Dx by radiology only Plural effusion

Published on: April 13, 2021 • By: afuller7900 · In Forum: Cats
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afuller7900
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April 13, 2021 at 10:18pm
I have a 14 year old spayed cat.  She presented with a mammary cyst/tumor and a light cough. I took her in for xray to rule out lung cancer before removing the cyst and it came back positive for plural effusion. I'm in key west with limited options for answers from drs. I can't find one that's up to speed on any meds to help her be more comfortable. Got the dx about a month ago they gave antibiotics and steroid and told me to come back when she gets worse. I'm here to prevent that as much as possible.  She only coughs maybe twice a day at this time and she has a diminishing appetite but will drink and gets up to go potty. What I'm looking for are names of meds that can work on 1)appetite stimulation 2) medication that can cause inflammation in the lining of the lung to give more room for the fluid 3) lasix & ANYTHING ELSE WE CAN THINK OF. I am doing the research for the dr and he said he will make sure we get her the meds needed if I tell him what could help. We can get one compounded so it has maximum benefits It can be a natural med homeopathic i think they call it   I am just trying to find any information to help,  so whatever you got send it my way.  I'm doing the research but the dr makes the final call he is just to busy to learn something new.  There are only a hand full of vets here and none of them will deal with cancer. Help me make my little ones last months the best possible please   Thank you
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Liz Buchanan BVSc
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April 14, 2021 at 08:24pm
Hello!   The pleura is the name given to a very thin membrane, like a bag, that goes around the outside of the lung tissue and is very close to the lung.  In a pleural effusion, fluid fills that bag, which makes it hard for the lungs to inflate when the cat breathes in.  There are a number of places this fluid can come from;  sometimes it is connected to a tumour, or a bleed into the space around the outside of the lung;  other times it is secondary to heart disease.  It can also consist of infectious fluid.  This is a fairly common condition of the cat and I would expect your vet to have a good knowledge of it;  often they can drain the fluid from around the outside of the airways using a needle, in order to create space to breathe, but this may not treat the cause and therefore the condition may recur.
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Liz Buchanan BVSc
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April 14, 2021 at 08:41pm
I have been trying to think of a better way to explain this.  Imagine blowing up a plastic bag in the air.  This represents the lung, getting filled with air, outside the body.  Now image blowing the balloon up inside a plastic box (the ribcage).  It can inflate to a certain size, but then stops inflating.  This represents the lung within the ribcage, getting filled with air.  Now image that someone fills the ribcage (the plastic box) with water.  It would now be very hard to blow the balloon up.  This is what happens to the lung in a pleural effusion.  This is a physical problem (water around the outside of the lung, stopping it from inflating properly) and therefore not one that is generally solved by giving medication.  However, putting a needle in through the wall of the plastic box can remove / drain the fluid away and thereby give relief.  However, this relief is often temporary if the pleural space fills up again.  I hope that this analogy helps.
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Liz Buchanan BVSc
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April 14, 2021 at 08:44pm
Usually, a radiograph is thought to be diagnostic a pleural effusion as it shows it very well (if not the underlying cause), but a clinician will usually have a firm suspicion from listening to the chest alone.
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afuller7900
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April 15, 2021 at 04:17am
Thank you for that answer. That was a great analogy. I'm attaching the xrays fur reference but for now the dr says that taking out the fluid would be to invasive. I read in my research that there may be a medication that can cause the plura to inflame creating space for the fluid to move more so the lung can expand. She is declining and we are prepared to say goodbye but I don't want the fluid to be the reason. She is otherwise ok just uncomfortable to move cause of the lack of o2 so if I can find a way, short term, even to help with that. I'm trying to find the medication that causes the inflammation...... it's a start Maybe lasix on board also????? Can that even with with this?????Screenshot_20210327-205623_GmailScreenshot_20210327-205604_Gmail20210328_165329   Thank you for any assistance
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David Harris BVSc MRCVS
Keymaster
April 16, 2021 at 05:48pm
I'm afraid we aren't in a position to second-guess your vet - in most cases, pleural effusions like this are, sadly, due to either heart failure or tumours. In terms of inflaming the pleura to create more space, my gut call is that that would be pouring petrol on the fire: any inflammation would cause more fluid to be produced, worsening the problem. Use of diuretics will often pull the fluid out temporarily, but isn't a solution - it's palliative. Good luck with her.
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