Small Animals Fracture Repair

Radiographic Interpretation of the thorax

Figure 1: Severe bronchial lung disease with hyperinflation. The most likely rule out is feline asthma. Focal pneumonia

There is severe bonchial disease which is generalized. Multiple doughnuts can be seen in the lung fields. The diaphragm is displaced caudally and flattened. There is a large triangle between the heart, caudal vena cava and diaphragm. These later changes indicate hyperfiltration and air-trapping. On the dorsoventral view there is a focal increased soft tissue opacity in the most distal aspect of the lung which most likely represents alveolar lung disease-pneumonia. Definitive air bronchograms within this opacity are hard to appreciate.

Figures 2, 3: Normal thorax.1 year old Doberman. Right lateral and ventrodorsal views of the thorax. No abnormalities are identified. Note the rounded appearance of the heart on the ventrodorsal view which is due to the orientation of the heart within the thoracic cavity in deep chested dogs. The ventrodorsal view is slightly underexposed which makes accentuated pulmonary markings.

Figures 4, 5: 13 year old female spayed mixed breed dog. Injury to the tail 2 days previously. On auscultation, wheezes and crackles were noted. A fluctuant mass was palpated along the right thoracic wall. Right lateral and ventrodorsal views of the thorax. There is a large fat density mass adjacent to the right thoracic wall. On the ventrodorsal view on the right caudal lung, a 3 cm soft tissue mass with internal gas density cavitations is seen. The right cranial lobar bronchus is markedly dilated and does not taper normally, indicating bronchiectasis. There is moderate to severe diffuse bronchointerstitial lung opacity noted throughout the remainder of the thorax. Pleural fissure lines are identified which most likely represent pleural thickening particularly on the lateral view. There is slight straightening of the caudal border of the heart on the lateral view, indicating mild left atrial enlargement.

Diagnosis

Cavitary soft tissue mass in the right caudal lung lobe. The most likely rule out is primary lung neoplasia such as adenocarcinoma or squamous cell carcinoma with other consideration given to fungal granuloma or abscess. Severe bronchiecstasis. Moderate to severe bronchointerstitial lung disease. Mild left atrial wall enlargement. Fat tumor (lipoma) located along the right thoracic wall.

Figures 6, 7: 5 year old spayed female mixed breed dog suffering from  seven day course of quadraparesis. Right lateral and ventrodorsal views of the thorax. No radiographic abnormalities are noted. The ventrodorsal view is slightly underexposed, which enhances the appearance of the pulmonary parenchyma. Normal thorax.

Figure 8: Ventrodorsal views of the thorax. Prominent bronchial lung disease. There is a prominent bronchial pattern located throughout the lung.

These are best seen on the ventrodorsal view where prominent "doughnuts" are identified in the right caudal and left cranial lung lobes. There is no radiographic evidence of heartworm disease.

Figure 9: 8 year old female spayed German Shepard. Bilateral severe hip dysplasia. Thorax films were made to assess for anesthesia.Right lateral and ventrodorsal views of the thorax. The cardiac silhouette is of normal size on the lateral view. On the ventrodorsal view there is slight increased prominence to the region of the main pulmonary artery. Pulmonary vasculature appears to be within the normal limits. There is a mild to moderate bronchointerstitial lung opacity with the interstitial component predominating. The interstitial component does not have a specific pattern, rather it appears to be a "gray lung".

Radiographic opinion

Bronchointerstitial lung disease. Mild cardiomegaly with particular enlargement of the main pulmonary artery segment. This radiograph is a good example of a geriatric thorax.

Figures 10, 11:

Signalment

13 year old male castrated DSH

History

Dyspnea for 2 months duration which is intermittently responsive to steroid and antibiotic therapy.

Radiographs made

Right lateral and ventrodorsal views of the thorax.

 Findings

There is severe diffuse bronchial lung disease with intermittent bronchiectasis and emphysema. The emphysema appears as several radiolucent areas towards the periphery of the lung which is more dilated than normal bronchial structures. Multiple "doughnuts" can be identified. There is a mild generalized interstitial opacity.

Radiographic opinion

Chronic severe bronchial lung disease with end-stage bronchiectasis and emphysema. This cat probably had feline asthma for a significant length of time.

Figure 12, 13:

Signalment

13 year old male castrated DSH

History

Dyspnea for 2 months duration which is intermittently responsive to steroid and antibiotic therapy.

Radiographs made

Right lateral and ventrodorsal views of the thorax.

 Findings:

There is severe diffuse bronchial lung disease with intermittent bronchiectasis and emphysema. The emphysema appears as several radiolucent areas towards the periphery of the lung which is more dilated than normal bronchial structures. Multiple "doughnuts" can be identified. There is a mild generalized interstitial opacity.

Radiographic opinion

Chronic severe bronchial lung disease with end-stage bronchiectasis and emphysema. This cat probably had feline asthma for a significant length of time.

Figures 14, 15:

Signalment:

3 year old male Miniature Poodle.

History:

Dog was involved in a dog fight and has pain along the left body wall.

Radiographs made:

Right lateral and ventrodorsal views of the thorax.

Findings:

There is a soft tissue swelling and subcutaneous emphysema along the left thoracic wall. The left fourth through eighth ribs are fractured, some in multiple places. There is a large separation between the fifth and sixth ribs on the left side. The lungs appear to petrude outside the thoracic cavity at this site. Focal increased soft tissue lung opacity can be seen in the left caudal lung lobe on the ventrodorsal view which most likely represents pulmonary contusions.

Radiographic opinion:

Thoracic wall trauma. A flail chest is suspected.

Figures 16, 17, 18:

Signalment:

10 year old female Poodle.

History:

Chronic coughing which has a honking nature for 4 months duration.

Radiographs made:

Ventrodorsal and 2 right lateral radiographs (one made during inspiration and one made during expiration).

Findings:

There is a total collapse of the intrathoracic trachea during expiration. There is a mild cardiomegaly particularly along the right side. A mild bronchointerstitial lung opacity is present.

Radiographic opinion:

Collapsing intra-thoracic trachea. The right heart enlargement may be due to cur pulmonale or mild tricuspid insufficiency.

Figures 19, 20:

Signalment:

12 year old male castrated mixed breed dog.

History:

Chronic coughing and recent onset of dyspnea.

Radiographs made:

Right lateral and ventrodorsal views of the thorax.

Findings:

There is severe diffuse bronchointerstitial pulmonary infiltrate. Some of the bronchi appear thickened and there is some bronchial mineralization. There is right sided cardiomegaly. These cardiac changes may be due to cor pulmonale secondary to chroCase

Radiographic opinion:

Severe generalized bronchointerstitial lung disease. Obesity.