This week’s case is a 10 year old mixed breed dog with lethargy and inappetence. This case is challenging. See what you think of it and post in the comments.
In the thorax, there is a diffuse mixed pulmonary pattern with miliary nodular and bronchial components. There are also alveolar infiltrates in the ventral portion of the left cranial lung lobes, best noted on the right lateral projection. There is ill-defined soft tissue opacity dorsal to the carina, which may represent lymphadenopathy. The cardiovascular structures are within normal limits. Within the abdomen, the liver is enlarged, causing focal poor peritoneal detail.
- fungal pneumonia
- metastatic disease
- bronchoalveolar carcinoma
- hepatomegaly due to systemic or infiltrative disease
This dog had a positive titre for coccidioidomycosis. Pulmonary infiltrates are often nodular but can appear diffuse. The ventral distribution of the alveolar component may indicate an additional secondary bacterial pneumonia. The hepatomegaly was presumed to be due to disseminated fungal infection.