Today’s case is a 2.5-year-old male neutered Great Pyrenees dog presenting for a 7-month history of cough, decreased appetite, weight loss, and a 5-month history of increased respiratory rate and sound.
There is alveolar pulmonary pattern and complete consolidation of the accessory lung lobe, which extends to the right caudal lung lobe. There are additional nodules in the cranial and caudal lung lobes, one of which is visible ventral to the 6th thoracic vertebra. The aerated lung lobes appear hyperinflated, giving the appearance of lifting the cardiac silhouette from the sternum. The cardiac silhouette and pulmonary vasculature are normal. There are multiple thickened pleural fissure lines but no overt effusion is noted.
DIfferential diagnoses for the lobar pattern in the accessory lobe and pulmonary nodules include infectious inflammatory disease (fungal pneumonia, migrating foreign body), and less likely neoplasia in a young dog. CT examination could be considered to further evaluate this region.
Coccidiodomycosis – positive on serology