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In all walks in
life one learns with the passage of time. We all know the phrase “It’s easy
to be wiser after the event”. Sadly that’s true for all of us and we
should learn from it. But it comes with a Cost.
We both think of
such events as “Pearls of Wisdom”, in which we learn something new every
day.
We store this
“Lesson learned” in our memory, and use it when a similar occasion arises,
providing one knows about it initially but not if they don’t
take the time to read and grasp all forms of information placed at their
disposal.
However people
seldom bother to read all articles about medical matters or health problems.
They glance and “say can’t be bothered with all that”
Well, if you’re
still with me so far, be patient, read on and you may find yourself in the
exact same situation in future as I describe. If you do and recall my words
in time, you may just save your Afghan from much pain and suffering.
THE
PROBLEM
I
note various references have been made to Chylothorax in our Breed by some
breed stalwarts over a period of years and that this is suggested as coming
from hereditary causes, i.e. congenital.
Gossip and
innuendos are rife when you do not understand the subject.
My task is not to
give a sermon but attempt to educate all persons who may be interested in
this much maligned subject, but primarily in the welfare of their hound.
it is
absolute rubbish to either infer or suggest this is a Disease caused by
Hereditary or Generic history within the Breed, and more particular held
against any one Kennel.
Much rumour
exists in our Breed as Myth and Authoristic rumours (much like the story of
there being two types and CH Zardin was the role model, both being untrue.)
But that's a story
to evolve in another article, at another time if, people are interested.
THE
SUBJECT MATTER “CTX”
Similarly it is
with the case with CTX over the years about Chylothorax, more commonly
referred to as CTX.
I have
studied the subject in depth and at great length and learned from the
writings, experiments and papers of Theresa W Fossum, over the last 3 years,
who is one , if not the leading renowned World specialist of this subject in
Texas University. USA.
Now are in the
position to know as much about this matter as anyone in the breed in the UK,
as well as Sylvia Evans, the latter having reported on some Afghans who had
apparently died with this problem. She has shouted the cause on numerous
occasions quite rightly.
“DODGER” was
a dog who it is written elsewhere in another well published article as one
who tragically died with CTX. It is worthy to note the Vet concerned
actually wrote that “He died with this very rare condition going on to state
it was a one in a two million occurrence” I have never seen anywhere
such a categorical statement but it is enough to describe this rare
condition.
Other known
UK participants have been Jayne Edwards, Gillian Knight. Just to name a few
previous interested parties who allegedly had an Afghan diagnosed with CTX.
I actually
wrote an article and published for Wikipedia on the subject in April 2008
dismissing reports about the disease in Afghan Hounds as being prevalent and
congenital. At the same time I wrote and issued a global Challenge for any
person to produce evidence or to prove that CTX is or was genetic. I am
still waiting.
Although
cases have and will continue to exist, where CTX develops it is mainly
caused by other causes.
EVALUATION
OF CTX
Almost
everywhere one investigated the subject; one reads the disease was a
predisposition in Afghan hounds.
Thus putting up
the breed as one of the main diseases for mortality, which is not true. Of
course, Afghans are not the only breed who seems to be highlighted, but they
stand out!
My findings did
certainly not support this myth, and neither does consulting our own Kennel
Club here in the UK.
In fact
investigation into OUR BREEDS HEALTH PROBLEMS carried out by them into the
cause of Mortality in over 143 Afghans by the B.S.A.V.A dying in our breed
in the UK, produced 21 known causes, not one was listed categorically as
dying from CTX; however certain other causes they list have played their
part in CTX resulting in death, i.e. from other known and unknown causes.
Trauma is
mentioned as the cause in 5 Afghans due to RTA, in other words due to an
external influence. but nothing as genetic.
Sinics will
say “well that is not proof it is not congenital and may well shrug their
shoulders and scoff.”
In reply I say
with evidence there is no evidence whatsoever recorded that it is congenital
or generic. And until proven otherwise, it is INNOCENT.
DEFINITION
IN SIMPLE TERMS
So what is
CTX? For the uninitiated. It is a rare complex disorder in Domestic animals.
As an aside it is prevalent in Cats and found in the Human race, mostly
children.
In the end, in
Dogs it is fatal... so what is it in lay terms?
“CTX is, and
to the point is non infectious to other forms of life. CTX in simple
terminology is a collection of CHYLE, a milky white and sometimes pink
substance located in the plural space. It is Lymphatic fluid from the
intestine due to a high concentration of fat that is or has leaked out from
the thoracic duct. This would otherwise be carried intact to enter the blood
stream. Repair of this duct is impossible, for the exact leakage and
rupture, which can be as little as a pinhole is almost impossible to locate,
and certainly too late when discovered and found by the Vet ( always
assuming they had experience of the symptoms seen and are diagnosable very
early on).
Anything that
causes rupture to this duct will cause seepage and effusion of fluid into
the pleural space.
This as an
after effect ,can cause extreme and sometimes
immediate fatality if not treated as soon as it is apparent.
However almost
everyone I have spoken to over the years has never heard of this word unless
it has happened to your Afghan and say “Why do we need to take notice”...
why indeed is my reply. To prove my point Sylvia Evans tried to organize a
symposium with a well known specialist here in the UK and received no
support whatsoever! It was aborted!
SYMPTOMS
So what are the
broad symptoms..?
Many things I tell
people, but one sure sign is the “Sphinx effect” in which difficulty occurs
in respiration and breathing. The dog will sit in the sphinx position, hence
the term used.
NOW before you all
dash off to your Vet because you see your dog sitting as I describe, I must
emphasize only suspect something IF it is accompanied by one of the
complaints listed above.
I do not want to
panic” Keepers of the Breed” with paranoia. Stop, think and listen... then
decide. In this case if you actually suspect something is wrong don’t
hesitate seek medical assistance.
If you
remember nothing else in future “think Sphinx position” and CTX will enter
your mind.
All dogs will in
this situation take up this position to ease their breathing. Other
accompanying forms are refusal to eat, often with vomiting, chest pain,
discomfort... moaning, murmuring, forceful coughing, lethargy, loss of
appetite, etc, but not necessary restricted thereto, all of which can cause
blood clots that elevate pressures in the blood stream. These conditions
will eventually lead to a lack of Oxygen in the lungs.
Immediately
one suspects this, the dog should be taken to the vet. Ironically my own vet
when consulted had only seen one case at their surgery in 45 years with a GSD, never an Afghan.
AT
THE VETS
cannot over
emphasize that Time is the Essence, a phrase more apt.
At the very first
examination by the vet one is often asked “can you tell me anything that has
happened to your Afghan in the past period? Anything strange you can call to
mind that will help in my diagnosis?”
Of course
you are mystified, for at this juncture you will be not aware of the serious
of the life threatening CTX, yet to be established.
Just think
Afghans run and run, often they will collide with each other. Would you see
it every time? NO... usually it will occur outside when you are not present.
Such side impact of the way I describe will and can be one of the main
causes to develop Trauma. Another very common factor is “Road accident” (RTA)
Insist as soon as
you are pretty sure something or event has happened prior to your visit and
you have similar symptoms, ASK immediately for an x ray and a Blood Test
from a Spinal tap.
The
immediate confirmation of the presence of CHYLE is made by undertaking a
Spinal Tap, in which fluid is drawn out through the vertebrae by a needle
and the contents analyzed.
The presence
of TRIGLYCERIDE as seen in the blood will confirm the presence of CHYLE. The
obvious discolourisation in the test tube will be another pretty positive
sign to the naked eye.
IDEOPATHIC
CTX
Predisposition
suggests it occurs in mostly Deep “barrel-chested breed (of which Afghans
form part)......but to actually state this is Hereditary or Congenital is
unfounded.......
”THERE IS NOT ONE
SINGLE CASE TO CONFIRM OR TO RE-AFFIRM THIS UNFOUNDED STATEMENT.”
Almost all forms
of CTX are termed IDIOPATHIC CTX
Whilst some refer
to it as a disease, which in itself, I will explain as simply being an
abnormal condition that affects any normal function of the animal, it is
attributed to certain health problems. Such as Cancer, Heartworm, Cardiac
disease, Tumour, Lung Lobe torsion, and Trauma. Etc.
The latter
and some event that happened to your Afghan earlier, in itself is mostly
responsible for thoracic duct puncture due to external impact or pressure
and the principal cause of CTX.
Simple examples of
this can be, sudden side impact, a knock, car accidents, hit by a car door,
falling off a grooming table, and the like all can produce this fatal
condition later.
Immediate
action by the vet, can, after the diagnosis of CHYLE, be carried out by
draining of the fluid from the chest cavity. This will afford some relief to
the dog and their respiratory problems... but in the long term inevitably
the symptom re-occurs again. Often the dog will be placed on a low fat diet
as an intermediary measure. I say this because this is only a temporary
measure.
One has to
be careful during anaesthesia due to the sensitivity to such measures, an
issue the Afghan shares in common with other Sighthound Breeds. We have
personal experience of this.
It has not been
uncommon to lose a dog during the draining of fluid due to this very problem
as our breed has relatively low levels of body fat.
Many
journals describe quite correctly as CTX being a rare condition in itself,
but as I will describe it is caused by External Influences in the main, “in
laymen’s words Dogs die with CTX ......Not from it and as a genetically
inherited condition”.
Other
clinical methods have been tried with the treatment of the drug” Rutin”.
Some limited success has been recorded but not to a full recovery. Other
methods by way of a “SHUNT” to bypass the thoracic duct have been tried in
Michigan and Ohio, again without positive long term success.
Immediate
treatment must be sought through surgery to prevent scar tissue forming
around their organs to protect them from the Chyle fluid.
It should be
remembered that this condition CTX can be extremely difficult to diagnose.
I cannot
over emphasize mostly this is IDIOPATHIC CTX i.e. resulting from unknown
causes. In this instance other than draining the cavity the fluid will
reappear
OUR
OWN EXPERIENCE
Most persons
will recall we lost our beautiful black bitch “Passionata du Menuel Galopin
from Jahadi (our French Import) almost 6 years ago.
She
developed at first, only a very few of these overall symptoms, only loss of
bodyweight, and being slightly listless. Our vet did not associate with CTX.
When we took her on the first visit.
Later on a
Saturday she was seen in the “Sphinx Position” and developed mild coughing
and was taken back to the vets in emergency. An immediate x ray determined
that cloudy substance CHYLE was present.
They tried
to drain the effusion from the cavity, but within 4 hours she died. It is
not uncommon for animals even during this process to tragically die. We then
learned about that word that most cannot spell and let alone say. Since then
we have studied from Dr Fossum.
When we were asked
is there anything strange you can tell us by the vet we said “nothing we can
recall”
3 weeks later our
immediate neighbour stopped her car and enquired “Is your bitch Ok? We asked
why? And then was told she saw her escape from our property and run into the
road and was “apparently” slightly knocked by the car, but then as she said”
appears to shake it off and run away.” She, seeing her run back thought
nothing more of it, thinking it had missed her.
This was the first
we had heard about this, although we did know she had jumped a 5 foot fence
and got out only to be recaptured by Lesley within 5 minutes. We knew
nothing about any car incident until related to us later.
Then and
only then did we know that was the cause of her Trauma and CTX.
Until that time we
were unaware of any impact. We have never revealed this publicly as the
cause of death until now, both Lesley and I have been devastated not only by
her passing but the cause.
Thus this impact
led to the rupture of the duct, the chest filled up with Chyle and the lack
of Oxygen killed her.
In these
deep “barrel” chested breeds it has been noted it is mainly in middle aged
animals
CONCLUSION
I will end my
note by repeating CTX having been diagnosed before or after death has never
been proved as a cause of development through established genetic problems.
If you have
reached the end of this article, then cast the words CTX to memory, If at
some future date you happen to remember these words and have used them to
quickly ascertain the possible cause for sudden illness then come and speak
later to me, for I will then be reassured that we may have prevented much
pain and suffering to your Afghan.
DAN JAMES.......JAHADI AFGHANS (EST 1961).........FEB 2009
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