This week’s case is an 11 year old male neutered Cavalier King Charles Spaniel presented for an episode of acute onset collapse with inability to support himself on the hind limbs and disorientation.
http://bit.ly/cod111006
11 year old Cavalier King Charles Spaniel
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On the lateral projection, Cardiac silhouette show a global enlargement, displacing the trachea dorsally. Caudal lung field is increased in radiopacity and air bronchograms are visible in cranial lung lobes. Diaphragmatic border is obliterated in its ventral portion.
On the ventrodorsal view right diaphragmatic crus cannot be followed in its normal course. Cardiac shadow is markedly enlarged and air bronchograms are pronounced in the right caudal lobe, with increased alveolar radiopacity. Pylorus of the stomach seems to be displaced.
Differential diagnosis should include peritoneopericardial herniation.
Severe cardiomegaly with alveolar pattern mostly in the right middle lung lobe. Due to the acute nature of the collapse I suspect pericardial effusion. Due to the concurrent alveolar pattern I suspect a bleeding disorder.
Other considerations should should be peritoneal-pericardial hernia (less likely because od the concurrent alveolar changes), or congestive heart failure- since it’s very acute I would suspect a ruptured chordae tendinae, or atrial rapture
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