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.
There is severe generalized cardiomegaly with dorsal deviation of the trachea on the lateral projection. The cardiac enlargement and mild rotational position on the d/v has caused the cardiac apex to shift to the right. There is a severe alveolar pattern present within the right caudal lung lobe, as well as air bronchograms indicating a milder alveolar pattern in the left cranial and left caudal lung lobes. The pulmonary vasculature is difficult to assess due to overlying alveolar infiltrates. Within the viewable abdomen, there is a small amount of foreign material within the stomach.
Severe generalized cardiomegaly. Differentials for this finding should include severe valvular disease or dilated cardiomyopathy. Alveolar pulmonary infiltrates are attributed to cardiogenic edema. Echocardiogram is recommended for further evaluation if clinically indicated.
Left heart failure with asymmetric pulmonary edema.
Eccentric jets in dogs with mitral valve disease may cause asymmetric pulmonary edema in approximately 1/3 of cases.
Diana A, Guglielmini C, Pivetta M, et al. Radiographic features of cardiogenic pulmonary edema in dogs with mitral regurgitation: 61 cases (1998-2007). Journal of the American Veterinary Medical Association 2009;235:1058-1063.