Today’s case is a 2 month old female domestic short haired cat who presents for difficulty breathing. Take a look and post your comments below. Answers available on Monday.
2 month old domestic short haired cat
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{ 4 comments… read them below or add one }
Looks like pretty normal margins except for right around the neck, and I don’t see any skeletal problems with the possible exception of a vertical line running through the pelvis on the lateral that may be completely normal, I suppose. Three things jump out right away–liquid density in the abdomen, a patch of radiolucency running just under all the thoracic structures, and a great big wtf in the thorax. The lung seems to be much further caudal than normal, due to the heterogenous soft-tissue density structure cranial to it. There is what looks like a liver lobe cranioventral to the lung as well, but my guess is it’s likely the heart. The cervical region just cranioventral to the base of the skull doe snot contain structures that I recognize as normal– where’s the trachea?– and appears to have a very amorphous liquid-to-soft tissue density structure filling much of the area and distending the skin of the neck.
For the big ol’ weird thoracic mass, the most obvious ddx is a mediastinal mass, and for the abdomen, ascites. I would call a diaphragmatic hernia with massively distended intestine crazy, not only because the mass doesn’t look like large intestine, but because I’d expect the abdominal fluid to be filling the thorax as well in that case. I’m only mentioning it because on one of the laterals, way up in the neck it kinda looks like poop filled bowel loops.
Lymphoma could cause both the mediastinal mass and leaky bowels; FIP explaines the ascites, and if it has a noneffusive component affecting the lungs and mandibular lymph node as well, well that would explain it all.
Thank You for this website, it’s great! It’s time for my first comment…Excuse me my English
I think that radiopaque mediastinal mass is probably the ingesta in extremely distended esophagus (megaesophagus) displacing trachea ventrally. Lack of air or ingesta over the carina makes right aortic arch a probable diagnosis to me (or foreign body which stopped just in this place
). Consolidation of the right medial lung lobe can be an aspiration pneumonia. Cardiac size and silhouette is normal to me and its horizontal displacement is an effect of the pressure on the heart base. Slightly increased interstitial pattern is normal in this age such as loss of serosal detail in the abdomen due to small amount of peritoneal fat.
Dilated esophagus with alimentary contents within it; cranial to cardiac silhouette. Displacement of the heart, lungs and trachea. There is a focal increased pulmonary density wich could be related to a pneumonia secondary to aspiration. It seems a vascular ring anomaly – arterious ductus persistent.
There is a mass effect in the cranial mediastinal area. The “mass” looks like it is filled with ingesta. This could be megaesophagus due to a vascular ring anomaly
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