Thoracic omentalization for long-term management of neoplastic pleural effusion in a cat.

CASE DESCRIPTION

An 11-year-old neutered female domestic longhair cat was evaluated because of a 1-week history of progressive dyspnea, signs of depression, and loss of appetite. A histiocytic sarcoma had been excised from the mammary gland 6 weeks earlier.

CLINICAL FINDINGS

Physical examination findings were consistent with pleural effusion, and thoracic and abdominal radiography and ultrasonography revealed pleural effusion, a thoracic mass involving the aorta and pulmonary artery, and a caudal abdominal mass that most likely represented enlarged iliac lymph nodes. Cytologic examination of the pleural fluid and fine-needle aspirates from the iliac and right popliteal lymph nodes revealed abundant cells with neoplastic characteristics of indeterminate origin. The clinical diagnosis was generalized malignant neoplasia.

TREATMENT AND OUTCOME

Pleural drainage was necessary every 5 to 6 days. Exploratory thoracotomy and biopsy of the mass were recommended for better characterization of the thoracic disease. Simultaneously, palliative treatment by advancement of the omentum into the thorax was performed. A final diagnosis of disseminated histiocytic sarcoma was made, and treatment with doxorubicin was begun after surgery. During the 13 months after surgery, the cat was free from signs of respiratory tract disease and had normal activity levels with good exercise tolerance. Fifteen months after surgery, the cat's clinical condition worsened and the cat died.

CLINICAL RELEVANCE

Findings suggested that thoracic omentalization may be considered for palliative treatment of cats with refractory neoplastic pleural effusion when frequent thoracocentesis is necessary and other treatments are not suitable.