","doi-asserted-by":"publisher","first-page":"234","DOI":"10.1016\/j.tvjl.2010.05.010","article-title":"Pleural omentalisation with en bloc ligation of the thoracic duct and pericardiectomy for idiopathic chylothorax in nine dogs and four cats","volume":"188","author":"Bussadori R","year":"2011","unstructured":"Bussadori R, Provera A, Martano M, . Pleural omentalisation with en bloc ligation of the thoracic duct and pericardiectomy for idiopathic chylothorax in nine dogs and four cats. Vet J. 2011;188(2):234\u2013236. doi: 10.1016\/j.tvjl.2010.05.01010.1016\/j.tvjl.2010.05.010"},{"issue":"12","key":"ref21","series-title":"J Feline Med Surg","doi-asserted-by":"publisher","first-page":"928","DOI":"10.1177\/1098612X12451797","article-title":"Thoracoscopic en bloc thoracic duct sealing and partial pericardectomy for the treatment of chylothorax in two cats","volume":"14","author":"Haimel G","year":"2012","unstructured":"Haimel G, Liehmann L, Dupr\u00e9 G. Thoracoscopic en bloc thoracic duct sealing and partial pericardectomy for the treatment of chylothorax in two cats. J Feline Med Surg. 2012;14(12):928\u2013931.10.1177\/1098612X12451797"},{"issue":"8","key":"ref22","series-title":"Vet Surg","first-page":"935","article-title":"Use of the PleuralPort device for management of pleural effusion in six dogs and four cats","volume":"40","author":"Brooks AC","year":"2011","unstructured":"Brooks AC, Hardie RJ. Use of the PleuralPort device for management of pleural effusion in six dogs and four cats. Vet Surg. 2011;40(8):935\u2013941. doi: 10.1111\/j.1532-950X.2011.00901.x"},{"issue":"2","key":"ref23","series-title":"J Vet Intern Med","doi-asserted-by":"publisher","first-page":"672","DOI":"10.1111\/jvim.12257","article-title":"Salvage cisterna chyli and thoracic duct glue embolization in 2 dogs with recurrent idiopathic chylothorax","volume":"28","author":"Clendaniel DC","year":"2014","unstructured":"Clendaniel DC, Weisse C, Culp WTN, Berent A, Solomon JA. Salvage cisterna chyli and thoracic duct glue embolization in 2 dogs with recurrent idiopathic chylothorax. J Vet Intern Med. 2014;28(2):672\u2013677.10.1111\/jvim.12257"},{"issue":"8","key":"ref24","series-title":"J Am Vet Med Assoc","doi-asserted-by":"publisher","first-page":"976","DOI":"10.2460\/javma.252.8.976","article-title":"Comparison of thoracic duct ligation plus subphrenic pericardiectomy with or without cisterna chyli ablation for treatment of idiopathic chylothorax in cats","volume":"252","author":"Stockdale SL","year":"2018","unstructured":"Stockdale SL, Gazzola KM, Strouse JB, Stanley BJ, Hauptman JG, Mison MB. Comparison of thoracic duct ligation plus subphrenic pericardiectomy with or without cisterna chyli ablation for treatment of idiopathic chylothorax in cats. J Am Vet Med Assoc. 2018;252(8):976\u2013981.10.2460\/javma.252.8.976"},{"issue":"10","key":"ref25","series-title":"J Am Vet Med Assoc","doi-asserted-by":"publisher","first-page":"1667","DOI":"10.2460\/javma.2005.226.1667","article-title":"Spontaneous resolution of iatrogenic chylothorax in a cat","volume":"226","author":"Greenberg MJ","year":"2005","unstructured":"Greenberg MJ, Weisse CW. Spontaneous resolution of iatrogenic chylothorax in a cat. J Am Vet Med Assoc. 2005;226(10):1667\u20131670.10.2460\/javma.2005.226.1667"},{"issue":"4","key":"ref26","series-title":"Vet Surg","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1053\/jvet.2003.50044","article-title":"Popliteal and mesenteric lymph node injection with methylene blue for coloration of the thoracic duct in dogs","volume":"32","author":"Enwiller TM","year":"2003","unstructured":"Enwiller TM, Radlinsky MG, Mason DE, Roush JK. Popliteal and mesenteric lymph node injection with methylene blue for coloration of the thoracic duct in dogs. Vet Surg. 2003;32(4):359\u2013364.10.1053\/jvet.2003.50044"},{"issue":"5","key":"ref27","series-title":"J Am Anim Hosp Assoc","first-page":"539","article-title":"Constrictive pleuritis with chylothorax in a cat: a case report","volume":"23","author":"Glennon JC","year":"1987","unstructured":"Glennon JC, Rothwell JT, Flanders JA, . Constrictive pleuritis with chylothorax in a cat: a case report. J Am Anim Hosp Assoc. 1987;23(5):539\u2013543."},{"issue":"7","key":"ref28","series-title":"Compendium","first-page":"531","article-title":"Prevention of reexpansion pulmonary edema and ischemia-reperfusion injury in the management of diaphragmatic herniation","volume":"28","author":"Macho RG","year":"2006","unstructured":"Macho RG, Worth AJ. Prevention of reexpansion pulmonary edema and ischemia-reperfusion injury in the management of diaphragmatic herniation. Compendium. 2006;28(7):531\u2013540."},{"issue":"3","key":"ref29","series-title":"Compendium","first-page":"178","article-title":"Traumatic diaphragmatic herniation: pathophysiology and management","volume":"27","author":"Worth AJ","year":"2005","unstructured":"Worth AJ, Machon RG. Traumatic diaphragmatic herniation: pathophysiology and management. Compendium. 2005;27(3)178\u2013191."},{"key":"ref30","series-title":"J Vis Surg","doi-asserted-by":"publisher","first-page":"84","DOI":"10.21037\/jovs.2017.05.03","article-title":"VATS and open chest surgery in diagnosis and treatment of benign pleural diseases","volume":"3","author":"Perikleous P","year":"2017","unstructured":"Perikleous P, Rathinam S, Waller DA. VATS and open chest surgery in diagnosis and treatment of benign pleural diseases. J Vis Surg. 2017;3:84.10.21037\/jovs.2017.05.03"},{"issue":"6","key":"ref31","series-title":"Semin Respir Crit Care Med","doi-asserted-by":"publisher","first-page":"743","DOI":"10.1055\/s-0030-1269834","article-title":"Chylothorax and cholesterol pleural effusion","volume":"31","author":"Huggins JT","year":"2010","unstructured":"Huggins JT. Chylothorax and cholesterol pleural effusion. Semin Respir Crit Care Med. 2010;31(6):743\u2013750.10.1055\/s-0030-1269834"},{"issue":"2","key":"ref32","series-title":"Eur J Cardiothorac Surg","doi-asserted-by":"publisher","first-page":"362","DOI":"10.1016\/j.ejcts.2007.04.024","article-title":"Aetiology and management of chylothorax in adults","volume":"32","author":"Nair SK","year":"2007","unstructured":"Nair SK, Petko M, Hayward MP. Aetiology and management of chylothorax in adults. Eur J Cardiothorac Surg. 2007;32(2):362\u2013369.10.1016\/j.ejcts.2007.04.024"},{"issue":"3","key":"ref33","series-title":"Asian Cardiovasc Thorac Ann","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1177\/0218492316629281","article-title":"Effect of decortication and pleurectomy in chronic empyema patients","volume":"24","author":"Bagheri R","year":"2016","unstructured":"Bagheri R, Haghi SZ, Dalouee MN, . Effect of decortication and pleurectomy in chronic empyema patients. Asian Cardiovasc Thorac Ann. 2016;24(3):245\u2013249.10.1177\/0218492316629281"},{"issue":"10","key":"ref34","series-title":"Am J Dis Child","first-page":"1092","article-title":"Reexpansion pulmonary edema","volume":"145","author":"Jardine OS","year":"1991","unstructured":"Jardine OS. Reexpansion pulmonary edema. Am J Dis Child. 1991;145(10):1092\u20131094."},{"key":"ref35","series-title":"OAJ Case Rep","first-page":"010","article-title":"Acute unilateral reexpansion pulmonary edema after pleuropulmonary decortication","volume":"1","author":"Belliraj L","year":"2019","unstructured":"Belliraj L, Lakranbi M, Lahlou A, . Acute unilateral reexpansion pulmonary edema after pleuropulmonary decortication. OAJ Case Rep. 2019;1:010. doi: 10.33118\/oaj.rep.2019.01.010"}],"container-title":["Journal of the American Veterinary Medical Association"],"original-title":[],"link":[{"URL":"https:\/\/avmajournals.avma.org\/view\/journals\/javma\/260\/3\/javma.21.01.0018.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/avmajournals.avma.org\/downloadpdf\/journals\/javma\/260\/3\/javma.21.01.0018.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/avmajournals.avma.org\/downloadpdf\/journals\/javma\/260\/3\/javma.21.01.0018.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,7]],"date-time":"2025-03-07T12:50:30Z","timestamp":1741351830000},"score":1,"resource":{"primary":{"URL":"https:\/\/avmajournals.avma.org\/view\/journals\/javma\/260\/3\/javma.21.01.0018.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,1]]},"references-count":35,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.2460\/javma.21.01.0018","relation":{},"ISSN":["0003-1488"],"issn-type":[{"value":"0003-1488","type":"print"}],"subject":[],"published":{"date-parts":[[2022,2,1]]}}}