The radiographs are negative for aggressive osteolytic bone lesions.
Solid consolidation of the cranial compartment of the left cranial lung lobe with mild
bilateral pleural effusion is noted – the two main differential diagnoses here are lobar
neoplasia with pleural carcinomatosis versus lobar pneumonia with reactive/septic
pleuritis. The findings do not support the presence of a lobar torsion or lung atelectasis.
Consider ultrasound guided sampling for further definition. This should be enforced
with the patient sedated or under general anesthesia. The patient has to be monitored
for develeopment of pneumothorax after the procedure. The risk of development of a
relevant pneumothorax iss lightly higher in cats as compared with dogs in my
experience. But the diagnostic accuracy of fine needle aspiration oft he lung is
reasonable to justify the procedure and superior to bronchoalveolar lavage to rule
out/in neoplastic lung infiltrates.
Moderate bronchial pattern – incidental age related versus allergic feline lower airway
disease. Likely unrelated to the current clinical presentation.
Possible splenomegaly – requires ultrasonographic verification depending on the
clinicla indication.
Gallbladder sand – usually not significant but may be associated with chronic
cholangiohepatitis/-cystitis and obstructive biliary disease on occassion.
Renal sand/calculi – likely non obstructive and incidental at this point.
Overall a full abdominal ultrasound with non cardiac thoracic ultrasound and possible
sampling of the left cranial lung would certainly make sense to further define the
abdominal changes and evaluate for possible structural changes of the kidneys that
may not be apparent radiographically.