Today’s case is a 12 year old male neutered Domestic Shorthair cat with anorexia and increased respiratory effort for 3 days. What is your radiographic diagnosis?
The cardiac silhouette is markedly enlarged on all projections. There is a bulge in the region of the carina and at the base of the right middle lung lobe, which is increased in opacity. The pulmonary vasculature is enlarged. There is a diffuse bronchointerstitial pattern throughout the lungs, and there is increased opacity in the region of the left cranial lung lobe.
Cardiomegaly is most likely due to cardiomyopathy due to primary heart disease or hyperthyroidism. The mass effect in the right cranial thorax may be a pulmonary mass with secondary right middle lobe atelectasis or an enlarged cardiac chamber. The diffuse bronchointerstitial pattern is consistent with lower airway disease, which may have infectious and noninfectious inflammatory components. The opacity in the left cranial thorax may be due to effusion or a cranial thoracic mass.
- Hypertrophic cardiomyopathy
- Ruled out thoracic mass by ultrasound examination – enlarged atrium
- No abnormalities in left cranial thorax
Normal thoracic structures.
Normal plueral space.
increased soft tissue opacity at the right middle lung lobe on LL view with the lobar sign.
Doughnut rings on the caudal lung lobes.
Aerophagia inducing the inflation of the cervical esophagus and stomach.
Cardiomegaly larger than 2.5 ICS in contact with the diaphragamtc cupola on lateral and larger than the half of the thoracic cavity width on VD view.
Dilated CVC size?
Right middle lung lobe with alveolar pattern and the increased volume displacing the caudal lung lobes but also it may be a pathological change of the cardiomeglay. -> Echocardiography would be needed.
DIffuse bronchial pattern with doughnut rings.
Valentine shape cardiomegaly with the dilated caudal pulmonary arteries and vessels.
Neoplasia, Lung lobe collapse most likely /Granuloma, Abscesses
Chronic bronchitis, Asthma(more likely)/ Eosinophilic brochopneumopathy(less likely)
I totally missed the left cranial lung lobe change on the VD view.
Thanks for the good case to read!
Is the right cupola of the diaphragm displaced cranially a little? Say, from the atelectic middle right lung lobe? (Still a novice on rads.)
Allison Zwingenberger says
Perhaps a bit asymmetric at the diaphragm, which is usually not clinically significant. There is also some rotation on the d/v.