This week’s case is a 7-year-old male neutered Domestic Shorthair cat with difficulty breathing. What are the two main findings?
Findings
There is increased pharyngeal dilation with increased soft tissue opacity in the region of the larynx. The cervical and thoracic trachea appear small. The cardiac silhouette is markedly enlarged with a rounded appearance. Within the abdomen, the liver is poorly visualized. The stomach is gas distended and is located in close proximity to the diaphragm. There is poor definition of the ventral diaphragm and cardiac silhouette.Differential Diagnosis
- Pericardial peritoneal diaphragmatic hernia. This is likely an incidental finding.
- Upper airway obstruction. Differential diagnoses include laryngeal neoplasia, edema, and inflammation.
I saw pretty much all findings on my own except the small trachea. After reading your findings and taking a 2nd look at it, I can see subjectively that is small.
Is there an objective way to assess the size of the trachea ?
Thanks in advance
Why is the dilatated oesophagus not a megaoesophagus ?
This is a very nice teaching case, because it shows the dangers of “tunnel vision” – when you’re presented with a gross pathology like that cardiac silhouette it’s easy to miss out on the smaller things. Nicely done.
As of the previous question – megaesophagus describes a syndrome of segmental or diffuse dilatation of the esophagus due to several causes including hypomotility and loss of normal peristaltic activity or obstruction. The radiographic sign is oesophageal dilation.