Obesity and exspiration contribute to the impression of increased lung opacity. However there is the impression of a predominantly bronchointerstitial rightsided and caudodorsal pulmonary infiltrate which is not cardiogenic in origin.
Mainly inflammatory processes (bronchopneumonia) with bacterial, viral or parasitic aetiology should be considered. An allergic cause – such as pulmonary infiltrates with eosinophils – should be considered less likely. The findings are not typical for a neoplastic infiltrate.
An endoscopic examination with BAL, blood-work and a faecal examination (rule out lung worm infection) would be ideal for further definition. As further investigation, ultrasound of the right caudal and middle lung lobe with guided sampling should be considered.
Anemia, bradycardia and fever may result in mild generalized cardiomegaly. Age related bilateral atrio-ventricular endocardiosis is considered less likely. An echocardiography may be considered in case of a systolic heart murmur.
The possible subcutaneous lesion should be rechecked clinically.