{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T14:01:04Z","timestamp":1781272864428,"version":"3.54.1"},"reference-count":68,"publisher":"American Veterinary Medical Association (AVMA)","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["javma"],"published-print":{"date-parts":[[2026,6,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To identify the most frequent underlying causes of chylothorax in cats and to assess whether clinical and laboratory findings at presentation could predict etiology and outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Cats diagnosed with chylothorax were retrospectively enrolled in 2 veterinary centers between 2006 and 2022. Data collected for each case included signalment, history, physical examination findings, pleural effusion analysis, hematologic and imaging results, etiology, treatment (medical and\/or surgical), and survival time. Descriptive statistics and multinomial logistic regression were used to identify markers of etiology. Associations with survival were assessed with the Cox proportional hazards models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>35 cats met the inclusion criteria. Cardiac disease was the most common etiology (57%), followed by idiopathic (31%), neoplasia (9%), and peritoneopericardial diaphragmatic hernia (3%). Cats with neoplastic chylothorax were significantly older than those in other etiologic groups. Cats with cardiac chylothorax had a higher left atrial-to-aortic ratio (median, 2.4) than cats in other etiologic groups (&lt; 1.4). Median survival times for cardiac, idiopathic, neoplastic, and peritoneopericardial diaphragmatic hernia etiology were 172, 416, 38, and 27 days, respectively. Regardless of the chylothorax etiology, survival was negatively correlated to older cats and low rectal temperature on initial arrival to the hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Cardiac disease was the predominant cause of chylothorax. All cats with a left atrial-to-aortic ratio &gt; 1.4 had a cardiac etiology. All cats aged over 14 years had a neoplastic etiology. Felines with a cardiac etiology had a poorer prognosis than idiopathic cases. Neoplastic cats had the shortest survival time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance<\/jats:title>\n                    <jats:p>An echocardiogram should be considered for all cats diagnosed with chylothorax.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2460\/javma.26.01.0029","type":"journal-article","created":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T13:34:54Z","timestamp":1781271294000},"page":"1-9","source":"Crossref","is-referenced-by-count":0,"title":["Cardiac etiology is the leading cause of feline chylothorax: 35 cases (2006\u20132022)"],"prefix":"10.2460","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-7765-861X","authenticated-orcid":true,"given":"Lucas","family":"Severac","sequence":"first","affiliation":[{"name":"Veterinary Medical Teaching Hospital, Faculty of Veterinary Medicine, University of Montreal, St-Hyacinthe, QC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tristan","family":"Juette","sequence":"additional","affiliation":[{"name":"Veterinary Medical Teaching Hospital, Faculty of Veterinary Medicine, University of Montreal, St-Hyacinthe, QC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B\u00e9r\u00e9nice","family":"Conversy","sequence":"additional","affiliation":[{"name":"Veterinary Medical Teaching Hospital, Faculty of Veterinary Medicine, University of Montreal, St-Hyacinthe, QC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1272","reference":[{"issue":"12","key":"ref1","series-title":"J Feline Med Surg","first-page":"1102","article-title":"Retrospective analysis of pleural effusion in cats","volume":"21","author":"K\u00f6nig A","year":"2019","unstructured":"K\u00f6nig A, Hartmann K, Mueller RS, Wess G, Schulz BS. Retrospective analysis of pleural effusion in cats. J Feline Med Surg. 2019;21(12):1102-1110. doi:10.1177\/1098612X18816489"},{"issue":"2","key":"ref2","series-title":"J Am Vet Med Assoc","first-page":"181","article-title":"Characterization of and factors associated with causes of pleural effusion in cats","volume":"253","author":"Ruiz MD","year":"2018","unstructured":"Ruiz MD, Vessi\u00e8res F, Ragetly GR, Hernandez JL. Characterization of and factors associated with causes of pleural effusion in cats. J Am Vet Med Assoc. 2018;253(2):181-187. doi:10.2460\/javma.253.2.181"},{"issue":"2","key":"ref3","series-title":"J Am Vet Med Assoc","first-page":"291","article-title":"Diagnosis and treatment of chylothorax associated with lymphoblastic lymphosarcoma in four cats","volume":"198","author":"Forrester SD","year":"1991","unstructured":"Forrester SD, Fossum TW, Rogers KS. Diagnosis and treatment of chylothorax associated with lymphoblastic lymphosarcoma in four cats. J Am Vet Med Assoc. 1991;198(2):291-294. doi:10.2460\/javma.1991.198.02.291"},{"issue":"1","key":"ref4","series-title":"J Am Vet Med Assoc","first-page":"84","article-title":"Chylothorax associated with right-sided heart failure in five cats","volume":"204","author":"Fossum TW","year":"1994","unstructured":"Fossum TW, Miller MW, Rogers KS, Bonagura JD, Meurs KM. Chylothorax associated with right-sided heart failure in five cats. J Am Vet Med Assoc. 1994;204(1):84-89. doi:10.2460\/javma.1994.204.01.84"},{"issue":"4","key":"ref5","series-title":"J Am Vet Med Assoc","first-page":"672","article-title":"Chylothorax in cats: 37 cases (1969-1989)","volume":"198","author":"Fossum TW","year":"1991","unstructured":"Fossum TW, Forrester SD, Swenson CL,  Chylothorax in cats: 37 cases (1969-1989). J Am Vet Med Assoc. 1991;198(4):672-678. doi:10.2460\/javma.1991.198.04.672"},{"issue":"2","key":"ref6","series-title":"J Feline Med Surg","first-page":"135","article-title":"Lung lobe torsion associated with chylothorax in a cat","volume":"13","author":"Mclane MJ","year":"2011","unstructured":"Mclane MJ, Buote NJ. Lung lobe torsion associated with chylothorax in a cat. J Feline Med Surg. 2011;13(2):135-138. doi:10.1016\/j.jfms.2010.09.013"},{"issue":"8","key":"ref7","series-title":"Can Vet J","first-page":"847","article-title":"Chylothorax associated with thrombosis of the cranial vena cava","volume":"51","author":"Singh A","year":"2010","unstructured":"Singh A, Brisson BA. Chylothorax associated with thrombosis of the cranial vena cava. Can Vet J. 2010;51(8):847-852."},{"key":"ref8","series-title":"Veterinary Surgery: Small Animal","first-page":"2035","article-title":"Thoracic cavity","author":"Tobias KM","year":"2018","unstructured":"Tobias KM, Darrow BJ, Radlinsky MJ. Thoracic cavity. In: Johnston SA, Tobias KM, eds. Veterinary Surgery: Small Animal. 2nd ed. Elsevier Saunders; 2018:2035\u20132042."},{"issue":"3","key":"ref9","series-title":"J Am Anim Hosp Assoc","first-page":"134","article-title":"Chylothorax associated with a congenital peritoneopericardial diaphragmatic hernia in a dog","volume":"45","author":"Schmiedt CW","year":"2009","unstructured":"Schmiedt CW, Washabaugh KF, Rao DB, Stepien RL. Chylothorax associated with a congenital peritoneopericardial diaphragmatic hernia in a dog. J Am Anim Hosp Assoc. 2009;45(3):134-137. doi:10.5326\/0450134"},{"issue":"11","key":"ref10","series-title":"J Am Vet Med Assoc","first-page":"1107","article-title":"Chylothorax subsequent to infection of cats with Dirofilaria immitis","volume":"164","author":"Donahoe JM","year":"1974","unstructured":"Donahoe JM, Kneller SK, Thompson PE. Chylothorax subsequent to infection of cats with Dirofilaria immitis. J Am Vet Med Assoc. 1974;164(11):1107-1110. doi:10.2460\/javma.1974.164.11.1107"},{"issue":"5","key":"ref11","series-title":"J Am Vet Med Assoc","first-page":"663","article-title":"Surgical removal of heartworms from a cat with caval syndrome","volume":"206","author":"Glaus TM","year":"1995","unstructured":"Glaus TM, Jacobs GJ, Rawlings CA, Watson ED, Calvert CA. Surgical removal of heartworms from a cat with caval syndrome. J Am Vet Med Assoc. 1995;206(5):663-666. doi:10.2460\/javma.1995.206.05.663"},{"issue":"2","key":"ref12","series-title":"Vet Clin North Am Small Anim Pract","first-page":"467","article-title":"Canine and feline exudative pleural diseases","volume":"50","author":"Epstein SE","year":"2020","unstructured":"Epstein SE, Balsa IM. Canine and feline exudative pleural diseases. Vet Clin North Am Small Anim Pract. 2020;50(2):467-487. doi:10.1016\/j.cvsm.2019.10.008"},{"issue":"5","key":"ref13","series-title":"J Am Vet Med Assoc","first-page":"652","article-title":"Treatment of idiopathic chylothorax in dogs and cats","volume":"212","author":"Birchard SJ","year":"1998","unstructured":"Birchard SJ, Smeak DD, McLoughlin MA. Treatment of idiopathic chylothorax in dogs and cats. J Am Vet Med Assoc. 1998;212(5):652-657. doi:10.2460\/javma.1998.212.05.652"},{"issue":"3","key":"ref14","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):345-348."},{"issue":"1","key":"ref15","series-title":"Can Vet J","first-page":"51","article-title":"The medical management of idiopathic chylothorax in a domestic long-haired cat","volume":"45","author":"Gould L","year":"2004","unstructured":"Gould L. The medical management of idiopathic chylothorax in a domestic long-haired cat. Can Vet J. 2004;45(1):51-54."},{"issue":"8","key":"ref16","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):729-731."},{"issue":"7","key":"ref17","series-title":"J Small Anim Pract","first-page":"405","article-title":"Surgical management of a double-chambered right ventricle and chylothorax in a Labrador Retriever","volume":"47","author":"Tanaka R","year":"2006","unstructured":"Tanaka R, Shimizu M, Hirao H,  Surgical management of a double-chambered right ventricle and chylothorax in a Labrador Retriever. J Small Anim Pract. 2006;47(7):405-408. doi:10.1111\/j.1748-5827.2006.00079.x"},{"issue":"5","key":"ref18","series-title":"Vet Surg","first-page":"852","article-title":"Outcome of video-assisted thoracoscopic treatment of idiopathic chylothorax in 15 cats","volume":"53","author":"Dickson R","year":"2024","unstructured":"Dickson R, Adam A, Garcia Rubio D,  Outcome of video-assisted thoracoscopic treatment of idiopathic chylothorax in 15 cats. Vet Surg. 2024;53(5):852-859. doi:10.1111\/vsu.14098"},{"issue":"5","key":"ref19","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 (1987-1992)","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 (1987-1992). J Am Vet Med Assoc. 1994;205(5):711-715. doi:10.2460\/javma.1994.205.05.711"},{"issue":"1","key":"ref20","series-title":"Vet Surg","first-page":"70","article-title":"Treatment of idiopathic chylothorax in dogs and cats: a systematic review","volume":"49","author":"Reeves LA","year":"2020","unstructured":"Reeves LA, Anderson KM, Luther JK, Torres BT. Treatment of idiopathic chylothorax in dogs and cats: a systematic review. Vet Surg. 2020;49(1):70-79. doi:10.1111\/vsu.13322"},{"issue":"8","key":"ref21","series-title":"J Am Vet Med Assoc","first-page":"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):976-981. doi:10.2460\/javma.252.8.976"},{"issue":"2","key":"ref22","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):317-324. doi:10.2460\/javma.1992.201.02.317"},{"issue":"3","key":"ref23","series-title":"J Stat Softw","first-page":"1","article-title":"Fast estimation of multinomial logit models: R package mnlogit","volume":"75","author":"Hasan A","year":"2016","unstructured":"Hasan A, Wang Z, Mahani AS. Fast estimation of multinomial logit models: R package mnlogit. 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J Vet Intern Med. 2007;21(1):76-80. doi:10.1892\/0891-6640(2007)21[76:dcrvic]2.0.co;2"},{"issue":"2","key":"ref28","series-title":"Am J Vet Res","first-page":"250","article-title":"Quantitative assessment of velocities of the annulus of the left atrioventricular valve and left ventricular free wall in healthy cats by use of two-dimensional color tissue Doppler imaging","volume":"67","author":"Chetboul V","year":"2006","unstructured":"Chetboul V, Sampedrano CC, Tissier R,  Quantitative assessment of velocities of the annulus of the left atrioventricular valve and left ventricular free wall in healthy cats by use of two-dimensional color tissue Doppler imaging. Am J Vet Res. 2006;67(2):250-258. doi:10.2460\/ajvr.67.2.250. 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J Feline Med Surg. 2019;21(12):1102-1110. doi:10.1177\/1098612X18816489"},{"issue":"2","key":"ref2","series-title":"J Am Vet Med Assoc","first-page":"181","article-title":"Characterization of and factors associated with causes of pleural effusion in cats","volume":"253","author":"Ruiz MD","year":"2018","unstructured":"Ruiz MD, Vessi\u00e8res F, Ragetly GR, Hernandez JL. Characterization of and factors associated with causes of pleural effusion in cats. J Am Vet Med Assoc. 2018;253(2):181-187. doi:10.2460\/javma.253.2.181"},{"issue":"2","key":"ref3","series-title":"J Am Vet Med Assoc","first-page":"291","article-title":"Diagnosis and treatment of chylothorax associated with lymphoblastic lymphosarcoma in four cats","volume":"198","author":"Forrester SD","year":"1991","unstructured":"Forrester SD, Fossum TW, Rogers KS. Diagnosis and treatment of chylothorax associated with lymphoblastic lymphosarcoma in four cats. J Am Vet Med Assoc. 1991;198(2):291-294. doi:10.2460\/javma.1991.198.02.291"},{"issue":"1","key":"ref4","series-title":"J Am Vet Med Assoc","first-page":"84","article-title":"Chylothorax associated with right-sided heart failure in five cats","volume":"204","author":"Fossum TW","year":"1994","unstructured":"Fossum TW, Miller MW, Rogers KS, Bonagura JD, Meurs KM. Chylothorax associated with right-sided heart failure in five cats. J Am Vet Med Assoc. 1994;204(1):84-89. doi:10.2460\/javma.1994.204.01.84"},{"issue":"4","key":"ref5","series-title":"J Am Vet Med Assoc","first-page":"672","article-title":"Chylothorax in cats: 37 cases (1969-1989)","volume":"198","author":"Fossum TW","year":"1991","unstructured":"Fossum TW, Forrester SD, Swenson CL,  Chylothorax in cats: 37 cases (1969-1989). J Am Vet Med Assoc. 1991;198(4):672-678. doi:10.2460\/javma.1991.198.04.672"},{"issue":"2","key":"ref6","series-title":"J Feline Med Surg","first-page":"135","article-title":"Lung lobe torsion associated with chylothorax in a cat","volume":"13","author":"Mclane MJ","year":"2011","unstructured":"Mclane MJ, Buote NJ. Lung lobe torsion associated with chylothorax in a cat. J Feline Med Surg. 2011;13(2):135-138. doi:10.1016\/j.jfms.2010.09.013"},{"issue":"8","key":"ref7","series-title":"Can Vet J","first-page":"847","article-title":"Chylothorax associated with thrombosis of the cranial vena cava","volume":"51","author":"Singh A","year":"2010","unstructured":"Singh A, Brisson BA. Chylothorax associated with thrombosis of the cranial vena cava. Can Vet J. 2010;51(8):847-852."},{"key":"ref8","series-title":"Veterinary Surgery: Small Animal","first-page":"2035","article-title":"Thoracic cavity","author":"Tobias KM","year":"2018","unstructured":"Tobias KM, Darrow BJ, Radlinsky MJ. Thoracic cavity. In: Johnston SA, Tobias KM, eds. Veterinary Surgery: Small Animal. 2nd ed. Elsevier Saunders; 2018:2035\u20132042."},{"issue":"3","key":"ref9","series-title":"J Am Anim Hosp Assoc","first-page":"134","article-title":"Chylothorax associated with a congenital peritoneopericardial diaphragmatic hernia in a dog","volume":"45","author":"Schmiedt CW","year":"2009","unstructured":"Schmiedt CW, Washabaugh KF, Rao DB, Stepien RL. Chylothorax associated with a congenital peritoneopericardial diaphragmatic hernia in a dog. J Am Anim Hosp Assoc. 2009;45(3):134-137. doi:10.5326\/0450134"},{"issue":"11","key":"ref10","series-title":"J Am Vet Med Assoc","first-page":"1107","article-title":"Chylothorax subsequent to infection of cats with Dirofilaria immitis","volume":"164","author":"Donahoe JM","year":"1974","unstructured":"Donahoe JM, Kneller SK, Thompson PE. Chylothorax subsequent to infection of cats with Dirofilaria immitis. J Am Vet Med Assoc. 1974;164(11):1107-1110. doi:10.2460\/javma.1974.164.11.1107"},{"issue":"5","key":"ref11","series-title":"J Am Vet Med Assoc","first-page":"663","article-title":"Surgical removal of heartworms from a cat with caval syndrome","volume":"206","author":"Glaus TM","year":"1995","unstructured":"Glaus TM, Jacobs GJ, Rawlings CA, Watson ED, Calvert CA. Surgical removal of heartworms from a cat with caval syndrome. J Am Vet Med Assoc. 1995;206(5):663-666. doi:10.2460\/javma.1995.206.05.663"},{"issue":"2","key":"ref12","series-title":"Vet Clin North Am Small Anim Pract","first-page":"467","article-title":"Canine and feline exudative pleural diseases","volume":"50","author":"Epstein SE","year":"2020","unstructured":"Epstein SE, Balsa IM. Canine and feline exudative pleural diseases. 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