Today’s case is a 6-year-old Doberman with a cough. See what you think and write your interpretation in the comments section.
There is mild generalized cardiomegaly with severe left atrial enlargement. The left atrium appears as a round soft tissue opacity superimposed on the cardiac silhouette on the d/v projection. There is a diffuse, dense interstitial to alveolar pattern that is worse cranioventrally. The cranial lobar vein is larger than the artery on the left lateral projection. There are multiple fissure lines visible that are not widened.
Left heart failure due to dilated cardiomyopathy.
There is a cranioventral distribution to the pulmonary edema which can occur in long-standing cases where the fluid settles to the ventral portions of the lungs. The nodular opacities are caused by enlarged vessels and areas of interstitial to alveolar pattern.
The fissure lines are not widened making pleural effusion less likely. The lung lobe borders may be more visible than normal because of the increased density of the lungs.
These images were taken two weeks after beginning therapy for DCM. The pulmonary vessels remain enlarged, but the edema has mostly resolved leaving an interstitial pattern.