Radiology Packet 13

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Radiology Packet 13

• Thorax Pleural cavity

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7-year old MC DSH

• Hx Presented for evaluation of progressive
  respiratory distress. History obtained from the
  owner suggests the cat has been lethargic for 2
  weeks and anorexic for 3 days. They noticed the
  cat has been breathing faster for the last few
  days and 12 hours ago became obviously dyspneic.

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7-year old MC DSH

• RF
• There is an overall increased density within the
  thoracic cavity.
• Pleural fissure lines are present as well as an
  increased density surrounding the costophrenic
  angle.
• There is marked retraction of the caudal dorsal
  lungs from the thoracic walls and the lung
  margins appear rounded.
• Soft tissue opacity is present especially along
  the left thoracic wall and costrophrenic angle.
• A large amount of free air is present in the
  right hemi-thorax.
• The right caudal lung lobe appears markedly
  decreased in size and rounded.
• A mediastinal shift to the left is present.
• RD
• Pleural effusion
• Unilateral tension pneumothorax

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7-year old MC DSH

• R/O
• Pleural effusion
• Chylothorax
• Hemothorax
• Pyothorax
• Hydrothorax
• CHF
• Neoplasia
• Pneumothorax
• Traumatic
• Spontaneous
• Secondary to underlying pulmonary disease
• Next
• Thoracocentesis - immediately
• Cytology and culture of the fluid

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9-year old M German Shepherd

• Hx Presented with a history of abdominal
  distension and weakness. The diagnostic work-up
  revealed the presence of a splenic mass and free
  abdominal fluid.

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9-year old M German Shepherd

• RF
• The heart and pulmonary vessels appear normal.
• In the lateral view there is retraction of the
  ventral lung tissue away from the sternum.
• The apex of the heart silhouettes with an area of
  soft tissue opacity ventrally.
• In the VD view there is increased opacity of the
  lung fields but this change is much more obvious
  in the left lung field.
• There is minor retraction of pulmonary tissue
  from the thoracic wall at the caudal lung tips. A
  pleural fissure line is present at the 5th
  intercostal space on the right.
• There is an impression of increased opacity of
  the cranial abdomen which is consistent with the
  presence of free abdominal fluid.
• RD
• Pleural effusion
• R/O
• Chylothorax
• Hemothorax
• Pyothorax
• Hydrothorax

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4-year old FS DSH

• Hx Presented in acute respiratory distress after
  being outside all night. The owners indicate that
  she was fine the previous evening.

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4-year old FS DSH

• RF
• The heart is partially obscured by surrounding
  lung changes but appears normal.
• In the lateral view two triangular structures of
  soft tissue opacity are seen in the caudal thorax
  these are retracted caudal lung lobes.
• There is free air between the caudal lung lobes
  and the diaphragm. The free air is difficult to
  see in the VD - likely due to positioning.
• In the VD there is an area of increased opacity
  that silhouettes with the heart along the left
  side. This is seen on the lateral film cranial to
  the heart.
• Increased size of the thoracic cavity has pushed
  the liver and other abdominal organs caudally
  giving the false appearance of hepatomegaly.
• RD
• Bilateral pneumothorax
• Pulmonary contusion

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8-year old miniature poodleTrixie

• Hx presented with dyspnea

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8-year old miniature poodleTrixie

• RF
• Soft tissue silhouetting of the ventral portion
  of the heart with the sternum and diaphragm.
• Pleural fissure lines.
• The caudal mediastinal area is opacified by soft
  tissue diaphragm is not seen here.
• Retraction of the right middle and caudal lung
  lobes from the thoracic wall, with soft tissue
  opacity between the lobes and the wall.
• Trachea is diverging from the spine.
• RD
• Pleural effusion
• R/O
• Chylothorax
• Pyothorax
• Hydrothorax
• Hemothorax
• Next
• Thoracocentesis

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8-month old PugPugwash

• Hx Two days ago the owner noticed an open bag of
  rat poison and suspects the puppy ate some of it.
  Yesterday the puppy became depressed and
  lethargic. When presented today he was dyspneic.

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8-month old PugPugwash

• RF
• Diffuse increase in opacity in the thoracic
  cavity.
• The cardiac silhouette is obscured and the lung
  lobes are retracted and rounded.
• In the lateral view the trachea is elevated and
  in the VD view the cranial mediastinal appears
  widened.
• Due to the large volume of fluid in the thorax it
  is difficult to evaluate the lungs for changes.
• RD
• Pleural effusion
• Possible widened cranial mediastinum
• R/O
• Rodenticide toxicity
• Next
• Evaluation of coagulation and treat with Vitamin K

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11-year old Golden RetrieverKatie

• Hx Presented with dyspnea.

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11-year old Golden RetrieverKatie

• RF
• Increased overall opacity of the thorax.
• Pleural fissure lines are present and the lung
  lobe margins are rounded on the lateral view.
• The cranial mediastinum is mildly widened.
• Multiple medium size soft nodules are present in
  various lung lobes.
• RD
• Massive pleural effusion
• Pulmonary nodules
• R/O
• Pleural fluid secondary to neoplasia
• Cranial mediastinal mass
• Next
• Thoracocentesis