Use of direct fluorescein sodium lymphography for thoracic duct identification in a dog with idiopathic chylothorax

Abstract

AbstractA 2‐year‐6‐month‐old, female, neutered Greyhound was diagnosed with idiopathic chylothorax. Surgery was performed, which included thoracic duct ligation, subtotal pericardectomy, total right caudal lung lobectomy, chyli cisterna ablation and pleural port device placement. Fluorescein sodium was injected into a mesenteric lymph node through a right paracostal laparotomy for colourisation of the different branches of the thoracic duct to assist in identification. A sterile ultraviolet torch (LED 395 nm) was used to activate the fluorescent yellow‐green signal, enabling visual assessment of the thoracic duct and its branches. Finally, the different branches were ligated using haemovascular clips. Success of the thoracic duct ligation was assessed by contrast fluoroscopy. The dog recovered well from the surgery, but was euthanased without investigation 4 weeks after the procedure due to anorexia, diarrhoea and abdominal pain. This is the first report of thoracic duct ligation for idiopathic chylothorax in a dog using fluorescein sodium as a fluorophore to help with the identification of all the thoracic duct branches.