Case Study

RAD – Cardiomegaly and hyperperfusion of the lung in a 12 year old FS Maltese dog

This 12 year old FS Maltese dog presented with morning time anxiety, panting and attention seeking behavior (demanding and pawing to be held). Hx of mitral valve disease with compensation on echo (no heart meds). CCL rupture LH not repaired but current instability in LH with positive drawer and thrust. Physical Exam: BCS 7/9 4/6 holosystolic murmur. cyanotic and stressed when in dorsal recumbency for radiograph. Panting excessively, harsh lung sounds. Partial weight bearing on LH. Calm in exam room.

CBC/Chem/UA: wnl

DX

Mild leftsided cardiomegaly and hyperperfusion of the lung is noted and consistent with the known mitral regurgitation. There is no evidence of congestive heart failure at this point. Except for the cardiac changes the findings are compatible with the expected geriatric changes and the known stifle osteoarthirits.

Image Interpretation

Rads of the thorax and abdomen –
Osseous structures:
Mild degenerative changes were associated with the axial sceleton. Moderate osteoarthritic changes of the stifle are noted.

Intrathoracic structures:
There is a moderate generalized bronchointerstitial pattern. The cardiac silhouette covers 3.5 intercostal spaces in width and is mildly elongated. Mild elevation of the trachea is noted. The caudal contour of the heart is rounded. However there is no obvious atrial tenting. Mild dilation of the pulmonary vasculature is noted. There is no evidence of cardiogenic pulmonary edema.

Intraabdominal structures:
There is mild aerophagia. Multifocal thin linear calcification of the renal diverticuli and pelvis is noted for the left kidney.

Outcome

The mild aerophagia is an indirect sign of pain, stress, dyspnea or maldigestion.
The calcification of the renal collective system is unlinkely to be obstructive or of any other clinical significance. However full ultrasonographic exmination of the abdomen, cardiac echo (if not yet done so) and neurologic workup should be considered for further definition.

Patient Information

Patient Name : Bella D'Antoni/PHAH

Gender : Female, Spayed

Species : Canine

Type of Imaging : Ultrasound

Status : Complete

Liz Wuz Here : Yes

Clinical Signs

Decreased Drinking

History

Cruciate ligament injury
Mitral insufficiency

Exam Finding

Cranial drawer posiive
Heart Murmur
Panting

Images

Clinical Signs

Decreased Drinking