Today’s case is an 8-month-old male English Bulldog with a 3-week history of vomiting/regurgitation, lethargy, and cough. What are the congenital abnormalities?
Neck: On the lateral radiograph of the neck, the trachea is markedly narrowed. The nasopharynx is decreased in size and the soft palate appears thickened.
Thorax: There is an interstitial to alveolar pulmonary pattern in the left and right cranial lung lobes and right middle lung lobe. The cardiac silhouette is normal in size. There are multiple hemivertebrae in the spine, consistent with breed. On the d/v projections, there is an alternately fluid and gas-filled rounded structure in the caudal mediastinum. This is not visible on the lateral projections.
Tracheal narrowing and soft palate thickening consistent with brachycephalic syndrome
Sliding hiatal hernia with secondary aspiration pneumonia
An esophagram was performed and distal esophagitis as well as poor motility were diagnosed. The poor esophageal function and hiatal hernia likely contributed to the aspiration pneumonia. The brachycephalic syndrome likely increased intrathoracic pressure, worsening the hiatal hernia.