Today we have a 10-year-old male neutered Yorkshire Terrier with 3-day history of worsening cough and lethargy. This one is interesting, see what you think and post your comments.
Findings
There is an ill-definded, lobar alveolar pattern in the left caudal lung lobe. There is a diffuse interstitial pattern and visible fissure lines, most likely due to a small amount of pleural effusion. The cranial mediastinum is widened on the d/v projection, however there is no evidence of a mediastinal mass on the lateral projection.
Differential Diagnosis
- inhaled foreign body with mediastinal abscess and pleuritis
- hemorrhage due to rodenticide toxicity
- pulmonary thromboembolism
Diagnosis
Collapsed while taking out for walk the next day. Mucous membranes were pale and the dog became dyspneic and weak. Moved to emergency room where oxygen was administered and an IV catheter was placed. T=94.8. 900ml of warm LRS was bolused over approximately 15 mins followed by 120ml per hour. An ICU panel was submitted showing hemoglobin=3.5, pH=6.981, CO2=32.5, HCO3-=7.6, Potassium=2.7, Glucose=215, Lactate=19, PCV=13, TP=3.2.
- Coagulopathy – suspected rodenticide toxicity.
The patient was treated with plasma, packed red blood cells and Vitamin K. Radiographs taken one week later were normal.