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重度の胸水の為、呼吸困難を示した3歳避妊メス ウィペットが来院した。胸水の細胞診、生化学的検査結果および原因疾患除外により特発性乳び胸と診断した。ニューメチレンブルーを腸間膜リンパ節に注入後、胸管結紮術（TDL）と乳び槽切除術（CCA）を実施した。しかしながら術後も乳び性滲出液の持続が認められたため、10日後に2回目のTDLを実施した。TDL後、リンパ管造影検査により胸管交通が残存していることを確認したことから、能動的胸腔腹腔シャントチューブ（デンバーシャント）も装着した。2回目の手術後、乳び性浸出液の量は徐々に減少し、術後180日目にはシャントチューブからの滲出液の排出は認められなくなった。第1,098病日現在、乳び胸の再発は認められていない。

To determine the prevalence and location of recurrent thoracolumbar intervertebral disc extrusion (T-L IVDE) after hemilaminectomy with prophylactic fenestration (PF) and to document PF-related complications.Retrospective case series.Chondrodystrophic dogs (n = 793).In 662 successfully recovered dogs (1 year follow-up), the prevalence of dogs with recurrent T-L IVDE that required a 2nd surgery and dogs with clinical signs that improved without surgery was evaluated. Prevalence of second disc extrusions (SDEs) within T11-L4 intervertebral discs was compared between PF discs and non-PF discs.T-L SDEs were intraoperatively confirmed in 15 dogs (2.3%), 2-61 months after initial surgery and 66 dogs (10.0%) had signs of T-L IVDE recurrence that improved without surgery (mean follow-up, 44.7 months). No dog had further extrusion at the initial T-L site. SDE occurred at a PF disc (n = 1), adjacent to PF discs (8), or at distant discs (6). Prevalence of SDE in non-PF discs was 26.2 times higher than PF discs (95% CI: 3.4, 203.4; P.001). Major PF-related complications included iatrogenic introduction of the disc material into the spinal canal (n = 1), and vertebral subluxation/instability (3) at 1-88 months postoperatively.SDE is more likely to occur at non-PF discs than PF discs when PF is performed at spaces predisposed to disc extrusion. PF is a safe and effective treatment to prevent SDE in chondrodystrophic dogs.

Objectives To determine the prevalence and location of recurrent thoracolumbar intervertebral disc extrusion (T-L IVDE) after hemilaminectomy with prophylactic fenestration (PF) and to document PF-related complications. Study Design Retrospective case series. Sample population Chondrodystrophic dogs (n = 793). Methods In 662 successfully recovered dogs (>1 year follow-up), the prevalence of dogs with recurrent T-L IVDE that required a 2nd surgery and dogs with clinical signs that improved without surgery was evaluated. Prevalence of second disc extrusions (SDEs) within T11-L4 intervertebral discs was compared between PF discs and non-PF discs. Results T-L SDEs were intraoperatively confirmed in 15 dogs (2.3%), 2–61 months after initial surgery and 66 dogs (10.0%) had signs of T-L IVDE recurrence that improved without surgery (mean follow-up, 44.7 months). No dog had further extrusion at the initial T-L site. SDE occurred at a PF disc (n = 1), adjacent to PF discs (8), or at distant discs (6). Prevalence of SDE in non-PF discs was 26.2 times higher than PF discs (95% CI: 3.4, 203.4; P < .001). Major PF-related complications included iatrogenic introduction of the disc material into the spinal canal (n = 1), and vertebral subluxation/instability (3) at 1–88 months postoperatively. Conclusion SDE is more likely to occur at non-PF discs than PF discs when PF is performed at spaces predisposed to disc extrusion. PF is a safe and effective treatment to prevent SDE in chondrodystrophic dogs.