enalapril and Chylothorax

The successful management of cranial vena cava syndrome with suspected secondary chylothorax due to mediastinal cryptococcal granuloma in a 4-year-old male domestic shorthair cat is described. Treatment included long-term antifungal medication, short-term corticosteroids, intermittent thoracocentesis, rutin, octreotide, and enalapril.

Topics: Animals; Antifungal Agents; Antihypertensive Agents; Cat Diseases; Cats; Chylothorax; Cryptococcosis; Enalapril; Fluconazole; Granuloma; Ketoconazole; Male; Rutin; Superior Vena Cava Syndrome; Vena Cava, Superior

A domestic shorthaired cat was presented with a 1-month history of cardiomegaly and recurrent chylothorax. The heart rate was 130 beats/min and no P waves were present on a surface electrocardiogram. Thoracic radiographs and an echocardiogram demonstrated severe biatrial dilatation, pleural effusion and restrictive pleural disease. Permanent atrial standstill was suspected. Pleurocentesis was performed and therapy was started with enalapril, frusemide and aspirin. Intracardiac electrograms revealed no atrial activity, and atrial pacing failed to elicit atrial or ventricular depolarisations. The patient was euthanased. Necropsy showed severe atrial wall thinning with marked cardiocyte loss. Persistent atrial standstill is a rare disease in the cat. Clinical signs may have been due to loss of atrial function, ventricular diastolic dysfunction, bradycardia, neurohormonal activation and reduced atrial natriuretic peptide plasma concentrations.

Topics: Animals; Anti-Inflammatory Agents, Non-Steroidal; Antihypertensive Agents; Arrhythmias, Cardiac; Aspirin; Cardiomegaly; Cat Diseases; Cats; Chylothorax; Diuretics; Echocardiography, Doppler, Color; Electrocardiography; Electrophysiology; Enalapril; Fatal Outcome; Female; Furosemide; Heart Atria; Lameness, Animal; Myocardium; Radiography, Thoracic; Recurrence