I haven't felt like posting on here primarily because I don't want
anyone telling me I'm not doing enough for my cat or making me second
guess my decisions.  But, it's a long weekend and I guess I feel like
mentioning it now.  FWIW, I'm in AZ, we have no vet schools here and
I'm not flying her to some other state's vet school.

My cat Abbey, who is only 4 (we found her abandoned in the desert on
6/17/01 and she was only about 5 weeks old) has chylothorax, which is a
fairly rare condition in cats where there is a small hole in the
thoracic wall where lymphatic fluids from the digestive system (chyle)
seep into the pleural cavity so there is a large fluid buildup.

Abbey had no symptoms that we noticed until 3 and a half weeks ago.  I
came home from work on a Thurs. night and she was breathing very oddly,
rapidly and shallowly.  My own vet was closed by this time and I didn't
want to go to the actual emergency vet, as it's kinda icky there, so I
called another vet who I have been to before.  They are a practice who
takes their own emergency calls 24 hours a day whereas my "real" vet
just has a message saying to take your animal to the emergency vet.

Anyway, her chest was tapped (220ml), the fluid was sent out, the
diagnosis was confirmed as chylothorax.  She had x-rays, full blood
panel, no causes were determined--it can be caused by trauma, heart
conditions, lymphoma, other cancers, or by nothing at all  She is FeLV-
and nothing indicated any other conditions present so her diagnosis is
idiopathic chylothorax.  I was told and later read on my own that
chylothorax has a bad prognosis.  Further complicating Abbey's
condition is that she has fibrosing pleuritis, meaning that the fluid
was present in her pleural cavity for awhile (cats are very good at
masking their symptoms until they hit a critical mass) and scarred the
outside of her lungs, making them small and contracted.  This makes a
bad prognosis officially a grave prognosis.  She is not expected to be
able to overcome this but it is, of course, a possibility.  She will
always have diminished lung capacity, though.

She was sent home with lasix and clavamox.  The first week, she was
quiet, had to be coaxed to eat, seemed a little glum but not in pain
really.  By the end of the week, she was almost back to normal and
stayed good for another 2 weeks, eating, playing, hanging out with her
"brother," Scottie, my orange kitty, and avoiding her other brother
Marbles, our aggressive, bizarre cat.

3 weeks to the day, last Thursday, I came home from work and she was
breathing bad again.  Not as bad as the first time but definitely
somewhat labored.  Called the vet, took her in again, same routine,
drained her chest (140ml), x-rays.  This was a different vet at this
same practice.  He talked me into keeping her the night in an incubator
with oxygen running.  She wound up staying 2 nights, getting several
lasix injections, aminophylline injections, polycillin injections, but
she wasn't eating there so we brought her home yesterday.  She seems to
be resting comfortably, eating a little on her own and more if coaxed,
not her perky self but not as withdrawn like after the 1st time it was
done.  She is still on lasix, clavamox, and we are going to give her
vitamin E and rutin, both things we read about that the vet said
couldn't hurt but won't necessarily help.

So, that's it.  My sweet little girl kitty, she's very tiny, may not be
with us much longer.  The thing is...and I hate to say this because of
potential flaming...I have a monetary limit on what I can spend when
the prognosis is poor.  I don't have an actual figure but each time
we've gone, it has cost $700-800 so I assume if it happens again (which
is "expected"), it will cost about the same.  I might opt to not keep
her there overnight as that didn't seem to help much, imo, but the
draining and the x-rays are standard.  She also had to be anesthesized
for the draining this time although not the first time.

I'm not asking for advice on when to stop.  I guess I will have to
decide that myself.  Originally, I told myself that if she went a month
without needing draining, I would do it again.  Well, she only went 3
weeks but she had been so improved that I felt I needed to do it again.
Now, once again, I feel like I will do it a third time, but
practically speaking, I can't do it forever.

There is a surgery but it is a very painful surgery with a low success
rate where they open the chest, strip the lining off the lungs, insert
chest tubes for awhile.  It's painful and I wouldn't do it.  Both vets
said they would not subject their own cats to it.  I'm sure that would
require a specialist.  The only other option is to insert a chest tube
for several days or more but that is a procedure where she would remain
hospitalized for the whole time and there's no guarantees with that
either as that does nothing to seal the hole.  She won't eat there, she
looks miserable there, and, once again, very low success rate.
Basically, everything has a very low success rate.  The only thing that
one can hope for is that the hole seals itself, which can happen.  But
that could happen after 2 drainings, 20 drainings, or never.  The
prognosis is very grave, that's what they keep telling me.  But I have
read on the internet of a cat who has survived for 3 years now with
just the treatment Abbey is getting.  This one cat in particular only
has to have his chest drained every few months now.  And he has lung
scarring like Abbey does, too.  So there is a glimmer of hope, it's
just a matter of how long I want to put her and us through this, I
guess, and also of how many times I can afford to do so, sadly.  The
cat I mentioned above is a shelter mascot cat who goes to a university
vet shcool for his treatments so I'm sure money is not as much of an
object.  The shelter probably gets donations for his care (he has a
webpage) and the school probably donates some of the treatment.

To complicate things further, as of 6/2, I will be alone for 18 days to
pill her twice a day myself.  It takes both of us to do it now so it
will be a major challenge.  Plus any decisions that need to be made
during that time will be mine alone as Tony will be in China on
business.

I guess at some point, TBD, when/if it happens again, when I take her
in, I will have to choose euthanasia instead of the draining.  If you
feel so inclined, she is accepting prayers, good thoughts, and positive
energy here in Phoenix, if you want to send some her way.

Candace